Erin Fitzgerald, a staff member of HDI is wearing a blue flannel and holding a washboard to make music. they are on a blue background with HDI's logo in the top left.

“All people offer perspective that is valuable to the rest of the world.” HDI Staff Erin Fitzgerald speaks on their experience with Neurodiversity and mental health

The following article discusses suicide, which some readers may find distressing. 

Erin Fitzgerald could always see the signs that she was different growing up – the tools to recognize how simply didn’t exist yet.  

“I grew up in an era where mental health was talked about very differently from how it is talked about today. There are some similarities and holdovers, but a lot of differences too,” Fitzgerald, who also identifies as queer and uses she/they pronouns, said. “In the 70s and 80s, I do not remember any conversation around mental health or counseling that did not feel totally pathologized. I do not remember myself or anyone else getting referred to talk with someone or getting assessed for something based on how we were doing or how we were feeling inside. I would only hear about mental health if someone were seen as causing a problem for other people, or seen as a problem themselves.”  

Fitzgerald also grew up in a household with a parent who was diagnosed with a severe mental illness, who did not have the same options for support and resources that exist today. “It makes me sad to think about this, because my dad struggled quite a bit and had a hard time finding the right kind of support,” she shared. “He ultimately died by suicide, which is an all-too-common scenario when people do not have the support that they need to address their mental health issues. I cannot help but wonder if he were living in a different time, and if he could have found the kind of support that exists now, how things might have gone differently.”  

Fitzgerald, who works with HDI as the CTP Coordinator with HDI’s Supported Higher Education Partnership, has had her own journey with mental health. She has had family that struggled, has worked as a support provider, and has sought support from the system as well. She was given multiple diagnoses before finally being assessed for autism and sensory processing disorder as an adult.  

“It wasn’t until some years later that I even heard the term ‘Neurodiversity,’” Fitzgerald said. “That really clicked some things in place for me. It was a turning point for me to think about the way I was wired as being a neurotype and an identity, and not a problem to be solved or a thing to be fixed.”  

For Fitzgerald, this was a revelation – and a total reversal of how anything related to mental health was treated in the past.  

But the signs were always there, and looking back, Fitzgerald sees them clearly – both in how it’s affected her view of the world at large, and how it’s affected her view of something deeply important to her – art.  

“It is interesting – I think that way my brain is wired has always affected my view on the world as well as my art. But I have not always been in good touch with what that wiring was,” Fitzgerald said. “So only in recent years do I feel that I am able to understand the degree to which that affects my view of the world, and how that is portrayed in art.”  

comic from spectrum with four squares. the top left has a person wearing a hospital gown holding their head with text reading, "Sometimes it takes a crash..." the next square show a person laying face down with text that says, “…to find a landing…” the next shows that person crouching on the ground with one foot on the floor, with text that says “…to find your footing…” the final square shows that person wearing a grey t-shirt and pants standing an a podium with a rainbow flag behind them with text reading, “…find your place.”

That’s a big part of how Fitzgerald relates to the world. Art, she said, is an essential part of her life.  

“When it comes down to it, art is the primary way that I process information and emotions. This has always been true, and not just with visual art. Music, writing, theater, any kind of creative expression – it all helps me to process things,” Fitzgerald said. “Consuming it, creating it, engaging with it, talking about it – all of these actions are extremely important to me. I can’t imagine life without being swirled up in the arts on a regular basis.”  

Today, Fitzgerald creates a cartoon called SPECTRUM that explores the multiple aspects of her journey and identity. She started the project after attending a class with Lynda Barry – somewhat accidentally, she noted.  

“I did not go there to learn cartooning specifically, but after the workshop I started drawing cartoons every day. I did not set out to draw a cartoon called SPECTRUM, or to cover specific topics such as Neurodivergence and Queerness. But that is what kept coming out on the page, so that is what I went with,” Fitzgerald said. “I have been drawing SPECTRUM cartoons ever since, and it has been a great tool for me to further process the world around me and to think more deeply about my interactions within it. It has also turned out to be a good tool for having conversations with other people around those subjects.”  

Cartoons like SPECTRUM are relevant to an emerging field known as Graphic Medicine, one that Fitzgerald says is still finding its identity. But it’s one she finds exciting for its diversity in application and accessibility. Graphic Medicine is, explained simply, the intersection between the realms of graphic arts (such as illustration and comics) and health and medicine. This can take many different forms, which is part of the appeal. It also does something that is central to a lot of work that Fitzgerald does – gives a voice to more people to share their experiences.  

“I was drawn to this field for many reasons,” Fitzgerald said. “The part of this field that is most appealing to me is the fact that engaging with and creating graphic works can increase understanding of topics such as overall health, medicine, mental health, identity, and community engagement. It can intersect and therefore help connect people and ideas from all different disciplines and perspectives.”  

Fitzgerald also notes that the principles of graphic medicine are in line with those of Universal Design and Universal Design for Learning in a few key ways – in giving people additional tools to communicate and understand concepts related to health and medicine, and in giving a voice to people receiving supports – allowing everyone the chance to learn together. In addition, graphic formats provide context and color to raw data, adding images and stories to the numbers.  

Fitzgerald is also working on a wordless graphic memoir called InQuest, which documents her perspective about the mental health system. She hopes the project will help increase understanding of that system from the perspective of people who have navigated it from the other side. “The message I find most important from that project is this: the perspective of a person experiencing a mental health crisis is valid and meaningful, and should not be dismissed,” she said. More information about that project can be found here

A spectrum comic that has someone not in frame ask, “So…can you tell me about your strengths?” A person that looks nervous responds, “Well I don’t mean to brag…but my amygdala is huge.”

Today, Fitzgerald works with people with intellectual and developmental disabilities (IDD) as they attend college – something that has only recently become an option for many. That, Fitzgerald says, is because people have historically not included the voices of people with IDD in conversations about higher education.  

“I think this is partly because of that tendency in our society to separate people into categories based on what we are told they do or don’t know, or can or can’t do,” she said. “If we want to be truly inclusive, we need to see everyone else as a partner in this journey, and not only in a specific role of expert or learner. That is how we got here, so we need to expand our own perceptions as we continue to build the way forward.”  

In general, that is a uniting factor in a lot of what Fitzgerald does – working to ensure that voices of all people are heard and valued in the process.  

“One of the main things I want people to understand about mental health and IDD is that all people offer perspective that is valuable to the rest of the world. In our society, we tend to put certain perspectives up on a pedestal as being more important, and putting other perspectives in a category as being less valued,” she said. “We tend to separate people into categories of those with expertise to share, and those who need that expertise. That is oversimplified and can be quite dangerous. It is important for us to recognize the value in all human perspective, and to stop pathologizing everything that is outside of the norm. I think we have come a long way in this, but we still have a long way to go.”  

Read Fitzgerald’s ongoing comic, SPECTRUM, here

staff spotlight photo of Calisa Fitzpatrick

Good communication makes the world go round! A staff spotlight on Calisa Fitzpatrick

Calisa Fitzpatrick thinks good communication makes the world go round.

For her, there is immense power in a team working together towards a common goal. And as a member of the Evaluations Team, a big part of her job is helping ensure that HDI is doing that in every way it can.

“We work with partners to help inform them about the impact their programs or services are making on the individuals they intend to serve and hopefully provide them with information to inform decision-making to improve those programs and services,” Fitzpatrick said. “We ask a lot of questions, have lots of conversations, and then come up with a plan to evaluate all the things they’re doing.”

She didn’t set out to be involved in evaluations, but she fell into it, as she puts it. Fitzpatrick Holds a master’s in Health Administration and a psychology undergraduate and directed an outpatient program for adolescents at a behavioral health hospital. Her work has always had a strong focus on helping young people address their own challenges with mental health and reducing stigma around receiving services. What she does now still serves the same mission, but looks at it from a different angle.

Her story is not a unique one. Many from the evaluations team didn’t start there, and Fitzpatrick sees that as a boon to the team.

“We bring a lot of diverse perspectives to our work, experiences from the healthcare world, mental health services, education, or research-based activities,” she said.

Fitzpatrick’s path was a strange one. She hadn’t been at HDI for more than two months before COVID-19 changed everything and had to effectively relearn her new job after having barely learned it on the first place. This is where her teamwork proved incredibly beneficial.

“We have a lot of camaraderie on the unit. We get a lot of support from each other,” she said. “Coworkers just understood where we all were, and they were willing to work through that together.”

Likewise, getting to know those colleagues – both directly in evaluations and in other partnerships.

“I enjoy the relationships that are being built. That sharing of knowledge has been super important,” she said. “I appreciate the conversations with grant partners like the Kentucky Department of Education, the Department of Behavioral Health, Developmental and Intellectual Disabilities. There’s so many people that are really dedicated to their work, so getting to know them and how they think about the work they do and seeing that passion for it has been inspiring.”

As someone who values teamwork so much, it comes as no surprise that Fitzpatrick loves sports too. She’s an avid runner and a rookie pickleball player with a desire to compete.

But it’s not just the teamwork that she values, as you can find her taking a nice run, or

She wants to get her heart going and she likes to challenge herself to go higher. She’s already run several marathons. Now, she’s considering running another.

“It takes a lot of discipline to get out there and constantly do it,” she said. “When something is demanding mentally or physically, that’s something I like. It might sound like ‘Oh, why would anyone want to do that,’ but I like being pushed.”

Ultimately though, a lot of her life comes down to healthy communications, healthy relationships, and healthy collaboration.

“That’s so imperative to the work that we do,” she said. “My faith guides me to do to others as you would have them do to you. I think that’s where a lot of teamwork and collaboration stems from…I also think I can learn from others. I don’t know it all, so I value that collaboration.”

Staff photo Jay Hatcher on a dark blue background

Coding a Brighter Future. A staff spotlight on Jay Hatcher

There’s an alchemy to coding, a place where art meets science, a perfect fusion of technical know-how and creativity.  Jay Hatcher has lived in that space since he was a kid.

“I’ve been a software engineer for about 17 years, but I’ve been learning to program computers since I was 10,” Hatcher said. “I’ve always enjoyed the creative artistry and technical challenge of getting a computer to do what you want it to. I like figuring out how to translate real-world problems and goals into a working application, either to meet a need or just to see what’s possible. It’s the most complex and creative field of engineering I know.”

Hatcher is a software engineer at HDI. He’s been here for more than a decade, and during that time he’s been involved in web design, software engineering, and software tools for HDI projects.  Lately, he’s also been working on a project called Ucalculia, which seeks to provide a resource for an often-overlooked disability known as dyscalculia.

“I’ve been at HDI since 2011,” Hatcher said. “I was drawn to HDI’s mission to help people of all abilities and a focus on meeting real human needs rather than just producing a consumable product like so much of the software industry.”

Hatcher also sees some overlap in HDI’s mission and his own work.

“I like that we focus on enabling and empowering others,” he said. “In my mind, software engineering is about empowerment, making new opportunities and possibilities a reality for people.”

Within HDI itself, Hatcher also finds a lot of internal systems that focus on empowering people as well – including a highly collaborative environment filled with people that bring out the best in one another.

“I’m proud of the team I’m a part of and the way we work together to figure out solutions to problems,” he said. “I’ve done some neat projects, big and small, but my ability to learn new approaches to software development, try out creative solutions to problems, and learn what challenges need solving wouldn’t be possible without the great team we have here at HDI.”

In his personal life, Hatcher loves spending time with his family, including his two sons, Eli, age 9, and Liam, age 6. He’s a heavy reader, focusing on non-fiction and speculative fiction. A couple recent favorites include The Knowledge Gap by Natalie Wexler and Galileo’s Error by Philip Goff. He’s also a longtime fan of the Lord of the Rings trilogy. He considers his faith a major guiding star too – one that he feels deeply relates to his work at HDI.

“Living out my faith is the most important thing to me. Acting with compassion, striving to understand others, and learning to connect to people along life’s journey has enriched my life and helped me to avoid the tendency to live in my head. I’m glad I can work at a place where our values align so well with my personal convictions,” he said. “I could not ask for a more rewarding place to work, and I’m thrilled to see the great things HDI will do in the future.”

baby playing with blocks

UK expands training to help substance-exposed children

Educators from the University of KY are providing a unique service to address a desperate need- training students to work with babies born substance exposed.

The team of educators includes Dr. Jennifer Grisham and Dr. Sarah Hawkins-Lear from UK’s Interdisciplinary Early Childhood Education (IECE); Dr. Joneen Lowman and Dr. Judith Page from Communication Sciences and Disorders (CSD), and Dr. Caroline Gooden from the Human Development Institute (HDI). They have been awarded funding from the US Department of Education to provide training for IECE teachers and speech pathologists to work across disciplines with babies who are born substance exposed. The project is called Neonatal Abstinence Syndrome Training for Interdisciplinary Professionals (NASTIPS).  NASTIPS will train IECE and CSD graduate students to provide high quality interdisciplinary interventions to children born substance-exposed; that is, children whose mothers used substances such as illicit drugs or alcohol during pregnancy.

“We have lots of babies in Kentucky who are born substance exposed as a result of the opioid epidemic,” Gooden said, adding that opioids join alcohol as a common cause of substance exposure in children. “It’s a huge epidemic, and most of our teachers aren’t trained to recognize it or to know what to do with it.”

Substance exposure is a multifaceted situation, and it will take many different approaches to help these children and their families.

NASTIPS builds on a prior HDI training program called Project SCOPE (Supporting Children of the Opioid Epidemic) that used telehealth sessions to help providers across disciplines work with children who are born substance exposed and their families.

“We recognize that we need to have an interdisciplinary approach to work with this population,” Gooden said. “It’s not a single-symptom kind of situation. We have babies who need services, families who need services, and doctors who seek training in substance abuse treatment methods. It’s a complex network of services that we need to build.”

There are other agencies in KY that are working to create supports to help this population, and Gooden says the work they’re doing is critically needed and are partners in this effort. This project addresses an unmet need for IECE teacher and speech/language pathologist (SLP) training that has not been provided to date.  

“We’re excited because there is no such training program in Kentucky…We’re excited about this because it brings an educational component to programs in KY that are desperately needed,” Gooden said, adding that  “most of our teachers and SLPs aren’t trained to recognize neonatal abstinence syndrome (NAS) or to support children with NAS, which is what this project will provide.”

To that end, the project will train two cohorts of eight students each for two years of study, serving a total of 16 students over four years, to use high quality practices with these children and their families.  

“These teachers and speech therapists will effectively know how to work with the children on their caseloads and will be able to assist other teachers and SLPs in their agencies across the state,” Gooden said.

She stressed that for this project, the focus isn’t only on teaching the children; also, families are a key part of their children’s success. The program will take a holistic approach, helping its students work with the whole family.

“In most early childhood settings, you have lots of involvement with families, which is wonderful,” Gooden said. “One thing we can’t stress enough is that as an IECE teacher or SLP, we need to be really accepting of where our families are. They might be in recovery; they might be struggling to get in recovery and to get the services they need as a family. They need our support and not our judgment.” Gooden stressed that as important as it is to recognize and address the effects of substance exposure in children, it is just as important to treat these children and their families with compassion.  “We need to be nonjudgmental and serve these children where they are, as well as their families. Families with substance use disorder suffer from lots of stigma, which can be a barrier to their treatment and recovery,” she said. “We want to address the whole family’s needs and the whole child’s needs.”

“I hate being treated like an emergency waiting to happen.” UK student Bailey Patterson speaks on her experience with suicide and wanting to help others

The following article discusses suicide, suicidal ideation, miscarriage, and sexual abuse, which some readers may find distressing. 

Bailey Patterson was 4 or 5 when she began struggling with suicidal thoughts. 

“Things like ‘I wish I’d never been born,’ ‘I don’t want to be here,’ ‘I wish I would die,’” Patterson, a senior Interdisciplinary Disability Studies major at UK who identifies as multiply disabled, said. “Those thoughts progressed as life threw me more curveballs, where I was pretty actively having suicidal thoughts probably every day of my life when I was in middle school and high school. Still, I would never have a plan, it was just pretty aggressive thoughts.” 

That lasted until she was 16, when a friend had experienced a traumatic event for which Patterson felt responsible. Her mother interrupted her first suicide attempt shortly after that.

Patterson is not alone in struggling with suicidal thoughts. According to the American Foundation for Suicide Prevention, suicide is the 11th leading cause of death in the US. The World Health Organization reports that it is the fourth leading cause of death among 15 to 29-year-olds. The CDC reports that 12.3 million American adults have serious suicidal thoughts and 1.7 million attempt suicide. In 2022, 49,449 people died by suicide. 

Patterson considers herself chronically suicidal, but stresses that suicide is a complex issue. Mental illness is often a component of it – according to the National Alliance on Mental Illness, 46 percent of people who die by suicide have a known mental health condition – but Patterson stresses that there are other extenuating circumstances. She remembers her first stay as an inpatient in a mental health facility. The only other patients in her ward were girls, ages 12 to 17.

“There was a really common thread about gender-based violence,” she said. “Several of the girls on the ward had been sexually abused by older men.” 

Patterson noted that she thinks this ties into a major factor in suicide that is commonly overlooked.

“There’s this narrative in popular culture that if someone is suicidal, it’s because they don’t see the value in their lives or they’re depressed, and you can do this that and the other to make it go away. You can take long walks and you can eat healthier and you’ll feel less depressed,” she said. “For many people, the cause of the suicidal thoughts or the depression is the situation they’re living in. There are people living in current abusive situations that they feel they have no way of escaping from, there are people who are dealing with interpersonal violence or abuse, there are people who are homeless, there are people who are in poverty, there are people who are experiencing systemic interpersonal racism and sexism and bigotry. Those things are not things that you can walk and eat better to get rid of.”

That means that addressing those issues will help also help address the risk of suicide among marginalized populations. Patterson believes that addressing those issues while promoting mental health will do a lot to solve the problem.  

“I feel like if we understood that and worked towards those goals while also keeping in mind personal wellness and self-care and things like that, that would be a big help,” she said. “A lot of people are overlooking some of the greatest causes of distress that are leading people to be suicidal.”

She also remembers difficult times and experiences for both her and the others she met during her two inpatient stays. Among them, she particularly recalls a patient with a fear of needles being given medication by injection against her wishes when that patient felt there were other ways to administer similar medication and another woman on her second trip to inpatient services who had been pregnant when she was checked in and miscarried after being given a medication early in her stay.

That experience awakened in Patterson a desire to help others with the same struggles. Now, she channels that into standing against abuse and the loss of autonomy in psychiatric settings. Currently, Bailey is a Student Informatician with SPHERE at HDI, Officer of the Disabled and Ill Student Coalition, and an activism and research advocate in the Mad Pride and Psychiatric Survivors movements.

“The feeling of solidarity with these other with these other people who were also experiencing something similar to what I was in the moment, being there, hearing their stories changed my life,” she said. “That was the first moment where I thought ‘this is important and I want to do something about this for the rest of my life.’”

Helping others is one of the ways in which she deals with the frequent thoughts of suicide that she still experiences – and feels like she will always experience. 

“I manage, like a lot of us do,” she said. “Take it one day at a time and try to take care of myself as best I can, but I do not foresee a life for myself where I do not feel suicidal in some degree most days of my life. That’s probably just the way it is for me. That’s something that I’m going to have to continue to manage for the rest of my life, and I think that’s ok.”

She’s found a few coping mechanisms that can help when the thoughts get particularly bad. 

“One of the things that I do is I try to imagine a time in the future where I am happy,” she said. “That can be really hard, especially when you’re very depressed, but I have a couple of things in my mind, scenarios where I could be doing this thing that would be a happy moment for me. I try to really picture it and stay in that moment…then I try with all my might to believe that could happen for me one day. That’s my best coping mechanism thus far.” 

And if someone close to you is struggling with suicidal thoughts, Patterson stressed that one of the best ways to help is to keep treating them like a human being. 

“Anyone who hears that their loved one is going to have emotions that come up for them, but I think the number one thing you can do is not freak out,” she said. “You should be there, and you should attend to the problems…I sometimes get the feeling that we are treated like a danger. I hate being treated like an emergency waiting to happen. I think the best thing you can do is just be calm and present for that person and realize that the person speaking to you is the person you’ve known.”

Warning signs of suicide may include: 

  • No longer participating in things they enjoy
  • Feeling sad all or most of the time
  • Talking about dying or wishing not to be alive
  • Feeling hopeless or feeling like one has no purpose
  • Withdrawing from social groups or saying goodbye
  • Giving away important items

If you are struggling with suicidal thoughts, help is available. You can call the suicide and crisis lifeline at 988 or text SAVE to the Crisis Text Line at 741741. Both services are free and available 24/7. If someone is in immediate danger call 911 or go to your local Emergency Room.

This article represents the opinions of the author and interviewee, not that of the University of Kentucky.