Mental health stigma, it’s a personal thing

Tulalip Tribes Mental Health Team


By Kay Feather, MA, LMHC, ATR, EMDR, Sandplay & Art Therapy, Tulalip Family Services

There is much written about mental health stigma, long articles from many perspectives, some about how mental health stigma lives in Native Country.  The common thread for me is the shame I have felt and seen in my life and those around me.  I see it when someone does not want to share their illness with a new friend or family member, fearing that they will be looked down upon.   I see it when a medication might help and there is hesitancy in taking it because that means “I’m mentally ill”.

Mental Health Stigma is a very personal issue.  I have struggled with depression for most of my life and have loved ones who are caught in the grip of mental illness.   I realized recently that even though I am a mental health counselor and work daily to help others alleviate the effects it has on their lives, that I had an attitude about mental illness.

Shame is the part of mental health stigma that makes it so painful.  Shame buries us in self-doubt and we tend to suffer in silence, fearing what someone might think of us.  So we don’t share or ask for help when we are in need.  Mental health stigma undermines our efforts towards wellness and an ability to heal.

So you see, Mental Health Stigma is a very personal issue.  It is for anyone who suffers with mental illness, or has a family member who does.  Mental health stigma shadows one’s ability to understand and have compassion for another’s pain and struggle.

When one is diagnosed with cancer, diabetes, or some other illness, friends and family gather round and offer support.  There may be sadness, shock, fear, and also shame, but it does not cripple our ability to reach out.

Mental illness is a broad term for many different diagnosis, several hundred in the Diagnostic Manual of Mental Illnesses.    There are many different behaviors with the different diagnosis, but one thing that is true for all of them; the person is suffering, they are in pain.  It manifests in many different ways, but they are suffering.  And being given a diagnosis is not necessarily a permanent thing, with help it can change.

I urge you to look within and find the compassion you have for your loved one and know that they need your love, your kindness and understanding to live a full life.   Educate yourself on their mental illness, talk with them, and ask how you can help.  And if you suffer from mental illness, allow yourself to love yourself and know that it’s not your fault, you didn’t do anything wrong.  Sometimes things happen in life and it just doesn’t feel fair.   Seek help, educate yourself, and know that you are stronger than your diagnosis.  .

Here are some resources that you may find helpful:

  •   National Alliance on Mental Illness This organization offers support group and education for those who suffer with mental illness and those who love and support them.
  •   The Mighty is a website that has articles written by those who are healing from mental illness, disabilities and illness of all sorts.  I have been following this one on Facebook, and have found a wealth of support here.

Here at Tulalip we have two teams to help you:

  • Adult Mental Health Team  360-716-4400
  • Child, Youth and Family Team    360-716-4072

Promoting Men’s Health


By Micheal Rios, Tulalip News 

Early detection is key for the treatment of heart disease, diabetes, prostate cancer, and many other diseases that disproportionately affect men. However, men are less likely to seek preventative care than women. Despite growing awareness, men usually take a back seat approach to maintaining their health. We will shy away from seeking advice, delaying possible treatment and/or waiting until symptoms become so bad we have no other option but to seek medical attention. To make matters worse, we refuse to participate in the simple and harmless pursuit of undergoing annual screenings.

Enter the Annual Men’s Health Fair held at the Karen I. Fryberg Tulalip Health Clinic on Friday, December 16. This year’s health fair provided us men the opportunity to become more aware of our own health. With various health screenings being offered for the low, low price of FREE, we were able to get in the driver’s seat and take charge of our own health. Blood sugar, cholesterol, and prostate screenings were among the options for men to participate in. Along with all the preventative health benefits of participating in these screenings, as if that was not reason enough, they gave out numerous goodies and a complimentary “Indian taco” lunch to every man who showed up to take charge of his health.

At 16.1 percent, Native Americans have the highest age-adjusted prevalence of diabetes among all U.S. racial and ethnic groups. Also, Native Americans are 2.2 times more likely to have diabetes compared with non-Hispanic whites (per Clearly we are at a greater risk when it comes to diabetes, making it all more crucial to have glucose testing and diabetes screenings performed on an annual basis. For those men who attended the health fair, they were able to quickly have their glucose (blood sugar) tested with just a prick of the finger.

According to the Centers for Disease Control and Prevention (CDC), heart disease is the first and stroke the sixth leading cause of death among Native Americans. High blood pressure is a precursor to possible heart disease and stroke. High blood pressure is also very easily detected by having routine checks of your blood pressure taken periodically.



Representatives from Health First Chiropractic, the Marysville branch, were on hand as well to offer a free posture analysis. Using a spinal analysis machine, the patient advocate conducted postural exams on a number of men and reviewed the results with each participant. Good posture can help you exercise more safely and achieve better general health. When you sit or stand correctly, your organs will be better aligned, which reduces indigestion and helps your lungs to function at full capacity. Your core muscles will be strengthened and your back and shoulders will feel more comfortable.

Along with the various health screenings being offered there were information booths available that ranged from alternative health care options in the local area, ways to have cleaner air in your home, and methods to change eating habits to live a heathier lifestyle. There was a booth where we could have our grip tested, a method used for assessing joint and muscle fatigue. Another booth offered us the opportunity to have our BMI (body mass index) and body fat percentage measured. Wondered if you need to cut back on those weekend treats? Or if you need to start leading a more active lifestyle? Well if that BMI was too high and you didn’t like what your body fat percentage was, now you know the answer.



Face it, as we get older, we all need to become more aware of the inevitable health concerns that may one day affect us. The possibility of having to deal with high cholesterol, high blood pressure, diabetes, or the possibility of prostate cancer looms over us all. The only way to avoid such health concerns to heighten our awareness of these preventable conditions. Health educators empower us to be more proactive about our health by getting annual screenings, detecting issues early, as well as seeking medical treatment before a simple, treatable issue becomes life altering.

At the conclusion of the Men’s Health Fair, Jennie Fryberg, Health Information Manager, said the following, “I’d like to personally thank all the men that came out and participated in the men’s health fair today! Way to come and take care of your health, men.”


Mumps and the Vaccine that Safeguards Against the Disease.

By Bryan Cooper, Tulalip Health Clinic


The Tulalip Tribes values the health of its citizens and strives to educate all members about disease prevention. Recently, there have been some questions and concerns regarding Mumps and the vaccine that safeguards against the disease.

Mumps cases, although rare, are reported each year in the State of Washington.  In 2014, 9 cases were reported. Last year recorded just 7 cases. To date, this year has only 3 official cases of Mumps.  By comparison, in 1980 there were 166 cases and 1985 there were 165, so the numbers have dramatically dropped.

Who should get vaccinated? 

Generally, anyone 18 to 60 years of age should get at least one dose of mumps-containing vaccine; however, most people received MMR vaccine as children as it is a school requirement.  Anyone who can show that they have been vaccinated against measles, mumps, and rubella (MMR), or that they have had these diseases in the past, do not need MMR vaccine.

That said, some people should either not get MMR vaccine or should wait.

  • Anyone who has ever had a life-threatening allergic reaction to the antibiotic neomycin, or any other component of MMR vaccine, should not get the vaccine. Tell your doctor if you have any severe allergies.
  • Anyone who had a life-threatening allergic reaction to a previous dose of MMR or MMRV vaccine should not get another dose.
  • Some people who are sick at the time the shot is scheduled may be advised to wait until they recover before getting MMR vaccine.
  • Pregnant women should not get MMR vaccine. Pregnant women who need the vaccine should wait until after giving birth. Women should then avoid getting pregnant for 4 weeks after vaccination with MMR vaccine.

What are the side effects of the vaccine?

A vaccine, like any medicine, is capable of causing serious problems, such as severe allergic reactions. However, the risk of MMR vaccine causing serious harm, or death, is extremely small.  Certainly, getting MMR vaccine is much safer than getting measles, mumps or rubella.

Most people who get MMR vaccine do not have any serious problems with it, but here is the official list of possible adverse effects:

Mild problems

  • Fever (up to 1 person out of 6)
  • Mild rash (about 1 person out of 20)
  • Swelling of glands in the cheeks or neck (about 1 person out of 75)

If these problems occur, it is usually within 6-14 days after the shot. They occur less often after the second dose.

Moderate problems

  • Seizure (jerking or staring) caused by fever (about 1 out of 3,000 doses)
  • Temporary pain and stiffness in the joints, mostly in teenage or adult women (up to 1 out of 4)
  • Temporary low platelet count, which can cause a bleeding disorder (about 1 out of 30,000 doses)

Severe problems (very rare)  

  • Serious allergic reaction (less than 1 out of a 1,000,000 doses)

Several other severe problems have been reported after a child gets MMR vaccine, including:

  • Deafness
  • Long-term seizures, coma, or lowered consciousness
  • Permanent brain damage

Frankly, these are so rare that it is hard to tell whether the vaccine causes them.

Globalization has exposed many cultures to diseases they would not otherwise be exposed to.  Many of the diseases such as syphilis, smallpox, measles, mumps, and bubonic plague were of European origin; Native Americans at the time exhibited little immunity, and the traditional indigenous medical treatments such as sweatlodges unwittingly worsened smallpox mortality rates.  Over time, immune responses increased and knowledge of effective treatments and care to the “new” disease were developed, and mortality rates improved.

Life is full of risks; healthy choices and wisdom of our elders should guide our way.  Vaccines have and will continue to save countless lives.  As we uncover new diseases, we, as a global people, can more effectively address treatments and cures much better then if everyone was isolated.  Sometimes, quarantine is the only option to halt progression of a disease, but most often, standard precautions like frequent hand washing and covering your mouth and nose when you sneeze or cough keep us healthy.

Men urged to think healthy and get checked

By Micheal Rios, Tulalip News 

The Karen I. Fryberg Tulalip Health Clinic is reminding men to take charge of their health as the upcoming Men’s Health Fair is right around the corner. Scheduled to take place on Friday, December 9, from 9:00a.m. – 3:00p.m., the annual health fair is all about raising awareness for men’s health, with a particular focus on preventative measures.

“Getting men to understand their own health, to think about their health, and then getting them to show up and take advantage of the all the preventative health screenings we offer could make a big difference in their lives,” says Jennie Fryberg, Health Information Manager for the clinic. “Our Tulalip men are so used to putting family first, making sure their kids and loved ones are taken care of, that they forget to make themselves a priority when it comes to their own health.”

Some of the health prevention measures offered will be a cholesterol screening, blood pressure checks, prostate screening (via a blood draw), hearing and vision tests, diabetes screening, as well as many informational booths.

Hypertension (high blood pressure) and high cholesterol are two of the most frequent diagnosis for Native men. Both can be easily screened for and detected with the simple prevention screenings offered that the health fair. If detection occurs, follow-up appointments can be schedule right on the spot.

In recent years at the health fair, Jennie says there are typically three or four men who, based on their screening results, decide to schedule follow-up appointments.

“Prevention is the best kind of medicine. That’s why we have our Men’s Health Fair, to help our men be as healthy as possible. If we do detect something like hypertension or possible diabetes, then we can start the treatment process right away.”

Along with all the preventative screenings and informational booths there will also be demonstrations by Haggen Northwest Fresh meat department and Klesick Farms. The demos will focus on healthy eating made simple, along with detailing the various health advantages of eating local and organic.

For those who still require that extra incentive to attend the health fair and make their health a priority, let’s not forget about the raffle giveaway. All men who attend and participate in the screenings will be entered into a raffle that includes various prizes and goodies. Highlights raffle prizes include chainsaws, tools, and a stand-up freezer. As a reminder, you do not need to be in attendance at the raffle drawing to win. All winners will be contacted through phone and/or e-mail to collect their prizes.

“This building is named after [my] mom and one of her messages she always said was, ‘Our health fairs are a one stop shop.’ You can come in, get all your screenings done at once, no need for multiple appointments sitting in the office,” Jennie concludes. “By taking advantage of our one stop shop health fair, our men can make sure they are healthy and in best condition to take care of their families for years to come.”


8.5"x11" Flyer

Information about Acute Flaccid Myelitis (AFM)

Submitted by Jason McKerry, MD, FAAP, Karen I Fryberg Tulalip Health Clinic 

Many of you may have heard about the recent cases of acute neurological illness seen in kids at the Seattle Children’s Hospital. I know that a child’s health is the most important thing in every parent’s life. I want to share some important information about the illness, Acute Flaccid Myelitis (AFM), a rare condition that affects the nervous system.

Below are common questions and answers provided by the State Department of Health:

Q: What is Acute Flaccid Myelitis (AFM)?

A: AFM is a rare condition with sudden onset of weakness of one or more limbs, sometimes accompanied by weakness of the muscles of the face and eyes.  In severe cases, the breathing muscles can be involved. In all cases, there are distinctive lesions in certain areas of the spinal cord seen with an MRI.

  • Symptoms of AFM vary in severity and range from mild weakness of a limb to absence of movement in all limbs.
  • Unlike most other diseases, suspected AFM are only reports.
  • The cases receive a final classification as confirmed or probable AFM, or are ruled out, only following a review by expert neurologists from the Centers for Disease Control and Prevention.

Q: How common is AFM?

A: AFM is quite rare. Last year, Washington state had no cases, and in 2014 there were only two, so this number of suspected cases within about a six-week time span is unusual. Clusters similar in size to the one we are currently seeing have happened elsewhere in the US, for example, in Colorado and Arizona.

Even with an increase in cases in 2016, AFM remains a very rare disease. Less than one in a million people will ever develop it.

Q: What causes AFM?

A: AFM can be caused by a variety of germs, such as enteroviruses, which typically cause milder illness in children such as respiratory infections. Other causes may be West Nile Virus, autoimmune disease or environmental toxins. For most reported cases across the US, the cause has not been identified.

It can also be mistaken for conditions that cause inflammation of the nerves such as transverse myelitis and Guillain-Barré syndrome.

However, when enteroviruses get into the central nervous system, they can cause more serious illnesses like inflammation of the brain. Polio virus, which is not being considered as the cause of these children’s illnesses, is a cause of AFM that is rare now in the US due to vaccination.

Q: Do you know what caused any of these potential cases?

A: At this point we do not know what has caused these potential AFM cases.

  • Oftentimes, despite extensive laboratory testing, a cause for AFM is not able to be identified.
  • It’s not known why some people develop AFM while others don’t.

Q: Is AFM contagious?

A: AFM is a syndrome, which is basically a group of symptoms caused by many different things. Many of the germs that cause AFM are contagious, such as enteroviruses, which typically cause milder illnesses in children such as respiratory infections. Enteroviruses can get into the central nervous system and cause more serious illnesses like inflammation of the brain, although this is uncommon.

Some of the germs known to cause AFM are contagious between people while others are not. West Nile Virus for example is only transmitted by mosquitos while common cold germs are transmitted between people.

Q: Are these cases connected to each other?

A: At this point we don’t know if these cases are connected in any way.

  • They came from four different counties (Whatcom, King, Pierce and Franklin).
  • Their age ranges between 3 to age 14.
  • And while we can’t discuss specific cases, some have unique symptoms from the others.

Q: Could this be something else?

A: AFM is one of a number of conditions that can result in neurologic illness with limb weakness. Such illnesses can result from a variety of causes, including viral infections, environmental toxins, genetic disorders, and an abnormal immune response that attacks the body’s nerves.

Q: How is AFM diagnosed?

A: AFM is difficult to diagnose because it can look nearly identical to other conditions or syndromes. It is diagnosed based on a combination of symptoms and a type of imaging test called an MRI or laboratory results.

A doctor can rule out other neurological disease by careful examination, for example, looking at the location of muscle weakness, muscle tone, and reflexes. An MRI is essential to diagnose AFM.

Q: Can adults get it?

A: Yes, but it may be more likely to affect children, perhaps because they typically haven’t built up as much immunity to germs as adults.

Q: Is there a treatment?

A: There is no specific treatment for acute flaccid myelitis, other than what doctors call supportive care, which means treating the symptoms. A doctor who specializes in treating brain and spinal cord illnesses (neurologist) may recommend certain interventions on a case-by-case basis.

Q: Do people who get it get their movement back?

A: According to the CDC some do. The CDC did a survey of patients from cases in 2014 investigation and got 56 responses. A small number had complete recovery of limb function after about 4 months, but some had no improvement.  Right now there is no long-term information available, but the CDC is working with states to collect the information.

Q: Is there any way to prevent it?

A: Because being infected by any one of a number of viruses are possible causes of AFM, steps to avoid infections include good hand washing and avoiding contact with people with respiratory and diarrhea infections may help.

AFM can be caused by different things, and because doctors know so little about the cause, there are no known specific preventative measures to recommend.

  • You can help protect yourselves from some of the known causes of acute flaccid myelitis by:
  • Washing your hands often with soap and water,
  • Avoiding close contact with sick people, and
  • Cleaning surfaces with a disinfectant, especially those that a sick person has touched.

Q: What is the investigation looking at?

A: We’ve worked to make sure that tests are being done that might point to a cause – these tests are now being reviewed by us and the CDC and we hope to have some preliminary information back soon.

We are investigating whether the cases have any links to one another and are reviewing other information including if they had recent illnesses. While the types of tests are really comprehensive, sometimes no direct cause is found.

I want to reassure all of our families that we are aware of the cases of AFM in our state and we want to provide our expertise and offer information to concerned individuals and families as requested. If your child is acting ill or unusually, please don’t hesitate to come see us at the clinic or contact us with any questions or concerns, 360-716-4511.

Kicking tobacco addiction through peer support and culture

Ashley Tiedeman, Tulalip Tobacco Cessation Program Coordinator (2nd from right), and program members show the woven cedar frog pins they made during a habit replacement class.

Ashley Tiedeman, Tulalip Tobacco Cessation Program Coordinator (2nd from right), and program members show the woven cedar frog pins they made during a habit replacement class.


By Kalvin Valdillez, Tulalip News 

One of the most difficult challenges one might have to personally face in their lifetime is kicking the tobacco addiction. Without even realizing it, long-time smokers’ entire lives are mapped out the moment they first began to crave a cancer stick. Social circles were most likely affected first. Many non-smokers cannot bear to be around smokers because of factors such as the lingering smell of stale smoke a cigarette user often carries. And smokers know that their non-smoking friends and family members have good intentions but their words can sometimes sound preachy, making the smoker feel judged. For this reason, smokers tend to socialize and associate themselves with other smokers and vice versa for non-smokers.

This creates a problem for smokers who are trying to quit. Because of the bonding experience smokers share during work, social and family events, smokers often feel like they are stepping into a completely different world, not to mention the withdrawal symptoms like cravings and irritability they experience from quitting. Smokers who attempt to kick the habit struggle because that’s exactly what it is, a habit. They usually adhere to an internal schedule when it comes to lighting up a stogie such as after a meal or once they hit the road on their daily commute.

A large part of why smokers relapse is the lack of a support system. Since smokers often associate with smokers, if a person who is trying to quit has been smoking a long time, chances are their closest friends are smokers as well. This can sometimes lead to peer pressure, doubt, and negativity from their friends, which then results into a ‘might as well’ attitude. In that moment of weakness, a cig is lit and the chances of quitting again are put on hold for a few months. Many smokers who attempt to quit multiple times, begin secretly trying to quit to avoid public humiliation.

Tulalip’s Tobacco Cessation Program provides smokers with all the resources they need to drop the bad habit for good. Some of the resources include one-on-one counseling, nicotine patches and gum, new friends and support systems, and fun crafts and activities that smokers can use while they slowly begin to transition to a smoke-free life.

Ashley Tiedeman, Tobacco Cessation Program Coordinator, invites and encourages smokers to check out one of her classes, which are held on a monthly basis. She wants to ensure smokers that the program is designed to support and assist during the excruciating quitting process.

She states, “If someone is still smoking but is interested in quitting, they can still come to these classes because that’s the whole idea behind it, to see if different activities or crafts can help.” Ashley says the program does not pressure smokers into quitting but rather gives them a healthy alternative. Whether the alternative is cedar weaving, beading, or having great conversation with others struggling to quit, Ashley has created a space where smokers can feel comfortable and have a fun time while forgetting that cigarettes once ruled everything around them.

Group participant and master haida weaver, Lisa Telford stated, “No matter what I do, how many times I screw up and fall off the wagon, Ashley takes me back because she cares about us.”

For assistance with kicking the tobacco addiction and for additional information contact the Tulalip Cessation Program at (360) 716-5719.



Contact Kalvin Valdillez at