DiversityNursing Blog

Whether you're a Nurse dealing with the daily stresses of the healthcare profession or simply looking for ways to unwind and recharge, this list of activities is designed to help you make the most of the spring season. From outdoor yoga sessions to mindful walks in nature, each suggestion is aimed at promoting relaxation, rejuvenation, and overall well-being. So take a moment to prioritize self-care and indulge in these activities that will benefit your physical and mental health, and allow you to fully embrace the beauty of the season.

Outdoor Yoga Sessions: Find a serene spot in nature and allow yourself to fully immerse in the sounds and sights of the natural world. As you roll out your yoga mat and take a deep breath of the fresh spring air, feel the gentle warmth of the sun on your skin. With each yoga pose, let go of the stresses and tensions that have built up, allowing your mind to find peace and your body to release any pent-up energy. 

Hiking Adventures: Embark on a journey of discovery as you explore the winding trails and hidden gems of nearby nature reserves. Let each step be a reminder of the beauty and tranquility nature has to offer, while also providing your body with the exercise it craves. Take in the sights and sounds of the natural world around you, allowing yourself to fully immerse in the wonders of the spring season.

Picnic in the Park: Pack a basket with an assortment of fresh fruits, crunchy veggies, and homemade sandwiches, and head to a park or garden for a delightful picnic experience. Spread out a cozy blanket under the shade of a blooming tree or beside a calming pond. As you savor each bite of your snacks, take in the sweet scents of spring. Engage in light-hearted conversations with your loved ones, sharing laughter and creating cherished memories.

Gardening: Start a small garden or volunteer at a community garden to connect with nature and relieve stress. Planting seeds, nurturing them as they grow, and watching flowers bloom or vegetables thrive can be incredibly therapeutic. The act of gardening allows you to disconnect from the stresses of everyday life and focus on the beauty and growth that nature offers. Additionally, volunteering at a community garden not only provides a sense of purpose and fulfillment but also allows you to connect with like-minded individuals who share a passion for cultivating the earth. 

Nature Photography: Take up photography as a hobby and allow the beauty of spring landscapes, blooming flowers, and vibrant wildlife to be your inspiration. Whether you focus on the delicate petals of a newly bloomed flower, the playful squirrels in the park, or the colors of a sunset over a lake, let your photography skills transport you to a world of creativity and inspiration.

Mindfulness Meditation: Make it a daily ritual to set aside a few moments for mindfulness meditation, allowing yourself to sink into a state of deep relaxation and mental clarity. Find a quiet and comfortable space where you can fully focus on your breath, letting go of any distractions or worries that may be weighing on your mind. With each inhale and exhale, feel the tension melting away from your body and the chatter in your mind quieting down. Embrace the present moment fully, allowing yourself to be fully present and aware of your surroundings. By dedicating yourself to this practice each day, you can cultivate a sense of inner peace and calm that will carry you through the challenges of the day with grace and ease.

Bike Riding: Dust off your bicycle and embark on a scenic ride through parks or peaceful trails. Let the rhythm of your pedaling guide you through lush greenery, fragrant flowers, and chirping birds, immersing yourself in the beauty of nature. Cycling outdoors is not just a form of exercise but a soul-soothing experience that connects you to the world around you. So saddle up, explore new paths, and let the joy of cycling in the springtime refresh your body and mind.

Outdoor Workouts: Embrace the fresh air and sunshine by taking your workout routine outdoors. Whether it's a brisk jog or walk through a scenic park, or a series of bodyweight exercises in a peaceful outdoor setting, working out in nature can enhance not only your physical fitness but also your mental well-being. So lace up your sneakers, hop on your bike, or simply find a patch of grass to move your body and feel the benefits of exercising in the great outdoors.

Kayaking or Canoeing: Paddle your way to tranquility and adventure by spending a relaxing afternoon kayaking or canoeing in the waters of nearby lakes or rivers. Feel the gentle breeze against your skin as you glide across the water, surrounded by the peaceful sounds of nature. Take in the sights of lush greenery, vibrant flowers, and maybe even spot some wildlife along the way. 

Botanical Garden Visits: Explore the enchanting world of local botanical gardens, where colorful spring blossoms await your admiration. Take a leisurely stroll through curated displays of flowers, trees, and plants, each offering a unique glimpse into the beauty and diversity of the natural world. Engage with staff or informational signage to learn more about the different plant species, their origins, and the significance of their conservation. 

Outdoor Cooking: Gather your closest friends and family for a fun-filled cookout or even enjoy a nice meal on your own. Fire up the grill and sizzle your favorite meats or veggies to perfection, the act of cooking over an open flame adds an extra layer of flavor and excitement to your meal. Set up a cozy outdoor dining area with string lights and comfortable seating, creating the perfect ambiance for enjoying your delicious feast. 

Stargazing Nights: Set aside an evening under the starry sky for a magical stargazing experience. Gaze up at the vast expanse of the universe, contemplating the mysteries and wonders that lie beyond our reach. Feel a sense of awe and humility as you witness the beauty of the cosmos, reminding yourself of the infinite possibilities and boundless beauty that surrounds us. 

Attend Outdoor Events: Look for outdoor concerts, festivals, or farmers' markets in your area to enjoy the vibrant atmosphere of spring. Let the music, art, and flavors of the season fill your senses as you connect with your community and embrace the spirit of renewal and growth. 

Wildflower Picking: As you wander through the fields or farms, take your time to admire the array of wildflowers that bloom in vibrant hues.  Display your hand-picked beauties in a vase or mason jar, creating a floral arrangement that serves as a reminder of the beauty and serenity of the natural world. Embrace the simplicity and joy of wildflower picking as a mindful and grounding activity that connects you to the earth and brings a piece of the outdoors into your home.

Bird Watching: Dive into the fascinating world of bird watching by grabbing a pair of binoculars and a bird identification book. Take the time to immerse yourself in the peaceful surroundings of nature as you observe local bird species in their natural habitats. Try bringing some bird seed with you to feed the local wildlife. 

Outdoor Reading: Find a cozy spot in the park or your backyard and immerse yourself in a good book while enjoying the warmth of the sun. Allow yourself to be transported to different worlds, as the words on the pages paint vivid images in your mind. Feel the gentle breeze rustling the pages of your book, adding to the peaceful ambiance of your reading retreat. 

Nurses, we encourage you to embrace this list of activities as a way to prioritize self-care and enhance your overall well-being during the rejuvenating spring season. Let these suggestions guide you in finding moments of relaxation and rejuvenation amidst the demands of your profession.

Working in the healthcare field is both demanding and stressful. Nurses often face challenges like adjusting to irregular hours, taking on extra shifts, and coping with the emotional toll of losing patients. While healthcare professionals are skilled at problem-solving, healing, and managing pressure, they are not immune to the lasting impact of stress and trauma.

“Even before the pandemic, healthcare workers faced challenging working conditions that lead to burnout. This includes long work hours, risk for hazardous exposures, stressful work, and high administrative burdens,” John Howard, M.D, director of NIOSH, said in a release. “Hospital leaders need support to implement organizational changes. Practical adjustments can reduce burnout and strengthen professional wellbeing within their hospitals.”

Therefore, it is essential to ensure healthcare professionals have access to mental health programs and spaces that promote well being. Incorporating straightforward design changes within hospitals can greatly enhance the mental wellness of healthcare staff.

Massachusetts General Hospital (MGH) in Boston is currently building a 482-bed expansion called Cambridge Street centered around enhancing staff and patient satisfaction, optimizing operational efficiency, and promoting environmental stewardship. Several years ago, MGH’s 150-bed Lunder Building was created with the same goals in mind. 

According to Harvard Business Review, The Lunder building offers plentiful access to daylight through a glass-encased stairwell used only by staff, who have adopted the corridor as a de facto meeting space (nicknamed the “stair conference room”). Staff also use this stairwell as a place to “be alone together” and report that they find comfort watching employees traverse the stairwell while they use the space to think and decompress.

Exposure to daylight impacts work-related stress and job satisfaction and is found to affect clinician burnout. Since less noise can reduce stress among caregivers and also help patients recover from illness, the Lunder building uses a variety of sound-absorbing materials and techniques to make the patient floors 35% quieter than typical health care buildings. 

An article from Jacobs.com mentions, Peer-reviewed research emphasizes the therapeutic benefits of nature in healthcare settings. Exposure to natural light, greenery, and outdoor views has been linked to reduced stress and better sleep, faster recovery times, and improved overall patient outcomes. One study found that patients with bedside windows overlooking nature healed faster, experienced fewer complications and required less pain medication compared to those with views of brick walls.

The influence of nature’s benefits extends beyond patients. Research shows hospital staff working in environments with natural elements report lower stress levels and higher job satisfaction, and it has a knock-on effect — this leads to better patient outcomes, too. Improving staff retention and engagement directly impacts cost and productivity, too.

Many healthcare facilities are embracing the idea of providing support spaces that allow staff to utilize their break times and choose how they recharge during their valuable moments of rest. For example, some hospitals are implementing restorative zones and including nap areas for staff, situated conveniently close to patient units for ease of access.

Wellness rooms support employees’ mental well-being by providing a designated space for relaxation and stress relief. These wellness rooms usually include yoga mats for stretching and meditation, a cozy reading nook stocked with donated books for staff to enjoy, exercise equipment for physical activity, comfortable seating for relaxation, and decor inspired by nature for a tranquil atmosphere.

Organizations are exploring innovative solutions to support their staff's well-being through nutrition, such as satellite food lockers, mobile ordering apps, and discounted meal programs featuring healthy options.

Given the increasing concern about workplace violence within the healthcare community, hospitals are prioritizing the integration of security measures into their design, construction, and renovation processes. The goal is to create designs that help reduce fear, cut incidence of crime, and improve overall quality of life and well-being for staff and patients.

Healing gardens have become a vital component of hospital landscape design, offering a multitude of benefits for both patients and staff. These serene spaces not only enhance well-being and recovery but also play a crucial role in reducing stress, anxiety, and depression. By incorporating greenery, healing gardens provide a therapeutic sanctuary that fosters physical, emotional, and environmental wellness within healthcare facilities.

In conclusion, implementing design modifications within healthcare facilities can significantly improve the mental well-being of healthcare professionals.

A Nurse’s life requires a level of selflessness and compassion that is incomparable to most, if not all, other careers. In this demanding and fast-paced world, where caregivers are faced with numerous challenges and responsibilities, the practice of mindfulness has emerged as a valuable tool for maintaining physical, mental, and emotional well-being. Mindfulness, rooted in ancient meditation practices, involves cultivating present-moment awareness and non-judgmental acceptance. Millions of employees in all career categories and positions are currently practicing mindfulness. In recent years, its incorporation into Nursing practice has demonstrated remarkable benefits, enhancing patient care, reducing burnout, and fostering a more compassionate and effective healthcare environment.

Enhanced Patient Care

Mindfulness in Nursing has a direct positive impact on patient care. When Nurses practice mindfulness, they become attuned to the present moment, allowing them to be fully present with their patients. By actively listening, observing, and engaging without judgment, Nurses can create a deeper connection with patients. This connection fosters a sense of trust and empathy, which are crucial elements in effective patient care.

Mindfulness also contributes to clinical decision-making. When Nurses are fully present, they can better assess patients' needs and conditions, leading to more accurate diagnoses and treatment plans. Furthermore, mindful Nurses tend to notice subtle changes in patients' conditions that might otherwise go unnoticed, potentially preventing complications or deterioration.

Reduced Burnout and Stress

Nursing is undoubtedly a high-stress profession, accompanied by long shifts, critical decisions, and emotionally charged situations. Mindfulness practices offer Nurses valuable tools to manage and reduce these stressors. Regular mindfulness practice has been shown to lower cortisol levels, the body's stress hormone, leading to decreased anxiety and burnout.

Through mindfulness techniques such as deep breathing, practicing muscle relaxation, and meditation, Nurses can activate the body's relaxation response, promoting a sense of calm even in the midst of chaotic situations. This not only benefits Nurses' mental and emotional well-being but also helps them maintain their focus, clarity, and resilience, which are essential for providing quality patient care.

Cultivation of Compassion and Empathy

Mindfulness fosters compassion and empathy – qualities that are fundamental to Nursing practice. By practicing self-compassion, Nurses learn to be kind and understanding toward themselves, even when facing challenges or mistakes. This self-compassion extends naturally to patients, as Nurses become more attuned to their emotions and needs. This heightened empathy can significantly improve the patient experience, making them feel understood, cared for, and respected.

Incorporating mindfulness into their routines also enables Nurses to better navigate emotionally charged situations. They can respond to patients' and families' emotions with patience and understanding, rather than reacting impulsively. This emotional regulation creates a more supportive environment for everyone involved.

In the ever-evolving landscape of Nursing, the integration of mindfulness practices holds immense promise. From enhancing patient care to reducing burnout and stress, cultivating compassion and empathy, and improving communication, the benefits of mindfulness in Nursing are undeniable. By adopting mindfulness techniques, Nurses can create a more holistic, patient-centered, and empathetic healthcare environment. With hundreds of mobile apps and programs, practicing mindfulness has now become easier than ever.  As mindfulness continues to gain recognition, its incorporation into Nursing education and practice stands to elevate the quality of care and the well-being of both Nurses and their patients.

May is mental health awareness month, a time to raise awareness and promote education about mental health, as well as reduce the stigma associated with mental illness. Did you know, 1 in 5 American adults experience a mental health condition in a given year?

• Get enough sleep: Aim to get 7-8 hours of sleep.
• Eat a healthy diet: Make sure to eat a balanced diet that includes plenty of fruits, vegetables, whole grains, and lean protein.
• Stay hydrated: Drink plenty of water.
• Exercise regularly: Aim to get at least 30 minutes of moderate exercise most days of the week.
• Take breaks: Take short breaks throughout your day to rest and recharge.
• Practice mindfulness: Try incorporating mindfulness exercises into your daily routine, such as deep breathing or meditation.
• Connect with colleagues: Connect with colleagues who understand the challenges of being a Nurse. You can talk to them about work-related stress and share coping strategies.
• Seek professional help: If you're struggling with your mental health, seek professional help from a mental health provider. This can be a therapist, psychiatrist, or psychologist.
• Use employee assistance programs: Many healthcare organizations offer employee assistance programs that provide confidential counseling and support services.
• Set boundaries: It's important to set boundaries and say no to additional responsibilities if you're feeling overwhelmed.
• Pursue hobbies and interests: Make time for activities that bring you joy and help you relax, such as reading, listening to music, or practicing a hobby.
• Take care of your physical appearance: Dress in clothes that make you feel comfortable and confident, and take pride in your appearance.
• Practice gratitude: Take time each day to reflect on what you're grateful for, whether it's a supportive colleague, a successful patient outcome, or simply the beauty of nature.

Resources

• Employee Assistance Programs (EAPs): Many hospitals and healthcare facilities offer EAPs that provide free, confidential counseling services to employees.
• National Alliance on Mental Illness (NAMI): NAMI offers support groups, educational resources, and advocacy for individuals and families affected by mental illness.
• Substance Abuse and Mental Health Services Administration (SAMHSA): SAMHSA offers a national helpline, treatment referral service, and resources for mental health and substance abuse disorders.
• Crisis Text Line: This free, 24/7 text messaging service provides support for individuals experiencing a mental health crisis. Text "HOME" to 741741 to connect with a trained crisis counselor.
• Mindfulness apps: Apps like Headspace, Calm, and Insight Timer offer guided meditations and mindfulness exercises to help reduce stress and improve mental well-being.

Remember, self-care is an ongoing process, and it's important to make it a priority in your life. By taking care of yourself, you'll be better equipped to care for your patients and thrive in your career as a Nurse.

While physical health is undoubtedly important, so is Mental Health. Millions of Americans are affected by mental illness each year. Psychiatric Nurses have the specialized knowledge and skills needed to treat these illnesses. 

According to the American Psychiatric Nurses Association (APNA), Psychiatric Nurses make up the second largest group of behavioral health professionals in the U.S.

In the United States, suicide is a leading cause of death and in 2020, about:

• 1 in 5 American adults experienced a Mental Health issue
• 1 in 6 young people experienced a major depressive episode
• 1 in 20 Americans lived with a serious mental illness, such as schizophrenia, bipolar disorder, or major depression

The pandemic has increased the need for Mental Health care. According to a report from the Centers for Disease Control (CDC), the percentage of adults with recent symptoms of an anxiety or a depressive disorder increased from 36.4% to 41.5% from August 2020 to February 2021.  

There is a dire need for more Psychiatric Mental Health Nurses (PMHNs).

More than 75% of all U.S. counties have a shortage of Mental Health professionals and almost all counties have an unmet need for Psychiatrists.

Mental Health Nurses work in a wide variety of inpatient and outpatient work settings, either as a specialty position or in primary care. Some job opportunities include military care, forensics, private practices, clinics, community health centers, public health facilities, schools, substance abuse centers, senior centers, hospice, rehabilitation services, telehealth and case management.

The day to day duties of PMHNs include:

• Conducting an assessment of a patient’s status
• Conducting intake screenings, initial evaluation, and triage
• Providing nursing care following a treatment plan
• Administering medication and/or other treatment regimens
• Teaching patients self-care activities
• Engaging in crisis intervention and situation stabilization (when necessary)
• Educating patients on how to manage their condition
• Providing education to patients’ families and communities
• Working efficiently alongside other members of an interdisciplinary team

“It’s a very rewarding field. As a Psychiatric health care provider, you may be the first person to talk to someone about why they are in crisis, and that can be a humbling experience," said Emma Mangano, DNP, PMHNP at Johns Hopkins Hospital. 

Some essential traits of a Mental Health Nurse include:

• Critical Thinking
• Good Communication
• Empathy
• Reliability 
• Confidence
• Compassion

The salary of a PMHN depends on their level of experience and the amount of specialized training they have undergone. According to Indeed, the average Mental Health Nurse's salary in the U.S. is $87,156.

A career in Mental Health Nursing can be demanding, but it is extremely rewarding.

Psychiatric/Mental Health Nurse Practitioner (PMHNP) Windi Woods, says that the best part of the job is “knowing that this team is the end of the road for most of these patients and we give them hope." 

Art therapy is a growing trend throughout hospitals in the United States. Art therapy is an evidenced-based practice that supports the emotional, physical, social and spiritual well-being of patients of all ages through the therapeutic use of art-making. 

These programs use a wide range of outlets such as drawing, painting, sculpting, collage, and photography as tools to:

• Process feelings about a new diagnosis 
• Provide a sense of control through normalizing activities to help them adjust to hospitalization and/or illness
• Cause relaxation and reduction of anxiety
• Rebuild self-esteem
• Help manage pain
• Support groups of patients with similar diagnosis
• Support siblings and family members in caring for their loved one in the hospital
• And more!

Childrens National Hospital uses trained art therapists who offer resources like nature art therapy in the Healing Garden and gallery displays to give children the opportunity to express themselves through creative activities. They are also a Beads of Courage member hospital.

The University of Florida Shands Hospital arts in medicine program started small back in 1990. Jill Sonke, an artist at the hospital said, "No one is suggesting in arts and health that the arts can replace medicine or health care or other therapies or interventions. But the arts have a place in the sphere of whole person care. There's so many ways in which the arts can address things like loneliness and social isolation."

Not every hospital has an in-house art program, many bring in outside help from organizations such as, the Museum of Fine Arts (MFA) or the Caring Arts Foundation Program.

MFA Artful Healing offers art-making activities for children, teens, young adults, and their families in Boston-area hospitals and healthcare centers. The MFA currently provides off-site workshops at Boston Children's Hospital, Massachusetts General Hospital, and Dana-Farber Cancer Institute.

A Parent at Boston Children's Hospital said, "We’ve been here more than ten times in the last two weeks . . . but this is the first time I’ve seen my son smiling. Thank you for that!”

The Caring Arts Foundation Program uses professional photographers to take portraits of patients and their families at Lurie Children’s Hospital. They provide fun wardrobes and props. A common area in the hospital is transformed into a studio with lighting and backdrops. Parents are provided with a full set of photos of their child at no cost — a priceless keepsake. These photo sessions give patients and their families a break from cancer treatment while providing lasting memories. 

There are large disparities in mental healthcare across races and ethnicities in the U.S. Many factors contribute to the poor mental health outcomes of minority populations. Such as:

• Inaccessible mental healthcare services
• Transportation issues, difficulty finding childcare/taking time off work
• Lacking health insurance coverage
• Cultural stigma regarding mental healthcare
• The lack of Black, Indigenous, and people of color (BIPOC) healthcare professionals
• Racism, bias, and discrimination in healthcare
• Language barriers

Even before the pandemic, healthcare providers experienced burnout and other negative mental health issues. Now more than ever, it is critical health systems take steps to support their staff's well-being.

Recently, more healthcare organizations have started to hire Chief Wellness Officers (CWO), as a strategy to address burnout, mental health, and compassion fatigue.

Jonathan Ripp MD, MPH, Chief Wellness Officer at the Icahn School of Medicine at Mount Sinai, said there were only a handful of Chief Wellness Officer positions when he was appointed to the role in May 2018. “There has been at least a dozen more who have been named in the past year, and several more places that are looking to create the position,” said Dr. Ripp. “I would not be surprised if, 10 years from now, it's commonplace for most large organizations to have a Chief Wellness Officer or equivalent, taking this challenge on, and doing so in a way that is effective.”

The ultimate goal of this role is to aid system-wide changes that enable staff to practice in a culture that prioritizes and promotes mental health and well-being.

The CWO is responsible for measuring well-being across their organization. Then, they create and implement wellness programs that address the current environment causing burnout and stress.

The hiring of a CWO is not a remedy all on its own. The CWO works in collaboration with other leaders and staff to prioritize well-being and would ultimately lower costs and improve patient care.

According to Beckers Hospital Review, burnout and depression result in major costs to health systems due to an increase in medical errors, reduced quality of care, and turnover. Research has found that for every dollar invested in wellness, hospitals can see a $3 to $6 return on investment.

Medical Schools are also following the hiring trend.

Holder said, "Mental and emotional wellness is essential to complete health. We simply cannot ignore this fact. I view my role as another way to serve the students, faculty and physicians in Brown’s medical school, and aid them in not just meeting their immediate self-care needs but also creating and developing plans that can help them learn more about how to take care of themselves in a way that's sustainable for a profession that demands a lot."

“Wellness and self-care is more important than ever before. These next few years will be critical for health care workers as we address the mental and physical burdens from COVID-19,” said George Washington University's Chief Wellness Officer, Lorenzo Norris, MD.

Hopefully this position sticks around, even after the pandemic passes, because burnout and mental health have been issues in the healthcare field all along.

Hospitals are seeing more cases of severe depression and suicidal thoughts among children, particularly attempts to overdose. 

The coronavirus pandemic has drastically changed the way children and teens learn, play and socialize. Many studies found forced isolation and loneliness among children correlated with an increased risk of depression.

Children’s Hospital Colorado, declared a "State of Emergency" in youth mental health. Jena Hausmann, CEO said, "It has been devastating to see suicide become the leading cause of death for Colorado’s children." 

According to the CDC, the proportion of children who arrived in emergency departments with mental health issues increased 24% from March through October 2020, compared with the same period in 2019. Among preteens and adolescents, it rose by 31%. 

Matthew Davis, MD, MAPP, Chair of the Department of Medicine at Lurie Children’s, emphasized the need for accessible, affordable mental health care for pediatric patients has greatly increased because of the pandemic. In fact, nearly 1 in 5 parents said they were unable to access  mental or behavioral health care for their child at some point, most often because they could not find a specialty provider, they could not afford it, or they could not get an appointment in a timely fashion.

Some hospitals like Cincinnati Children’s Hospital Medical Center in Ohio report running at full capacity and having more children “boarding,” or sleeping in EDs before being admitted to the psychiatric unit. 

Terrie Andrews, a Psychologist and Administrator of behavioral health at Wolfson Children’s Hospital in Florida said, "Up to 25 children have been held on surgical floors while waiting for a spot to open in the inpatient psychiatric unit. Their wait could last as long as five days."

Hospitals are not only seeing a higher volume of patients, but these patients have more intense illnesses.

Dr. Jennifer Downs, a pediatric psychiatrist at Connecticut Children’s said, “Instead of seeing kids who are saying, ‘I’m thinking about suicide,’ we’re seeing kids who have had attempts. Instead of seeing kids who are maybe brought in because of parents who feel that they’re verbally out of control, yelling, screaming, saying awful things, we’re seeing kids who are having physical aggression.”

According to The American Academy of Pediatrics, if you notice any of the following symptoms in your children, be sure to contact your child’s Physician as soon as possible:

– unusual changes in mood, such as ongoing irritability, feelings of hopelessness or rage, and frequent conflicts with friends and family
– changes in behavior, such as stepping back from personal relationships
– a loss of interest in activities previously enjoyed
– a hard time falling or staying asleep, or starting to sleep all the time
– changes in appetite, weight, or eating patterns
– problems with memory, thinking, or concentration
– less interest in schoolwork and drop in academic effort
– changes in appearance, such as lack of basic personal hygiene
– an increase in risky or reckless behaviors, such as using drugs or alcohol

If you have contemplated suicide or someone you know has talked about it, call the National Suicide Prevention Lifeline at 1-800-273-8255, or use the online Lifeline Chat, both available 24 hours a day, seven days a week.