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"content": "\u003cp>When Greta Christina fell into a deep depression five years ago, she called up her therapist — someone she’d had a great connection with when she needed therapy in the past. And she was delighted to find out that he was now on staff at Kaiser Permanente, her insurer, meaning she wouldn’t have to pay out of pocket anymore to see him.\u003c/p>\n\u003cp>But the excitement was short-lived. Over time, her appointments went from every two weeks to every four and then to every five or six.\u003c/p>\n\u003cp>“To tell somebody with serious, chronic, disabling depression that they can only see their therapist every five or six weeks is like telling somebody with a broken leg that they can only see their physical therapist every five or six weeks,” she said. “It’s not enough. It’s not even close to enough.”\u003c/p>\n\u003cp>Then, this summer, Christina was diagnosed with breast cancer. Everything related to her cancer care — her mammogram, biopsy, surgery appointments — happened promptly, like a “well-oiled machine,” she said, while her depression care stumbles along.\u003c/p>\n\u003cp>[pullquote size=\"medium\" align=\"right\" citation=\"Greta Christina\"]‘To tell somebody with serious, chronic, disabling depression that they can only see their therapist every five or six weeks is like telling somebody with a broken leg that they can only see their physical therapist every five or six weeks. It’s not enough. It’s not even close to enough.’[/pullquote]\u003c/p>\n\u003cp>“It is a hot mess,” she said. “I need to be in therapy — I have cancer! And still nothing has changed.”\u003c/p>\n\u003cp>A bill sitting on Gov. Gavin Newsom’s desk aims to fix this problem for all Californians. \u003ca href=\"https://leginfo.legislature.ca.gov/faces/billNavClient.xhtml?bill_id=202120220SB221\">Senate Bill 221\u003c/a>, which passed both houses of the Legislature in a near unanimous vote, would require health insurers across the state to reduce those wait times to no more than 10 business days. While current state law requires insurers to provide initial mental health appointments in 10 days, there is no clear regulation around follow-up appointments, resulting in what state Sen. Scott Wiener, D-San Francisco, the bill’s author, calls “obscene delays.”\u003c/p>\n\u003cp>\u003ca href=\"https://www.chcf.org/blog/californians-want-action-health-care-costs-mental-health-treatment/\">Half of Californians say they have to wait too long to see a mental health provider when they need one\u003c/a>, according to a survey by the California Health Care Foundation. At Kaiser Permanente specifically, 87% of therapists said weekly appointments were not available to patients who needed it, according to a survey by the \u003ca href=\"https://nuhw.org/\">National Union of Healthcare Workers\u003c/a>, which represents Kaiser’s therapists and was the main sponsor of the bill.\u003c/p>\n\u003cp>“It just feels so unethical,” said triage therapist Brandi Plumley, referring to the typical two-month wait time she sees at Kaiser’s mental health clinic in Vallejo.\u003c/p>\n\u003cp>Every day she takes multiple crisis calls from patients who have a therapist assigned to them already, but can’t get in to see them, she said, adding the providers’ caseloads are “enormous.”\u003c/p>\n\u003cp>[ad fullwidth]\u003c/p>\n\u003cp>“It’s heartbreaking. And it eats on me day after day after day,” Plumley said. “What Kaiser simply needs to do is hire more clinicians.”\u003c/p>\n\u003cp>But Kaiser says there just aren’t enough out there. The integrated health system currently has 300 open clinical positions it is trying to fill, according to a statement from Yener Balan, Kaiser’s Northern California vice president of behavioral health. Even hiring more clinicians won’t solve the problem, Balan said, adding, “We all must reimagine our approach to the existing national model of care.”\u003c/p>\n\u003cp>Kaiser lodged formal concerns about the bill when it was first introduced, and the trade group representing insurers throughout the state, the California Association of Health Plans (CAHP), formally opposed the bill, saying a shortage of therapists would make it too difficult to meet the two-week mandate.\u003c/p>\n\u003cp>“The COVID-19 pandemic has only exacerbated this workforce shortage, and demand for these services [has] significantly increased,” said CAHP lobbyist Jedd Hampton at a state Senate hearing for the bill last spring, citing \u003ca href=\"https://healthforce.ucsf.edu/sites/healthforce.ucsf.edu/files/publication-pdf/California%E2%80%99s%20Current%20and%20Future%20Behavioral%20Health%20Workforce.pdf\">a UCLA study that predicted California would have nearly 30% fewer therapists than needed to meet demand by 2028\u003c/a>. “Simply put, mandating increased frequency of appointments without addressing the underlying workforce shortage will not lead to increased quality of care.”\u003c/p>\n\u003caside class=\"alignright\">\n\u003ch4 style=\"text-align: center\">\u003ca href=\"https://www.kqed.org/stateofhealth/series/state-of-mind\" target=\"_blank\" rel=\"noopener noreferrer\">\u003cspan style=\"color: #000000\">Special Series: State of Mind\u003c/span>\u003c/a>\u003c/h4>\n\u003cfigure>\u003ca href=\"https://www.kqed.org/stateofhealth/series/state-of-mind\" target=\"_blank\" rel=\"noopener noreferrer\">\u003cimg decoding=\"async\" src=\"https://ww2.kqed.org/app/uploads/sites/10/2016/08/RS20817_State-of-Mind-qut.jpg\" alt=\"\">\u003c/a>\u003c/figure>\n\u003cp style=\"text-align: left\">State of Mind: In this \u003ca href=\"https://www.kqed.org/stateofhealth/series/state-of-mind\">2016 special series by KQED’s The California Report and State of Health\u003c/a>, we traveled across the state to find out why it’s so difficult to get mental health care.\u003c/p>\n\u003c/aside>\n\u003cp>But lawmakers pushed back and \u003ca href=\"https://www.kqed.org/stateofhealth/185843/just-like-patients-therapists-also-battle-insurance-red-tape\">accused insurers of overstating the shortage\u003c/a>. If insurers want to attract more therapists to their networks, the responsibility is on them to pay better rates and reduce administrative burdens, said state Sen. Connie Leyva, D-Chino. And if insurers want more young people to enter the mental health care profession, they have to improve the salaries and working conditions of the field now, said state Sen. Richard Pan, D-Sacramento.\u003c/p>\n\u003cp>As bipartisan support for the bill grew, insurers withdrew their opposition. The bill passed the Legislature with 111 lawmakers voting for it and one voting against.\u003c/p>\n\u003cp>“COVID, and the fact that every single one of us has been impacted significantly in terms of our isolation, I believe, has made legislators’ focus, and their understanding of the importance of treatment, almost universal,” said Julie Snyder, government affairs director for the \u003ca href=\"https://steinberginstitute.org/\">Steinberg Institute\u003c/a>, a supporter of the bill.\u003c/p>\n\u003cp>The bill itself, which would take effect in July 2022 if signed by the governor, is a solid step forward toward improving access to mental health care, with communities of color standing to benefit the most, said Lonnie Snowden, professor of health policy and management at UC Berkeley.\u003c/p>\n\u003cp>African Americans, Asian Americans and Latinos face the most barriers getting into care, he said, and when people of color do come in for treatment, there is a high discontinuation rate.\u003c/p>\n\u003cp>“So anything you can do to speed up people’s future appointments is probably going to disproportionately benefit people who are already staying away because of barriers,” Snowden said. “If you can remove one of the barriers, they’re the ones who stand to benefit.”\u003c/p>\n\u003cp>But there has to be some form of oversight and enforcement for the new rules to work, said Keith Humphreys, a psychiatry professor at Stanford University. Kaiser has data systems that can track the time between appointments, but other insurers contract with therapists in private practice, who manage their own caseloads and schedules.\u003c/p>\n\u003cp>“Who would keep track of whether people who’ve been seen once were seen again in 10 days when \u003ca href=\"https://www.kqed.org/stateofhealth/185796/single-moms-search-for-therapist-foiled-by-insurance-companies\">it’s hard enough just to keep track of how many providers we have\u003c/a> and who they are seeing?” he said. “And if someone wasn’t seen again in 10 days, how do we tell the cases when they were denied care they wanted versus the cases where they decided one appointment is all they wanted?”\u003c/p>\n\u003cp>These are questions that will fall to state regulators, the California Department of Managed Health Care and the Department of Insurance.\u003c/p>\n\u003cp>Regardless, Greta Christina says she is desperate for the bill to become law. She’s thought about looking for a new therapist outside Kaiser so she can be seen more frequently. But she really likes her therapist. She says it’s too hard to think of starting over with someone new while she’s in the middle of a cancer crisis. So she has decided to wait.\u003c/p>\n\u003cp>“Knowing that this bill is on the horizon has been helping me hang on,” she said.\u003c/p>\n\u003cp>[ad floatright]\u003c/p>\n",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>“It is a hot mess,” she said. “I need to be in therapy — I have cancer! And still nothing has changed.”\u003c/p>\n\u003cp>A bill sitting on Gov. Gavin Newsom’s desk aims to fix this problem for all Californians. \u003ca href=\"https://leginfo.legislature.ca.gov/faces/billNavClient.xhtml?bill_id=202120220SB221\">Senate Bill 221\u003c/a>, which passed both houses of the Legislature in a near unanimous vote, would require health insurers across the state to reduce those wait times to no more than 10 business days. While current state law requires insurers to provide initial mental health appointments in 10 days, there is no clear regulation around follow-up appointments, resulting in what state Sen. Scott Wiener, D-San Francisco, the bill’s author, calls “obscene delays.”\u003c/p>\n\u003cp>\u003ca href=\"https://www.chcf.org/blog/californians-want-action-health-care-costs-mental-health-treatment/\">Half of Californians say they have to wait too long to see a mental health provider when they need one\u003c/a>, according to a survey by the California Health Care Foundation. At Kaiser Permanente specifically, 87% of therapists said weekly appointments were not available to patients who needed it, according to a survey by the \u003ca href=\"https://nuhw.org/\">National Union of Healthcare Workers\u003c/a>, which represents Kaiser’s therapists and was the main sponsor of the bill.\u003c/p>\n\u003cp>“It just feels so unethical,” said triage therapist Brandi Plumley, referring to the typical two-month wait time she sees at Kaiser’s mental health clinic in Vallejo.\u003c/p>\n\u003cp>Every day she takes multiple crisis calls from patients who have a therapist assigned to them already, but can’t get in to see them, she said, adding the providers’ caseloads are “enormous.”\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>“It’s heartbreaking. And it eats on me day after day after day,” Plumley said. “What Kaiser simply needs to do is hire more clinicians.”\u003c/p>\n\u003cp>But Kaiser says there just aren’t enough out there. The integrated health system currently has 300 open clinical positions it is trying to fill, according to a statement from Yener Balan, Kaiser’s Northern California vice president of behavioral health. Even hiring more clinicians won’t solve the problem, Balan said, adding, “We all must reimagine our approach to the existing national model of care.”\u003c/p>\n\u003cp>Kaiser lodged formal concerns about the bill when it was first introduced, and the trade group representing insurers throughout the state, the California Association of Health Plans (CAHP), formally opposed the bill, saying a shortage of therapists would make it too difficult to meet the two-week mandate.\u003c/p>\n\u003cp>“The COVID-19 pandemic has only exacerbated this workforce shortage, and demand for these services [has] significantly increased,” said CAHP lobbyist Jedd Hampton at a state Senate hearing for the bill last spring, citing \u003ca href=\"https://healthforce.ucsf.edu/sites/healthforce.ucsf.edu/files/publication-pdf/California%E2%80%99s%20Current%20and%20Future%20Behavioral%20Health%20Workforce.pdf\">a UCLA study that predicted California would have nearly 30% fewer therapists than needed to meet demand by 2028\u003c/a>. “Simply put, mandating increased frequency of appointments without addressing the underlying workforce shortage will not lead to increased quality of care.”\u003c/p>\n\u003caside class=\"alignright\">\n\u003ch4 style=\"text-align: center\">\u003ca href=\"https://www.kqed.org/stateofhealth/series/state-of-mind\" target=\"_blank\" rel=\"noopener noreferrer\">\u003cspan style=\"color: #000000\">Special Series: State of Mind\u003c/span>\u003c/a>\u003c/h4>\n\u003cfigure>\u003ca href=\"https://www.kqed.org/stateofhealth/series/state-of-mind\" target=\"_blank\" rel=\"noopener noreferrer\">\u003cimg decoding=\"async\" src=\"https://ww2.kqed.org/app/uploads/sites/10/2016/08/RS20817_State-of-Mind-qut.jpg\" alt=\"\">\u003c/a>\u003c/figure>\n\u003cp style=\"text-align: left\">State of Mind: In this \u003ca href=\"https://www.kqed.org/stateofhealth/series/state-of-mind\">2016 special series by KQED’s The California Report and State of Health\u003c/a>, we traveled across the state to find out why it’s so difficult to get mental health care.\u003c/p>\n\u003c/aside>\n\u003cp>But lawmakers pushed back and \u003ca href=\"https://www.kqed.org/stateofhealth/185843/just-like-patients-therapists-also-battle-insurance-red-tape\">accused insurers of overstating the shortage\u003c/a>. If insurers want to attract more therapists to their networks, the responsibility is on them to pay better rates and reduce administrative burdens, said state Sen. Connie Leyva, D-Chino. And if insurers want more young people to enter the mental health care profession, they have to improve the salaries and working conditions of the field now, said state Sen. Richard Pan, D-Sacramento.\u003c/p>\n\u003cp>As bipartisan support for the bill grew, insurers withdrew their opposition. The bill passed the Legislature with 111 lawmakers voting for it and one voting against.\u003c/p>\n\u003cp>“COVID, and the fact that every single one of us has been impacted significantly in terms of our isolation, I believe, has made legislators’ focus, and their understanding of the importance of treatment, almost universal,” said Julie Snyder, government affairs director for the \u003ca href=\"https://steinberginstitute.org/\">Steinberg Institute\u003c/a>, a supporter of the bill.\u003c/p>\n\u003cp>The bill itself, which would take effect in July 2022 if signed by the governor, is a solid step forward toward improving access to mental health care, with communities of color standing to benefit the most, said Lonnie Snowden, professor of health policy and management at UC Berkeley.\u003c/p>\n\u003cp>African Americans, Asian Americans and Latinos face the most barriers getting into care, he said, and when people of color do come in for treatment, there is a high discontinuation rate.\u003c/p>\n\u003cp>“So anything you can do to speed up people’s future appointments is probably going to disproportionately benefit people who are already staying away because of barriers,” Snowden said. “If you can remove one of the barriers, they’re the ones who stand to benefit.”\u003c/p>\n\u003cp>But there has to be some form of oversight and enforcement for the new rules to work, said Keith Humphreys, a psychiatry professor at Stanford University. Kaiser has data systems that can track the time between appointments, but other insurers contract with therapists in private practice, who manage their own caseloads and schedules.\u003c/p>\n\u003cp>“Who would keep track of whether people who’ve been seen once were seen again in 10 days when \u003ca href=\"https://www.kqed.org/stateofhealth/185796/single-moms-search-for-therapist-foiled-by-insurance-companies\">it’s hard enough just to keep track of how many providers we have\u003c/a> and who they are seeing?” he said. “And if someone wasn’t seen again in 10 days, how do we tell the cases when they were denied care they wanted versus the cases where they decided one appointment is all they wanted?”\u003c/p>\n\u003cp>These are questions that will fall to state regulators, the California Department of Managed Health Care and the Department of Insurance.\u003c/p>\n\u003cp>Regardless, Greta Christina says she is desperate for the bill to become law. She’s thought about looking for a new therapist outside Kaiser so she can be seen more frequently. But she really likes her therapist. She says it’s too hard to think of starting over with someone new while she’s in the middle of a cancer crisis. So she has decided to wait.\u003c/p>\n\u003cp>“Knowing that this bill is on the horizon has been helping me hang on,” she said.\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"title": "'Repeatedly Misled the Public': Facebook Whistleblower Frances Haugen Details How Network Hurts Kids, Fuels Division",
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"content": "\u003cp>A former Facebook data scientist told Congress on Tuesday that the social network giant’s products harm children and fuel polarization in the U.S. while its executives refuse to change because they elevate profits over safety. And she laid responsibility with the company’s CEO Mark Zuckerberg.\u003c/p>\n\u003cp>[pullquote align=\"right\" size=\"medium\" citation=\"Frances Haugen, former Facebook employee\"]‘The company’s leadership knows how to make Facebook and Instagram safer but won’t make the necessary changes because they have put their astronomical profits before people.’[/pullquote]Frances Haugen testified to the Senate Commerce Subcommittee on Consumer Protection, Product Safety, and Data Security. Speaking confidently at a charged hearing, she \u003ca href=\"https://www.npr.org/2021/10/05/1043207218/whistleblower-to-congress-facebook-products-harm-children-and-weaken-democracy\">accused the company\u003c/a> of being aware of apparent harm to some teens from Instagram and being dishonest in its public fight against hate and misinformation.\u003c/p>\n\u003cp>“Facebook’s products harm children, stoke division and weaken our democracy,” Haugen said. “The company’s leadership knows how to make Facebook and Instagram safer but won’t make the necessary changes because they have put their astronomical profits before people.”\u003c/p>\n\u003cp>“Congressional action is needed,” she said. “They won’t solve this crisis without your help.”\u003c/p>\n\u003cp>The former employee challenging the social network giant with 2.8 billion users worldwide and nearly $1 trillion in market value is a 37-year-old data expert from Iowa with a degree in computer engineering and a master’s degree in business from Harvard. Prior to being recruited by Facebook in 2019, she worked for 15 years at tech companies including Google, Pinterest and Yelp.\u003c/p>\n\u003cp>Haugen said the company has acknowledged publicly that integrity controls were crucially needed for its systems that stoke the engagement of users, but then it disabled some of those controls.\u003c/p>\n\u003cp>In dialogue with receptive senators of both parties, Haugen, who focused on algorithm products in her work at Facebook, explained the importance to the company of algorithms that govern what shows up on users’ news feeds. She said a 2018 change to the content flow contributed to more divisiveness and ill will in a network ostensibly created to bring people closer together.\u003c/p>\n\u003cp>Despite the enmity that the new algorithms were feeding, she said Facebook found that they helped keep people coming back — a pattern that helped the social media giant sell more of the digital ads that generate most of its revenue.\u003c/p>\n\u003cp>Senators agreed.\u003c/p>\n\u003cp>“It has profited off spreading misinformation and disinformation and sowing hate,” said Democratic Sen. Richard Blumenthal of Connecticut, the panel’s chair. “Facebook’s answers to Facebook’s destructive impact always seems to be more Facebook, we need more Facebook — which means more pain, and more money for Facebook.”\u003c/p>\n\u003cfigure id=\"attachment_11891071\" class=\"wp-caption alignnone\" style=\"max-width: 2560px\">\u003cimg loading=\"lazy\" decoding=\"async\" class=\"wp-image-11891071 size-full\" src=\"https://ww2.kqed.org/app/uploads/sites/10/2021/10/GettyImages-1235711393-1-scaled.jpg\" alt=\"In the foreground is the back of Frances Haugen's out-of-focus head, and seated beyond her, and in focus, are Senators Marsha Blackburn and Richard Blumenthal on either side of her head.\" width=\"2560\" height=\"1644\" srcset=\"https://cdn.kqed.org/wp-content/uploads/sites/10/2021/10/GettyImages-1235711393-1-scaled.jpg 2560w, https://cdn.kqed.org/wp-content/uploads/sites/10/2021/10/GettyImages-1235711393-1-800x514.jpg 800w, https://cdn.kqed.org/wp-content/uploads/sites/10/2021/10/GettyImages-1235711393-1-1020x655.jpg 1020w, https://cdn.kqed.org/wp-content/uploads/sites/10/2021/10/GettyImages-1235711393-1-160x103.jpg 160w, https://cdn.kqed.org/wp-content/uploads/sites/10/2021/10/GettyImages-1235711393-1-1536x986.jpg 1536w, https://cdn.kqed.org/wp-content/uploads/sites/10/2021/10/GettyImages-1235711393-1-2048x1315.jpg 2048w, https://cdn.kqed.org/wp-content/uploads/sites/10/2021/10/GettyImages-1235711393-1-1920x1233.jpg 1920w\" sizes=\"auto, (max-width: 2560px) 100vw, 2560px\">\u003cfigcaption class=\"wp-caption-text\">Senators Marsha Blackburn (R-Tenn.), left, and Richard Blumenthal (D-Conn.) listen as former Facebook employee and whistleblower Frances Haugen testifies before the Senate Committee on Commerce, Science, and Transportation on Capitol Hill, Oct. 5, 2021, in Washington, D.C. \u003ccite>(Drew Angerer/Pool/ AFP/via Getty Images)\u003c/cite>\u003c/figcaption>\u003c/figure>\n\u003cp>Haugen said she believed Facebook didn’t set out to build a destructive platform. But “in the end, the buck stops with Mark,” she said referring to Zuckerberg, who controls more than 50% of Facebook’s voting shares. “There is no one currently holding Mark accountable but himself.”\u003c/p>\n\u003cp>[pullquote align=\"right\" size=\"medium\" citation=\"Sen. Richard Blumenthal (D-Conn.)\"]‘Facebook’s answers to Facebook’s destructive impact always seems to be more Facebook.’[/pullquote]Haugen said she believed that Zuckerberg was familiar with some of the internal research showing concerns for potential negative impacts of Instagram.\u003c/p>\n\u003cp>The government needs to step in with stricter oversight of the company, Haugen said.\u003c/p>\n\u003cp>Like fellow tech giants Google, Amazon and Apple, Facebook has enjoyed minimal regulation. A number of bipartisan legislative proposals for the tech industry address data privacy, protection of young people and anti-competitive conduct. But getting new laws through Congress is a heavy slog. The Federal Trade Commission has adopted a stricter stance recently toward Facebook and other companies.\u003cbr>\n[ad fullwidth]\u003cbr>\nThe subcommittee is examining Facebook’s use of information from its own researchers on Instagram that could indicate potential harm for some of its young users, especially girls, while it publicly downplayed the negative impacts\u003c/p>\n\u003cp>For some of the teens devoted to Instagram, the peer pressure generated by the visually focused platform has \u003ca href=\"https://www.kqed.org/arts/13897329/facebook-calls-links-to-depression-inconclusive-these-researchers-disagree\">led to mental health and body-image problems\u003c/a> and, in some cases, eating disorders and suicidal thoughts, the research leaked by Haugen showed.\u003c/p>\n\u003cp>One internal study cited 13.5% of teen girls saying Instagram makes thoughts of suicide worse and 17% of teen girls saying it makes eating disorders worse.\u003c/p>\n\u003cp>Because of the drive for user engagement, Haugen testified, “Facebook knows that they are leading young users to anorexia content … It’s just like cigarettes. Teenagers don’t have any self-regulation. We need to protect the kids.”\u003c/p>\n\u003cp>[aside postID=\"news_11891045\" hero=\"https://ww2.kqed.org/app/uploads/sites/10/2019/12/cellphone-1920-1020x681.jpg\"]Haugen has come forward with a wide-ranging condemnation of Facebook, buttressed with tens of thousands of pages of internal research documents she secretly copied before leaving her job in the company’s civic integrity unit. She also has filed complaints with federal authorities alleging that Facebook’s own research shows that it amplifies hate, misinformation and political unrest but the company hides what it knows.\u003c/p>\n\u003cp>“The company intentionally hides vital information from the public, from the U.S. government and from governments around the world,” Haugen said. “The documents I have provided to Congress prove that Facebook has repeatedly misled the public about what its own research reveals about the safety of children, the efficacy of its artificial intelligence systems and its role in spreading divisive and extreme messages.”\u003c/p>\n\u003cp>After recent reports in The Wall Street Journal based on documents she leaked to the newspaper raised a public outcry, Haugen revealed her identity in a CBS “60 Minutes” interview aired Sunday night.\u003c/p>\n\u003cp>As the public relations debacle over the Instagram research grew last week, Facebook put on hold its work on a kids’ version of Instagram, which the company says is meant mainly for tweens age 10 to 12.\u003c/p>\n\u003cp>Haugen said that Facebook prematurely turned off safeguards designed to thwart misinformation and incitement to violence after Joe Biden defeated Donald Trump last year, alleging that contributed to the deadly Jan. 6 assault on the U.S. Capitol.\u003c/p>\n\u003cp>After the November election, Facebook dissolved the civic integrity unit where Haugen had been working. That, she says, was the moment she realized “I don’t trust that they’re willing to actually invest what needs to be invested to keep Facebook from being dangerous.”\u003c/p>\n\u003cp>[aside label ='More Stories' tag='silicon-valley']Haugen says she told Facebook executives when they recruited her that she wanted to work in an area of the company that fights misinformation, because she had lost a friend to online conspiracy theories.\u003c/p>\n\u003cp>Facebook maintains that Haugen’s allegations are misleading and insists there is no evidence to support the premise that it is the primary cause of social polarization.\u003c/p>\n\u003cp>“Even with the most sophisticated technology, which I believe we deploy, even with the tens of thousands of people that we employ to try and maintain safety and integrity on our platform, we’re never going to be absolutely on top of this 100% of the time,” Nick Clegg, Facebook’s vice president of policy and global affairs, said Sunday on CNN’s “Reliable Sources.”\u003c/p>\n\u003cp>That’s because of the “instantaneous and spontaneous form of communication” on Facebook, Clegg said, adding, “I think we do more than any reasonable person can expect to.”\u003cbr>\n[ad fullwidth]\u003c/p>\n\u003cp>[ad floatright]\u003c/p>\n",
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"content": "\u003cdiv class=\"post-body\">\u003cp>Frances Haugen testified to the Senate Commerce Subcommittee on Consumer Protection, Product Safety, and Data Security. Speaking confidently at a charged hearing, she \u003ca href=\"https://www.npr.org/2021/10/05/1043207218/whistleblower-to-congress-facebook-products-harm-children-and-weaken-democracy\">accused the company\u003c/a> of being aware of apparent harm to some teens from Instagram and being dishonest in its public fight against hate and misinformation.\u003c/p>\n\u003cp>“Facebook’s products harm children, stoke division and weaken our democracy,” Haugen said. “The company’s leadership knows how to make Facebook and Instagram safer but won’t make the necessary changes because they have put their astronomical profits before people.”\u003c/p>\n\u003cp>“Congressional action is needed,” she said. “They won’t solve this crisis without your help.”\u003c/p>\n\u003cp>The former employee challenging the social network giant with 2.8 billion users worldwide and nearly $1 trillion in market value is a 37-year-old data expert from Iowa with a degree in computer engineering and a master’s degree in business from Harvard. Prior to being recruited by Facebook in 2019, she worked for 15 years at tech companies including Google, Pinterest and Yelp.\u003c/p>\n\u003cp>Haugen said the company has acknowledged publicly that integrity controls were crucially needed for its systems that stoke the engagement of users, but then it disabled some of those controls.\u003c/p>\n\u003cp>In dialogue with receptive senators of both parties, Haugen, who focused on algorithm products in her work at Facebook, explained the importance to the company of algorithms that govern what shows up on users’ news feeds. She said a 2018 change to the content flow contributed to more divisiveness and ill will in a network ostensibly created to bring people closer together.\u003c/p>\n\u003cp>Despite the enmity that the new algorithms were feeding, she said Facebook found that they helped keep people coming back — a pattern that helped the social media giant sell more of the digital ads that generate most of its revenue.\u003c/p>\n\u003cp>Senators agreed.\u003c/p>\n\u003cp>“It has profited off spreading misinformation and disinformation and sowing hate,” said Democratic Sen. Richard Blumenthal of Connecticut, the panel’s chair. “Facebook’s answers to Facebook’s destructive impact always seems to be more Facebook, we need more Facebook — which means more pain, and more money for Facebook.”\u003c/p>\n\u003cfigure id=\"attachment_11891071\" class=\"wp-caption alignnone\" style=\"max-width: 2560px\">\u003cimg loading=\"lazy\" decoding=\"async\" class=\"wp-image-11891071 size-full\" src=\"https://ww2.kqed.org/app/uploads/sites/10/2021/10/GettyImages-1235711393-1-scaled.jpg\" alt=\"In the foreground is the back of Frances Haugen's out-of-focus head, and seated beyond her, and in focus, are Senators Marsha Blackburn and Richard Blumenthal on either side of her head.\" width=\"2560\" height=\"1644\" srcset=\"https://cdn.kqed.org/wp-content/uploads/sites/10/2021/10/GettyImages-1235711393-1-scaled.jpg 2560w, https://cdn.kqed.org/wp-content/uploads/sites/10/2021/10/GettyImages-1235711393-1-800x514.jpg 800w, https://cdn.kqed.org/wp-content/uploads/sites/10/2021/10/GettyImages-1235711393-1-1020x655.jpg 1020w, https://cdn.kqed.org/wp-content/uploads/sites/10/2021/10/GettyImages-1235711393-1-160x103.jpg 160w, https://cdn.kqed.org/wp-content/uploads/sites/10/2021/10/GettyImages-1235711393-1-1536x986.jpg 1536w, https://cdn.kqed.org/wp-content/uploads/sites/10/2021/10/GettyImages-1235711393-1-2048x1315.jpg 2048w, https://cdn.kqed.org/wp-content/uploads/sites/10/2021/10/GettyImages-1235711393-1-1920x1233.jpg 1920w\" sizes=\"auto, (max-width: 2560px) 100vw, 2560px\">\u003cfigcaption class=\"wp-caption-text\">Senators Marsha Blackburn (R-Tenn.), left, and Richard Blumenthal (D-Conn.) listen as former Facebook employee and whistleblower Frances Haugen testifies before the Senate Committee on Commerce, Science, and Transportation on Capitol Hill, Oct. 5, 2021, in Washington, D.C. \u003ccite>(Drew Angerer/Pool/ AFP/via Getty Images)\u003c/cite>\u003c/figcaption>\u003c/figure>\n\u003cp>Haugen said she believed Facebook didn’t set out to build a destructive platform. But “in the end, the buck stops with Mark,” she said referring to Zuckerberg, who controls more than 50% of Facebook’s voting shares. “There is no one currently holding Mark accountable but himself.”\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"content": "\u003cdiv class=\"post-body\">\u003cp>Haugen said she believed that Zuckerberg was familiar with some of the internal research showing concerns for potential negative impacts of Instagram.\u003c/p>\n\u003cp>The government needs to step in with stricter oversight of the company, Haugen said.\u003c/p>\n\u003cp>Like fellow tech giants Google, Amazon and Apple, Facebook has enjoyed minimal regulation. A number of bipartisan legislative proposals for the tech industry address data privacy, protection of young people and anti-competitive conduct. But getting new laws through Congress is a heavy slog. The Federal Trade Commission has adopted a stricter stance recently toward Facebook and other companies.\u003cbr>\n\u003c/p>\u003c/div>",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003cbr>\nThe subcommittee is examining Facebook’s use of information from its own researchers on Instagram that could indicate potential harm for some of its young users, especially girls, while it publicly downplayed the negative impacts\u003c/p>\n\u003cp>For some of the teens devoted to Instagram, the peer pressure generated by the visually focused platform has \u003ca href=\"https://www.kqed.org/arts/13897329/facebook-calls-links-to-depression-inconclusive-these-researchers-disagree\">led to mental health and body-image problems\u003c/a> and, in some cases, eating disorders and suicidal thoughts, the research leaked by Haugen showed.\u003c/p>\n\u003cp>One internal study cited 13.5% of teen girls saying Instagram makes thoughts of suicide worse and 17% of teen girls saying it makes eating disorders worse.\u003c/p>\n\u003cp>Because of the drive for user engagement, Haugen testified, “Facebook knows that they are leading young users to anorexia content … It’s just like cigarettes. Teenagers don’t have any self-regulation. We need to protect the kids.”\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"content": "\u003cdiv class=\"post-body\">\u003cp>Haugen has come forward with a wide-ranging condemnation of Facebook, buttressed with tens of thousands of pages of internal research documents she secretly copied before leaving her job in the company’s civic integrity unit. She also has filed complaints with federal authorities alleging that Facebook’s own research shows that it amplifies hate, misinformation and political unrest but the company hides what it knows.\u003c/p>\n\u003cp>“The company intentionally hides vital information from the public, from the U.S. government and from governments around the world,” Haugen said. “The documents I have provided to Congress prove that Facebook has repeatedly misled the public about what its own research reveals about the safety of children, the efficacy of its artificial intelligence systems and its role in spreading divisive and extreme messages.”\u003c/p>\n\u003cp>After recent reports in The Wall Street Journal based on documents she leaked to the newspaper raised a public outcry, Haugen revealed her identity in a CBS “60 Minutes” interview aired Sunday night.\u003c/p>\n\u003cp>As the public relations debacle over the Instagram research grew last week, Facebook put on hold its work on a kids’ version of Instagram, which the company says is meant mainly for tweens age 10 to 12.\u003c/p>\n\u003cp>Haugen said that Facebook prematurely turned off safeguards designed to thwart misinformation and incitement to violence after Joe Biden defeated Donald Trump last year, alleging that contributed to the deadly Jan. 6 assault on the U.S. Capitol.\u003c/p>\n\u003cp>After the November election, Facebook dissolved the civic integrity unit where Haugen had been working. That, she says, was the moment she realized “I don’t trust that they’re willing to actually invest what needs to be invested to keep Facebook from being dangerous.”\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"content": "\u003cdiv class=\"post-body\">\u003cp>Haugen says she told Facebook executives when they recruited her that she wanted to work in an area of the company that fights misinformation, because she had lost a friend to online conspiracy theories.\u003c/p>\n\u003cp>Facebook maintains that Haugen’s allegations are misleading and insists there is no evidence to support the premise that it is the primary cause of social polarization.\u003c/p>\n\u003cp>“Even with the most sophisticated technology, which I believe we deploy, even with the tens of thousands of people that we employ to try and maintain safety and integrity on our platform, we’re never going to be absolutely on top of this 100% of the time,” Nick Clegg, Facebook’s vice president of policy and global affairs, said Sunday on CNN’s “Reliable Sources.”\u003c/p>\n\u003cp>That’s because of the “instantaneous and spontaneous form of communication” on Facebook, Clegg said, adding, “I think we do more than any reasonable person can expect to.”\u003cbr>\n\u003c/p>\u003c/div>",
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"content": "\u003cp>Jocelyn Barajas is bent over a soup of crushed strawberries, holding a pipette.\u003c/p>\n\u003cp>She’s a rising high school freshman in Castro Valley taking summer classes this year. Her science class has started a new experiment, with their goal being to extract DNA from strawberries.\u003c/p>\n\u003cp>At first, Jocelyn was not thrilled with the idea of summer school. Going through her last year of middle school during a pandemic made her lose some faith in education. All her classes were online and she says teachers never gave kids a chance to share what they were going through.\u003c/p>\n\u003cp>“People probably went through depression and we didn’t know about it because we always had our camera offs,” she said. “We never had or could have spoken because there was so little time in all of our virtual classes.”\u003cbr>\n[ad fullwidth]\u003cbr>\nSeveral of Jocelyn’s classmates at Castro Valley High School feel the same way. Online learning made it really difficult for them to engage with what they were learning about.\u003c/p>\n\u003cp>“Every time I was on a Zoom call or a Google Meet call, I would just storm out and go to a different couch and just watch YouTube,” said Rico Lupian, another incoming freshman.\u003c/p>\n\u003cp>[pullquote align=\"right\" size=\"medium\" citation=\"Jocelyn Barajas, Rising High School Freshman\"]‘People probably went through depression and we didn’t know about it because we always had our cameras off.’[/pullquote]Months of isolation away from the classroom has helped bring down the emotional well-being among many students in the Castro Valley Unified School District, they and their teachers told KQED. School officials hope to start the healing process through art and increased access to mental health professionals.\u003c/p>\n\u003cp>To help students readjust to classroom life before the new school year, officials at CVUSD tripled summer school attendance. But experienced educators, like Jazz Monique Hudson, noticed something was off when the students started coming in.\u003c/p>\n\u003cp>She is an \u003ca href=\"http://www.jazzhudson.com/about/\">arts educator \u003c/a>who teaches writing and poetry as part of the \u003ca href=\"https://www.fsmei.org\">Freedom Soul Media Education Initiatives\u003c/a>, which uses a culturally relevant curriculum. “We cannot approach education the same way we did before,” she said. “Not at all.”\u003c/p>\n\u003cfigure id=\"attachment_11884099\" class=\"wp-caption alignnone\" style=\"max-width: 2560px\">\u003cimg loading=\"lazy\" decoding=\"async\" class=\"size-full wp-image-11884099\" src=\"https://ww2.kqed.org/app/uploads/sites/10/2021/08/IMG_5449-scaled.jpg\" alt=\"A head shot of Jazz Monique Hudson. She is wearing a dark-colored jacket and is smiling at the camera. Behind her is a school building.\" width=\"2560\" height=\"1920\" srcset=\"https://cdn.kqed.org/wp-content/uploads/sites/10/2021/08/IMG_5449-scaled.jpg 2560w, https://cdn.kqed.org/wp-content/uploads/sites/10/2021/08/IMG_5449-800x600.jpg 800w, https://cdn.kqed.org/wp-content/uploads/sites/10/2021/08/IMG_5449-1020x765.jpg 1020w, https://cdn.kqed.org/wp-content/uploads/sites/10/2021/08/IMG_5449-160x120.jpg 160w, https://cdn.kqed.org/wp-content/uploads/sites/10/2021/08/IMG_5449-1536x1152.jpg 1536w, https://cdn.kqed.org/wp-content/uploads/sites/10/2021/08/IMG_5449-2048x1536.jpg 2048w, https://cdn.kqed.org/wp-content/uploads/sites/10/2021/08/IMG_5449-1920x1440.jpg 1920w\" sizes=\"auto, (max-width: 2560px) 100vw, 2560px\">\u003cfigcaption class=\"wp-caption-text\">Jazz Monique Hudson is an arts educator and Oakland youth poet laureate who teaches writing and poetry in Castro Valley Unified School District. For her, working with kids in person again has been an opportunity to learn more about how they’ve been processing trauma and what she can do to support them. \u003ccite>(Julia McEvoy/KQED)\u003c/cite>\u003c/figcaption>\u003c/figure>\n\u003cp>“[We must process] things around anxiety and, like, learning how to be back in the classroom,” she explained. “Let alone use a pencil and paper, because it’s been all on a Chromebook.”\u003c/p>\n\u003cp>Hudson gave her students a writing assignment the first week: to write down who they are. When she noticed that a lot of them were struggling to get something down on paper, she stopped the whole lesson and asked them to share instead what they were feeling at the moment.\u003c/p>\n\u003cp>[pullquote align=\"right\" size=\"medium\" citation=\"Jazz Monique Hudson, Artist and Educator\"]‘The pandemic was a trauma and a harm and it should be treated as such.’[/pullquote]“A lot of the journal prompts were, ‘I’m feeling anxiety about being in a classroom. I don’t know how to talk to people. I don’t know how to make friends’,” she said.\u003c/p>\n\u003cp>In teaching, Hudson explains, resiliency among children can sometimes be understood as the process of a person learning how to restore themselves back to a feeling of wholeness after a difficult or traumatic event.\u003c/p>\n\u003cp>“But I’ve never seen a situation of a person moving into resiliency and going back to who they were before that trauma or before that harm,” she said. “The pandemic was a trauma and a harm and it should be treated as such.”\u003c/p>\n\u003cfigure id=\"attachment_11884098\" class=\"wp-caption alignnone\" style=\"max-width: 2560px\">\u003cimg loading=\"lazy\" decoding=\"async\" class=\"wp-image-11884098 size-full\" src=\"https://ww2.kqed.org/app/uploads/sites/10/2021/08/IMG_5387-scaled.jpg\" alt=\"A whiteboard with a big piece of paper attached to it. On the big piece of paper, there are several categories drawn with a marker. The large piece of paper is titled 'Mental Health,' and the categories are, 'I'm great!', 'I'm okay,' 'I'm meh,' 'I'm struggling,' and 'Please check-in.' There are many post-its in the first two categories.\" width=\"2560\" height=\"1920\" srcset=\"https://cdn.kqed.org/wp-content/uploads/sites/10/2021/08/IMG_5387-scaled.jpg 2560w, https://cdn.kqed.org/wp-content/uploads/sites/10/2021/08/IMG_5387-800x600.jpg 800w, https://cdn.kqed.org/wp-content/uploads/sites/10/2021/08/IMG_5387-1020x765.jpg 1020w, https://cdn.kqed.org/wp-content/uploads/sites/10/2021/08/IMG_5387-160x120.jpg 160w, https://cdn.kqed.org/wp-content/uploads/sites/10/2021/08/IMG_5387-1536x1152.jpg 1536w, https://cdn.kqed.org/wp-content/uploads/sites/10/2021/08/IMG_5387-2048x1536.jpg 2048w, https://cdn.kqed.org/wp-content/uploads/sites/10/2021/08/IMG_5387-1920x1440.jpg 1920w\" sizes=\"auto, (max-width: 2560px) 100vw, 2560px\">\u003cfigcaption class=\"wp-caption-text\">Daily activities, like sharing with the class how you’re feeling, are meant to help students stay connected to their emotions and articulate what’s going in their lives. Jazz Monique Hudson, educator at Castro Valley Unified, says that months of online learning and isolation have made it harder for students to communicate. “We cannot approach education the same way we did before,” she said. \u003ccite>(Julia McEvoy/KQED)\u003c/cite>\u003c/figcaption>\u003c/figure>\n\u003ch3>Fostering Mental Wellness\u003c/h3>\n\u003cp>As part of the summer school experience, the district enlisted a team of artists to teach writing courses over the summer, where students could talk about their emotions.\u003c/p>\n\u003cp>One of these artists is a 2016 Oakland Youth Poet Laureate, \u003ca href=\"https://www.youtube.com/watch?v=dLml8bvLnmY\">Azariah Cole-Shephard\u003c/a>. She’s had conversations with several of her students to learn how they’ve dealt with everything that’s happened during the pandemic. What’s struck her is how the past year has so deeply eroded their sense of self-worth.\u003c/p>\n\u003cp>[pullquote align=\"right\" size=\"medium\" citation=\"Azariah Cole-Shepard, Artist and Educator\"]‘Poetry is an important vehicle for trauma management and mental wellness because it teaches you how to cope with the things that are going on around you.’[/pullquote]Some of her students have complicated relationships with their parents or family members, and being in close quarters with them for over a year has affected their well-being.\u003c/p>\n\u003cp>Many openly hear, she said, “that they’re incapable of things.”\u003c/p>\n\u003cp>In Cole-Shephard’s classroom, students can write about what’s been going on in their lives, using poetry as a tool to understand a little more what they’re feeling.\u003c/p>\n\u003cp>“Poetry is an important vehicle for trauma management and mental wellness because it teaches you how to cope with the things that are going on around you, but then also serves as a vehicle for guidance in the healing process,” she said.\u003c/p>\n\u003cp>She hopes that in her class, students can understand that just because they’re going through a dark time in life, they don’t need to stay in it.\u003c/p>\n\u003cp>“Giving them the ability to do things like create images to go along with the poetry or create comic strips that incorporate a story,” she said, are activities that are resonating with the students.\u003c/p>\n\u003cp>KQED spoke with several students enrolled in the summer school program to understand what’s on their minds a few days before the fall semester starts on Aug. 10.\u003c/p>\n\u003cp>Jocelyn, the incoming high school freshman, said most of her family came down with COVID-19. Her brother is rarely home because he has to work.\u003c/p>\n\u003cp>“So I was pretty lonely, which is why I had to move in with my grandparents,” Jocelyn said.\u003c/p>\n\u003cp>Jocelyn’s grades also suffered while she struggled with learning from home. She said the quality of her educational experience dropped.\u003c/p>\n\u003cp>“We didn’t learn a lot,” Jocelyn said. “We got less than what we deserved.”\u003c/p>\n\u003cp>One of her classmates, Gracelynn Nichol, also had to move in with her grandparents after her mother lost her job. “It was rough. My mom still doesn’t have a job,” she said. “My mental health was so messed up during the whole pandemic.”\u003c/p>\n\u003cp>And for Rico Lupian, being at home all the time made it harder to process the hard news of COVID-19 infections in his family. “My mom’s sister got COVID. She’s cured now,” he said. “And then her whole family got COVID.”\u003c/p>\n\u003cfigure id=\"attachment_11884100\" class=\"wp-caption alignnone\" style=\"max-width: 2560px\">\u003cimg loading=\"lazy\" decoding=\"async\" class=\"wp-image-11884100 size-full\" src=\"https://ww2.kqed.org/app/uploads/sites/10/2021/08/IMG_5396-scaled.jpg\" alt=\"A teacher explains something to a student at the student's desk. The teacher has long, curly hair and is wearing a white shirt. The teacher reads and points to some papers. The student is sitting down at their desk and looks at what the teacher points at.\" width=\"2560\" height=\"1920\" srcset=\"https://cdn.kqed.org/wp-content/uploads/sites/10/2021/08/IMG_5396-scaled.jpg 2560w, https://cdn.kqed.org/wp-content/uploads/sites/10/2021/08/IMG_5396-800x600.jpg 800w, https://cdn.kqed.org/wp-content/uploads/sites/10/2021/08/IMG_5396-1020x765.jpg 1020w, https://cdn.kqed.org/wp-content/uploads/sites/10/2021/08/IMG_5396-160x120.jpg 160w, https://cdn.kqed.org/wp-content/uploads/sites/10/2021/08/IMG_5396-1536x1152.jpg 1536w, https://cdn.kqed.org/wp-content/uploads/sites/10/2021/08/IMG_5396-2048x1536.jpg 2048w, https://cdn.kqed.org/wp-content/uploads/sites/10/2021/08/IMG_5396-1920x1440.jpg 1920w\" sizes=\"auto, (max-width: 2560px) 100vw, 2560px\">\u003cfigcaption class=\"wp-caption-text\">A writing class at Castro Valley High’s summer school program. \u003ccite>(Julia McEvoy)\u003c/cite>\u003c/figcaption>\u003c/figure>\n\u003ch3>‘A Veil Has Been Lifted Off the Adults’ Eyes’\u003c/h3>\n\u003cp>While many students kept their computer cameras off during distance learning, others did not. In those cases, distance learning allowed teachers to see inside kids’ homes, giving them a real look — albeit through computer screens — at what some families and students were experiencing during the pandemic.\u003c/p>\n\u003cp>Marion Meadows, the district’s head of behavioral health, shared what some of the teachers noticed through their virtual classrooms.\u003c/p>\n\u003cp>“They could see depression,” she said. “They could see kids using drugs in the background, they could see their family life.”\u003c/p>\n\u003cp>Learning more about how students are experiencing the pandemic was a wake-up call for teachers, who in turn relayed what they saw to administrators.\u003c/p>\n\u003cp>“It’s like a veil has been lifted off the adults’ eyes,” Meadows said.\u003c/p>\n\u003cp>Besides preparing classroom discussions about mental health and trauma management, Meadows says district teachers spent the past year developing anti-racist lesson plans for every single grade. If teachers intend to connect with their students, she says, they’ve got to understand how the pandemic replicated racist systems already in place.\u003c/p>\n\u003cp>[aside label ='Related Coverage' tag='distance-learning']“Lack of access to health care, socioeconomic disparities, health disparities,” she explained. “The pandemic worsened it and then added an academic piece on it and an isolation piece on it.”\u003c/p>\n\u003cp>Thanks to the \u003ca href=\"https://oese.ed.gov/offices/education-stabilization-fund/elementary-secondary-school-emergency-relief-fund/\">Elementary and Secondary School Emergency Relief Fund\u003c/a>, part of the federal government’s CARES Act, the district has money to actually translate the teachers’ plans into action.\u003c/p>\n\u003cp>It spent some of those dollars to hire more social workers and restorative justice practitioners who could train teachers on how to create spaces where students feel safe talking about what’s bothering them. It even launched parent support circles to help families cope with stress.\u003c/p>\n\u003cp>For many students, going back to school itself is the start of healing. Seeing the inside of a classroom once again signaled that things are going back to normal. Rico thinks there is something to that.\u003c/p>\n\u003cp>“I finally get to see all my friends,” he said. “I get to make new friends and it just feels good just to be in school.”\u003cbr>\n[ad fullwidth]\u003c/p>\n\u003cp>[ad floatright]\u003c/p>\n",
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"content": "\u003cdiv class=\"post-body\">\u003cp>Months of isolation away from the classroom has helped bring down the emotional well-being among many students in the Castro Valley Unified School District, they and their teachers told KQED. School officials hope to start the healing process through art and increased access to mental health professionals.\u003c/p>\n\u003cp>To help students readjust to classroom life before the new school year, officials at CVUSD tripled summer school attendance. But experienced educators, like Jazz Monique Hudson, noticed something was off when the students started coming in.\u003c/p>\n\u003cp>She is an \u003ca href=\"http://www.jazzhudson.com/about/\">arts educator \u003c/a>who teaches writing and poetry as part of the \u003ca href=\"https://www.fsmei.org\">Freedom Soul Media Education Initiatives\u003c/a>, which uses a culturally relevant curriculum. “We cannot approach education the same way we did before,” she said. “Not at all.”\u003c/p>\n\u003cfigure id=\"attachment_11884099\" class=\"wp-caption alignnone\" style=\"max-width: 2560px\">\u003cimg loading=\"lazy\" decoding=\"async\" class=\"size-full wp-image-11884099\" src=\"https://ww2.kqed.org/app/uploads/sites/10/2021/08/IMG_5449-scaled.jpg\" alt=\"A head shot of Jazz Monique Hudson. She is wearing a dark-colored jacket and is smiling at the camera. Behind her is a school building.\" width=\"2560\" height=\"1920\" srcset=\"https://cdn.kqed.org/wp-content/uploads/sites/10/2021/08/IMG_5449-scaled.jpg 2560w, https://cdn.kqed.org/wp-content/uploads/sites/10/2021/08/IMG_5449-800x600.jpg 800w, https://cdn.kqed.org/wp-content/uploads/sites/10/2021/08/IMG_5449-1020x765.jpg 1020w, https://cdn.kqed.org/wp-content/uploads/sites/10/2021/08/IMG_5449-160x120.jpg 160w, https://cdn.kqed.org/wp-content/uploads/sites/10/2021/08/IMG_5449-1536x1152.jpg 1536w, https://cdn.kqed.org/wp-content/uploads/sites/10/2021/08/IMG_5449-2048x1536.jpg 2048w, https://cdn.kqed.org/wp-content/uploads/sites/10/2021/08/IMG_5449-1920x1440.jpg 1920w\" sizes=\"auto, (max-width: 2560px) 100vw, 2560px\">\u003cfigcaption class=\"wp-caption-text\">Jazz Monique Hudson is an arts educator and Oakland youth poet laureate who teaches writing and poetry in Castro Valley Unified School District. For her, working with kids in person again has been an opportunity to learn more about how they’ve been processing trauma and what she can do to support them. \u003ccite>(Julia McEvoy/KQED)\u003c/cite>\u003c/figcaption>\u003c/figure>\n\u003cp>“[We must process] things around anxiety and, like, learning how to be back in the classroom,” she explained. “Let alone use a pencil and paper, because it’s been all on a Chromebook.”\u003c/p>\n\u003cp>Hudson gave her students a writing assignment the first week: to write down who they are. When she noticed that a lot of them were struggling to get something down on paper, she stopped the whole lesson and asked them to share instead what they were feeling at the moment.\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"content": "‘The pandemic was a trauma and a harm and it should be treated as such.’",
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"content": "\u003cdiv class=\"post-body\">\u003cp>“A lot of the journal prompts were, ‘I’m feeling anxiety about being in a classroom. I don’t know how to talk to people. I don’t know how to make friends’,” she said.\u003c/p>\n\u003cp>In teaching, Hudson explains, resiliency among children can sometimes be understood as the process of a person learning how to restore themselves back to a feeling of wholeness after a difficult or traumatic event.\u003c/p>\n\u003cp>“But I’ve never seen a situation of a person moving into resiliency and going back to who they were before that trauma or before that harm,” she said. “The pandemic was a trauma and a harm and it should be treated as such.”\u003c/p>\n\u003cfigure id=\"attachment_11884098\" class=\"wp-caption alignnone\" style=\"max-width: 2560px\">\u003cimg loading=\"lazy\" decoding=\"async\" class=\"wp-image-11884098 size-full\" src=\"https://ww2.kqed.org/app/uploads/sites/10/2021/08/IMG_5387-scaled.jpg\" alt=\"A whiteboard with a big piece of paper attached to it. On the big piece of paper, there are several categories drawn with a marker. The large piece of paper is titled 'Mental Health,' and the categories are, 'I'm great!', 'I'm okay,' 'I'm meh,' 'I'm struggling,' and 'Please check-in.' There are many post-its in the first two categories.\" width=\"2560\" height=\"1920\" srcset=\"https://cdn.kqed.org/wp-content/uploads/sites/10/2021/08/IMG_5387-scaled.jpg 2560w, https://cdn.kqed.org/wp-content/uploads/sites/10/2021/08/IMG_5387-800x600.jpg 800w, https://cdn.kqed.org/wp-content/uploads/sites/10/2021/08/IMG_5387-1020x765.jpg 1020w, https://cdn.kqed.org/wp-content/uploads/sites/10/2021/08/IMG_5387-160x120.jpg 160w, https://cdn.kqed.org/wp-content/uploads/sites/10/2021/08/IMG_5387-1536x1152.jpg 1536w, https://cdn.kqed.org/wp-content/uploads/sites/10/2021/08/IMG_5387-2048x1536.jpg 2048w, https://cdn.kqed.org/wp-content/uploads/sites/10/2021/08/IMG_5387-1920x1440.jpg 1920w\" sizes=\"auto, (max-width: 2560px) 100vw, 2560px\">\u003cfigcaption class=\"wp-caption-text\">Daily activities, like sharing with the class how you’re feeling, are meant to help students stay connected to their emotions and articulate what’s going in their lives. Jazz Monique Hudson, educator at Castro Valley Unified, says that months of online learning and isolation have made it harder for students to communicate. “We cannot approach education the same way we did before,” she said. \u003ccite>(Julia McEvoy/KQED)\u003c/cite>\u003c/figcaption>\u003c/figure>\n\u003ch3>Fostering Mental Wellness\u003c/h3>\n\u003cp>As part of the summer school experience, the district enlisted a team of artists to teach writing courses over the summer, where students could talk about their emotions.\u003c/p>\n\u003cp>One of these artists is a 2016 Oakland Youth Poet Laureate, \u003ca href=\"https://www.youtube.com/watch?v=dLml8bvLnmY\">Azariah Cole-Shephard\u003c/a>. She’s had conversations with several of her students to learn how they’ve dealt with everything that’s happened during the pandemic. What’s struck her is how the past year has so deeply eroded their sense of self-worth.\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"content": "\u003cdiv class=\"post-body\">\u003cp>Some of her students have complicated relationships with their parents or family members, and being in close quarters with them for over a year has affected their well-being.\u003c/p>\n\u003cp>Many openly hear, she said, “that they’re incapable of things.”\u003c/p>\n\u003cp>In Cole-Shephard’s classroom, students can write about what’s been going on in their lives, using poetry as a tool to understand a little more what they’re feeling.\u003c/p>\n\u003cp>“Poetry is an important vehicle for trauma management and mental wellness because it teaches you how to cope with the things that are going on around you, but then also serves as a vehicle for guidance in the healing process,” she said.\u003c/p>\n\u003cp>She hopes that in her class, students can understand that just because they’re going through a dark time in life, they don’t need to stay in it.\u003c/p>\n\u003cp>“Giving them the ability to do things like create images to go along with the poetry or create comic strips that incorporate a story,” she said, are activities that are resonating with the students.\u003c/p>\n\u003cp>KQED spoke with several students enrolled in the summer school program to understand what’s on their minds a few days before the fall semester starts on Aug. 10.\u003c/p>\n\u003cp>Jocelyn, the incoming high school freshman, said most of her family came down with COVID-19. Her brother is rarely home because he has to work.\u003c/p>\n\u003cp>“So I was pretty lonely, which is why I had to move in with my grandparents,” Jocelyn said.\u003c/p>\n\u003cp>Jocelyn’s grades also suffered while she struggled with learning from home. She said the quality of her educational experience dropped.\u003c/p>\n\u003cp>“We didn’t learn a lot,” Jocelyn said. “We got less than what we deserved.”\u003c/p>\n\u003cp>One of her classmates, Gracelynn Nichol, also had to move in with her grandparents after her mother lost her job. “It was rough. My mom still doesn’t have a job,” she said. “My mental health was so messed up during the whole pandemic.”\u003c/p>\n\u003cp>And for Rico Lupian, being at home all the time made it harder to process the hard news of COVID-19 infections in his family. “My mom’s sister got COVID. She’s cured now,” he said. “And then her whole family got COVID.”\u003c/p>\n\u003cfigure id=\"attachment_11884100\" class=\"wp-caption alignnone\" style=\"max-width: 2560px\">\u003cimg loading=\"lazy\" decoding=\"async\" class=\"wp-image-11884100 size-full\" src=\"https://ww2.kqed.org/app/uploads/sites/10/2021/08/IMG_5396-scaled.jpg\" alt=\"A teacher explains something to a student at the student's desk. The teacher has long, curly hair and is wearing a white shirt. The teacher reads and points to some papers. The student is sitting down at their desk and looks at what the teacher points at.\" width=\"2560\" height=\"1920\" srcset=\"https://cdn.kqed.org/wp-content/uploads/sites/10/2021/08/IMG_5396-scaled.jpg 2560w, https://cdn.kqed.org/wp-content/uploads/sites/10/2021/08/IMG_5396-800x600.jpg 800w, https://cdn.kqed.org/wp-content/uploads/sites/10/2021/08/IMG_5396-1020x765.jpg 1020w, https://cdn.kqed.org/wp-content/uploads/sites/10/2021/08/IMG_5396-160x120.jpg 160w, https://cdn.kqed.org/wp-content/uploads/sites/10/2021/08/IMG_5396-1536x1152.jpg 1536w, https://cdn.kqed.org/wp-content/uploads/sites/10/2021/08/IMG_5396-2048x1536.jpg 2048w, https://cdn.kqed.org/wp-content/uploads/sites/10/2021/08/IMG_5396-1920x1440.jpg 1920w\" sizes=\"auto, (max-width: 2560px) 100vw, 2560px\">\u003cfigcaption class=\"wp-caption-text\">A writing class at Castro Valley High’s summer school program. \u003ccite>(Julia McEvoy)\u003c/cite>\u003c/figcaption>\u003c/figure>\n\u003ch3>‘A Veil Has Been Lifted Off the Adults’ Eyes’\u003c/h3>\n\u003cp>While many students kept their computer cameras off during distance learning, others did not. In those cases, distance learning allowed teachers to see inside kids’ homes, giving them a real look — albeit through computer screens — at what some families and students were experiencing during the pandemic.\u003c/p>\n\u003cp>Marion Meadows, the district’s head of behavioral health, shared what some of the teachers noticed through their virtual classrooms.\u003c/p>\n\u003cp>“They could see depression,” she said. “They could see kids using drugs in the background, they could see their family life.”\u003c/p>\n\u003cp>Learning more about how students are experiencing the pandemic was a wake-up call for teachers, who in turn relayed what they saw to administrators.\u003c/p>\n\u003cp>“It’s like a veil has been lifted off the adults’ eyes,” Meadows said.\u003c/p>\n\u003cp>Besides preparing classroom discussions about mental health and trauma management, Meadows says district teachers spent the past year developing anti-racist lesson plans for every single grade. If teachers intend to connect with their students, she says, they’ve got to understand how the pandemic replicated racist systems already in place.\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"content": "\u003cdiv class=\"post-body\">\u003cp>“Lack of access to health care, socioeconomic disparities, health disparities,” she explained. “The pandemic worsened it and then added an academic piece on it and an isolation piece on it.”\u003c/p>\n\u003cp>Thanks to the \u003ca href=\"https://oese.ed.gov/offices/education-stabilization-fund/elementary-secondary-school-emergency-relief-fund/\">Elementary and Secondary School Emergency Relief Fund\u003c/a>, part of the federal government’s CARES Act, the district has money to actually translate the teachers’ plans into action.\u003c/p>\n\u003cp>It spent some of those dollars to hire more social workers and restorative justice practitioners who could train teachers on how to create spaces where students feel safe talking about what’s bothering them. It even launched parent support circles to help families cope with stress.\u003c/p>\n\u003cp>For many students, going back to school itself is the start of healing. Seeing the inside of a classroom once again signaled that things are going back to normal. Rico thinks there is something to that.\u003c/p>\n\u003cp>“I finally get to see all my friends,” he said. “I get to make new friends and it just feels good just to be in school.”\u003cbr>\n\u003c/p>\u003c/div>",
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"content": "\u003cp>The California Legislature is poised to allocate $20 million to the Santa Clara County Valley Transportation Authority to support employee needs and facility repairs following a deadly mass shooting at one of its facilities last month.\u003c/p>\n\u003cp>The last-minute addendum to the state budget, spearheaded by state Sen. Dave Cortese and Assemblymember Ash Kalra, both Democrats from San Jose, is split into two bills — one expected to go before both the Assembly and Senate on Monday — with half the funding earmarked for \"worker support and facility improvements\" and the other half for \"mental health services, worker training, and retraining.\"[pullquote align=\"right\" size=\"medium\" citation=\"John Courtney, president of Amalgamated Transit Union Local 265\"]'These families are very scared and afraid. We absolutely have to let them know that there was a process in place to take care of all the family members and all the grieving families.'[/pullquote]\"The long-term mental health impacts of experiencing something like that is truly unknown to most of us, but something that professional assistants and resources can help deal with,\" Cortese said.\u003c/p>\n\u003cp>Local leaders said the funding is essential for the VTA to jump-start its recovery process, resume light rail service and meet the most pressing needs of employees and their families after such a traumatic event.\u003c/p>\n\u003cp>\"These funds for worker mental health support, relocation and retraining, and facility upgrades, are imperative to addressing the workforce's health and well-being, rebuilding regional transit, and preventing future workplace violence,\" Kalra said in a statement.\u003c/p>\n\u003cp>Early on May 26, a VTA employee \u003ca href=\"https://www.kqed.org/news/11875404/official-multiple-people-killed-in-shooting-at-san-jose-vta-railyard\">shot and killed\u003c/a> nine of his co-workers at a light rail facility in San Jose, before turning the gun on himself. Most of the victims were light rail drivers or engineers. Nearly 100 employees witnessed the massacre.\u003c/p>\n\u003cp>\"A hundred people witnessed it directly or indirectly, 100 people were impacted and had to evacuate the site, hide, run out on rooftops and then, really, be put in a position where they're grieving,\" Cortese said. \"They've lost their team, and they aren't really clear as to what safety measures have been put in place before they come back or what kind of assistance there is for them.\"\u003c/p>\n\u003cp>The funding would be used in part to provide grief counseling to employees who lost friends and co-workers, and to support staff who may want to be retrained and relocated.\u003c/p>\n\u003cp>\"We lost members of our family — essential union employees that provided vital public transit service every day of this pandemic,\" said John Courtney, president of Amalgamated Transit Union Local 265. \"This funding will go a long way as we work to build back our community.\"\u003c/p>\n\u003cp>[ad fullwidth]VTA light rail service was suspended indefinitely following the shooting.\u003c/p>\n\u003cp>Courtney said the mental health of VTA employees is critical to restarting the rail service.\u003c/p>\n\u003cp>\"These families are very scared and afraid,\" Courtney said. \"We absolutely have to let them know that there was a process in place to take care of all the family members and all the grieving families.\"\u003c/p>\n\u003cp>He said the state funding would also be essential to repair equipment and computers damaged during the shooting.\u003c/p>\n\u003cp>The shooting occurred at the Guadalupe Light Rail Yard, which Courtney described as the \"nerve center\" of all VTA operations — the transit agency's main facility for light rail vehicle storage and dispatch, maintenance, technical training and other services.\u003c/p>\n\u003cp>[aside label=\"related coverage\" tag=\"vta-shooting\"]Operators at the facility also manage daily communications between all of VTA's service vehicles, including both light rail trains and its fleet of approximately 400 active transit buses.\u003c/p>\n\u003cp>Some local leaders and VTA officials have also hinted at the possibility of demolishing the facility, which has been in operation since 1987, and sparked safety concerns even before the incident. Nearly 380 employees regularly worked there prior to the shooting.\u003c/p>\n\u003cp>Cortese said he recently got a phone call from the son of one of the victims, asking if local and state officials have done anything yet in response to the tragedy.\u003c/p>\n\u003cp>\"We heard politicians say we're going to do whatever we can to help. You know, we're going to do everything we can to make sure this doesn't happen again,\" he said. \"We just want to make sure after a few weeks of quiet, you know, near silence about what the state's response might be, that there actually is some help coming. And, you know, hopefully that'll lift peoples spirits a little bit.\"\u003c/p>\n\u003cp>\u003cem>This post includes reporting from KQED's Arooba Kazmi and Julie Chang, and Bay City News.\u003c/em>\u003c/p>\n\u003cp>\u003c/p>\n",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\"The long-term mental health impacts of experiencing something like that is truly unknown to most of us, but something that professional assistants and resources can help deal with,\" Cortese said.\u003c/p>\n\u003cp>Local leaders said the funding is essential for the VTA to jump-start its recovery process, resume light rail service and meet the most pressing needs of employees and their families after such a traumatic event.\u003c/p>\n\u003cp>\"These funds for worker mental health support, relocation and retraining, and facility upgrades, are imperative to addressing the workforce's health and well-being, rebuilding regional transit, and preventing future workplace violence,\" Kalra said in a statement.\u003c/p>\n\u003cp>Early on May 26, a VTA employee \u003ca href=\"https://www.kqed.org/news/11875404/official-multiple-people-killed-in-shooting-at-san-jose-vta-railyard\">shot and killed\u003c/a> nine of his co-workers at a light rail facility in San Jose, before turning the gun on himself. Most of the victims were light rail drivers or engineers. Nearly 100 employees witnessed the massacre.\u003c/p>\n\u003cp>\"A hundred people witnessed it directly or indirectly, 100 people were impacted and had to evacuate the site, hide, run out on rooftops and then, really, be put in a position where they're grieving,\" Cortese said. \"They've lost their team, and they aren't really clear as to what safety measures have been put in place before they come back or what kind of assistance there is for them.\"\u003c/p>\n\u003cp>The funding would be used in part to provide grief counseling to employees who lost friends and co-workers, and to support staff who may want to be retrained and relocated.\u003c/p>\n\u003cp>\"We lost members of our family — essential union employees that provided vital public transit service every day of this pandemic,\" said John Courtney, president of Amalgamated Transit Union Local 265. \"This funding will go a long way as we work to build back our community.\"\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"content": "\u003cdiv class=\"post-body\">\u003cp>VTA light rail service was suspended indefinitely following the shooting.\u003c/p>\n\u003cp>Courtney said the mental health of VTA employees is critical to restarting the rail service.\u003c/p>\n\u003cp>\"These families are very scared and afraid,\" Courtney said. \"We absolutely have to let them know that there was a process in place to take care of all the family members and all the grieving families.\"\u003c/p>\n\u003cp>He said the state funding would also be essential to repair equipment and computers damaged during the shooting.\u003c/p>\n\u003cp>The shooting occurred at the Guadalupe Light Rail Yard, which Courtney described as the \"nerve center\" of all VTA operations — the transit agency's main facility for light rail vehicle storage and dispatch, maintenance, technical training and other services.\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"content": "\u003cdiv class=\"post-body\">\u003cp>Operators at the facility also manage daily communications between all of VTA's service vehicles, including both light rail trains and its fleet of approximately 400 active transit buses.\u003c/p>\n\u003cp>Some local leaders and VTA officials have also hinted at the possibility of demolishing the facility, which has been in operation since 1987, and sparked safety concerns even before the incident. Nearly 380 employees regularly worked there prior to the shooting.\u003c/p>\n\u003cp>Cortese said he recently got a phone call from the son of one of the victims, asking if local and state officials have done anything yet in response to the tragedy.\u003c/p>\n\u003cp>\"We heard politicians say we're going to do whatever we can to help. You know, we're going to do everything we can to make sure this doesn't happen again,\" he said. \"We just want to make sure after a few weeks of quiet, you know, near silence about what the state's response might be, that there actually is some help coming. And, you know, hopefully that'll lift peoples spirits a little bit.\"\u003c/p>\n\u003cp>\u003cem>This post includes reporting from KQED's Arooba Kazmi and Julie Chang, and Bay City News.\u003c/em>\u003c/p>\n\u003cp>\u003c/p>\n\u003c/div>\u003c/p>",
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"slug": "theres-only-1-drug-for-postpartum-depression-why-does-kaiser-permanente-make-it-so-hard-to-get",
"title": "There's Only 1 Drug for Postpartum Depression. Why Does Kaiser Permanente Make It So Hard to Get?",
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"headTitle": "There’s Only 1 Drug for Postpartum Depression. Why Does Kaiser Permanente Make It So Hard to Get? | KQED",
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"content": "\u003cp>[dropcap]W[/dropcap]hen Miriam McDonald decided she wanted to have another baby at age 44, her doctor told her she had a better chance of winning the lottery. So when she got pregnant, she and her husband were thrilled. But within three days of giving birth to their son, everything turned.\u003c/p>\n\u003cp>“I was thinking, ‘Oh my God, what did I do?’ I just brought this baby into this world and I can barely take care of myself right now,” she said. “I feel exhausted. I haven’t slept in three days. I haven’t really eaten in three days.”\u003c/p>\n\u003cp>As the weeks went by, her depression got worse. She felt sad, but also indifferent. She didn’t want to hold her baby, she didn’t want to change him. She said she felt no connection with him at all.\u003c/p>\n\u003cp>This confused her – she never felt anything like this after her first two kids – and she worried her mood might hurt her son. \u003ca href=\"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4113321/#R2\">Untreated postpartum depression can affect babies’ cognitive and social development\u003c/a>. For the mother, it can be life or death. \u003ca href=\"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4113321/\">Suicide accounts for 20% of maternal deaths\u003c/a>.\u003c/p>\n\u003cp>“Every day, I was crying. Every day, I felt like I just wanted to die. Every day, I thought about ending my life,” said McDonald, who is Latina and works at UC Davis as an IT professional.\u003c/p>\n\u003cp>[ad fullwidth]\u003c/p>\n\u003cp>\u003cspan style=\"font-weight: 400\">She went to Kaiser Permanente, her health care provider, for help. She said they put her on a merry-go-round of medication trial and error. The first drug her doctor prescribed made her anxious. The second drug gave her horrific nightmares. A third drug gave her auditory and visual hallucinations that took seven weeks to go away. \u003c/span>\u003c/p>\n\u003cp>\u003cspan style=\"font-weight: 400\">Then, her doctor retired. And when McDonald complained to her new doctor that she was still depressed four months after giving birth, the physician suggested more medications.\u003c/span>\u003c/p>\n\u003cp>“I was desperate,” McDonald said. “I was like, ‘I’m trying to help myself, but things are just getting worse.’ So what am I left with?”\u003c/p>\n\u003cp>\u003cspan style=\"font-weight: 400\">She started doing her own research and learned about a new treatment called brexanolone. It’s \u003ca href=\"https://www.fda.gov/news-events/press-announcements/fda-approves-first-treatment-post-partum-depression\">the \u003c/a>\u003c/span>\u003cspan style=\"font-weight: 400\">first and only drug\u003c/span>\u003cspan style=\"font-weight: 400\"> approved by the U.S. Food and Drug Administration to treat postpartum depression, which \u003ca href=\"https://www.americashealthrankings.org/explore/health-of-women-and-children/measure/postpartum_depression/state/CA\">affects \u003c/a>\u003c/span>\u003cspan style=\"font-weight: 400\">1 out of 8 new mothers\u003c/span>\u003cspan style=\"font-weight: 400\"> in California. Instead of targeting the serotonin system in the brain, like most antidepressants, brexanolone works by rebalancing the stress hormones that can get out of kilter after having a baby. It’s delivered through an IV infusion over 2 1/2 days in the hospital. \u003c/span>\u003c/p>\n\u003cp>In \u003cspan style=\"font-weight: 400\">clinical trials\u003c/span>\u003cspan style=\"font-weight: 400\">, \u003ca href=\"https://www.fda.gov/media/121348/download\">75% of women who got brexanolone started to feel better\u003c/a> immediately after the three-day treatment. Half the women went into complete remission.\u003c/span>\u003c/p>\n\u003cp>\u003cspan style=\"font-weight: 400\">McDonald wanted to try it. \u003c/span>\u003c/p>\n\u003cfigure id=\"attachment_11879318\" class=\"wp-caption aligncenter\" style=\"max-width: 2560px\">\u003cimg loading=\"lazy\" decoding=\"async\" class=\"size-full wp-image-11879318\" src=\"https://ww2.kqed.org/app/uploads/sites/10/2021/06/trying-to-smile-1-scaled.jpg\" alt=\"\" width=\"2560\" height=\"1920\" srcset=\"https://cdn.kqed.org/wp-content/uploads/sites/10/2021/06/trying-to-smile-1-scaled.jpg 2560w, https://cdn.kqed.org/wp-content/uploads/sites/10/2021/06/trying-to-smile-1-800x600.jpg 800w, https://cdn.kqed.org/wp-content/uploads/sites/10/2021/06/trying-to-smile-1-1020x765.jpg 1020w, https://cdn.kqed.org/wp-content/uploads/sites/10/2021/06/trying-to-smile-1-160x120.jpg 160w, https://cdn.kqed.org/wp-content/uploads/sites/10/2021/06/trying-to-smile-1-1536x1152.jpg 1536w, https://cdn.kqed.org/wp-content/uploads/sites/10/2021/06/trying-to-smile-1-2048x1536.jpg 2048w, https://cdn.kqed.org/wp-content/uploads/sites/10/2021/06/trying-to-smile-1-1920x1440.jpg 1920w\" sizes=\"auto, (max-width: 2560px) 100vw, 2560px\">\u003cfigcaption class=\"wp-caption-text\">For the first year of her son’s life, Miriam McDonald says all her smiles were fake or strained. \u003ccite>(Courtesy Miriam McDonald)\u003c/cite>\u003c/figcaption>\u003c/figure>\n\u003cp>\u003cspan style=\"font-weight: 400\">“People walk out of the hospital, wanting to be with their child, wanting to return home,” said \u003c/span>\u003ca href=\"https://www.med.unc.edu/psych/directory/riah-patterson/\">\u003cspan style=\"font-weight: 400\">Dr. Riah Patterson\u003c/span>\u003c/a>\u003cspan style=\"font-weight: 400\">, who has been treating women with brexanolone at the University of North Carolina at Chapel Hill since it became available in summer 2019. “There is a hopefulness, a brightness. You can really see that transformation in the hospital room over those 60 hours. It’s pretty miraculous.”\u003c/span>\u003c/p>\n\u003cp>\u003cspan style=\"font-weight: 400\">When McDonald asked her doctor for brexanolone, she said no. \u003c/span>\u003c/p>\n\u003cp>In an email, she said the existing studies were “not very impressive.” She told McDonald that she didn’t meet Kaiser’s criteria for the drug: She would have had to try and fail four medications and electroconvulsive therapy before she could try brexanolone. And all this had to happen within six months of having her baby, or she couldn’t try it at all.\u003c/p>\n\u003cp>How could anyone qualify, McDonald wondered?\u003c/p>\n\u003cp>\u003cspan style=\"font-weight: 400\">“This is crazy. By the time you even try one drug, that’s like four weeks out,” she said. “Another drug is four weeks out, another drug is four weeks out. There’s just no way.”\u003c/span>\u003c/p>\n\u003cp>[pullquote size=\"medium\" align=\"right\" citation=\"State Sen. Scott Wiener, D-San Francisco\"]‘If Kaiser is making it effectively impossible to get a particular, important mental health treatment, that could definitely be a violation of our parity law.’[/pullquote]\u003cspan style=\"font-weight: 400\">Kaiser’s guidance is an outlier. KQED analyzed guidelines from a dozen health plans operating in California. Three of them require women to fail one medication before trying brexanolone. One plan – the state’s Medi-Cal program for low-income women – requires two fails. But Kaiser is the only system KQED found that recommends women first fail four drugs.\u003c/span>\u003c/p>\n\u003cp>\u003cspan style=\"font-weight: 400\">“That’s absurd,” said UNC’s Patterson, one of several experts in postpartum depression who, in turn, called Kaiser’s guidance “ridiculous,” “harsh,” “abusive” and “insane.”\u003c/span>\u003c/p>\n\u003cp>\u003cspan style=\"font-weight: 400\">It may also be illegal. \u003c/span>\u003c/p>\n\u003cp>\u003cspan style=\"font-weight: 400\">Under a \u003c/span>\u003ca href=\"https://leginfo.legislature.ca.gov/faces/billTextClient.xhtml?bill_id=201920200SB855\">\u003cspan style=\"font-weight: 400\">new state law that took effect in January\u003c/span>\u003c/a>\u003cspan style=\"font-weight: 400\"> , health plans must conform to “generally accepted standards of care,” including nonprofit guidelines, scientific literature and expert consensus, when making decisions about mental health treatment.\u003c/span>\u003c/p>\n\u003cp>\u003cspan style=\"font-weight: 400\">“If Kaiser is making it effectively impossible to get a particular, important mental health treatment, that could definitely be a violation of our parity law,” said state Sen. Scott Wiener, D-San Francisco, the bill’s author. \u003c/span>\u003c/p>\n\u003cp>\u003cspan style=\"font-weight: 400\">Kaiser says it always follows the law. It says its integrated structure makes it different from traditional insurers. At Kaiser, a patient’s doctor determines whether a medication is necessary, not the health plan, and the criteria doctors use are recommendations, not requirements or prerequisites that patients need to “exhaust,” said Dr. Maria Koshy, Kaiser’s chair of psychiatry for Northern California. \u003c/span>\u003c/p>\n\u003cp>\u003cspan style=\"font-weight: 400\">“At the end of the day, this is an individual clinical decision by both the provider – the physician – and the patient,” she said.\u003c/span>\u003c/p>\n\u003cp>\u003cspan style=\"font-weight: 400\">But former Kaiser clinicians and legislative experts familiar with Kaiser’s model say the culture around these recommendations is to follow them. Doctors get questioned or can face consequences if they don’t, said Wiener.\u003c/span>\u003c/p>\n\u003ch3>‘It Saved My Life’\u003c/h3>\n\u003cp>\u003cspan style=\"font-weight: 400\">McDonald’s physician followed the criteria as if they were prerequisites when she declined to prescribe brexanolone. Kaiser’s grievance department sent a letter to another woman, Yesenia Muñoz, denying brexanolone because she had not failed enough medications.\u003c/span>\u003c/p>\n\u003cp>\u003cspan style=\"font-weight: 400\">“When I talked to the caseworker at Kaiser that had denied the medication, he said that Zulresso was very expensive,” said Muñoz, referring to brexanolone’s brand name.\u003c/span>\u003c/p>\n\u003cp>\u003cspan style=\"font-weight: 400\">Brexanolone treatment costs $34,000 for the medication, plus the cost of the three-day hospital stay, which can tack on another $30,000, at least. Kaiser is not yet certified to administer the treatment in-house, so it must pay outside hospitals to provide it. It says it has plans to eventually open three of its own certified centers.\u003c/span>\u003c/p>\n\u003cp>\u003cspan style=\"font-weight: 400\">Muñoz was devastated by the denial. She was overwhelmed by postpartum depression and anxiety shortly after her daughter was born and, as a Latina, she said she was hesitant to seek help at first. When she did, none of the medications or therapies Kaiser offered her worked. She still felt suicidal.\u003c/span>\u003c/p>\n\u003cp>\u003cspan style=\"font-weight: 400\">“I could get out the door sometimes and take the stroller and go walk, and my mind kept on saying, ‘If you just step in front of the car, it’s all going to go away,’ ” she remembers.\u003c/span>\u003c/p>\n\u003cp>\u003cspan style=\"font-weight: 400\">Muñoz got help from family and co-workers to appeal Kaiser’s decision to the state, and after reviewing her medical records, regulators ordered Kaiser to pay for the brexanolone treatment.\u003c/span>\u003c/p>\n\u003cp>\u003cspan style=\"font-weight: 400\">Muñoz went to UC Davis Medical Center to get it, and she started feeling better within the first day.\u003c/span>\u003c/p>\n\u003cfigure id=\"attachment_11879428\" class=\"wp-caption aligncenter\" style=\"max-width: 1920px\">\u003cimg loading=\"lazy\" decoding=\"async\" class=\"size-full wp-image-11879428\" src=\"https://ww2.kqed.org/app/uploads/sites/10/2021/06/MunozAndBaby.jpg\" alt=\"Yesenia smiling holding baby\" width=\"1920\" height=\"1760\" srcset=\"https://cdn.kqed.org/wp-content/uploads/sites/10/2021/06/MunozAndBaby.jpg 1920w, https://cdn.kqed.org/wp-content/uploads/sites/10/2021/06/MunozAndBaby-800x733.jpg 800w, https://cdn.kqed.org/wp-content/uploads/sites/10/2021/06/MunozAndBaby-1020x935.jpg 1020w, https://cdn.kqed.org/wp-content/uploads/sites/10/2021/06/MunozAndBaby-160x147.jpg 160w, https://cdn.kqed.org/wp-content/uploads/sites/10/2021/06/MunozAndBaby-1536x1408.jpg 1536w\" sizes=\"auto, (max-width: 1920px) 100vw, 1920px\">\u003cfigcaption class=\"wp-caption-text\">After Yesenia Muñoz received brexanolone to treat her postpartum depression, she felt blessed, connected with her daughter and ‘happy enough to want to live.’ \u003ccite>(Courtesy Yesenia Munoz)\u003c/cite>\u003c/figcaption>\u003c/figure>\n\u003cp>\u003cspan style=\"font-weight: 400\">“The nurse came in and she said something funny and I laughed,” Muñoz said. “It was the first time I had laughed in so long.”\u003c/span>\u003c/p>\n\u003cp>\u003cspan style=\"font-weight: 400\">She started looking through photos and videos of her daughter on her phone and she says it was like she was experiencing those moments for the first time. She started making plans for the future. \u003c/span>\u003c/p>\n\u003cp>\u003cspan style=\"font-weight: 400\">“It was like a switch flicked and it made me happy enough to want to live,” she said. “It saved my life.”\u003c/span>\u003c/p>\n\u003ch3>‘There Is No Place Where We Say Kaiser Is Exempt’\u003c/h3>\n\u003cp>\u003cspan style=\"font-weight: 400\">In 2008, Congress passed a landmark federal law aimed at correcting imbalances in how insurers covered mental health treatments compared to physical health, later reinforced by the Affordable Care Act in 2010. \u003c/span>\u003cspan style=\"font-weight: 400\">But \u003c/span>\u003ca href=\"https://www.kqed.org/stateofhealth/series/state-of-mind\">\u003cspan style=\"font-weight: 400\">insurers found loopholes\u003c/span>\u003c/a>\u003cspan style=\"font-weight: 400\">, creating overly restrictive or self-serving criteria that made it easy to deny services, and as a result, save money.\u003c/span>\u003c/p>\n\u003cp>\u003cspan style=\"font-weight: 400\">California’s new law, \u003c/span>\u003ca href=\"https://leginfo.legislature.ca.gov/faces/billTextClient.xhtml?bill_id=201920200SB855\">\u003cspan style=\"font-weight: 400\">Senate Bill 855\u003c/span>\u003c/a>\u003cspan style=\"font-weight: 400\">, is aimed at tightening those loopholes, and has been \u003c/span>\u003ca href=\"https://www.statnews.com/2020/10/14/new-california-law-should-serve-as-a-national-model-for-mental-health-care-reform/\">\u003cspan style=\"font-weight: 400\">hailed by advocates as a national model\u003c/span>\u003c/a>\u003cspan style=\"font-weight: 400\"> for mental health reform. It requires health plans to use clinically based, expert-recognized criteria and guidelines in making medical decisions, with the goal of limiting arbitrary or cost-driven denials. \u003c/span>\u003c/p>\n\u003cp>\u003cspan style=\"font-weight: 400\">Kaiser raises questions about how precisely the new law applies to them, given its unique integrated structure, where doctors make determinations about what is medically necessary rather than the health plan side of the organization. Kaiser’s Dr. Koshy said SB 855’s requirement to comply with generally accepted standards of care “does not apply” to its brexanolone recommendations because they were developed and are used by doctors, not plan administrators. (When KQED asked Kaiser to provide the brexanolone policy its health plan uses, it said it didn’t have one.)\u003c/span>\u003c/p>\n\u003cp>\u003cspan style=\"font-weight: 400\">“We 100% intended this law to apply to the care people get at Kaiser,” said Julie Snyder, government affairs director at \u003ca href=\"https://steinberginstitute.org/\" target=\"_blank\" rel=\"noopener noreferrer\">the Steinberg Institute\u003c/a>, which co-sponsored the law. “There is no place where we say Kaiser is exempt.” \u003c/span>\u003c/p>\n\u003cp>[aside postID=stateofhealth_185796,stateofhealth_193386,stateofhealth_191734 label='Related Coverage']\u003cspan style=\"font-weight: 400\">Doctors at Kaiser have historically been “gatekeepers” for services in the system, said \u003ca href=\"https://psych-appeal.com/meiram-bendat-attorney-founder/\" target=\"_blank\" rel=\"noopener noreferrer\">Meiram Bendat\u003c/a>, an attorney and licensed psychotherapist who also advised on the law. It doesn’t matter if practice recommendations for brexanolone were written by doctors or administrators, or whether the recommendations are mandatory or optional – Bendat says they must be compliant with the law. \u003c/span>\u003c/p>\n\u003cp>\u003cspan style=\"font-weight: 400\">“If it’s inconsistent with generally accepted standards of care, then it has no place in California,” he said.\u003c/span>\u003c/p>\n\u003cp>\u003cspan style=\"font-weight: 400\">Some of Kaiser’s recommended criteria for brexanolone are aligned with generally accepted standards of care; for example, reserving the drug for women who are six months or less postpartum, which was a criterion used in the \u003c/span>\u003ca href=\"https://www.fda.gov/media/121348/download\">\u003cspan style=\"font-weight: 400\">clinical trials the FDA relied on when it approved the drug\u003c/span>\u003c/a>\u003cspan style=\"font-weight: 400\">. \u003c/span>\u003c/p>\n\u003cp>\u003cspan style=\"font-weight: 400\">But the recommendation to try four or five alternative treatments before considering brexanolone conflicts with the judgment of half a dozen women’s health experts interviewed for this story. They say there just isn’t enough time in the postpartum period. And there’s too much at stake. \u003c/span>\u003c/p>\n\u003cp>\u003cspan style=\"font-weight: 400\">Not only are babies at risk of developmental and emotional problems if their mother is depressed, \u003c/span>\u003ca href=\"https://neurosciencenews.com/paternal-anxiety-18177/#:~:text=Summary%3A%20A%20new%20study%20reports,this%20period%20was%20under%204%25.\">\u003cspan style=\"font-weight: 400\">husbands and partners are also at higher risk for depression and anxiety\u003c/span>\u003c/a>\u003cspan style=\"font-weight: 400\">. And because new moms are learning to breastfeed, and figuring out what’s part of the new normal and what’s not, it can take months just to recognize there’s a problem, said UNC’s Riah Patterson.\u003c/span>\u003c/p>\n\u003cp>\u003cspan style=\"font-weight: 400\">“It takes so long for this illness to come to recognition and for someone to actually get into an appointment and actually be seen by a provider,” she said.\u003c/span>\u003c/p>\n\u003cfigure id=\"attachment_11879416\" class=\"wp-caption aligncenter\" style=\"max-width: 1920px\">\u003cimg loading=\"lazy\" decoding=\"async\" class=\"size-full wp-image-11879416\" src=\"https://ww2.kqed.org/app/uploads/sites/10/2021/06/Riah-Patterson.jpg\" alt=\"\" width=\"1920\" height=\"1436\" srcset=\"https://cdn.kqed.org/wp-content/uploads/sites/10/2021/06/Riah-Patterson.jpg 1920w, https://cdn.kqed.org/wp-content/uploads/sites/10/2021/06/Riah-Patterson-800x598.jpg 800w, https://cdn.kqed.org/wp-content/uploads/sites/10/2021/06/Riah-Patterson-1020x763.jpg 1020w, https://cdn.kqed.org/wp-content/uploads/sites/10/2021/06/Riah-Patterson-160x120.jpg 160w, https://cdn.kqed.org/wp-content/uploads/sites/10/2021/06/Riah-Patterson-1536x1149.jpg 1536w\" sizes=\"auto, (max-width: 1920px) 100vw, 1920px\">\u003cfigcaption class=\"wp-caption-text\">Dr. Riah Patterson discusses patients and treatment plans with her trainee, a third-year psychiatry resident at the Center for Women’s Mood Disorders at UNC-Chapel Hill. \u003ccite>(Courtesy Riah Patterson)\u003c/cite>\u003c/figcaption>\u003c/figure>\n\u003cp>\u003cspan style=\"font-weight: 400\">Indeed, the FDA fast-tracked the approval of brexanolone in part because of how quickly it worked, allowing women to feel better and get back to their families in three days.\u003c/span>\u003c/p>\n\u003cp>\u003cspan style=\"font-weight: 400\">“It’s new, it’s promising,” said Kaiser’s Koshy, but, she added, “it’s not a benign medication.” \u003c/span>\u003ca href=\"https://www.fda.gov/media/121348/download\">\u003cspan style=\"font-weight: 400\">Six women in the clinical trials experienced loss or near loss of consciousness,\u003c/span>\u003c/a>\u003cspan style=\"font-weight: 400\"> which is why the FDA requires women to be continuously monitored in certified health centers when getting the infusion. \u003c/span>\u003c/p>\n\u003cp>\u003cspan style=\"font-weight: 400\">Also, the safety and efficacy data is limited, Koshy said. The clinical trials only compared brexanolone to placebo, not to alternative treatments. So while the data show brexanolone works better than nothing, there’s no data on whether it works better than Zoloft or electroconvulsive therapy. \u003c/span>\u003c/p>\n\u003cp>\u003cspan style=\"font-weight: 400\">Koshy says Kaiser is always reviewing practice recommendations as new evidence becomes available, but also acknowledged that Kaiser’s recommendations for brexanolone have not been updated since they were first developed two years ago, in July 2019. \u003c/span>\u003c/p>\n\u003cp>It is unclear what role the \u003ca href=\"https://dmhc.ca.gov/\">Department of Managed Health Care\u003c/a>, the state agency that regulates Kaiser, will play in resolving these questions. In a statement, the department said it will review any criteria or guidelines the Kaiser health plan uses for brexanolone, but said it does not have jurisdiction over physician decisions.\u003c/p>\n\u003cp>The DMHC also monitors patient complaints around new medications and treatments in order to identify problems with access to care. So far, \u003ca href=\"https://wpso.dmhc.ca.gov/imr/\">the DMHC has published two complaints about brexanolone in its public database\u003c/a> – both were filed by Kaiser patients.\u003c/p>\n\u003cp>\u003ca href=\"https://www.benefitscafe.com/insurance-companies/kaiserpermanente/\"> \u003cspan style=\"font-weight: 400\">Kaiser is the \u003c/span>\u003cspan style=\"font-weight: 400\">largest insurer in California\u003c/span>\u003c/a>\u003cspan style=\"font-weight: 400\">. It holds a 40% share of the market, covering 6.1 million patients. But at UC Davis, where Kaiser says it sends all patients who need brexanolone in Northern California, Kaiser patients are only 15% of those who got the drug, according to \u003c/span>\u003ca href=\"https://health.ucdavis.edu/team/search/1499/shannon-clark---obstetrics-and-gynecology-sacramento\">\u003cspan style=\"font-weight: 400\">Dr. Shannon Clark\u003c/span>\u003c/a>\u003cspan style=\"font-weight: 400\">, a psychiatrist and OB-GYN overseeing the treatments. \u003c/span>\u003c/p>\n\u003cp>\u003cspan style=\"font-weight: 400\">She says of the 13 women who’ve been treated at UC Davis in the last two years, only two were from Kaiser. One was Muñoz, who was approved only after the state intervened. The other was Whitney Worthington. Both women canceled their coverage with Kaiser over the postpartum mental health care they received.\u003c/span>\u003c/p>\n\u003cp>[pullquote size=\"medium\" align=\"right\" citation=\"Marcus Worthington, husband of Whitney Worthington\"]‘The only thing that changed was that we were able to stir up enough dirt and I was able to pitch a big enough fit … It finally got on somebody’s radar who wasn’t going to ignore it.’[/pullquote]\u003cspan style=\"font-weight: 400\">Worthington struggled with depression for most of her adult life, but when she decided to get pregnant, she got help from her psychiatrist and therapist to wean off her antidepressant. It was a grueling withdrawal process. \u003c/span>\u003c/p>\n\u003cp>\u003cspan style=\"font-weight: 400\">“That was the worst two months of my life,” she said. “Feeling suicidal at times. It was just miserable.” \u003c/span>\u003c/p>\n\u003cp>\u003cspan style=\"font-weight: 400\">She knew then that if she got depressed after her baby was born, she did not want to take medication because she wanted to have more children and didn’t want to go through withdrawal again. \u003c/span>\u003c/p>\n\u003cp>\u003cspan style=\"font-weight: 400\">When she ended up in the Kaiser ER with suicidal thoughts a few weeks after giving birth, she had to repeatedly decline offers — even threats — of medication. She saw a series of providers at two Kaiser hospitals and several told her she needed brexanolone. One said “it was her only hope.” \u003c/span>\u003c/p>\n\u003cp>\u003cspan style=\"font-weight: 400\">But Worthington was also told by other Kaiser providers that it wasn’t necessary, that Kaiser didn’t offer it at all, and that cost was an issue. The official denial that came from Kaiser’s billing department offered no reason, said Marcus Worthington, Whitney’s husband. \u003c/span>\u003c/p>\n\u003cp>\u003cspan style=\"font-weight: 400\">He spent weeks on the phone with multiple Kaiser representatives, fighting, negotiating and pleading, until a high-level administrator stepped in and personally approved it. \u003c/span>\u003c/p>\n\u003cp>\u003cspan style=\"font-weight: 400\">“The only thing that changed was that we were able to stir up enough dirt and I was able to pitch a big enough fit,” said Marcus, who is Latino and Native American. “I have a relatively Anglo-Saxon name and Whitney is a young white woman. Frankly, I think it all plays in that it finally got on somebody’s radar who wasn’t going to ignore it.”\u003c/span>\u003c/p>\n\u003cp>\u003cspan style=\"font-weight: 400\">After getting the treatment at UC Davis, Whitney says she could think clearly again and truly enjoy the last two months of maternity leave she had with her daughter. She called brexanolone “a total miracle.”\u003c/span>\u003c/p>\n\u003ch3>‘This Is How You Treat Postpartum Mental Health?’\u003c/h3>\n\u003cp>\u003cspan style=\"font-weight: 400\">Kaiser said it cannot comment on any individual cases because of privacy laws, but said generally, “We feel deep compassion for any patient experiencing the difficult and serious effects of postpartum depression, and our goal is always to support every patient’s safe return to a healthy mental state.”\u003c/span>\u003c/p>\n\u003cp>\u003cspan style=\"font-weight: 400\">When Miriam McDonald called Kaiser’s grievance department to complain about her treatment, Kaiser sent the cops to her house for a welfare check.\u003c/span>\u003c/p>\n\u003cp>\u003cspan style=\"font-weight: 400\">The officers were calm and nice, McDonald said, but when she closed the door, she cried her eyes out.\u003c/span>\u003c/p>\n\u003cp>\u003cspan style=\"font-weight: 400\"> \u003c/span>\u003cspan style=\"font-weight: 400\">“It just brought me to a whole new low,” she said. “Why didn’t my doctor call me and talk to me first? I mean, this is how you treat postpartum mental health? How dare\u003c/span> \u003cspan style=\"font-weight: 400\">you.”\u003c/span>\u003c/p>\n\u003cp>\u003cspan style=\"font-weight: 400\">McDonald also appealed Kaiser’s denial of brexanolone to state regulators, \u003ca href=\"https://www.2020mom.org/\" target=\"_blank\" rel=\"noopener noreferrer\">with help from advocates at 2020 Mom\u003c/a>, but by the time she got there, the clock had already run out. She was past the six-month postpartum cutoff. \u003c/span>\u003c/p>\n\u003cp>\u003cspan style=\"font-weight: 400\">She never got brexanolone.\u003c/span>\u003c/p>\n\u003cp>\u003cspan style=\"font-weight: 400\">Still, she continued to fight for relief and eventually got Kaiser to cover a different treatment called \u003c/span>\u003ca href=\"https://www.mayoclinic.org/tests-procedures/transcranial-magnetic-stimulation/about/pac-20384625\">\u003cspan style=\"font-weight: 400\">transcranial magnetic stimulation\u003c/span>\u003c/a>\u003cspan style=\"font-weight: 400\">, which uses an electromagnetic coil to stimulate nerve cells in the brain that control mood.\u003c/span>\u003c/p>\n\u003cfigure id=\"attachment_11879420\" class=\"wp-caption aligncenter\" style=\"max-width: 1920px\">\u003cimg loading=\"lazy\" decoding=\"async\" class=\"size-full wp-image-11879420\" src=\"https://ww2.kqed.org/app/uploads/sites/10/2021/06/Out-of-the-fog.jpg\" alt=\"\" width=\"1920\" height=\"1440\" srcset=\"https://cdn.kqed.org/wp-content/uploads/sites/10/2021/06/Out-of-the-fog.jpg 1920w, https://cdn.kqed.org/wp-content/uploads/sites/10/2021/06/Out-of-the-fog-800x600.jpg 800w, https://cdn.kqed.org/wp-content/uploads/sites/10/2021/06/Out-of-the-fog-1020x765.jpg 1020w, https://cdn.kqed.org/wp-content/uploads/sites/10/2021/06/Out-of-the-fog-160x120.jpg 160w, https://cdn.kqed.org/wp-content/uploads/sites/10/2021/06/Out-of-the-fog-1536x1152.jpg 1536w\" sizes=\"auto, (max-width: 1920px) 100vw, 1920px\">\u003cfigcaption class=\"wp-caption-text\">Miriam McDonald said she is finally feeling like herself again, a year and a half after her son’s birth. \u003ccite>(Courtesy Miriam McDonald)\u003c/cite>\u003c/figcaption>\u003c/figure>\n\u003cp>McDonald had to go five days a week for three months. Now, more than a year and a half after having her baby, she is finally feeling like herself again.\u003c/p>\n\u003cp>\u003cspan style=\"font-weight: 400\">“I can remember I woke up one day and I was excited. I had actual joy,” she remembers. “I got up and I walked into his room and I was like, ‘Hey, Nico! Hi! Hey, baby!’ And he jumped up from his crib and giggled and put his arms out. And I just swooped him up in my arms and cried. Because I was like, ‘I am so proud to be your mom.’ ”\u003c/span>\u003c/p>\n\u003cp>\u003cspan style=\"font-weight: 400\">Now when her son smiles at her, she genuinely smiles back. But she can’t help but grieve all the smiles she didn’t return. How she felt like she was barely there when her son took his first steps.\u003c/span>\u003c/p>\n\u003cp>[ad floatright]\u003c/p>\n\u003cp>\u003cspan style=\"font-weight: 400\">“I felt like I’ve been robbed really of all those moments,” she said, “of those little milestones, that I’m never going to get back.” \u003c/span>\u003c/p>\n\n",
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"excerpt": "Kaiser's practices around the new drug, brexanolone, may run afoul of a new California law designed to limit unfair denials of mental health treatment.",
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"title": "There's Only 1 Drug for Postpartum Depression. Why Does Kaiser Permanente Make It So Hard to Get? | KQED",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003cp>\u003c/p>\u003cp>\u003cspan class=\"utils-parseShortcode-shortcodes-__dropcapShortcode__dropcap\">W\u003c/span>\u003c/p>\u003cp>hen Miriam McDonald decided she wanted to have another baby at age 44, her doctor told her she had a better chance of winning the lottery. So when she got pregnant, she and her husband were thrilled. But within three days of giving birth to their son, everything turned.\u003c/p>\n\u003cp>“I was thinking, ‘Oh my God, what did I do?’ I just brought this baby into this world and I can barely take care of myself right now,” she said. “I feel exhausted. I haven’t slept in three days. I haven’t really eaten in three days.”\u003c/p>\n\u003cp>As the weeks went by, her depression got worse. She felt sad, but also indifferent. She didn’t want to hold her baby, she didn’t want to change him. She said she felt no connection with him at all.\u003c/p>\n\u003cp>This confused her – she never felt anything like this after her first two kids – and she worried her mood might hurt her son. \u003ca href=\"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4113321/#R2\">Untreated postpartum depression can affect babies’ cognitive and social development\u003c/a>. For the mother, it can be life or death. \u003ca href=\"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4113321/\">Suicide accounts for 20% of maternal deaths\u003c/a>.\u003c/p>\n\u003cp>“Every day, I was crying. Every day, I felt like I just wanted to die. Every day, I thought about ending my life,” said McDonald, who is Latina and works at UC Davis as an IT professional.\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>\u003cspan style=\"font-weight: 400\">She went to Kaiser Permanente, her health care provider, for help. She said they put her on a merry-go-round of medication trial and error. The first drug her doctor prescribed made her anxious. The second drug gave her horrific nightmares. A third drug gave her auditory and visual hallucinations that took seven weeks to go away. \u003c/span>\u003c/p>\n\u003cp>\u003cspan style=\"font-weight: 400\">Then, her doctor retired. And when McDonald complained to her new doctor that she was still depressed four months after giving birth, the physician suggested more medications.\u003c/span>\u003c/p>\n\u003cp>“I was desperate,” McDonald said. “I was like, ‘I’m trying to help myself, but things are just getting worse.’ So what am I left with?”\u003c/p>\n\u003cp>\u003cspan style=\"font-weight: 400\">She started doing her own research and learned about a new treatment called brexanolone. It’s \u003ca href=\"https://www.fda.gov/news-events/press-announcements/fda-approves-first-treatment-post-partum-depression\">the \u003c/a>\u003c/span>\u003cspan style=\"font-weight: 400\">first and only drug\u003c/span>\u003cspan style=\"font-weight: 400\"> approved by the U.S. Food and Drug Administration to treat postpartum depression, which \u003ca href=\"https://www.americashealthrankings.org/explore/health-of-women-and-children/measure/postpartum_depression/state/CA\">affects \u003c/a>\u003c/span>\u003cspan style=\"font-weight: 400\">1 out of 8 new mothers\u003c/span>\u003cspan style=\"font-weight: 400\"> in California. Instead of targeting the serotonin system in the brain, like most antidepressants, brexanolone works by rebalancing the stress hormones that can get out of kilter after having a baby. It’s delivered through an IV infusion over 2 1/2 days in the hospital. \u003c/span>\u003c/p>\n\u003cp>In \u003cspan style=\"font-weight: 400\">clinical trials\u003c/span>\u003cspan style=\"font-weight: 400\">, \u003ca href=\"https://www.fda.gov/media/121348/download\">75% of women who got brexanolone started to feel better\u003c/a> immediately after the three-day treatment. Half the women went into complete remission.\u003c/span>\u003c/p>\n\u003cp>\u003cspan style=\"font-weight: 400\">McDonald wanted to try it. \u003c/span>\u003c/p>\n\u003cfigure id=\"attachment_11879318\" class=\"wp-caption aligncenter\" style=\"max-width: 2560px\">\u003cimg loading=\"lazy\" decoding=\"async\" class=\"size-full wp-image-11879318\" src=\"https://ww2.kqed.org/app/uploads/sites/10/2021/06/trying-to-smile-1-scaled.jpg\" alt=\"\" width=\"2560\" height=\"1920\" srcset=\"https://cdn.kqed.org/wp-content/uploads/sites/10/2021/06/trying-to-smile-1-scaled.jpg 2560w, https://cdn.kqed.org/wp-content/uploads/sites/10/2021/06/trying-to-smile-1-800x600.jpg 800w, https://cdn.kqed.org/wp-content/uploads/sites/10/2021/06/trying-to-smile-1-1020x765.jpg 1020w, https://cdn.kqed.org/wp-content/uploads/sites/10/2021/06/trying-to-smile-1-160x120.jpg 160w, https://cdn.kqed.org/wp-content/uploads/sites/10/2021/06/trying-to-smile-1-1536x1152.jpg 1536w, https://cdn.kqed.org/wp-content/uploads/sites/10/2021/06/trying-to-smile-1-2048x1536.jpg 2048w, https://cdn.kqed.org/wp-content/uploads/sites/10/2021/06/trying-to-smile-1-1920x1440.jpg 1920w\" sizes=\"auto, (max-width: 2560px) 100vw, 2560px\">\u003cfigcaption class=\"wp-caption-text\">For the first year of her son’s life, Miriam McDonald says all her smiles were fake or strained. \u003ccite>(Courtesy Miriam McDonald)\u003c/cite>\u003c/figcaption>\u003c/figure>\n\u003cp>\u003cspan style=\"font-weight: 400\">“People walk out of the hospital, wanting to be with their child, wanting to return home,” said \u003c/span>\u003ca href=\"https://www.med.unc.edu/psych/directory/riah-patterson/\">\u003cspan style=\"font-weight: 400\">Dr. Riah Patterson\u003c/span>\u003c/a>\u003cspan style=\"font-weight: 400\">, who has been treating women with brexanolone at the University of North Carolina at Chapel Hill since it became available in summer 2019. “There is a hopefulness, a brightness. You can really see that transformation in the hospital room over those 60 hours. It’s pretty miraculous.”\u003c/span>\u003c/p>\n\u003cp>\u003cspan style=\"font-weight: 400\">When McDonald asked her doctor for brexanolone, she said no. \u003c/span>\u003c/p>\n\u003cp>In an email, she said the existing studies were “not very impressive.” She told McDonald that she didn’t meet Kaiser’s criteria for the drug: She would have had to try and fail four medications and electroconvulsive therapy before she could try brexanolone. And all this had to happen within six months of having her baby, or she couldn’t try it at all.\u003c/p>\n\u003cp>How could anyone qualify, McDonald wondered?\u003c/p>\n\u003cp>\u003cspan style=\"font-weight: 400\">“This is crazy. By the time you even try one drug, that’s like four weeks out,” she said. “Another drug is four weeks out, another drug is four weeks out. There’s just no way.”\u003c/span>\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"content": "‘If Kaiser is making it effectively impossible to get a particular, important mental health treatment, that could definitely be a violation of our parity law.’",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003cspan style=\"font-weight: 400\">Kaiser’s guidance is an outlier. KQED analyzed guidelines from a dozen health plans operating in California. Three of them require women to fail one medication before trying brexanolone. One plan – the state’s Medi-Cal program for low-income women – requires two fails. But Kaiser is the only system KQED found that recommends women first fail four drugs.\u003c/span>\u003c/p>\n\u003cp>\u003cspan style=\"font-weight: 400\">“That’s absurd,” said UNC’s Patterson, one of several experts in postpartum depression who, in turn, called Kaiser’s guidance “ridiculous,” “harsh,” “abusive” and “insane.”\u003c/span>\u003c/p>\n\u003cp>\u003cspan style=\"font-weight: 400\">It may also be illegal. \u003c/span>\u003c/p>\n\u003cp>\u003cspan style=\"font-weight: 400\">Under a \u003c/span>\u003ca href=\"https://leginfo.legislature.ca.gov/faces/billTextClient.xhtml?bill_id=201920200SB855\">\u003cspan style=\"font-weight: 400\">new state law that took effect in January\u003c/span>\u003c/a>\u003cspan style=\"font-weight: 400\"> , health plans must conform to “generally accepted standards of care,” including nonprofit guidelines, scientific literature and expert consensus, when making decisions about mental health treatment.\u003c/span>\u003c/p>\n\u003cp>\u003cspan style=\"font-weight: 400\">“If Kaiser is making it effectively impossible to get a particular, important mental health treatment, that could definitely be a violation of our parity law,” said state Sen. Scott Wiener, D-San Francisco, the bill’s author. \u003c/span>\u003c/p>\n\u003cp>\u003cspan style=\"font-weight: 400\">Kaiser says it always follows the law. It says its integrated structure makes it different from traditional insurers. At Kaiser, a patient’s doctor determines whether a medication is necessary, not the health plan, and the criteria doctors use are recommendations, not requirements or prerequisites that patients need to “exhaust,” said Dr. Maria Koshy, Kaiser’s chair of psychiatry for Northern California. \u003c/span>\u003c/p>\n\u003cp>\u003cspan style=\"font-weight: 400\">“At the end of the day, this is an individual clinical decision by both the provider – the physician – and the patient,” she said.\u003c/span>\u003c/p>\n\u003cp>\u003cspan style=\"font-weight: 400\">But former Kaiser clinicians and legislative experts familiar with Kaiser’s model say the culture around these recommendations is to follow them. Doctors get questioned or can face consequences if they don’t, said Wiener.\u003c/span>\u003c/p>\n\u003ch3>‘It Saved My Life’\u003c/h3>\n\u003cp>\u003cspan style=\"font-weight: 400\">McDonald’s physician followed the criteria as if they were prerequisites when she declined to prescribe brexanolone. Kaiser’s grievance department sent a letter to another woman, Yesenia Muñoz, denying brexanolone because she had not failed enough medications.\u003c/span>\u003c/p>\n\u003cp>\u003cspan style=\"font-weight: 400\">“When I talked to the caseworker at Kaiser that had denied the medication, he said that Zulresso was very expensive,” said Muñoz, referring to brexanolone’s brand name.\u003c/span>\u003c/p>\n\u003cp>\u003cspan style=\"font-weight: 400\">Brexanolone treatment costs $34,000 for the medication, plus the cost of the three-day hospital stay, which can tack on another $30,000, at least. Kaiser is not yet certified to administer the treatment in-house, so it must pay outside hospitals to provide it. It says it has plans to eventually open three of its own certified centers.\u003c/span>\u003c/p>\n\u003cp>\u003cspan style=\"font-weight: 400\">Muñoz was devastated by the denial. She was overwhelmed by postpartum depression and anxiety shortly after her daughter was born and, as a Latina, she said she was hesitant to seek help at first. When she did, none of the medications or therapies Kaiser offered her worked. She still felt suicidal.\u003c/span>\u003c/p>\n\u003cp>\u003cspan style=\"font-weight: 400\">“I could get out the door sometimes and take the stroller and go walk, and my mind kept on saying, ‘If you just step in front of the car, it’s all going to go away,’ ” she remembers.\u003c/span>\u003c/p>\n\u003cp>\u003cspan style=\"font-weight: 400\">Muñoz got help from family and co-workers to appeal Kaiser’s decision to the state, and after reviewing her medical records, regulators ordered Kaiser to pay for the brexanolone treatment.\u003c/span>\u003c/p>\n\u003cp>\u003cspan style=\"font-weight: 400\">Muñoz went to UC Davis Medical Center to get it, and she started feeling better within the first day.\u003c/span>\u003c/p>\n\u003cfigure id=\"attachment_11879428\" class=\"wp-caption aligncenter\" style=\"max-width: 1920px\">\u003cimg loading=\"lazy\" decoding=\"async\" class=\"size-full wp-image-11879428\" src=\"https://ww2.kqed.org/app/uploads/sites/10/2021/06/MunozAndBaby.jpg\" alt=\"Yesenia smiling holding baby\" width=\"1920\" height=\"1760\" srcset=\"https://cdn.kqed.org/wp-content/uploads/sites/10/2021/06/MunozAndBaby.jpg 1920w, https://cdn.kqed.org/wp-content/uploads/sites/10/2021/06/MunozAndBaby-800x733.jpg 800w, https://cdn.kqed.org/wp-content/uploads/sites/10/2021/06/MunozAndBaby-1020x935.jpg 1020w, https://cdn.kqed.org/wp-content/uploads/sites/10/2021/06/MunozAndBaby-160x147.jpg 160w, https://cdn.kqed.org/wp-content/uploads/sites/10/2021/06/MunozAndBaby-1536x1408.jpg 1536w\" sizes=\"auto, (max-width: 1920px) 100vw, 1920px\">\u003cfigcaption class=\"wp-caption-text\">After Yesenia Muñoz received brexanolone to treat her postpartum depression, she felt blessed, connected with her daughter and ‘happy enough to want to live.’ \u003ccite>(Courtesy Yesenia Munoz)\u003c/cite>\u003c/figcaption>\u003c/figure>\n\u003cp>\u003cspan style=\"font-weight: 400\">“The nurse came in and she said something funny and I laughed,” Muñoz said. “It was the first time I had laughed in so long.”\u003c/span>\u003c/p>\n\u003cp>\u003cspan style=\"font-weight: 400\">She started looking through photos and videos of her daughter on her phone and she says it was like she was experiencing those moments for the first time. She started making plans for the future. \u003c/span>\u003c/p>\n\u003cp>\u003cspan style=\"font-weight: 400\">“It was like a switch flicked and it made me happy enough to want to live,” she said. “It saved my life.”\u003c/span>\u003c/p>\n\u003ch3>‘There Is No Place Where We Say Kaiser Is Exempt’\u003c/h3>\n\u003cp>\u003cspan style=\"font-weight: 400\">In 2008, Congress passed a landmark federal law aimed at correcting imbalances in how insurers covered mental health treatments compared to physical health, later reinforced by the Affordable Care Act in 2010. \u003c/span>\u003cspan style=\"font-weight: 400\">But \u003c/span>\u003ca href=\"https://www.kqed.org/stateofhealth/series/state-of-mind\">\u003cspan style=\"font-weight: 400\">insurers found loopholes\u003c/span>\u003c/a>\u003cspan style=\"font-weight: 400\">, creating overly restrictive or self-serving criteria that made it easy to deny services, and as a result, save money.\u003c/span>\u003c/p>\n\u003cp>\u003cspan style=\"font-weight: 400\">California’s new law, \u003c/span>\u003ca href=\"https://leginfo.legislature.ca.gov/faces/billTextClient.xhtml?bill_id=201920200SB855\">\u003cspan style=\"font-weight: 400\">Senate Bill 855\u003c/span>\u003c/a>\u003cspan style=\"font-weight: 400\">, is aimed at tightening those loopholes, and has been \u003c/span>\u003ca href=\"https://www.statnews.com/2020/10/14/new-california-law-should-serve-as-a-national-model-for-mental-health-care-reform/\">\u003cspan style=\"font-weight: 400\">hailed by advocates as a national model\u003c/span>\u003c/a>\u003cspan style=\"font-weight: 400\"> for mental health reform. It requires health plans to use clinically based, expert-recognized criteria and guidelines in making medical decisions, with the goal of limiting arbitrary or cost-driven denials. \u003c/span>\u003c/p>\n\u003cp>\u003cspan style=\"font-weight: 400\">Kaiser raises questions about how precisely the new law applies to them, given its unique integrated structure, where doctors make determinations about what is medically necessary rather than the health plan side of the organization. Kaiser’s Dr. Koshy said SB 855’s requirement to comply with generally accepted standards of care “does not apply” to its brexanolone recommendations because they were developed and are used by doctors, not plan administrators. (When KQED asked Kaiser to provide the brexanolone policy its health plan uses, it said it didn’t have one.)\u003c/span>\u003c/p>\n\u003cp>\u003cspan style=\"font-weight: 400\">“We 100% intended this law to apply to the care people get at Kaiser,” said Julie Snyder, government affairs director at \u003ca href=\"https://steinberginstitute.org/\" target=\"_blank\" rel=\"noopener noreferrer\">the Steinberg Institute\u003c/a>, which co-sponsored the law. “There is no place where we say Kaiser is exempt.” \u003c/span>\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003cspan style=\"font-weight: 400\">Doctors at Kaiser have historically been “gatekeepers” for services in the system, said \u003ca href=\"https://psych-appeal.com/meiram-bendat-attorney-founder/\" target=\"_blank\" rel=\"noopener noreferrer\">Meiram Bendat\u003c/a>, an attorney and licensed psychotherapist who also advised on the law. It doesn’t matter if practice recommendations for brexanolone were written by doctors or administrators, or whether the recommendations are mandatory or optional – Bendat says they must be compliant with the law. \u003c/span>\u003c/p>\n\u003cp>\u003cspan style=\"font-weight: 400\">“If it’s inconsistent with generally accepted standards of care, then it has no place in California,” he said.\u003c/span>\u003c/p>\n\u003cp>\u003cspan style=\"font-weight: 400\">Some of Kaiser’s recommended criteria for brexanolone are aligned with generally accepted standards of care; for example, reserving the drug for women who are six months or less postpartum, which was a criterion used in the \u003c/span>\u003ca href=\"https://www.fda.gov/media/121348/download\">\u003cspan style=\"font-weight: 400\">clinical trials the FDA relied on when it approved the drug\u003c/span>\u003c/a>\u003cspan style=\"font-weight: 400\">. \u003c/span>\u003c/p>\n\u003cp>\u003cspan style=\"font-weight: 400\">But the recommendation to try four or five alternative treatments before considering brexanolone conflicts with the judgment of half a dozen women’s health experts interviewed for this story. They say there just isn’t enough time in the postpartum period. And there’s too much at stake. \u003c/span>\u003c/p>\n\u003cp>\u003cspan style=\"font-weight: 400\">Not only are babies at risk of developmental and emotional problems if their mother is depressed, \u003c/span>\u003ca href=\"https://neurosciencenews.com/paternal-anxiety-18177/#:~:text=Summary%3A%20A%20new%20study%20reports,this%20period%20was%20under%204%25.\">\u003cspan style=\"font-weight: 400\">husbands and partners are also at higher risk for depression and anxiety\u003c/span>\u003c/a>\u003cspan style=\"font-weight: 400\">. And because new moms are learning to breastfeed, and figuring out what’s part of the new normal and what’s not, it can take months just to recognize there’s a problem, said UNC’s Riah Patterson.\u003c/span>\u003c/p>\n\u003cp>\u003cspan style=\"font-weight: 400\">“It takes so long for this illness to come to recognition and for someone to actually get into an appointment and actually be seen by a provider,” she said.\u003c/span>\u003c/p>\n\u003cfigure id=\"attachment_11879416\" class=\"wp-caption aligncenter\" style=\"max-width: 1920px\">\u003cimg loading=\"lazy\" decoding=\"async\" class=\"size-full wp-image-11879416\" src=\"https://ww2.kqed.org/app/uploads/sites/10/2021/06/Riah-Patterson.jpg\" alt=\"\" width=\"1920\" height=\"1436\" srcset=\"https://cdn.kqed.org/wp-content/uploads/sites/10/2021/06/Riah-Patterson.jpg 1920w, https://cdn.kqed.org/wp-content/uploads/sites/10/2021/06/Riah-Patterson-800x598.jpg 800w, https://cdn.kqed.org/wp-content/uploads/sites/10/2021/06/Riah-Patterson-1020x763.jpg 1020w, https://cdn.kqed.org/wp-content/uploads/sites/10/2021/06/Riah-Patterson-160x120.jpg 160w, https://cdn.kqed.org/wp-content/uploads/sites/10/2021/06/Riah-Patterson-1536x1149.jpg 1536w\" sizes=\"auto, (max-width: 1920px) 100vw, 1920px\">\u003cfigcaption class=\"wp-caption-text\">Dr. Riah Patterson discusses patients and treatment plans with her trainee, a third-year psychiatry resident at the Center for Women’s Mood Disorders at UNC-Chapel Hill. \u003ccite>(Courtesy Riah Patterson)\u003c/cite>\u003c/figcaption>\u003c/figure>\n\u003cp>\u003cspan style=\"font-weight: 400\">Indeed, the FDA fast-tracked the approval of brexanolone in part because of how quickly it worked, allowing women to feel better and get back to their families in three days.\u003c/span>\u003c/p>\n\u003cp>\u003cspan style=\"font-weight: 400\">“It’s new, it’s promising,” said Kaiser’s Koshy, but, she added, “it’s not a benign medication.” \u003c/span>\u003ca href=\"https://www.fda.gov/media/121348/download\">\u003cspan style=\"font-weight: 400\">Six women in the clinical trials experienced loss or near loss of consciousness,\u003c/span>\u003c/a>\u003cspan style=\"font-weight: 400\"> which is why the FDA requires women to be continuously monitored in certified health centers when getting the infusion. \u003c/span>\u003c/p>\n\u003cp>\u003cspan style=\"font-weight: 400\">Also, the safety and efficacy data is limited, Koshy said. The clinical trials only compared brexanolone to placebo, not to alternative treatments. So while the data show brexanolone works better than nothing, there’s no data on whether it works better than Zoloft or electroconvulsive therapy. \u003c/span>\u003c/p>\n\u003cp>\u003cspan style=\"font-weight: 400\">Koshy says Kaiser is always reviewing practice recommendations as new evidence becomes available, but also acknowledged that Kaiser’s recommendations for brexanolone have not been updated since they were first developed two years ago, in July 2019. \u003c/span>\u003c/p>\n\u003cp>It is unclear what role the \u003ca href=\"https://dmhc.ca.gov/\">Department of Managed Health Care\u003c/a>, the state agency that regulates Kaiser, will play in resolving these questions. In a statement, the department said it will review any criteria or guidelines the Kaiser health plan uses for brexanolone, but said it does not have jurisdiction over physician decisions.\u003c/p>\n\u003cp>The DMHC also monitors patient complaints around new medications and treatments in order to identify problems with access to care. So far, \u003ca href=\"https://wpso.dmhc.ca.gov/imr/\">the DMHC has published two complaints about brexanolone in its public database\u003c/a> – both were filed by Kaiser patients.\u003c/p>\n\u003cp>\u003ca href=\"https://www.benefitscafe.com/insurance-companies/kaiserpermanente/\"> \u003cspan style=\"font-weight: 400\">Kaiser is the \u003c/span>\u003cspan style=\"font-weight: 400\">largest insurer in California\u003c/span>\u003c/a>\u003cspan style=\"font-weight: 400\">. It holds a 40% share of the market, covering 6.1 million patients. But at UC Davis, where Kaiser says it sends all patients who need brexanolone in Northern California, Kaiser patients are only 15% of those who got the drug, according to \u003c/span>\u003ca href=\"https://health.ucdavis.edu/team/search/1499/shannon-clark---obstetrics-and-gynecology-sacramento\">\u003cspan style=\"font-weight: 400\">Dr. Shannon Clark\u003c/span>\u003c/a>\u003cspan style=\"font-weight: 400\">, a psychiatrist and OB-GYN overseeing the treatments. \u003c/span>\u003c/p>\n\u003cp>\u003cspan style=\"font-weight: 400\">She says of the 13 women who’ve been treated at UC Davis in the last two years, only two were from Kaiser. One was Muñoz, who was approved only after the state intervened. The other was Whitney Worthington. Both women canceled their coverage with Kaiser over the postpartum mental health care they received.\u003c/span>\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"content": "‘The only thing that changed was that we were able to stir up enough dirt and I was able to pitch a big enough fit … It finally got on somebody’s radar who wasn’t going to ignore it.’",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003cspan style=\"font-weight: 400\">Worthington struggled with depression for most of her adult life, but when she decided to get pregnant, she got help from her psychiatrist and therapist to wean off her antidepressant. It was a grueling withdrawal process. \u003c/span>\u003c/p>\n\u003cp>\u003cspan style=\"font-weight: 400\">“That was the worst two months of my life,” she said. “Feeling suicidal at times. It was just miserable.” \u003c/span>\u003c/p>\n\u003cp>\u003cspan style=\"font-weight: 400\">She knew then that if she got depressed after her baby was born, she did not want to take medication because she wanted to have more children and didn’t want to go through withdrawal again. \u003c/span>\u003c/p>\n\u003cp>\u003cspan style=\"font-weight: 400\">When she ended up in the Kaiser ER with suicidal thoughts a few weeks after giving birth, she had to repeatedly decline offers — even threats — of medication. She saw a series of providers at two Kaiser hospitals and several told her she needed brexanolone. One said “it was her only hope.” \u003c/span>\u003c/p>\n\u003cp>\u003cspan style=\"font-weight: 400\">But Worthington was also told by other Kaiser providers that it wasn’t necessary, that Kaiser didn’t offer it at all, and that cost was an issue. The official denial that came from Kaiser’s billing department offered no reason, said Marcus Worthington, Whitney’s husband. \u003c/span>\u003c/p>\n\u003cp>\u003cspan style=\"font-weight: 400\">He spent weeks on the phone with multiple Kaiser representatives, fighting, negotiating and pleading, until a high-level administrator stepped in and personally approved it. \u003c/span>\u003c/p>\n\u003cp>\u003cspan style=\"font-weight: 400\">“The only thing that changed was that we were able to stir up enough dirt and I was able to pitch a big enough fit,” said Marcus, who is Latino and Native American. “I have a relatively Anglo-Saxon name and Whitney is a young white woman. Frankly, I think it all plays in that it finally got on somebody’s radar who wasn’t going to ignore it.”\u003c/span>\u003c/p>\n\u003cp>\u003cspan style=\"font-weight: 400\">After getting the treatment at UC Davis, Whitney says she could think clearly again and truly enjoy the last two months of maternity leave she had with her daughter. She called brexanolone “a total miracle.”\u003c/span>\u003c/p>\n\u003ch3>‘This Is How You Treat Postpartum Mental Health?’\u003c/h3>\n\u003cp>\u003cspan style=\"font-weight: 400\">Kaiser said it cannot comment on any individual cases because of privacy laws, but said generally, “We feel deep compassion for any patient experiencing the difficult and serious effects of postpartum depression, and our goal is always to support every patient’s safe return to a healthy mental state.”\u003c/span>\u003c/p>\n\u003cp>\u003cspan style=\"font-weight: 400\">When Miriam McDonald called Kaiser’s grievance department to complain about her treatment, Kaiser sent the cops to her house for a welfare check.\u003c/span>\u003c/p>\n\u003cp>\u003cspan style=\"font-weight: 400\">The officers were calm and nice, McDonald said, but when she closed the door, she cried her eyes out.\u003c/span>\u003c/p>\n\u003cp>\u003cspan style=\"font-weight: 400\"> \u003c/span>\u003cspan style=\"font-weight: 400\">“It just brought me to a whole new low,” she said. “Why didn’t my doctor call me and talk to me first? I mean, this is how you treat postpartum mental health? How dare\u003c/span> \u003cspan style=\"font-weight: 400\">you.”\u003c/span>\u003c/p>\n\u003cp>\u003cspan style=\"font-weight: 400\">McDonald also appealed Kaiser’s denial of brexanolone to state regulators, \u003ca href=\"https://www.2020mom.org/\" target=\"_blank\" rel=\"noopener noreferrer\">with help from advocates at 2020 Mom\u003c/a>, but by the time she got there, the clock had already run out. She was past the six-month postpartum cutoff. \u003c/span>\u003c/p>\n\u003cp>\u003cspan style=\"font-weight: 400\">She never got brexanolone.\u003c/span>\u003c/p>\n\u003cp>\u003cspan style=\"font-weight: 400\">Still, she continued to fight for relief and eventually got Kaiser to cover a different treatment called \u003c/span>\u003ca href=\"https://www.mayoclinic.org/tests-procedures/transcranial-magnetic-stimulation/about/pac-20384625\">\u003cspan style=\"font-weight: 400\">transcranial magnetic stimulation\u003c/span>\u003c/a>\u003cspan style=\"font-weight: 400\">, which uses an electromagnetic coil to stimulate nerve cells in the brain that control mood.\u003c/span>\u003c/p>\n\u003cfigure id=\"attachment_11879420\" class=\"wp-caption aligncenter\" style=\"max-width: 1920px\">\u003cimg loading=\"lazy\" decoding=\"async\" class=\"size-full wp-image-11879420\" src=\"https://ww2.kqed.org/app/uploads/sites/10/2021/06/Out-of-the-fog.jpg\" alt=\"\" width=\"1920\" height=\"1440\" srcset=\"https://cdn.kqed.org/wp-content/uploads/sites/10/2021/06/Out-of-the-fog.jpg 1920w, https://cdn.kqed.org/wp-content/uploads/sites/10/2021/06/Out-of-the-fog-800x600.jpg 800w, https://cdn.kqed.org/wp-content/uploads/sites/10/2021/06/Out-of-the-fog-1020x765.jpg 1020w, https://cdn.kqed.org/wp-content/uploads/sites/10/2021/06/Out-of-the-fog-160x120.jpg 160w, https://cdn.kqed.org/wp-content/uploads/sites/10/2021/06/Out-of-the-fog-1536x1152.jpg 1536w\" sizes=\"auto, (max-width: 1920px) 100vw, 1920px\">\u003cfigcaption class=\"wp-caption-text\">Miriam McDonald said she is finally feeling like herself again, a year and a half after her son’s birth. \u003ccite>(Courtesy Miriam McDonald)\u003c/cite>\u003c/figcaption>\u003c/figure>\n\u003cp>McDonald had to go five days a week for three months. Now, more than a year and a half after having her baby, she is finally feeling like herself again.\u003c/p>\n\u003cp>\u003cspan style=\"font-weight: 400\">“I can remember I woke up one day and I was excited. I had actual joy,” she remembers. “I got up and I walked into his room and I was like, ‘Hey, Nico! Hi! Hey, baby!’ And he jumped up from his crib and giggled and put his arms out. And I just swooped him up in my arms and cried. Because I was like, ‘I am so proud to be your mom.’ ”\u003c/span>\u003c/p>\n\u003cp>\u003cspan style=\"font-weight: 400\">Now when her son smiles at her, she genuinely smiles back. But she can’t help but grieve all the smiles she didn’t return. How she felt like she was barely there when her son took his first steps.\u003c/span>\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>\u003cspan style=\"font-weight: 400\">“I felt like I’ve been robbed really of all those moments,” she said, “of those little milestones, that I’m never going to get back.” \u003c/span>\u003c/p>\n\n\u003c/div>\u003c/p>",
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"slug": "oakland-just-redirected-18-million-away-from-police-into-violence-prevention-programs",
"title": "Oakland Just Redirected $18 Million Away From Police — Into Violence Prevention Programs",
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"headTitle": "Oakland Just Redirected $18 Million Away From Police — Into Violence Prevention Programs | KQED",
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"content": "\u003cp>Oakland city councilmembers redirected $18 million proposed for police spending from the mayor’s budget to alternative methods of violence prevention when the council passed a $3.8 billion budget Thursday evening.\u003c/p>\n\u003cp>The vote came at about 5:30 p.m. following hours of public comment and discussion at a virtual meeting.\u003c/p>\n\u003cp>[pullquote size=\"medium\" align=\"right\" citation=\"James Burch, policy director for the Anti Police-Terror Project\"]‘We’re talking about a police budget that is well over $300 million every year consistently and continues to increase — even this year.’[/pullquote]The cuts to police spending were made from Mayor Libby Schaaf’s proposed budget for fiscal years 2021-2023 released in May, which would have added two police academy classes to the usual four over the two-year budget cycle.\u003c/p>\n\u003cp>The mayor’s budget proposal was then amended by Council President Nikki Fortunato Bas and Councilmembers Carroll Fife, Dan Kalb and Noel Gallo. The amendment was what passed on Thursday.\u003c/p>\n\u003cp>“The budget passed today by the Oakland City Council makes bold investments to reimagine public safety through violence prevention and non-police strategies that I strongly support,” Schaaf said in a statement.\u003c/p>\n\u003cp>“Unfortunately, it also cuts 50 police officers who respond to Oaklanders’ 911 calls and enforce traffic safety,” Schaaf said.\u003c/p>\n\u003cfigure id=\"attachment_11879475\" class=\"wp-caption alignnone\" style=\"max-width: 800px\">\u003cimg loading=\"lazy\" decoding=\"async\" class=\"size-medium wp-image-11879475\" src=\"https://ww2.kqed.org/app/uploads/sites/10/2021/06/RS50148_011_Oakland_JuneteenthShootingVigil_06222021-qut-800x533.jpg\" alt=\"\" width=\"800\" height=\"533\" srcset=\"https://cdn.kqed.org/wp-content/uploads/sites/10/2021/06/RS50148_011_Oakland_JuneteenthShootingVigil_06222021-qut-800x533.jpg 800w, https://cdn.kqed.org/wp-content/uploads/sites/10/2021/06/RS50148_011_Oakland_JuneteenthShootingVigil_06222021-qut-1020x680.jpg 1020w, https://cdn.kqed.org/wp-content/uploads/sites/10/2021/06/RS50148_011_Oakland_JuneteenthShootingVigil_06222021-qut-160x107.jpg 160w, https://cdn.kqed.org/wp-content/uploads/sites/10/2021/06/RS50148_011_Oakland_JuneteenthShootingVigil_06222021-qut-1536x1024.jpg 1536w, https://cdn.kqed.org/wp-content/uploads/sites/10/2021/06/RS50148_011_Oakland_JuneteenthShootingVigil_06222021-qut.jpg 1920w\" sizes=\"(max-width: 800px) 100vw, 800px\">\u003cfigcaption class=\"wp-caption-text\">A few hundred people gathered at Lake Merritt for a vigil calling for peace on June 22, 2021, following the Juneteenth shooting that wounded seven people and left one man dead. \u003ccite>(Beth LaBerge/KQED)\u003c/cite>\u003c/figcaption>\u003c/figure>\n\u003cp>Six councilmembers voted in favor of the new budget, while Councilmembers Loren Taylor and Treva Reid opposed it because of concerns over an equitable distribution of city funds.\u003c/p>\n\u003cp>Both Taylor and Reid represent East Oakland.\u003c/p>\n\u003cp>The changes come amid a historic increase in violence in the city, with at least 61 homicides so far this year — nearly all by firearms — up about 90% from a year ago, Oakland Police Chief LeRonne Armstrong said Wednesday.\u003c/p>\n\u003cp>The violence was palpable last weekend when gunfire killed one and wounded at least six others in a shooting near Lake Merritt.\u003c/p>\n\u003cp>But Armstrong reportedly said no number of officers at the lake would have prevented the tragedy and some councilmembers used that statement to bolster their argument for less spending on police.\u003c/p>\n\u003cfigure id=\"attachment_11879449\" class=\"wp-caption alignnone\" style=\"max-width: 800px\">\u003cimg loading=\"lazy\" decoding=\"async\" class=\"size-medium wp-image-11879449\" src=\"https://ww2.kqed.org/app/uploads/sites/10/2021/06/RS50143_006_Oakland_JuneteenthShootingVigil_06222021-qut-800x533.jpg\" alt=\"\" width=\"800\" height=\"533\" srcset=\"https://cdn.kqed.org/wp-content/uploads/sites/10/2021/06/RS50143_006_Oakland_JuneteenthShootingVigil_06222021-qut-800x533.jpg 800w, https://cdn.kqed.org/wp-content/uploads/sites/10/2021/06/RS50143_006_Oakland_JuneteenthShootingVigil_06222021-qut-1020x680.jpg 1020w, https://cdn.kqed.org/wp-content/uploads/sites/10/2021/06/RS50143_006_Oakland_JuneteenthShootingVigil_06222021-qut-160x107.jpg 160w, https://cdn.kqed.org/wp-content/uploads/sites/10/2021/06/RS50143_006_Oakland_JuneteenthShootingVigil_06222021-qut-1536x1024.jpg 1536w, https://cdn.kqed.org/wp-content/uploads/sites/10/2021/06/RS50143_006_Oakland_JuneteenthShootingVigil_06222021-qut.jpg 1920w\" sizes=\"(max-width: 800px) 100vw, 800px\">\u003cfigcaption class=\"wp-caption-text\">Councilmember Nikki Fortunato Bas speaks at Lake Merritt during a vigil calling for peace on June 22, 2021, following the Juneteenth shooting that wounded seven people and left one man dead. \u003ccite>(Beth LaBerge/KQED)\u003c/cite>\u003c/figcaption>\u003c/figure>\n\u003cp>Many Oakland residents have been demanding less spending since the murder of George Floyd by police in Minneapolis, calling on city leaders to cut the Police Department’s budget by 50% and invest that money in alternatives to police.\u003c/p>\n\u003cp>One such group was the Anti Police-Terror Project. James Burch, policy director for the group, said the vote marked a tremendous victory after a six-year campaign. “And it speaks to how difficult it has been for us to gain traction and demand common sense out of the city council,” he said.\u003c/p>\n\u003cp>[ad fullwidth]\u003c/p>\n\u003cp>But Burch highlighted that while police won’t be seeing that $18 million, it’s “a drop in the bucket.”\u003c/p>\n\u003cp>“We’re talking about a police budget that is well over $300 million every year consistently and continues to increase — even this year. And so it’s important that we maintain that perspective,” he said.\u003c/p>\n\u003cp>[pullquote size=\"medium\" align=\"right\" citation=\"Oakland Councilmember Loren Taylor\"]‘We are asking people to jump out of an airplane without a parachute, promising to get to them before they need it to land.’[/pullquote]The previous two-year budget spent $665 million for police and constituted 19.6% of the city budget. The mayor’s proposed budget had slightly increased the total dollars for police to $692 million but decreased the percentage police use from the city budget to 17.9%.\u003c/p>\n\u003cp>APTP has been calling on investments like \u003ca href=\"https://www.kqed.org/news/11874272/build-something-powerful-oakland-aims-to-remove-police-from-some-nonviolent-911-calls\" target=\"_blank\" rel=\"noopener noreferrer\">Mobile Assistance Community Responders of Oakland\u003c/a>, also known as MACRO, which the council also supports.\u003c/p>\n\u003cp>Under a pilot program, trained MACRO personnel will respond to non-violent, non-criminal mental and behavioral health calls instead of police.\u003c/p>\n\u003cp>The budget passed Thursday will invest $4 million in MACRO.\u003c/p>\n\u003cfigure id=\"attachment_11879450\" class=\"wp-caption alignnone\" style=\"max-width: 800px\">\u003cimg loading=\"lazy\" decoding=\"async\" class=\"size-medium wp-image-11879450\" src=\"https://ww2.kqed.org/app/uploads/sites/10/2021/06/RS50164_027_Oakland_JuneteenthShootingVigil_06222021-qut-800x533.jpg\" alt=\"\" width=\"800\" height=\"533\" srcset=\"https://cdn.kqed.org/wp-content/uploads/sites/10/2021/06/RS50164_027_Oakland_JuneteenthShootingVigil_06222021-qut-800x533.jpg 800w, https://cdn.kqed.org/wp-content/uploads/sites/10/2021/06/RS50164_027_Oakland_JuneteenthShootingVigil_06222021-qut-1020x680.jpg 1020w, https://cdn.kqed.org/wp-content/uploads/sites/10/2021/06/RS50164_027_Oakland_JuneteenthShootingVigil_06222021-qut-160x107.jpg 160w, https://cdn.kqed.org/wp-content/uploads/sites/10/2021/06/RS50164_027_Oakland_JuneteenthShootingVigil_06222021-qut-1536x1024.jpg 1536w, https://cdn.kqed.org/wp-content/uploads/sites/10/2021/06/RS50164_027_Oakland_JuneteenthShootingVigil_06222021-qut.jpg 1920w\" sizes=\"(max-width: 800px) 100vw, 800px\">\u003cfigcaption class=\"wp-caption-text\">Oakland Councilmember Carol Fife speaks at Lake Merritt during a vigil calling for peace on June 22, 2021, following the Juneteenth shooting that wounded seven people and left one man dead. \u003ccite>(Beth LaBerge/KQED)\u003c/cite>\u003c/figcaption>\u003c/figure>\n\u003cp>Although the investments in alternatives to police are expected to reduce violence, Taylor expressed concern that they are not proven or in place.\u003c/p>\n\u003cp>[aside tag=\"opd\" label=\"More on Oakland police\"]“We are asking people to jump out of an airplane without a parachute, promising to get to them before they need it to land,” Taylor said in a statement.\u003c/p>\n\u003cp>Before the final vote, Reid put forth an amendment to add a third police academy class in the first year of the budget and reduce the number of classes to one in the second year.\u003c/p>\n\u003cp>Reid expressed concern about redirecting the proposed police spending when bullets are flying into the homes of East Oaklanders who she represents.\u003c/p>\n\u003cp>Reid’s amendment failed by a vote of 6-3, with Kalb, Taylor and Reid as the three votes in favor.\u003c/p>\n\u003cp>\u003cem>This story includes reporting from Bay City News and KQED’s Raquel Maria Dillon and Julie Chang.\u003c/em>\u003c/p>\n\u003cp>\u003c/p>\n",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003cp>Oakland city councilmembers redirected $18 million proposed for police spending from the mayor’s budget to alternative methods of violence prevention when the council passed a $3.8 billion budget Thursday evening.\u003c/p>\n\u003cp>The vote came at about 5:30 p.m. following hours of public comment and discussion at a virtual meeting.\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"content": "\u003cdiv class=\"post-body\">\u003cp>The cuts to police spending were made from Mayor Libby Schaaf’s proposed budget for fiscal years 2021-2023 released in May, which would have added two police academy classes to the usual four over the two-year budget cycle.\u003c/p>\n\u003cp>The mayor’s budget proposal was then amended by Council President Nikki Fortunato Bas and Councilmembers Carroll Fife, Dan Kalb and Noel Gallo. The amendment was what passed on Thursday.\u003c/p>\n\u003cp>“The budget passed today by the Oakland City Council makes bold investments to reimagine public safety through violence prevention and non-police strategies that I strongly support,” Schaaf said in a statement.\u003c/p>\n\u003cp>“Unfortunately, it also cuts 50 police officers who respond to Oaklanders’ 911 calls and enforce traffic safety,” Schaaf said.\u003c/p>\n\u003cfigure id=\"attachment_11879475\" class=\"wp-caption alignnone\" style=\"max-width: 800px\">\u003cimg loading=\"lazy\" decoding=\"async\" class=\"size-medium wp-image-11879475\" src=\"https://ww2.kqed.org/app/uploads/sites/10/2021/06/RS50148_011_Oakland_JuneteenthShootingVigil_06222021-qut-800x533.jpg\" alt=\"\" width=\"800\" height=\"533\" srcset=\"https://cdn.kqed.org/wp-content/uploads/sites/10/2021/06/RS50148_011_Oakland_JuneteenthShootingVigil_06222021-qut-800x533.jpg 800w, https://cdn.kqed.org/wp-content/uploads/sites/10/2021/06/RS50148_011_Oakland_JuneteenthShootingVigil_06222021-qut-1020x680.jpg 1020w, https://cdn.kqed.org/wp-content/uploads/sites/10/2021/06/RS50148_011_Oakland_JuneteenthShootingVigil_06222021-qut-160x107.jpg 160w, https://cdn.kqed.org/wp-content/uploads/sites/10/2021/06/RS50148_011_Oakland_JuneteenthShootingVigil_06222021-qut-1536x1024.jpg 1536w, https://cdn.kqed.org/wp-content/uploads/sites/10/2021/06/RS50148_011_Oakland_JuneteenthShootingVigil_06222021-qut.jpg 1920w\" sizes=\"(max-width: 800px) 100vw, 800px\">\u003cfigcaption class=\"wp-caption-text\">A few hundred people gathered at Lake Merritt for a vigil calling for peace on June 22, 2021, following the Juneteenth shooting that wounded seven people and left one man dead. \u003ccite>(Beth LaBerge/KQED)\u003c/cite>\u003c/figcaption>\u003c/figure>\n\u003cp>Six councilmembers voted in favor of the new budget, while Councilmembers Loren Taylor and Treva Reid opposed it because of concerns over an equitable distribution of city funds.\u003c/p>\n\u003cp>Both Taylor and Reid represent East Oakland.\u003c/p>\n\u003cp>The changes come amid a historic increase in violence in the city, with at least 61 homicides so far this year — nearly all by firearms — up about 90% from a year ago, Oakland Police Chief LeRonne Armstrong said Wednesday.\u003c/p>\n\u003cp>The violence was palpable last weekend when gunfire killed one and wounded at least six others in a shooting near Lake Merritt.\u003c/p>\n\u003cp>But Armstrong reportedly said no number of officers at the lake would have prevented the tragedy and some councilmembers used that statement to bolster their argument for less spending on police.\u003c/p>\n\u003cfigure id=\"attachment_11879449\" class=\"wp-caption alignnone\" style=\"max-width: 800px\">\u003cimg loading=\"lazy\" decoding=\"async\" class=\"size-medium wp-image-11879449\" src=\"https://ww2.kqed.org/app/uploads/sites/10/2021/06/RS50143_006_Oakland_JuneteenthShootingVigil_06222021-qut-800x533.jpg\" alt=\"\" width=\"800\" height=\"533\" srcset=\"https://cdn.kqed.org/wp-content/uploads/sites/10/2021/06/RS50143_006_Oakland_JuneteenthShootingVigil_06222021-qut-800x533.jpg 800w, https://cdn.kqed.org/wp-content/uploads/sites/10/2021/06/RS50143_006_Oakland_JuneteenthShootingVigil_06222021-qut-1020x680.jpg 1020w, https://cdn.kqed.org/wp-content/uploads/sites/10/2021/06/RS50143_006_Oakland_JuneteenthShootingVigil_06222021-qut-160x107.jpg 160w, https://cdn.kqed.org/wp-content/uploads/sites/10/2021/06/RS50143_006_Oakland_JuneteenthShootingVigil_06222021-qut-1536x1024.jpg 1536w, https://cdn.kqed.org/wp-content/uploads/sites/10/2021/06/RS50143_006_Oakland_JuneteenthShootingVigil_06222021-qut.jpg 1920w\" sizes=\"(max-width: 800px) 100vw, 800px\">\u003cfigcaption class=\"wp-caption-text\">Councilmember Nikki Fortunato Bas speaks at Lake Merritt during a vigil calling for peace on June 22, 2021, following the Juneteenth shooting that wounded seven people and left one man dead. \u003ccite>(Beth LaBerge/KQED)\u003c/cite>\u003c/figcaption>\u003c/figure>\n\u003cp>Many Oakland residents have been demanding less spending since the murder of George Floyd by police in Minneapolis, calling on city leaders to cut the Police Department’s budget by 50% and invest that money in alternatives to police.\u003c/p>\n\u003cp>One such group was the Anti Police-Terror Project. 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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>But Burch highlighted that while police won’t be seeing that $18 million, it’s “a drop in the bucket.”\u003c/p>\n\u003cp>“We’re talking about a police budget that is well over $300 million every year consistently and continues to increase — even this year. And so it’s important that we maintain that perspective,” he said.\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"content": "\u003cdiv class=\"post-body\">\u003cp>The previous two-year budget spent $665 million for police and constituted 19.6% of the city budget. The mayor’s proposed budget had slightly increased the total dollars for police to $692 million but decreased the percentage police use from the city budget to 17.9%.\u003c/p>\n\u003cp>APTP has been calling on investments like \u003ca href=\"https://www.kqed.org/news/11874272/build-something-powerful-oakland-aims-to-remove-police-from-some-nonviolent-911-calls\" target=\"_blank\" rel=\"noopener noreferrer\">Mobile Assistance Community Responders of Oakland\u003c/a>, also known as MACRO, which the council also supports.\u003c/p>\n\u003cp>Under a pilot program, trained MACRO personnel will respond to non-violent, non-criminal mental and behavioral health calls instead of police.\u003c/p>\n\u003cp>The budget passed Thursday will invest $4 million in MACRO.\u003c/p>\n\u003cfigure id=\"attachment_11879450\" class=\"wp-caption alignnone\" style=\"max-width: 800px\">\u003cimg loading=\"lazy\" decoding=\"async\" class=\"size-medium wp-image-11879450\" src=\"https://ww2.kqed.org/app/uploads/sites/10/2021/06/RS50164_027_Oakland_JuneteenthShootingVigil_06222021-qut-800x533.jpg\" alt=\"\" width=\"800\" height=\"533\" srcset=\"https://cdn.kqed.org/wp-content/uploads/sites/10/2021/06/RS50164_027_Oakland_JuneteenthShootingVigil_06222021-qut-800x533.jpg 800w, https://cdn.kqed.org/wp-content/uploads/sites/10/2021/06/RS50164_027_Oakland_JuneteenthShootingVigil_06222021-qut-1020x680.jpg 1020w, https://cdn.kqed.org/wp-content/uploads/sites/10/2021/06/RS50164_027_Oakland_JuneteenthShootingVigil_06222021-qut-160x107.jpg 160w, https://cdn.kqed.org/wp-content/uploads/sites/10/2021/06/RS50164_027_Oakland_JuneteenthShootingVigil_06222021-qut-1536x1024.jpg 1536w, https://cdn.kqed.org/wp-content/uploads/sites/10/2021/06/RS50164_027_Oakland_JuneteenthShootingVigil_06222021-qut.jpg 1920w\" sizes=\"(max-width: 800px) 100vw, 800px\">\u003cfigcaption class=\"wp-caption-text\">Oakland Councilmember Carol Fife speaks at Lake Merritt during a vigil calling for peace on June 22, 2021, following the Juneteenth shooting that wounded seven people and left one man dead. \u003ccite>(Beth LaBerge/KQED)\u003c/cite>\u003c/figcaption>\u003c/figure>\n\u003cp>Although the investments in alternatives to police are expected to reduce violence, Taylor expressed concern that they are not proven or in place.\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"content": "\u003cdiv class=\"post-body\">\u003cp>“We are asking people to jump out of an airplane without a parachute, promising to get to them before they need it to land,” Taylor said in a statement.\u003c/p>\n\u003cp>Before the final vote, Reid put forth an amendment to add a third police academy class in the first year of the budget and reduce the number of classes to one in the second year.\u003c/p>\n\u003cp>Reid expressed concern about redirecting the proposed police spending when bullets are flying into the homes of East Oaklanders who she represents.\u003c/p>\n\u003cp>Reid’s amendment failed by a vote of 6-3, with Kalb, Taylor and Reid as the three votes in favor.\u003c/p>\n\u003cp>\u003cem>This story includes reporting from Bay City News and KQED’s Raquel Maria Dillon and Julie Chang.\u003c/em>\u003c/p>\n\u003cp>\u003c/p>\n\u003c/div>\u003c/p>",
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"slug": "report-asian-americas-more-stressed-by-anti-asian-hate-than-covid-19",
"title": "Report: Asian Americans More Stressed by Anti-Asian Hate Than COVID-19",
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"headTitle": "Report: Asian Americans More Stressed by Anti-Asian Hate Than COVID-19 | KQED",
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"content": "\u003cp>Asian Americans may be experiencing more stress from first-hand anti-Asian racism than from COVID-19 itself, according to a new report from \u003ca href=\"https://stopaapihate.org/\" target=\"_blank\" rel=\"noopener noreferrer\">Stop AAPI Hate\u003c/a>.\u003c/p>\n\u003cp>\u003ca href=\"https://stopaapihate.org/mental-health-report/\" target=\"_blank\" rel=\"noopener noreferrer\">The report\u003c/a>, released last week, synthesizes findings from a survey of more than 400 Asian Americans, a national needs assessment on racism by the Asian American Psychological Association of more than 3,700 Asian Americans and a COVID-19 resilience study exploring the connection between pandemic stress and the stress of racism.[pullquote size=\"medium\" align=\"right\" citation=\"Russell Jeung, San Francisco State University Asian American Studies professor and co-founder of Stop AAPI Hate \"]‘Our respondents say their primary stressor during the pandemic is racism. They’re actually saying they’re more concerned about other Americans’ hate than they are about the pandemic.’[/pullquote]\u003c/p>\n\u003cp>While the report outlines the pain of a community experiencing discrimination and hate, it also presents a solution: Those who reported hate crimes they experienced, also reported lower levels of race-based traumatic stress.\u003c/p>\n\u003cp>Russell Jeung, a San Francisco State University Asian American Studies professor and one of the founders of Stop AAPI Hate, said the report’s findings show the trauma racial hatred can inflict.\u003c/p>\n\u003cp>“Our respondents say their primary stressor during the pandemic is racism. They’re actually saying they’re more concerned about other Americans’ hate than they are about the pandemic,” Jeung said. “That shows how traumatizing, how widespread, how fearful they are for their elders.”\u003c/p>\n\u003cp>[ad fullwidth]\u003c/p>\n\u003cp>Approximately 549,000 people have died in the U.S. from COVID-19 as of June 1, 2021, according to Johns Hopkins University.\u003c/p>\n\u003cp>Asian Americans reported lower levels of psychological distress than other groups in the U.S. before the pandemic, according to the report. But during the pandemic, about 62% of Asian American survey respondents said they or their family members had experienced covert or overt discriminatory incidents.\u003c/p>\n\u003cp>That led to an increase in depression and other disorders across the board, according to the report.\u003c/p>\n\u003cp>Almost half of Asian people surveyed reported anxiety during the pandemic, with 15% saying they had depressive symptoms. About one in three Asian and Asian American young adults reported clinically elevated symptoms of depression and general anxiety, and one in four reported a PTSD diagnosis, according to the report.\u003c/p>\n\u003cp>One in five Asian Americans who experienced racism display racial trauma, the reported noted, which can manifest as depression, intrusive thoughts, anger, hypervigilance, decreased self-esteem and other deleterious disorders.\u003c/p>\n\u003cp>After experiencing racism, Jeung said because of what’s happened, some people are avoiding places, and when they do go out they are being hypervigilant and “always watching their back in front of people, when they see someone running, they would actually jump out into the street and be more concerned about the person running at them than they are about the traffic,” he said. “So it’s shaping people’s behaviors.”\u003c/p>\n\u003cp>When stressors did arise, immigrants who did not speak English often faced barriers to obtaining mental health care, and also cultural barriers to pursuing that care in the first place.\u003c/p>\n\u003cp>Dr. Cindy Liu, a clinical psychologist and professor at Brigham and Women’s Hospital in Boston, worked on the survey, and said anti-Asian hate is not new. But now she feels like history is repeating itself.\u003c/p>\n\u003cp>“And that’s problematic, because we haven’t necessarily learned from the past. And so our hope is that this data can allow us to advocate to really sort of shift, and change the tide, and be able to ensure the health of all Asian Americans,” Liu said. [aside tag=\"asian-american, racism\" label=\"More Related Stories\"]\u003c/p>\n\u003cp>The people who led this survey want to see more access to mental health resources for the Asian American community, including language support.\u003c/p>\n\u003cp>For now, however, there are some findings that could help those in the Asian community who are experiencing racism.\u003c/p>\n\u003cp>About 28% of Asian Americans who reported racial trauma after a hate incident no longer met clinical criteria for race-based trauma after reporting that incident, according to the report.\u003c/p>\n\u003cp>“What it does beyond providing a platform of expressing their hurt is that it translates those feelings into action so that they have a productive outlet and they develop a collective voice,” Jeung said.\u003c/p>\n\u003cp>\u003c/p>\n\u003cp>Bringing hateful acts into the sunlight, then, may present a solution not only to stopping more incidents, but to healing.\u003c/p>\n\n",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003cp>Asian Americans may be experiencing more stress from first-hand anti-Asian racism than from COVID-19 itself, according to a new report from \u003ca href=\"https://stopaapihate.org/\" target=\"_blank\" rel=\"noopener noreferrer\">Stop AAPI Hate\u003c/a>.\u003c/p>\n\u003cp>\u003ca href=\"https://stopaapihate.org/mental-health-report/\" target=\"_blank\" rel=\"noopener noreferrer\">The report\u003c/a>, released last week, synthesizes findings from a survey of more than 400 Asian Americans, a national needs assessment on racism by the Asian American Psychological Association of more than 3,700 Asian Americans and a COVID-19 resilience study exploring the connection between pandemic stress and the stress of racism.\u003c/p>\u003c/div>",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>While the report outlines the pain of a community experiencing discrimination and hate, it also presents a solution: Those who reported hate crimes they experienced, also reported lower levels of race-based traumatic stress.\u003c/p>\n\u003cp>Russell Jeung, a San Francisco State University Asian American Studies professor and one of the founders of Stop AAPI Hate, said the report’s findings show the trauma racial hatred can inflict.\u003c/p>\n\u003cp>“Our respondents say their primary stressor during the pandemic is racism. They’re actually saying they’re more concerned about other Americans’ hate than they are about the pandemic,” Jeung said. “That shows how traumatizing, how widespread, how fearful they are for their elders.”\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>Approximately 549,000 people have died in the U.S. from COVID-19 as of June 1, 2021, according to Johns Hopkins University.\u003c/p>\n\u003cp>Asian Americans reported lower levels of psychological distress than other groups in the U.S. before the pandemic, according to the report. But during the pandemic, about 62% of Asian American survey respondents said they or their family members had experienced covert or overt discriminatory incidents.\u003c/p>\n\u003cp>That led to an increase in depression and other disorders across the board, according to the report.\u003c/p>\n\u003cp>Almost half of Asian people surveyed reported anxiety during the pandemic, with 15% saying they had depressive symptoms. About one in three Asian and Asian American young adults reported clinically elevated symptoms of depression and general anxiety, and one in four reported a PTSD diagnosis, according to the report.\u003c/p>\n\u003cp>One in five Asian Americans who experienced racism display racial trauma, the reported noted, which can manifest as depression, intrusive thoughts, anger, hypervigilance, decreased self-esteem and other deleterious disorders.\u003c/p>\n\u003cp>After experiencing racism, Jeung said because of what’s happened, some people are avoiding places, and when they do go out they are being hypervigilant and “always watching their back in front of people, when they see someone running, they would actually jump out into the street and be more concerned about the person running at them than they are about the traffic,” he said. “So it’s shaping people’s behaviors.”\u003c/p>\n\u003cp>When stressors did arise, immigrants who did not speak English often faced barriers to obtaining mental health care, and also cultural barriers to pursuing that care in the first place.\u003c/p>\n\u003cp>Dr. Cindy Liu, a clinical psychologist and professor at Brigham and Women’s Hospital in Boston, worked on the survey, and said anti-Asian hate is not new. But now she feels like history is repeating itself.\u003c/p>\n\u003cp>“And that’s problematic, because we haven’t necessarily learned from the past. And so our hope is that this data can allow us to advocate to really sort of shift, and change the tide, and be able to ensure the health of all Asian Americans,” Liu said. \u003c/p>\u003c/div>",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>The people who led this survey want to see more access to mental health resources for the Asian American community, including language support.\u003c/p>\n\u003cp>For now, however, there are some findings that could help those in the Asian community who are experiencing racism.\u003c/p>\n\u003cp>About 28% of Asian Americans who reported racial trauma after a hate incident no longer met clinical criteria for race-based trauma after reporting that incident, according to the report.\u003c/p>\n\u003cp>“What it does beyond providing a platform of expressing their hurt is that it translates those feelings into action so that they have a productive outlet and they develop a collective voice,” Jeung said.\u003c/p>\n\u003cp>\u003c/p>\n\u003cp>Bringing hateful acts into the sunlight, then, may present a solution not only to stopping more incidents, but to healing.\u003c/p>\n\n\u003c/div>\u003c/p>",
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"title": "‘Build Something Powerful’: Oakland Aims to Remove Police From Some Nonviolent 911 Calls",
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"headTitle": "‘Build Something Powerful’: Oakland Aims to Remove Police From Some Nonviolent 911 Calls | KQED",
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"content": "\u003cp>Some of the boldest reform experiments underway in the wake of the national reckoning on police violence and systemic racism following \u003ca href=\"https://www.npr.org/sections/trial-over-killing-of-george-floyd/\">George Floyd’s murder\u003c/a> are pilot projects \u003ca href=\"https://www.npr.org/2020/10/19/924146486/removing-cops-from-behavioral-crisis-calls-we-need-to-change-the-model\">in Denver, San Francisco\u003c/a>, \u003ca href=\"https://www.kgw.com/article/news/local/portland-street-response-team-mental-health-crises/283-ed2211d0-e73c-4d6b-82ec-91e94ad8c8ea\">Portland, Oregon\u003c/a>, and elsewhere. They’re confronting hard questions about what role, if any, police should play in responding to calls for persons in nonviolent mental health, drug, alcohol or homeless crises.\u003c/p>\n\u003cp>[pullquote size=\"medium\" align=\"right\" citation=\"Rebecca Kaplan, Oakland Vice Mayor and Councilmember\"]‘Not only mental health, but the whole range of lower-level issues that shouldn’t require a gun to be part of the response.’[/pullquote]This fall, Oakland aims to join those cities when it launches a pilot project to funnel some nonviolent, noncriminal calls to new, mobile teams of civilians.\u003c/p>\n\u003cp>“Not only mental health, but the whole range of lower-level issues that shouldn’t require a gun to be part of the response,” says Rebecca Kaplan, the city’s vice mayor who has championed the nascent program called Mobile Assistance Community Responders of Oakland, or MACRO.\u003c/p>\n\u003cp>Kaplan says sending police to mental health and behavioral calls they are not trained to handle is a grave mistake cities keep repeating. “Those cases often go very badly and sometimes horrifically,” she says. “We have seen horrific deaths, killings by police throughout the nation when they’ve been called for matters that deal with mental health or homelessness or public intoxication — or any of these matters that are not a violent crime — and should be better handled by a non-police response.”\u003c/p>\n\u003cp>\u003ca href=\"https://www.treatmentadvocacycenter.org/storage/documents/overlooked-in-the-undercounted.pdf\">One study estimates\u003c/a> people with an untreated mental illness are 16 times more likely to be killed during an encounter with police than other civilians.\u003c/p>\n\u003cp>MACRO is part of \u003ca href=\"https://www.oaklandca.gov/topics/reimagining-public-safety\">a wider effort by the Oakland City Council and Mayor Libby Schaaf\u003c/a> to rethink how law enforcement operates in a city where the police department has been \u003ca href=\"https://www.npr.org/2018/08/08/636319870/in-oakland-more-data-hasnt-meant-less-racial-disparity-during-police-stops\">under federal oversight now\u003c/a> for nearly two decades.\u003c/p>\n\u003cfigure id=\"attachment_11874273\" class=\"wp-caption alignnone\" style=\"max-width: 800px\">\u003cimg loading=\"lazy\" decoding=\"async\" class=\"size-medium wp-image-11874273\" src=\"https://ww2.kqed.org/app/uploads/sites/10/2021/05/rebecca-kaplan_slide-4afb02f36a43086cf9e5cf02d59a3bf756ee15d8-800x533.jpg\" alt=\"\" width=\"800\" height=\"533\" srcset=\"https://cdn.kqed.org/wp-content/uploads/sites/10/2021/05/rebecca-kaplan_slide-4afb02f36a43086cf9e5cf02d59a3bf756ee15d8-800x533.jpg 800w, https://cdn.kqed.org/wp-content/uploads/sites/10/2021/05/rebecca-kaplan_slide-4afb02f36a43086cf9e5cf02d59a3bf756ee15d8-1020x680.jpg 1020w, https://cdn.kqed.org/wp-content/uploads/sites/10/2021/05/rebecca-kaplan_slide-4afb02f36a43086cf9e5cf02d59a3bf756ee15d8-160x107.jpg 160w, https://cdn.kqed.org/wp-content/uploads/sites/10/2021/05/rebecca-kaplan_slide-4afb02f36a43086cf9e5cf02d59a3bf756ee15d8-1536x1023.jpg 1536w, https://cdn.kqed.org/wp-content/uploads/sites/10/2021/05/rebecca-kaplan_slide-4afb02f36a43086cf9e5cf02d59a3bf756ee15d8-1920x1279.jpg 1920w, https://cdn.kqed.org/wp-content/uploads/sites/10/2021/05/rebecca-kaplan_slide-4afb02f36a43086cf9e5cf02d59a3bf756ee15d8.jpg 1999w\" sizes=\"(max-width: 800px) 100vw, 800px\">\u003cfigcaption class=\"wp-caption-text\">Oakland City Vice Mayor and Councilmember Rebecca Kaplan says sending police to mental health and behavioral calls they aren’t trained for is a mistake cities keep repeating. \u003ccite>(Philip Pacheco/AFP via Getty Images)\u003c/cite>\u003c/figcaption>\u003c/figure>\n\u003ch3>Oakland’s Unique Strategy\u003c/h3>\n\u003cp>The pilot program will operate under the fire department, but the teams will be made up of civilians, not sworn firefighters. And in hiring, the program will place a greater emphasis on lived experience over formal education. It’s a unique Oakland take among urban police reform efforts underway. Most cities’ pilot street teams are sending out a trained and licensed clinical social worker or psychologist.\u003c/p>\n\u003cp>“I think the community was crystal clear and has continued to be crystal clear that they do not want a licensed social worker as part of the street team,” says Oakland Deputy Fire Chief Melinda Drayton.\u003c/p>\n\u003cp>And so Drayton, who’s spearheading the department’s efforts on MACRO, says the fire department aims to deliver what the community wants.\u003c/p>\n\u003cp>The civilian teams will deescalate problems, check vitals and potentially get a person in crisis off the streets, she says, by connecting him or her to services anywhere in the city \u003cem>except\u003c/em> a jail, a psychiatric ward or a hospital.\u003c/p>\n\u003cp>“We’ll be able to take them to city, private nonprofit community-based services, health care clinics. Maybe to their dad’s house,” Drayton says. “As simple as that. ‘Where are you going to feel safe for the night?'”\u003c/p>\n\u003cp>[ad fullwidth]\u003c/p>\n\u003cp>The plan is for a civilian emergency medical technician to be paired with someone, for example, with first-hand knowledge of the mental health, criminal justice, homeless or drug treatment systems.\u003c/p>\n\u003cp>“Sometimes people just need to be heard. Sometimes people just need a warm blanket. Sometimes people just need to sober up, you know?,” says Cat Brooks, co-founder of Oakland’s \u003ca href=\"https://www.antipoliceterrorproject.org/\">Anti Police-Terror Project\u003c/a>, who has worked on this issue for years. “I mean, sometimes, [people] need to be able to scream. Like, why is that such a big deal? Why does that scare us so much? Look at the world that we live in. I want to scream all the damn time!”\u003c/p>\n\u003cfigure id=\"attachment_11874323\" class=\"wp-caption alignnone\" style=\"max-width: 800px\">\u003cimg loading=\"lazy\" decoding=\"async\" class=\"size-medium wp-image-11874323\" src=\"https://ww2.kqed.org/app/uploads/sites/10/2021/05/RS48840_024_Alameda_MarioGonzalezPressConf_04272021-qut-800x533.jpg\" alt=\"\" width=\"800\" height=\"533\" srcset=\"https://cdn.kqed.org/wp-content/uploads/sites/10/2021/05/RS48840_024_Alameda_MarioGonzalezPressConf_04272021-qut-800x533.jpg 800w, https://cdn.kqed.org/wp-content/uploads/sites/10/2021/05/RS48840_024_Alameda_MarioGonzalezPressConf_04272021-qut-1020x679.jpg 1020w, https://cdn.kqed.org/wp-content/uploads/sites/10/2021/05/RS48840_024_Alameda_MarioGonzalezPressConf_04272021-qut-160x107.jpg 160w, https://cdn.kqed.org/wp-content/uploads/sites/10/2021/05/RS48840_024_Alameda_MarioGonzalezPressConf_04272021-qut-1536x1022.jpg 1536w, https://cdn.kqed.org/wp-content/uploads/sites/10/2021/05/RS48840_024_Alameda_MarioGonzalezPressConf_04272021-qut.jpg 1920w\" sizes=\"(max-width: 800px) 100vw, 800px\">\u003cfigcaption class=\"wp-caption-text\">Anti-Police Terror Project Co-founder, Cat Brooks, speaks during a news conference outside of the Alameda Police Department on April 27, 2021. \u003ccite>(Beth LaBerge/KQED)\u003c/cite>\u003c/figcaption>\u003c/figure>\n\u003cp>Brooks, a key advocate for MACRO, believes the best people to help are those with street knowledge of the systems that have failed them, what she calls “the medical-industrial complex.”\u003c/p>\n\u003cp>“And that complex — doctors, nurses, psychologists, social workers — stereotypes Black, brown and indigenous bodies. Criminalizes Black, brown and indigenous bodies just as much as law enforcement,” she says. “And so these models have to be more about the ideology and practice with which we respond.”\u003c/p>\n\u003ch3>Concerns About the Pilot\u003c/h3>\n\u003cp>Still, some worry emphasizing ideology over formal training goes against the science and art of mental health care and could undermine the program’s effectiveness.\u003c/p>\n\u003cp>“Social workers have a lot to offer as we re-imagine public safety, policing and seek to strengthen our crisis response capacity,” says Sarah Butts, director of public policy for the National Association of Social Workers.\u003c/p>\n\u003cp>She says the group fully supports communities creating whatever model works best for them. And Butts agrees that peer counselors with life experience in these systems can and are often an important part of any front-line response.\u003c/p>\n\u003cp>But she says extensive education and training do matter when addressing the often complex mix facing someone in a mental health or substance use crisis.\u003c/p>\n\u003cp>“Social workers will have a skill set — problem-solving, relationship building, de-escalation — that really lends itself to this to this type of community problem solving,” Butts says. She notes nonpolice responders must accurately assess the situation quickly under often stressful conditions. “And then decide what is the most effective response.”\u003c/p>\n\u003cp>Whatever model cities use, it’s important they collect and share data on what’s working and what’s not “so that we can learn from our experience and improve these systems,” Butts says.\u003c/p>\n\u003cp>\u003ca href=\"https://www.npr.org/2020/10/19/924146486/removing-cops-from-behavioral-crisis-calls-we-need-to-change-the-model\">As NPR has reported\u003c/a>, across the bay in San Francisco, the city’s new police-free Street Crisis Response Teams put a fire department paramedic with a trained clinical social worker and a peer counselor to help respond to some crisis calls for people who are homeless, intoxicated, having a mental health challenge, or all of the above.\u003c/p>\n\u003cp>The four teams now deployed in San Francisco’s pilot project are, so far, able to respond to only a small number of the overall behavioral crisis calls in that city. But it wants to scale up the program this summer when San Francisco Mayor London Breed hopes to add a companion program of unarmed “wellness” teams to work with the street teams to handle even lower-level calls. It’s part of the mayor’s wider \u003ca href=\"https://sfmayor.org/article/mayor-london-breed-announces-roadmap-new-police-reforms\">pledge to change policing\u003c/a> in the city.\u003c/p>\n\u003ch3>\u003cstrong>Flashpoints with Police \u003c/strong>\u003c/h3>\n\u003cp>With startling repetition non-criminal crisis calls to police — often by a friend or loved one — continue to be flashpoints for violence and death.\u003c/p>\n\u003cp>[aside postID=news_11870691 hero='https://ww2.kqed.org/app/uploads/sites/10/2021/04/RS48713_026_Alameda_MarioGonzalezVigil_04212021-qut-1020x679.jpg']Examples include \u003ca href=\"https://www.npr.org/2020/11/05/931643057/philadelphia-officials-promise-changes-after-walter-wallace-jr-shooting\">Walter Wallace in Philadelphia\u003c/a>, Daniel \u003ca href=\"https://www.npr.org/2020/09/03/909086022/daniel-prudes-death-ruled-a-homicide-he-was-restrained-by-police\">Prude in Rochester\u003c/a> and in late April, Oakland resident \u003ca href=\"https://www.npr.org/2021/04/29/991844355/lawyer-says-police-didnt-need-to-arrest-man-who-died-after-being-pinned-to-groun\">Mario Gonzalez, who died in Alameda Police custody\u003c/a>. The 26-year-old was in a small park in Alameda when 911 callers expressed concerned Gonzalez was mumbling to himself and maybe high or drunk.\u003c/p>\n\u003cp>“He was talking to himself and what else was he doing?” the 911 dispatcher asks one caller in tapes released by Alameda police.\u003c/p>\n\u003cp>“He’s just hanging out,” the caller says, “I mean, he seems like he’s tweaking. But he’s not doing anything wrong. He’s just scaring my wife.”\u003c/p>\n\u003cp>The two 911 calls make clear there’s no violence, imminent threat or any discernible criminal activity, save a couple bottles of booze with the security tags still attached, indicating they were probably stolen.\u003c/p>\n\u003cp>Alameda police soon arrive. \u003ca href=\"https://www.kqed.org/news/11871345/city-of-alameda-releases-police-body-cam-footage-of-mario-gonzalez-death\" target=\"_blank\" rel=\"noopener noreferrer\">Body cam footage\u003c/a> shows officers question Gonzalez about what he’s doing in the park, and ask for his ID. Gonzalez, who is calm but fidgety, mumbles several largely incoherent responses and does not appear to be fully lucid.\u003c/p>\n\u003cp>[aside postID=news_11871345 hero='https://ww2.kqed.org/app/uploads/sites/10/2021/04/RS48857_044_Alameda_MarioGonzalezPressConf_04272021-qut-1020x679.jpg']Without telling him he is under arrest, each officer grabs one of Gonzalez’s arms and proceeds to try to put his hands behind his back. When he bends over and resists being handcuffed, one officer says, “Please stop resisting us, OK? Don’t fight us.”\u003c/p>\n\u003cp>Gonzalez continues to resist, and the two officers take him to the wood chip-covered ground, pinning him on his stomach, with at least one officer pressing an elbow and knee into his back and shoulder. They eventually handcuff him.\u003c/p>\n\u003cp>The two officers continue pinning Gonzalez to the ground for a total of roughly five minutes, with at least one of them pressing his elbow and knee into his back.\u003c/p>\n\u003cp>As Gonzalez becomes motionless, the officers shout his first name, check for a pulse, roll him fully over, and begin administering CPR, with Gonzalez’s hands still restrained behind his back. About a minute later, they remove his handcuffs and continue performing CPR, repeatedly shouting for him to wake up.\u003c/p>\n\u003cp>[aside label=\"related coverage\" tag=\"mario-gonzalez\"]Gonzalez leaves behind a grieving family including a 4-year-old son. He was also the main caretaker of his 22-year-old autistic brother, his family has said.\u003c/p>\n\u003cp>The Alameda Police Department officers involved are on paid leave while multiple agencies investigate. An autopsy is pending.\u003c/p>\n\u003cp>Timothy T. Williams Jr., a police tactics expert, says police need clearer guidelines around “positional asphyxia” — or detaining someone in a way that compresses their airways and reduces the ability to breathe normally.\u003c/p>\n\u003cp>The Alameda Police Department’s \u003ca href=\"https://www.alamedaca.gov/files/assets/public/departments/alameda/police/alameda-police-department-policy-manual-11022020.pdf\" target=\"_blank\" rel=\"noopener noreferrer\">policy manual\u003c/a> states that a suspect “shall not be placed on his/her stomach for an extended period, as this could reduce the person’s ability to breathe.”\u003c/p>\n\u003cp>But Williams says that guideline isn’t specific or directed enough. “Once he or she is handcuffed, they are to be immediately removed from the prone position, put on their side, and, if possible, sat up.” Otherwise, he says, “You leave everything to subjective interpretation: What may be short to you may be long to me.”\u003c/p>\n\u003cp>“There was no reason whatsoever to go hands-on with Mario,” says civil rights lawyer Julia Sherwin, who represents his family. She has formally asked the U.S. Department of Justice to open a civil rights investigation into the Alameda Police Department.\u003c/p>\n\u003cp>Sherwin says Gonzalez was unarmed, holding only a comb. “He’s been combing his hair and he’s been loitering there for half an hour. Why this required a law enforcement response is beyond me.”\u003c/p>\n\u003cp>It’s instances like this that have led Oakland to its experiment.\u003c/p>\n\u003ch3>Much Work Remains\u003c/h3>\n\u003cp>In Oakland, Mayor Libby Schaaf originally pushed to put MACRO under an area nonprofit. The city council rejected that idea. Despite ongoing political tussles with the council, Schaaf “wholeheartedly supports this and it is part of her budget proposal,” says her communications director Justin Berton. “We hope it will be up and running as soon as humanly possible.”\u003c/p>\n\u003cp>Big details in implementing the plan remain. The fire agency, already stretched thin, now has to hire, train and equip new teams of civilians.\u003c/p>\n\u003cp>The Oakland Police Department, for their part, are largely staying quiet on the program for now and letting city hall, the Oakland City Council and fire department work it out.\u003c/p>\n\u003cp>And police will still, at first, handle all 5150 calls — that’s the code that allows police to involuntarily confine someone exhibiting behavior that’s “the result of a mental disorder,” and who appears to be endangering him or herself or others.\u003c/p>\n\u003cp>A big unanswered question is what percentage of the nearly quarter-million annual 911 police calls in Oakland will eventually be transferred to the new unarmed, police-free teams. One city councilwoman says the goal is 20% of nonviolent 911 calls within three years.\u003c/p>\n\u003cp>Deputy Fire Chief Drayton says, at first, the percentage will be far smaller. The aim is to grow over time but start small: one team working a swing shift five days a week going after the relatively low-hanging fruit of noise disturbances, welfare checks, loitering and such.\u003c/p>\n\u003cp>And the city’s 911 dispatchers will very likely need additional training. The program will put enormous pressure on those dispatchers who will, at first anyway, have to decide which calls to funnel to MACRO or to police for a more traditional response.\u003c/p>\n\u003cp>[pullquote size=\"medium\" align=\"right\" citation=\"Cat Brooks, co-founder of the Anti Police-Terror Project\"]‘Broad swaths of Black and brown people will not call the police ever for any reason…Why? Because our lived experience is police do not make it better when they show up.’[/pullquote]\u003cbr>\nBut activist Cat Brooks of the Anti Police-Terror Project says using the traditional 911 system at all for these new teams is a big mistake. She has helped set up a separate non-police, non-city run mental health response program that operates on weekend nights \u003ca href=\"https://www.antipoliceterrorproject.org/mh-first-oakland\">called MH First Oakland\u003c/a> that uses a separate phone number, not 911.\u003c/p>\n\u003cp>“Broad swaths of Black and brown people will not call the police ever for any reason. Someone could be being shot in broad daylight in front of their house, and they are not dialing 911. Why? Because our lived experience is police do not make it better when they show up,” says Brooks. “Things almost always are worse.”\u003c/p>\n\u003cp>Despite those big concerns, Brooks remains cautiously hopeful the new effort will mean real change for a city and police department that have been \u003ca href=\"https://www.npr.org/2018/08/08/636319870/in-oakland-more-data-hasnt-meant-less-racial-disparity-during-police-stops\">under federal oversight now\u003c/a> for nearly two decades.\u003c/p>\n\u003cp>“If we can just get out of the Oakland bureaucracy, red tape, ego and drama,” Brooks says with a smile, “I think there’s an opportunity for us to build something really powerful.”\u003c/p>\n\u003cp>\u003cem>This story includes additional reporting from KQED’s Matthew Green.\u003c/em>\u003c/p>\n\u003cdiv class=\"fullattribution\">Copyright 2021 NPR. To see more, visit https://www.npr.org.\u003cimg decoding=\"async\" src=\"https://www.google-analytics.com/__utm.gif?utmac=UA-5828686-4&utmdt=Oakland+Becomes+Latest+City+Looking+To+Take+Police+Out+Of+Some+Nonviolent+911+Calls&utme=8(APIKey)9(MDAxOTAwOTE4MDEyMTkxMDAzNjczZDljZA004)\">\u003c/div>\n\u003cp>[ad floatright]\u003c/p>\n",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003cp>Some of the boldest reform experiments underway in the wake of the national reckoning on police violence and systemic racism following \u003ca href=\"https://www.npr.org/sections/trial-over-killing-of-george-floyd/\">George Floyd’s murder\u003c/a> are pilot projects \u003ca href=\"https://www.npr.org/2020/10/19/924146486/removing-cops-from-behavioral-crisis-calls-we-need-to-change-the-model\">in Denver, San Francisco\u003c/a>, \u003ca href=\"https://www.kgw.com/article/news/local/portland-street-response-team-mental-health-crises/283-ed2211d0-e73c-4d6b-82ec-91e94ad8c8ea\">Portland, Oregon\u003c/a>, and elsewhere. They’re confronting hard questions about what role, if any, police should play in responding to calls for persons in nonviolent mental health, drug, alcohol or homeless crises.\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"content": "‘Not only mental health, but the whole range of lower-level issues that shouldn’t require a gun to be part of the response.’",
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"content": "\u003cdiv class=\"post-body\">\u003cp>This fall, Oakland aims to join those cities when it launches a pilot project to funnel some nonviolent, noncriminal calls to new, mobile teams of civilians.\u003c/p>\n\u003cp>“Not only mental health, but the whole range of lower-level issues that shouldn’t require a gun to be part of the response,” says Rebecca Kaplan, the city’s vice mayor who has championed the nascent program called Mobile Assistance Community Responders of Oakland, or MACRO.\u003c/p>\n\u003cp>Kaplan says sending police to mental health and behavioral calls they are not trained to handle is a grave mistake cities keep repeating. “Those cases often go very badly and sometimes horrifically,” she says. “We have seen horrific deaths, killings by police throughout the nation when they’ve been called for matters that deal with mental health or homelessness or public intoxication — or any of these matters that are not a violent crime — and should be better handled by a non-police response.”\u003c/p>\n\u003cp>\u003ca href=\"https://www.treatmentadvocacycenter.org/storage/documents/overlooked-in-the-undercounted.pdf\">One study estimates\u003c/a> people with an untreated mental illness are 16 times more likely to be killed during an encounter with police than other civilians.\u003c/p>\n\u003cp>MACRO is part of \u003ca href=\"https://www.oaklandca.gov/topics/reimagining-public-safety\">a wider effort by the Oakland City Council and Mayor Libby Schaaf\u003c/a> to rethink how law enforcement operates in a city where the police department has been \u003ca href=\"https://www.npr.org/2018/08/08/636319870/in-oakland-more-data-hasnt-meant-less-racial-disparity-during-police-stops\">under federal oversight now\u003c/a> for nearly two decades.\u003c/p>\n\u003cfigure id=\"attachment_11874273\" class=\"wp-caption alignnone\" style=\"max-width: 800px\">\u003cimg loading=\"lazy\" decoding=\"async\" class=\"size-medium wp-image-11874273\" src=\"https://ww2.kqed.org/app/uploads/sites/10/2021/05/rebecca-kaplan_slide-4afb02f36a43086cf9e5cf02d59a3bf756ee15d8-800x533.jpg\" alt=\"\" width=\"800\" height=\"533\" srcset=\"https://cdn.kqed.org/wp-content/uploads/sites/10/2021/05/rebecca-kaplan_slide-4afb02f36a43086cf9e5cf02d59a3bf756ee15d8-800x533.jpg 800w, https://cdn.kqed.org/wp-content/uploads/sites/10/2021/05/rebecca-kaplan_slide-4afb02f36a43086cf9e5cf02d59a3bf756ee15d8-1020x680.jpg 1020w, https://cdn.kqed.org/wp-content/uploads/sites/10/2021/05/rebecca-kaplan_slide-4afb02f36a43086cf9e5cf02d59a3bf756ee15d8-160x107.jpg 160w, https://cdn.kqed.org/wp-content/uploads/sites/10/2021/05/rebecca-kaplan_slide-4afb02f36a43086cf9e5cf02d59a3bf756ee15d8-1536x1023.jpg 1536w, https://cdn.kqed.org/wp-content/uploads/sites/10/2021/05/rebecca-kaplan_slide-4afb02f36a43086cf9e5cf02d59a3bf756ee15d8-1920x1279.jpg 1920w, https://cdn.kqed.org/wp-content/uploads/sites/10/2021/05/rebecca-kaplan_slide-4afb02f36a43086cf9e5cf02d59a3bf756ee15d8.jpg 1999w\" sizes=\"(max-width: 800px) 100vw, 800px\">\u003cfigcaption class=\"wp-caption-text\">Oakland City Vice Mayor and Councilmember Rebecca Kaplan says sending police to mental health and behavioral calls they aren’t trained for is a mistake cities keep repeating. \u003ccite>(Philip Pacheco/AFP via Getty Images)\u003c/cite>\u003c/figcaption>\u003c/figure>\n\u003ch3>Oakland’s Unique Strategy\u003c/h3>\n\u003cp>The pilot program will operate under the fire department, but the teams will be made up of civilians, not sworn firefighters. And in hiring, the program will place a greater emphasis on lived experience over formal education. It’s a unique Oakland take among urban police reform efforts underway. Most cities’ pilot street teams are sending out a trained and licensed clinical social worker or psychologist.\u003c/p>\n\u003cp>“I think the community was crystal clear and has continued to be crystal clear that they do not want a licensed social worker as part of the street team,” says Oakland Deputy Fire Chief Melinda Drayton.\u003c/p>\n\u003cp>And so Drayton, who’s spearheading the department’s efforts on MACRO, says the fire department aims to deliver what the community wants.\u003c/p>\n\u003cp>The civilian teams will deescalate problems, check vitals and potentially get a person in crisis off the streets, she says, by connecting him or her to services anywhere in the city \u003cem>except\u003c/em> a jail, a psychiatric ward or a hospital.\u003c/p>\n\u003cp>“We’ll be able to take them to city, private nonprofit community-based services, health care clinics. Maybe to their dad’s house,” Drayton says. “As simple as that. ‘Where are you going to feel safe for the night?'”\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>The plan is for a civilian emergency medical technician to be paired with someone, for example, with first-hand knowledge of the mental health, criminal justice, homeless or drug treatment systems.\u003c/p>\n\u003cp>“Sometimes people just need to be heard. Sometimes people just need a warm blanket. Sometimes people just need to sober up, you know?,” says Cat Brooks, co-founder of Oakland’s \u003ca href=\"https://www.antipoliceterrorproject.org/\">Anti Police-Terror Project\u003c/a>, who has worked on this issue for years. “I mean, sometimes, [people] need to be able to scream. Like, why is that such a big deal? Why does that scare us so much? Look at the world that we live in. I want to scream all the damn time!”\u003c/p>\n\u003cfigure id=\"attachment_11874323\" class=\"wp-caption alignnone\" style=\"max-width: 800px\">\u003cimg loading=\"lazy\" decoding=\"async\" class=\"size-medium wp-image-11874323\" src=\"https://ww2.kqed.org/app/uploads/sites/10/2021/05/RS48840_024_Alameda_MarioGonzalezPressConf_04272021-qut-800x533.jpg\" alt=\"\" width=\"800\" height=\"533\" srcset=\"https://cdn.kqed.org/wp-content/uploads/sites/10/2021/05/RS48840_024_Alameda_MarioGonzalezPressConf_04272021-qut-800x533.jpg 800w, https://cdn.kqed.org/wp-content/uploads/sites/10/2021/05/RS48840_024_Alameda_MarioGonzalezPressConf_04272021-qut-1020x679.jpg 1020w, https://cdn.kqed.org/wp-content/uploads/sites/10/2021/05/RS48840_024_Alameda_MarioGonzalezPressConf_04272021-qut-160x107.jpg 160w, https://cdn.kqed.org/wp-content/uploads/sites/10/2021/05/RS48840_024_Alameda_MarioGonzalezPressConf_04272021-qut-1536x1022.jpg 1536w, https://cdn.kqed.org/wp-content/uploads/sites/10/2021/05/RS48840_024_Alameda_MarioGonzalezPressConf_04272021-qut.jpg 1920w\" sizes=\"(max-width: 800px) 100vw, 800px\">\u003cfigcaption class=\"wp-caption-text\">Anti-Police Terror Project Co-founder, Cat Brooks, speaks during a news conference outside of the Alameda Police Department on April 27, 2021. \u003ccite>(Beth LaBerge/KQED)\u003c/cite>\u003c/figcaption>\u003c/figure>\n\u003cp>Brooks, a key advocate for MACRO, believes the best people to help are those with street knowledge of the systems that have failed them, what she calls “the medical-industrial complex.”\u003c/p>\n\u003cp>“And that complex — doctors, nurses, psychologists, social workers — stereotypes Black, brown and indigenous bodies. Criminalizes Black, brown and indigenous bodies just as much as law enforcement,” she says. “And so these models have to be more about the ideology and practice with which we respond.”\u003c/p>\n\u003ch3>Concerns About the Pilot\u003c/h3>\n\u003cp>Still, some worry emphasizing ideology over formal training goes against the science and art of mental health care and could undermine the program’s effectiveness.\u003c/p>\n\u003cp>“Social workers have a lot to offer as we re-imagine public safety, policing and seek to strengthen our crisis response capacity,” says Sarah Butts, director of public policy for the National Association of Social Workers.\u003c/p>\n\u003cp>She says the group fully supports communities creating whatever model works best for them. And Butts agrees that peer counselors with life experience in these systems can and are often an important part of any front-line response.\u003c/p>\n\u003cp>But she says extensive education and training do matter when addressing the often complex mix facing someone in a mental health or substance use crisis.\u003c/p>\n\u003cp>“Social workers will have a skill set — problem-solving, relationship building, de-escalation — that really lends itself to this to this type of community problem solving,” Butts says. She notes nonpolice responders must accurately assess the situation quickly under often stressful conditions. “And then decide what is the most effective response.”\u003c/p>\n\u003cp>Whatever model cities use, it’s important they collect and share data on what’s working and what’s not “so that we can learn from our experience and improve these systems,” Butts says.\u003c/p>\n\u003cp>\u003ca href=\"https://www.npr.org/2020/10/19/924146486/removing-cops-from-behavioral-crisis-calls-we-need-to-change-the-model\">As NPR has reported\u003c/a>, across the bay in San Francisco, the city’s new police-free Street Crisis Response Teams put a fire department paramedic with a trained clinical social worker and a peer counselor to help respond to some crisis calls for people who are homeless, intoxicated, having a mental health challenge, or all of the above.\u003c/p>\n\u003cp>The four teams now deployed in San Francisco’s pilot project are, so far, able to respond to only a small number of the overall behavioral crisis calls in that city. But it wants to scale up the program this summer when San Francisco Mayor London Breed hopes to add a companion program of unarmed “wellness” teams to work with the street teams to handle even lower-level calls. It’s part of the mayor’s wider \u003ca href=\"https://sfmayor.org/article/mayor-london-breed-announces-roadmap-new-police-reforms\">pledge to change policing\u003c/a> in the city.\u003c/p>\n\u003ch3>\u003cstrong>Flashpoints with Police \u003c/strong>\u003c/h3>\n\u003cp>With startling repetition non-criminal crisis calls to police — often by a friend or loved one — continue to be flashpoints for violence and death.\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"content": "\u003cdiv class=\"post-body\">\u003cp>Examples include \u003ca href=\"https://www.npr.org/2020/11/05/931643057/philadelphia-officials-promise-changes-after-walter-wallace-jr-shooting\">Walter Wallace in Philadelphia\u003c/a>, Daniel \u003ca href=\"https://www.npr.org/2020/09/03/909086022/daniel-prudes-death-ruled-a-homicide-he-was-restrained-by-police\">Prude in Rochester\u003c/a> and in late April, Oakland resident \u003ca href=\"https://www.npr.org/2021/04/29/991844355/lawyer-says-police-didnt-need-to-arrest-man-who-died-after-being-pinned-to-groun\">Mario Gonzalez, who died in Alameda Police custody\u003c/a>. The 26-year-old was in a small park in Alameda when 911 callers expressed concerned Gonzalez was mumbling to himself and maybe high or drunk.\u003c/p>\n\u003cp>“He was talking to himself and what else was he doing?” the 911 dispatcher asks one caller in tapes released by Alameda police.\u003c/p>\n\u003cp>“He’s just hanging out,” the caller says, “I mean, he seems like he’s tweaking. But he’s not doing anything wrong. He’s just scaring my wife.”\u003c/p>\n\u003cp>The two 911 calls make clear there’s no violence, imminent threat or any discernible criminal activity, save a couple bottles of booze with the security tags still attached, indicating they were probably stolen.\u003c/p>\n\u003cp>Alameda police soon arrive. \u003ca href=\"https://www.kqed.org/news/11871345/city-of-alameda-releases-police-body-cam-footage-of-mario-gonzalez-death\" target=\"_blank\" rel=\"noopener noreferrer\">Body cam footage\u003c/a> shows officers question Gonzalez about what he’s doing in the park, and ask for his ID. Gonzalez, who is calm but fidgety, mumbles several largely incoherent responses and does not appear to be fully lucid.\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"content": "\u003cdiv class=\"post-body\">\u003cp>Without telling him he is under arrest, each officer grabs one of Gonzalez’s arms and proceeds to try to put his hands behind his back. When he bends over and resists being handcuffed, one officer says, “Please stop resisting us, OK? Don’t fight us.”\u003c/p>\n\u003cp>Gonzalez continues to resist, and the two officers take him to the wood chip-covered ground, pinning him on his stomach, with at least one officer pressing an elbow and knee into his back and shoulder. They eventually handcuff him.\u003c/p>\n\u003cp>The two officers continue pinning Gonzalez to the ground for a total of roughly five minutes, with at least one of them pressing his elbow and knee into his back.\u003c/p>\n\u003cp>As Gonzalez becomes motionless, the officers shout his first name, check for a pulse, roll him fully over, and begin administering CPR, with Gonzalez’s hands still restrained behind his back. About a minute later, they remove his handcuffs and continue performing CPR, repeatedly shouting for him to wake up.\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"content": "\u003cdiv class=\"post-body\">\u003cp>Gonzalez leaves behind a grieving family including a 4-year-old son. He was also the main caretaker of his 22-year-old autistic brother, his family has said.\u003c/p>\n\u003cp>The Alameda Police Department officers involved are on paid leave while multiple agencies investigate. An autopsy is pending.\u003c/p>\n\u003cp>Timothy T. Williams Jr., a police tactics expert, says police need clearer guidelines around “positional asphyxia” — or detaining someone in a way that compresses their airways and reduces the ability to breathe normally.\u003c/p>\n\u003cp>The Alameda Police Department’s \u003ca href=\"https://www.alamedaca.gov/files/assets/public/departments/alameda/police/alameda-police-department-policy-manual-11022020.pdf\" target=\"_blank\" rel=\"noopener noreferrer\">policy manual\u003c/a> states that a suspect “shall not be placed on his/her stomach for an extended period, as this could reduce the person’s ability to breathe.”\u003c/p>\n\u003cp>But Williams says that guideline isn’t specific or directed enough. “Once he or she is handcuffed, they are to be immediately removed from the prone position, put on their side, and, if possible, sat up.” Otherwise, he says, “You leave everything to subjective interpretation: What may be short to you may be long to me.”\u003c/p>\n\u003cp>“There was no reason whatsoever to go hands-on with Mario,” says civil rights lawyer Julia Sherwin, who represents his family. She has formally asked the U.S. Department of Justice to open a civil rights investigation into the Alameda Police Department.\u003c/p>\n\u003cp>Sherwin says Gonzalez was unarmed, holding only a comb. “He’s been combing his hair and he’s been loitering there for half an hour. Why this required a law enforcement response is beyond me.”\u003c/p>\n\u003cp>It’s instances like this that have led Oakland to its experiment.\u003c/p>\n\u003ch3>Much Work Remains\u003c/h3>\n\u003cp>In Oakland, Mayor Libby Schaaf originally pushed to put MACRO under an area nonprofit. The city council rejected that idea. Despite ongoing political tussles with the council, Schaaf “wholeheartedly supports this and it is part of her budget proposal,” says her communications director Justin Berton. “We hope it will be up and running as soon as humanly possible.”\u003c/p>\n\u003cp>Big details in implementing the plan remain. The fire agency, already stretched thin, now has to hire, train and equip new teams of civilians.\u003c/p>\n\u003cp>The Oakland Police Department, for their part, are largely staying quiet on the program for now and letting city hall, the Oakland City Council and fire department work it out.\u003c/p>\n\u003cp>And police will still, at first, handle all 5150 calls — that’s the code that allows police to involuntarily confine someone exhibiting behavior that’s “the result of a mental disorder,” and who appears to be endangering him or herself or others.\u003c/p>\n\u003cp>A big unanswered question is what percentage of the nearly quarter-million annual 911 police calls in Oakland will eventually be transferred to the new unarmed, police-free teams. One city councilwoman says the goal is 20% of nonviolent 911 calls within three years.\u003c/p>\n\u003cp>Deputy Fire Chief Drayton says, at first, the percentage will be far smaller. The aim is to grow over time but start small: one team working a swing shift five days a week going after the relatively low-hanging fruit of noise disturbances, welfare checks, loitering and such.\u003c/p>\n\u003cp>And the city’s 911 dispatchers will very likely need additional training. The program will put enormous pressure on those dispatchers who will, at first anyway, have to decide which calls to funnel to MACRO or to police for a more traditional response.\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"content": "‘Broad swaths of Black and brown people will not call the police ever for any reason…Why? Because our lived experience is police do not make it better when they show up.’",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003cbr>\nBut activist Cat Brooks of the Anti Police-Terror Project says using the traditional 911 system at all for these new teams is a big mistake. She has helped set up a separate non-police, non-city run mental health response program that operates on weekend nights \u003ca href=\"https://www.antipoliceterrorproject.org/mh-first-oakland\">called MH First Oakland\u003c/a> that uses a separate phone number, not 911.\u003c/p>\n\u003cp>“Broad swaths of Black and brown people will not call the police ever for any reason. Someone could be being shot in broad daylight in front of their house, and they are not dialing 911. Why? Because our lived experience is police do not make it better when they show up,” says Brooks. “Things almost always are worse.”\u003c/p>\n\u003cp>Despite those big concerns, Brooks remains cautiously hopeful the new effort will mean real change for a city and police department that have been \u003ca href=\"https://www.npr.org/2018/08/08/636319870/in-oakland-more-data-hasnt-meant-less-racial-disparity-during-police-stops\">under federal oversight now\u003c/a> for nearly two decades.\u003c/p>\n\u003cp>“If we can just get out of the Oakland bureaucracy, red tape, ego and drama,” Brooks says with a smile, “I think there’s an opportunity for us to build something really powerful.”\u003c/p>\n\u003cp>\u003cem>This story includes additional reporting from KQED’s Matthew Green.\u003c/em>\u003c/p>\n\u003cdiv class=\"fullattribution\">Copyright 2021 NPR. To see more, visit https://www.npr.org.\u003cimg decoding=\"async\" src=\"https://www.google-analytics.com/__utm.gif?utmac=UA-5828686-4&utmdt=Oakland+Becomes+Latest+City+Looking+To+Take+Police+Out+Of+Some+Nonviolent+911+Calls&utme=8(APIKey)9(MDAxOTAwOTE4MDEyMTkxMDAzNjczZDljZA004)\">\u003c/div>\n\u003cp>\u003c/p>\u003c/div>",
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"disqusTitle": "After Angelo Quinto's Death, Momentum Builds to Add Mental Health Curriculum in Police Training",
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"content": "\u003cp>The officer who Cassandra Quinto-Collins says knelt on her son’s neck for over four minutes assured her it was standard protocol for sedating a person experiencing a mental breakdown.\u003c/p>\n\u003cp>“I was there watching it the whole time,” Quinto-Collins told The Associated Press. “I just trusted that they knew what they were doing.”\u003c/p>\n\u003cp>Angelo Quinto’s sister had called 911 for help calming him down during an episode of paranoia on Dec. 23. His family, who live in Antioch, says Quinto didn’t resist the officers — one who pushed his knee on the back of his neck, and another who restrained his legs — and the only noise he made was when he twice cried out, “Please don’t kill me.”\u003c/p>\n\u003cfigure id=\"attachment_11863516\" class=\"wp-caption alignnone\" style=\"max-width: 1119px\">\u003cimg class=\"size-full wp-image-11863516\" src=\"https://ww2.kqed.org/app/uploads/sites/10/2021/03/quinto-pic.jpg\" alt=\"\" width=\"1119\" height=\"500\" srcset=\"https://ww2.kqed.org/app/uploads/sites/10/2021/03/quinto-pic.jpg 1119w, https://ww2.kqed.org/app/uploads/sites/10/2021/03/quinto-pic-800x357.jpg 800w, https://ww2.kqed.org/app/uploads/sites/10/2021/03/quinto-pic-1020x456.jpg 1020w, https://ww2.kqed.org/app/uploads/sites/10/2021/03/quinto-pic-160x71.jpg 160w\" sizes=\"(max-width: 1119px) 100vw, 1119px\">\u003cfigcaption class=\"wp-caption-text\">The family of Angelo Quinto shared these three photographs with KQED's The Bay team earlier this year. \u003ccite>(Courtesy of the Quinto family)\u003c/cite>\u003c/figcaption>\u003c/figure>\n\u003cp>The officers replied, “We’re not going to kill you,” the family said. Police deny putting pressure on his neck. Three days later, the 30-year-old Navy veteran and Filipino immigrant died at a hospital.\u003c/p>\n\u003cp>[aside label ='Related Coverage' tag='police-reform']It is the latest stark example of the perils of policing people with mental health issues. In response to several high-profile deaths of people with mental health issues in police custody, lawmakers in at least eight states are introducing legislation to change how law enforcement agencies respond to those in crisis.\u003c/p>\n\u003cp>The proposals lean heavily on additional training for officers on how to interact with people with mental health problems. It’s a common response when lawmakers face widespread outcry over police brutality like the U.S. saw last year following the \u003ca href=\"https://www.kqed.org/news/tag/george-floyd\">death of George Floyd\u003c/a> in Minneapolis.\u003c/p>\n\u003cp>But none of the proposals appear to address the root question: Should police be the ones responding when someone is mentally ill?\u003c/p>\n\u003cp>In California, lawmakers introduced legislation on Feb. 11 that, among other things, would require prospective officers to complete college courses that address mental health, social services and psychology, without requiring a degree.\u003c/p>\n\u003cp>In New York, lawmakers in January proposed an effort to require law enforcement to complete a minimum of 32 credit hours of training that would include techniques on de-escalation and interacting with people who have mental health issues.\u003c/p>\n\u003cp>The proposal came nearly a year after Rochester, New York, officers put a spit hood over Daniel Prude’s head and pressed his naked body against the street until he stopped breathing. The victim’s family, like Quinto’s, said they had called 911 for help after Prude, who is Black, began having a mental health episode.\u003c/p>\n\u003cfigure id=\"attachment_11866839\" class=\"wp-caption alignnone\" style=\"max-width: 1920px\">\u003cimg class=\"size-full wp-image-11866839\" src=\"https://ww2.kqed.org/app/uploads/sites/10/2021/03/RS48159_039_SanFrancisco_RiseUpRally_03262021-qut.jpg\" alt=\"\" width=\"1920\" height=\"1278\" srcset=\"https://ww2.kqed.org/app/uploads/sites/10/2021/03/RS48159_039_SanFrancisco_RiseUpRally_03262021-qut.jpg 1920w, https://ww2.kqed.org/app/uploads/sites/10/2021/03/RS48159_039_SanFrancisco_RiseUpRally_03262021-qut-800x533.jpg 800w, https://ww2.kqed.org/app/uploads/sites/10/2021/03/RS48159_039_SanFrancisco_RiseUpRally_03262021-qut-1020x679.jpg 1020w, https://ww2.kqed.org/app/uploads/sites/10/2021/03/RS48159_039_SanFrancisco_RiseUpRally_03262021-qut-160x107.jpg 160w, https://ww2.kqed.org/app/uploads/sites/10/2021/03/RS48159_039_SanFrancisco_RiseUpRally_03262021-qut-1536x1022.jpg 1536w\" sizes=\"(max-width: 1920px) 100vw, 1920px\">\u003cfigcaption class=\"wp-caption-text\">Bella Collins, the sister of Angelo Quinto, speaks about the death of her brother while surrounded by family at the Embarcadero Plaza during a student-led rally to bring awareness to his death and show solidarity with the Asian American community, in San Francisco on March 26, 2021. \u003ccite>(Beth LaBerge/KQED)\u003c/cite>\u003c/figcaption>\u003c/figure>\n\u003cp>Similarly, in Utah, the mother of 13-year-old Linden Cameron called 911 in September because he was having a breakdown and she needed help from a crisis intervention officer. Salt Lake City police ended up shooting him multiple times as he ran away because they believed he made threats involving a weapon.\u003c/p>\n\u003cp>He was hospitalized, and no weapon was found. The officers were not crisis intervention specialists but had some mental health training.\u003c/p>\n\u003cp>Last month, Utah Gov. Spencer Cox signed legislation that will create a council to standardize training for police crisis intervention teams statewide.\u003c/p>\n\u003cp>At least 34 states already require officers to have training or other education on interacting with people who have physical or mental health conditions. But law enforcement experts say updated training is needed and agencies are far behind.\u003c/p>\n\u003cp>[pullquote align=\"right\" size=\"medium\" citation=\"Chuck Wexler, executive director of the Police Executive Research Forum\"]'The last thing a mother wants when they call the police is for an officer to use force. Especially in a situation that didn’t call for it because the officers weren’t trained in how to recognize a crisis.'[/pullquote]“The training that police have received for the past I’d say 25 years has not changed significantly, and it’s out of date, and it doesn’t meet today’s realities,” said Chuck Wexler, executive director of the Police Executive Research Forum, a Washington, D.C.-based think tank. “I mean the last thing a mother wants when they call the police is for an officer to use force. Especially in a situation that didn’t call for it because the officers weren’t trained in how to recognize a crisis.”\u003c/p>\n\u003cp>Some of the new legislation looks to strengthen or improve standards. But because mental health training is a mandate in a majority of states, some advocates and experts believe it may never fully prepare officers on how to respond.\u003c/p>\n\u003cp>The Treatment Advocacy Center, a nonprofit dedicated to getting treatment for the mentally ill, concluded in a 2015 report those with untreated mental illness are 16 times more likely to be killed during a police encounter than others.\u003c/p>\n\u003cp>“The solution that would have the most impact on the problem is to prevent people with mental illness from encountering law enforcement in the first place,” said Elizabeth Sinclair Hancq, co-author of the report.\u003c/p>\n\u003cp>Since that is not always possible, she said, another solution is to create co-responder programs where a social worker or other mental health professional assists officers on such calls.\u003c/p>\n\u003cp>[aside postID=\"news_11840071\" hero=\"https://ww2.kqed.org/app/uploads/sites/10/2020/10/RS43756_035_KQED_Oakland_Juneteenth_06192020-qut-1020x679.jpg\"]That is what Philadelphia introduced in October, weeks before officers fatally shot Walter Wallace Jr., a Black man, within a minute of arriving at his address for the third time in a day while he was having a mental health crisis. Police said Wallace ignored commands to drop a knife.\u003c/p>\n\u003cp>Other cities, including \u003ca href=\"https://www.kqed.org/news/tag/los-angeles\">Los Angeles\u003c/a>, \u003ca href=\"https://www.kqed.org/forum/2010101880391/in-major-police-reform-sfpd-will-no-longer-handle-most-psychiatric-and-behavioral-crisis-calls\">San Francisco\u003c/a> and Portland, Oregon, have similar programs.\u003c/p>\n\u003cp>For families of victims, who now say they regret calling 911 for help, required training and legislative reform are long overdue.\u003c/p>\n\u003cp>“In retrospect, it wasn’t the smartest idea to call the police,” said Isabella Collins, the 18-year-old sister of Quinto, who died in California. “But I just wanted him to be able to calm down, and I thought that they could help with that.”\u003c/p>\n\u003cp>Antioch police didn’t release details of Quinto’s death for more than a month. Antioch Police Chief Tammany Brooks has denied that officers used a knee or anything else to put pressure on Quinto’s head, neck or throat. An investigation and autopsy are underway.\u003c/p>\n\u003cp>The department didn’t respond to a request for comment.\u003c/p>\n\u003cp>Quinto’s family filed a wrongful-death claim against the city in February, claiming he “died as a direct consequence of the unreasonable force used against him.”\u003c/p>\n\u003cp>“I guess it was really naive of me to think that he wouldn’t get hurt,” Collins said.\u003cbr>\n[ad fullwidth]\u003c/p>\n\u003cp>[ad floatright]\u003c/p>\n",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003cp>The officer who Cassandra Quinto-Collins says knelt on her son’s neck for over four minutes assured her it was standard protocol for sedating a person experiencing a mental breakdown.\u003c/p>\n\u003cp>“I was there watching it the whole time,” Quinto-Collins told The Associated Press. “I just trusted that they knew what they were doing.”\u003c/p>\n\u003cp>Angelo Quinto’s sister had called 911 for help calming him down during an episode of paranoia on Dec. 23. His family, who live in Antioch, says Quinto didn’t resist the officers — one who pushed his knee on the back of his neck, and another who restrained his legs — and the only noise he made was when he twice cried out, “Please don’t kill me.”\u003c/p>\n\u003cfigure id=\"attachment_11863516\" class=\"wp-caption alignnone\" style=\"max-width: 1119px\">\u003cimg class=\"size-full wp-image-11863516\" src=\"https://ww2.kqed.org/app/uploads/sites/10/2021/03/quinto-pic.jpg\" alt=\"\" width=\"1119\" height=\"500\" srcset=\"https://ww2.kqed.org/app/uploads/sites/10/2021/03/quinto-pic.jpg 1119w, https://ww2.kqed.org/app/uploads/sites/10/2021/03/quinto-pic-800x357.jpg 800w, https://ww2.kqed.org/app/uploads/sites/10/2021/03/quinto-pic-1020x456.jpg 1020w, https://ww2.kqed.org/app/uploads/sites/10/2021/03/quinto-pic-160x71.jpg 160w\" sizes=\"(max-width: 1119px) 100vw, 1119px\">\u003cfigcaption class=\"wp-caption-text\">The family of Angelo Quinto shared these three photographs with KQED's The Bay team earlier this year. \u003ccite>(Courtesy of the Quinto family)\u003c/cite>\u003c/figcaption>\u003c/figure>\n\u003cp>The officers replied, “We’re not going to kill you,” the family said. Police deny putting pressure on his neck. Three days later, the 30-year-old Navy veteran and Filipino immigrant died at a hospital.\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"content": "\u003cdiv class=\"post-body\">\u003cp>It is the latest stark example of the perils of policing people with mental health issues. In response to several high-profile deaths of people with mental health issues in police custody, lawmakers in at least eight states are introducing legislation to change how law enforcement agencies respond to those in crisis.\u003c/p>\n\u003cp>The proposals lean heavily on additional training for officers on how to interact with people with mental health problems. It’s a common response when lawmakers face widespread outcry over police brutality like the U.S. saw last year following the \u003ca href=\"https://www.kqed.org/news/tag/george-floyd\">death of George Floyd\u003c/a> in Minneapolis.\u003c/p>\n\u003cp>But none of the proposals appear to address the root question: Should police be the ones responding when someone is mentally ill?\u003c/p>\n\u003cp>In California, lawmakers introduced legislation on Feb. 11 that, among other things, would require prospective officers to complete college courses that address mental health, social services and psychology, without requiring a degree.\u003c/p>\n\u003cp>In New York, lawmakers in January proposed an effort to require law enforcement to complete a minimum of 32 credit hours of training that would include techniques on de-escalation and interacting with people who have mental health issues.\u003c/p>\n\u003cp>The proposal came nearly a year after Rochester, New York, officers put a spit hood over Daniel Prude’s head and pressed his naked body against the street until he stopped breathing. The victim’s family, like Quinto’s, said they had called 911 for help after Prude, who is Black, began having a mental health episode.\u003c/p>\n\u003cfigure id=\"attachment_11866839\" class=\"wp-caption alignnone\" style=\"max-width: 1920px\">\u003cimg class=\"size-full wp-image-11866839\" src=\"https://ww2.kqed.org/app/uploads/sites/10/2021/03/RS48159_039_SanFrancisco_RiseUpRally_03262021-qut.jpg\" alt=\"\" width=\"1920\" height=\"1278\" srcset=\"https://ww2.kqed.org/app/uploads/sites/10/2021/03/RS48159_039_SanFrancisco_RiseUpRally_03262021-qut.jpg 1920w, https://ww2.kqed.org/app/uploads/sites/10/2021/03/RS48159_039_SanFrancisco_RiseUpRally_03262021-qut-800x533.jpg 800w, https://ww2.kqed.org/app/uploads/sites/10/2021/03/RS48159_039_SanFrancisco_RiseUpRally_03262021-qut-1020x679.jpg 1020w, https://ww2.kqed.org/app/uploads/sites/10/2021/03/RS48159_039_SanFrancisco_RiseUpRally_03262021-qut-160x107.jpg 160w, https://ww2.kqed.org/app/uploads/sites/10/2021/03/RS48159_039_SanFrancisco_RiseUpRally_03262021-qut-1536x1022.jpg 1536w\" sizes=\"(max-width: 1920px) 100vw, 1920px\">\u003cfigcaption class=\"wp-caption-text\">Bella Collins, the sister of Angelo Quinto, speaks about the death of her brother while surrounded by family at the Embarcadero Plaza during a student-led rally to bring awareness to his death and show solidarity with the Asian American community, in San Francisco on March 26, 2021. \u003ccite>(Beth LaBerge/KQED)\u003c/cite>\u003c/figcaption>\u003c/figure>\n\u003cp>Similarly, in Utah, the mother of 13-year-old Linden Cameron called 911 in September because he was having a breakdown and she needed help from a crisis intervention officer. Salt Lake City police ended up shooting him multiple times as he ran away because they believed he made threats involving a weapon.\u003c/p>\n\u003cp>He was hospitalized, and no weapon was found. The officers were not crisis intervention specialists but had some mental health training.\u003c/p>\n\u003cp>Last month, Utah Gov. Spencer Cox signed legislation that will create a council to standardize training for police crisis intervention teams statewide.\u003c/p>\n\u003cp>At least 34 states already require officers to have training or other education on interacting with people who have physical or mental health conditions. But law enforcement experts say updated training is needed and agencies are far behind.\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"content": "'The last thing a mother wants when they call the police is for an officer to use force. Especially in a situation that didn’t call for it because the officers weren’t trained in how to recognize a crisis.'",
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"content": "\u003cdiv class=\"post-body\">\u003cp>“The training that police have received for the past I’d say 25 years has not changed significantly, and it’s out of date, and it doesn’t meet today’s realities,” said Chuck Wexler, executive director of the Police Executive Research Forum, a Washington, D.C.-based think tank. “I mean the last thing a mother wants when they call the police is for an officer to use force. Especially in a situation that didn’t call for it because the officers weren’t trained in how to recognize a crisis.”\u003c/p>\n\u003cp>Some of the new legislation looks to strengthen or improve standards. But because mental health training is a mandate in a majority of states, some advocates and experts believe it may never fully prepare officers on how to respond.\u003c/p>\n\u003cp>The Treatment Advocacy Center, a nonprofit dedicated to getting treatment for the mentally ill, concluded in a 2015 report those with untreated mental illness are 16 times more likely to be killed during a police encounter than others.\u003c/p>\n\u003cp>“The solution that would have the most impact on the problem is to prevent people with mental illness from encountering law enforcement in the first place,” said Elizabeth Sinclair Hancq, co-author of the report.\u003c/p>\n\u003cp>Since that is not always possible, she said, another solution is to create co-responder programs where a social worker or other mental health professional assists officers on such calls.\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"content": "\u003cdiv class=\"post-body\">\u003cp>That is what Philadelphia introduced in October, weeks before officers fatally shot Walter Wallace Jr., a Black man, within a minute of arriving at his address for the third time in a day while he was having a mental health crisis. Police said Wallace ignored commands to drop a knife.\u003c/p>\n\u003cp>Other cities, including \u003ca href=\"https://www.kqed.org/news/tag/los-angeles\">Los Angeles\u003c/a>, \u003ca href=\"https://www.kqed.org/forum/2010101880391/in-major-police-reform-sfpd-will-no-longer-handle-most-psychiatric-and-behavioral-crisis-calls\">San Francisco\u003c/a> and Portland, Oregon, have similar programs.\u003c/p>\n\u003cp>For families of victims, who now say they regret calling 911 for help, required training and legislative reform are long overdue.\u003c/p>\n\u003cp>“In retrospect, it wasn’t the smartest idea to call the police,” said Isabella Collins, the 18-year-old sister of Quinto, who died in California. “But I just wanted him to be able to calm down, and I thought that they could help with that.”\u003c/p>\n\u003cp>Antioch police didn’t release details of Quinto’s death for more than a month. Antioch Police Chief Tammany Brooks has denied that officers used a knee or anything else to put pressure on Quinto’s head, neck or throat. An investigation and autopsy are underway.\u003c/p>\n\u003cp>The department didn’t respond to a request for comment.\u003c/p>\n\u003cp>Quinto’s family filed a wrongful-death claim against the city in February, claiming he “died as a direct consequence of the unreasonable force used against him.”\u003c/p>\n\u003cp>“I guess it was really naive of me to think that he wouldn’t get hurt,” Collins said.\u003cbr>\n\u003c/p>\u003c/div>",
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"title": "How One Woman's Cycle of Incarceration and Mental Illness Helped Heal a Rural System",
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"content": "\u003cp>\u003cem>This story is excerpted from the preview episode of \u003c/em>\u003ca href=\"https://www.artsandmedia.net/cause/november-in-my-soul/\">\u003cem>November In My Soul\u003c/em>\u003c/a>\u003cem>, a forthcoming podcast about mental Illness, confinement and liberty in California. It is co-produced and co-hosted by Lee Romney and Jenny Johnson. \u003c/em>\u003c/p>\n\u003cp>For years, Marlene Baker’s untreated mental illness kept her on the streets, hustling to stay warm and stay fed. Local law enforcement would pick her up for minor offenses — drinking in public or hitchhiking — then book her into the overcrowded jail and release her right back to the streets.\u003c/p>\n\u003cp>“Sometimes your mind plays tricks on you and you do things,” Baker, now 58, said in a 2019 interview at her tiny studio apartment in the Siskiyou County town of Weed. “I didn’t trust my mind for a long time. Still, I’ll wake up sometimes in the middle of the night screaming, like, is there a ghost in here or something? And then I just take my medicine.”\u003c/p>\n\u003cp>Stories of our colliding criminal justice and mental health systems play out across the country. That crisis is most visible, and most commonly reported, in urban areas. But Baker’s is a rural story, full of profound rural challenges. Siskiyou County, which abuts the Oregon border, spans 6,000 square miles and is home to just shy of 44,000 people. Community mental health resources are thin. Public transportation is almost nonexistent, housing is scarce and recruiting mental health clinicians nearly impossible. [aside tag=\"mental-health,criminal-justice\" label=\"more coverage\"]\u003c/p>\n\u003cp>Marlene Baker was too ill to voluntarily seek help for her condition. If she committed a more serious crime, she could receive the mental health treatment she needed. That’s because a felony charge would finally compel her to accept care provided through the criminal justice system. Recent data from Siskiyou County indicate the jail is often the landing place for people with serious mental illness: About half the inmates are \u003ca href=\"https://www.documentcloud.org/documents/20514156-jail_mentalhealth_jpsreport_02-03-2020#document/p8/a2022750\">prescribed psychiatric meds\u003c/a>, more than double the state median.\u003c/p>\n\u003cp>Mental illness plays a role in a high number of criminal cases here. What to do once those people enter the system, said Siskiyou County District Attorney Kirk Andrus, is a vexing question.\u003c/p>\n\u003cp>“You’ve got a community that wants to be protected,” he said. “But you also have a person who needs intervention and not necessarily the kind of intervention that we have to offer. It’s a massive problem.”\u003c/p>\n\u003cp>In Baker’s case, though, despite those rural challenges — in some ways because of them — a number of key people took some risks and bent some rules to help her heal in the community, with her freedom intact. And her success is helping to bring about some bold changes in the way Siskiyou County confronts its mental health crisis.\u003c/p>\n\u003cfigure id=\"attachment_11865504\" class=\"wp-caption aligncenter\" style=\"max-width: 1920px\">\u003cimg loading=\"lazy\" decoding=\"async\" class=\"size-full wp-image-11865504\" src=\"https://ww2.kqed.org/app/uploads/sites/10/2021/03/RS47876_MarleneWithElephant-qut.jpg\" alt=\"\" width=\"1920\" height=\"1440\" srcset=\"https://cdn.kqed.org/wp-content/uploads/sites/10/2021/03/RS47876_MarleneWithElephant-qut.jpg 1920w, https://cdn.kqed.org/wp-content/uploads/sites/10/2021/03/RS47876_MarleneWithElephant-qut-800x600.jpg 800w, https://cdn.kqed.org/wp-content/uploads/sites/10/2021/03/RS47876_MarleneWithElephant-qut-1020x765.jpg 1020w, https://cdn.kqed.org/wp-content/uploads/sites/10/2021/03/RS47876_MarleneWithElephant-qut-160x120.jpg 160w, https://cdn.kqed.org/wp-content/uploads/sites/10/2021/03/RS47876_MarleneWithElephant-qut-1536x1152.jpg 1536w\" sizes=\"(max-width: 1920px) 100vw, 1920px\">\u003cfigcaption class=\"wp-caption-text\">Marlene Baker, now 58, fills her small studio apartment with tapestries and artwork to make it homey. \u003ccite>(Lee Romney)\u003c/cite>\u003c/figcaption>\u003c/figure>\n\u003ch3>\u003cstrong>‘I grew up normal’ \u003c/strong>\u003c/h3>\n\u003cp>Baker is petite with a penchant for fashion and perfect dusky eye makeup. Her apartment, separated from Interstate 5 by a flimsy chain-link fence, can be loud. But Baker has spruced it up inside “to make it homey” with tapestries and artwork.\u003c/p>\n\u003cp>Her journey began in a “you-blink-you-miss-it” Central Valley town where, Baker said, “I grew up normal. We had a nice house. We had money. I went to school, graduated.”\u003cstrong> \u003c/strong>\u003c/p>\n\u003cp>She had two kids, got divorced and headed to her parents’ vacation home in Mount Shasta, where she landed a job in the front office of a local eye doctor. Then: an accident. Baker stepped out of her car onto black ice, taking her “whole spine out from the neck down.”\u003c/p>\n\u003cp>[pullquote size='medium' align='right' citation='Marlene Baker']‘I’d get hysterical and not know what’s really going around and verbally say stuff that didn’t make sense’[/pullquote]\u003c/p>\n\u003cp>Multiple surgeries followed, and Baker gave her kids to their dad to raise as her bones healed. There was a complication, though: A surgical tear in her spinal covering had left her brain stem dry for four days.\u003c/p>\n\u003cp>“I’d get hysterical and not know what’s really going around,” she said, “and verbally say stuff that didn’t make sense.”\u003c/p>\n\u003cp>Marlene had yet to get her diagnosis — schizoaffective disorder. She didn’t know about the underlying brain injury that likely caused her illness. She didn’t know she was ill, but her life was falling apart.\u003c/p>\n\u003cp>Baker wound up homeless in and around Mount Shasta, where winters are cold and bears and mountain lions wander through town at night.\u003c/p>\n\u003cp>“All the guys would watch over me while I slept at night,” she said, “and I’ve lost about four or five of them right now. The other ones, they’re still going in and out of mental hospitals.”\u003c/p>\n\u003cp>Baker’s parents had now moved to Mount Shasta, too, and they’d see her panhandling. They didn’t understand her angry outbursts and erratic behavior any better than she did.\u003c/p>\n\u003cp>“They were embarrassed,” Baker said. “They didn’t know what to do with me.”\u003c/p>\n\u003cp>This went on for more than 15 years.\u003c/p>\n\u003ch3>\u003cstrong>‘Not a single crisis bed’\u003c/strong>\u003c/h3>\n\u003cp>Even in big cities, where services are not as hard to come by, people often slip through the cracks of the voluntary mental health system. So, California’s \u003ca href=\"https://leginfo.legislature.ca.gov/faces/codes_displaySection.xhtml?lawCode=WIC§ionNum=5150\">Welfare and Institutions Code 5150\u003c/a> serves as an important tool to help people like Baker, who don’t know that they’re sick. Under that civil statute, anyone deemed a danger to themselves or others, or gravely disabled, can be temporarily committed to a locked psychiatric facility for treatment. There’s just one problem — there \u003ca href=\"https://www.documentcloud.org/documents/20515636-cha-psych-bed-data-report-sept-2018#document/p12/a2022952\">are no facilities like that in Siskiyou County\u003c/a>.\u003c/p>\n\u003cp>“If someone has a psychotic break, they go to a hospital that is hours and hours away,” said Siskiyou County Public Defender Lael Kayfetz. “You have to leave your family. You have to leave your support system.”\u003c/p>\n\u003cp>Baker was hospitalized just once under a 5150 hold: A case worker drove her 260 miles south to Sacramento. Mostly, though, Baker cycled in and out of the jail and back to the streets. Until 2013. [ad fullwidth]\u003c/p>\n\u003ch3>\u003cstrong>‘I’m going to kill you’\u003c/strong>\u003c/h3>\n\u003cp>Baker’s family rarely invited her over, but as a gesture of good will, they welcomed her to stay the night after a Thanksgiving meal. They woke up to her screams. She was in a psychosis — delusional and hallucinating. She thought an intruder had sliced her chest with a knife. She didn’t recognize her own family. And, in the chaos, she told her mom, “I’m going to kill you.”\u003c/p>\n\u003cp>“Her mom was scared,” said Kayfetz, who would represent Baker in connection with the incident. “So, they called law enforcement not understanding what they were setting in motion. There was no putting the brakes on that.”\u003c/p>\n\u003cp>The district attorney charged Baker with Penal Code Section 422: making criminal threats. When it’s charged as a felony, as it was in Baker’s case, “it’s a strike under the three strikes law,” Kayfetz said. “It changes everything about how you’re treated in the system, how you’re treated by law enforcement.”\u003c/p>\n\u003cp>A felony conviction can also make it difficult — or impossible — to get government-subsidized housing, for life.\u003c/p>\n\u003cp>[pullquote size='medium' align='right' citation='Siskiyou County Public Defender Lael Kayfetz']‘By some miracle she made it to her next court appearance and that is the thing that saved her’[/pullquote]\u003c/p>\n\u003cp>Baker was still psychotic. And she was clearly “incompetent to stand trial” — that means you can’t follow the proceedings, understand the charges or help your attorney. The process of regaining competency usually involves a trip to a state mental hospital, often after long waits in a jail cell. But for Baker, there was a hitch: Siskiyou County’s jail has so few beds for women that even those charged with felonies are often quickly set free. Baker was already out, with instructions in court for her first hearing in the case. If she failed to show up, the judge would likely issue a warrant for her arrest.\u003c/p>\n\u003cp>“By some miracle she made it to her next court appearance,” Kayfetz said, “and that is the thing that saved her.”\u003c/p>\n\u003ch3>\u003cstrong>Bending the Rules\u003c/strong>\u003c/h3>\n\u003cp>Sometimes, it takes an exception to create a new rule, and Baker became a test case. The judge, the public defender, county mental health officials and even the prosecutor, came to an agreement. Instead of returning her to jail or sending her to a state hospital hundreds of miles away, they’d try to help Baker on the outside.\u003c/p>\n\u003cp>The two psychologists who had to evaluate her competency arranged to do it at Kayfetz’s office, “something,” she said, “that had never been done before.”\u003c/p>\n\u003cp>Still, how Baker was going to keep complying with court demands — given her lack of housing and the county’s spotty public transportation — was not at all clear. If she had an address, county behavioral health workers could fetch her for her appointments.\u003c/p>\n\u003cp>“Lael told me, ‘You need [to get] off the street,’ ” Baker recalled. “Getting off the street was key to my healing.”\u003c/p>\n\u003cp>Baker’s case worker began to search, placing her first in a series of motels before, finally, a permanent home. It was small and noisy, but with four walls and a door with a lock. On her first night, Baker said, “I had a backpack for a pillow” and a comforter her case worker grabbed from the office. Still, she missed the outdoors.\u003c/p>\n\u003cp>“You breathe all the fresh air all night long, you’re under God’s heavens. It’s hard to stop being homeless,” she said. “You’re free.”\u003c/p>\n\u003cfigure id=\"attachment_11865581\" class=\"wp-caption aligncenter\" style=\"max-width: 1920px\">\u003cimg loading=\"lazy\" decoding=\"async\" class=\"size-full wp-image-11865581\" src=\"https://ww2.kqed.org/app/uploads/sites/10/2021/03/RS47870_MarleneChainlinkFencePantaloons-qut.jpg\" alt=\"\" width=\"1920\" height=\"1440\" srcset=\"https://cdn.kqed.org/wp-content/uploads/sites/10/2021/03/RS47870_MarleneChainlinkFencePantaloons-qut.jpg 1920w, https://cdn.kqed.org/wp-content/uploads/sites/10/2021/03/RS47870_MarleneChainlinkFencePantaloons-qut-800x600.jpg 800w, https://cdn.kqed.org/wp-content/uploads/sites/10/2021/03/RS47870_MarleneChainlinkFencePantaloons-qut-1020x765.jpg 1020w, https://cdn.kqed.org/wp-content/uploads/sites/10/2021/03/RS47870_MarleneChainlinkFencePantaloons-qut-160x120.jpg 160w, https://cdn.kqed.org/wp-content/uploads/sites/10/2021/03/RS47870_MarleneChainlinkFencePantaloons-qut-1536x1152.jpg 1536w\" sizes=\"(max-width: 1920px) 100vw, 1920px\">\u003cfigcaption class=\"wp-caption-text\">Marlene Baker’s tiny studio apartment, in a rundown former motel, is separated from Interstate 5 by a chain-link fence. On this day in September 2019, she shows off the old-fashioned pantaloons she’s hung there to dry. \u003ccite>(Lee Romney)\u003c/cite>\u003c/figcaption>\u003c/figure>\n\u003ch3>\u003cstrong>Freedom \u003c/strong>\u003c/h3>\n\u003cp>Baker had gained a different kind of freedom. But she was still facing a felony charge. To retain her liberty, she’d have to engage fully with treatment — something she had resisted for years. Now though, thanks to Siskiyou County’s only practicing psychiatrist, she built a bond and began to trust. They spoke about medicinal plants and healthy foods, and Baker agreed to long-acting injections of an anti-psychotic medication that cleared her mind.\u003c/p>\n\u003cp>It was time to enter a plea. Kayfetz knew a guilty plea would jeopardize Baker’s housing — and her stability. But there was another option — she could plead \u003ca href=\"https://leginfo.legislature.ca.gov/faces/codes_displaySection.xhtml?sectionNum=1026.&lawCode=PEN\">not guilty by reason of insanity.\u003c/a> That plea almost always means you go to a state mental hospital for a minimum of six months and often much longer. Baker had to stand up in court and say she understood she might spend the rest of her life there. Because Kayfetz had a plan.\u003c/p>\n\u003cp>Her client was thriving. Sending her hundreds of miles away to a state hospital, she argued, wasn’t necessary or humane.\u003c/p>\n\u003cp>Kirk Andrus, the district attorney, balked. But the judge agreed with Kayfetz. If Baker complied with her treatment, the felony charge would eventually be dismissed. For years, though, she’d have to check in regularly with the judge.\u003c/p>\n\u003cp>Her progress exceeded expectations. Four years after that fateful Thanksgiving, Baker received training to work as a peer facilitator for a weekly mental health support group. Dipping into her meager disability checks, she prepped healthy stews and soups for the group in her tiny kitchen and brought in Bingo prizes she bought at the Dollar General.\u003c/p>\n\u003cfigure id=\"attachment_11865582\" class=\"wp-caption aligncenter\" style=\"max-width: 1920px\">\u003cimg loading=\"lazy\" decoding=\"async\" class=\"size-full wp-image-11865582\" src=\"https://ww2.kqed.org/app/uploads/sites/10/2021/03/RS47871_MarleneLentilStew-qut.jpg\" alt=\"\" width=\"1920\" height=\"1440\" srcset=\"https://cdn.kqed.org/wp-content/uploads/sites/10/2021/03/RS47871_MarleneLentilStew-qut.jpg 1920w, https://cdn.kqed.org/wp-content/uploads/sites/10/2021/03/RS47871_MarleneLentilStew-qut-800x600.jpg 800w, https://cdn.kqed.org/wp-content/uploads/sites/10/2021/03/RS47871_MarleneLentilStew-qut-1020x765.jpg 1020w, https://cdn.kqed.org/wp-content/uploads/sites/10/2021/03/RS47871_MarleneLentilStew-qut-160x120.jpg 160w, https://cdn.kqed.org/wp-content/uploads/sites/10/2021/03/RS47871_MarleneLentilStew-qut-1536x1152.jpg 1536w\" sizes=\"(max-width: 1920px) 100vw, 1920px\">\u003cfigcaption class=\"wp-caption-text\">Marlene Baker prepares lentil stew in September 2019 in the tiny kitchen of her studio apartment. \u003ccite>(Lee Romney)\u003c/cite>\u003c/figcaption>\u003c/figure>\n\u003cp>Her relationship with her family healed, too, especially with her mom and sister.\u003c/p>\n\u003cp>Finally, on a sweltering August day in 2019, her case came up on the Siskiyou County Superior Court calendar for the very last time.\u003c/p>\n\u003cp>Marlene Baker got to the courthouse in a crushed velvet spaghetti-strap dress and lavender eye makeup. She hadn’t slept. She was too nervous. The judge congratulated her and declared her “restored” — as in restored to sanity. Within minutes, her long ordeal in the criminal justice system was over.\u003c/p>\n\u003ch3>\u003cstrong>Loss and Hope\u003c/strong>\u003c/h3>\n\u003cp>Sanity cannot stave off hardship. Within months of her court victory, Baker’s longtime case worker died unexpectedly. Then came COVID-19 and deep isolation. Baker’s peer group has technically been allowed to meet. But “nobody wants to go because it’s 6 feet apart and you can’t eat in there,” she said, “and that’s why they always came. I would bring them good food.”\u003c/p>\n\u003cp>Baker’s visits with her psychiatrist are no longer in person, just phone calls. So the long-acting injections are out, too. She has to remember to take her pills each morning. And last fall, more loss.\u003c/p>\n\u003cp>“My mom died, and two months later, my dad died,” she said.\u003c/p>\n\u003cp>Given all that, Kayfetz said, the fact that Baker is still housed and plugged in to mental health services is a victory. Beyond that, Baker’s success has helped bring about broader change.\u003c/p>\n\u003cp>Not long after her six-year fight to shed her felony charge came to an end, Siskiyou County launched what’s known as a behavioral health court. It wipes the criminal charges off the records of participants who complete treatment. Every inmate who arrives at the jail now takes an iPad questionnaire to determine if they need mental health services or would be good candidates for the new court. If they are, they get that treatment right here in the community, with their liberty intact.\u003c/p>\n\u003cp>[ad floatright]\u003c/p>\n",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003cp>\u003cem>This story is excerpted from the preview episode of \u003c/em>\u003ca href=\"https://www.artsandmedia.net/cause/november-in-my-soul/\">\u003cem>November In My Soul\u003c/em>\u003c/a>\u003cem>, a forthcoming podcast about mental Illness, confinement and liberty in California. It is co-produced and co-hosted by Lee Romney and Jenny Johnson. \u003c/em>\u003c/p>\n\u003cp>For years, Marlene Baker’s untreated mental illness kept her on the streets, hustling to stay warm and stay fed. Local law enforcement would pick her up for minor offenses — drinking in public or hitchhiking — then book her into the overcrowded jail and release her right back to the streets.\u003c/p>\n\u003cp>“Sometimes your mind plays tricks on you and you do things,” Baker, now 58, said in a 2019 interview at her tiny studio apartment in the Siskiyou County town of Weed. “I didn’t trust my mind for a long time. Still, I’ll wake up sometimes in the middle of the night screaming, like, is there a ghost in here or something? And then I just take my medicine.”\u003c/p>\n\u003cp>Stories of our colliding criminal justice and mental health systems play out across the country. That crisis is most visible, and most commonly reported, in urban areas. But Baker’s is a rural story, full of profound rural challenges. Siskiyou County, which abuts the Oregon border, spans 6,000 square miles and is home to just shy of 44,000 people. Community mental health resources are thin. Public transportation is almost nonexistent, housing is scarce and recruiting mental health clinicians nearly impossible. \u003c/p>\u003c/div>",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>Marlene Baker was too ill to voluntarily seek help for her condition. If she committed a more serious crime, she could receive the mental health treatment she needed. That’s because a felony charge would finally compel her to accept care provided through the criminal justice system. Recent data from Siskiyou County indicate the jail is often the landing place for people with serious mental illness: About half the inmates are \u003ca href=\"https://www.documentcloud.org/documents/20514156-jail_mentalhealth_jpsreport_02-03-2020#document/p8/a2022750\">prescribed psychiatric meds\u003c/a>, more than double the state median.\u003c/p>\n\u003cp>Mental illness plays a role in a high number of criminal cases here. What to do once those people enter the system, said Siskiyou County District Attorney Kirk Andrus, is a vexing question.\u003c/p>\n\u003cp>“You’ve got a community that wants to be protected,” he said. “But you also have a person who needs intervention and not necessarily the kind of intervention that we have to offer. It’s a massive problem.”\u003c/p>\n\u003cp>In Baker’s case, though, despite those rural challenges — in some ways because of them — a number of key people took some risks and bent some rules to help her heal in the community, with her freedom intact. And her success is helping to bring about some bold changes in the way Siskiyou County confronts its mental health crisis.\u003c/p>\n\u003cfigure id=\"attachment_11865504\" class=\"wp-caption aligncenter\" style=\"max-width: 1920px\">\u003cimg loading=\"lazy\" decoding=\"async\" class=\"size-full wp-image-11865504\" src=\"https://ww2.kqed.org/app/uploads/sites/10/2021/03/RS47876_MarleneWithElephant-qut.jpg\" alt=\"\" width=\"1920\" height=\"1440\" srcset=\"https://cdn.kqed.org/wp-content/uploads/sites/10/2021/03/RS47876_MarleneWithElephant-qut.jpg 1920w, https://cdn.kqed.org/wp-content/uploads/sites/10/2021/03/RS47876_MarleneWithElephant-qut-800x600.jpg 800w, https://cdn.kqed.org/wp-content/uploads/sites/10/2021/03/RS47876_MarleneWithElephant-qut-1020x765.jpg 1020w, https://cdn.kqed.org/wp-content/uploads/sites/10/2021/03/RS47876_MarleneWithElephant-qut-160x120.jpg 160w, https://cdn.kqed.org/wp-content/uploads/sites/10/2021/03/RS47876_MarleneWithElephant-qut-1536x1152.jpg 1536w\" sizes=\"(max-width: 1920px) 100vw, 1920px\">\u003cfigcaption class=\"wp-caption-text\">Marlene Baker, now 58, fills her small studio apartment with tapestries and artwork to make it homey. \u003ccite>(Lee Romney)\u003c/cite>\u003c/figcaption>\u003c/figure>\n\u003ch3>\u003cstrong>‘I grew up normal’ \u003c/strong>\u003c/h3>\n\u003cp>Baker is petite with a penchant for fashion and perfect dusky eye makeup. Her apartment, separated from Interstate 5 by a flimsy chain-link fence, can be loud. But Baker has spruced it up inside “to make it homey” with tapestries and artwork.\u003c/p>\n\u003cp>Her journey began in a “you-blink-you-miss-it” Central Valley town where, Baker said, “I grew up normal. We had a nice house. We had money. I went to school, graduated.”\u003cstrong> \u003c/strong>\u003c/p>\n\u003cp>She had two kids, got divorced and headed to her parents’ vacation home in Mount Shasta, where she landed a job in the front office of a local eye doctor. Then: an accident. Baker stepped out of her car onto black ice, taking her “whole spine out from the neck down.”\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>Multiple surgeries followed, and Baker gave her kids to their dad to raise as her bones healed. There was a complication, though: A surgical tear in her spinal covering had left her brain stem dry for four days.\u003c/p>\n\u003cp>“I’d get hysterical and not know what’s really going around,” she said, “and verbally say stuff that didn’t make sense.”\u003c/p>\n\u003cp>Marlene had yet to get her diagnosis — schizoaffective disorder. She didn’t know about the underlying brain injury that likely caused her illness. She didn’t know she was ill, but her life was falling apart.\u003c/p>\n\u003cp>Baker wound up homeless in and around Mount Shasta, where winters are cold and bears and mountain lions wander through town at night.\u003c/p>\n\u003cp>“All the guys would watch over me while I slept at night,” she said, “and I’ve lost about four or five of them right now. The other ones, they’re still going in and out of mental hospitals.”\u003c/p>\n\u003cp>Baker’s parents had now moved to Mount Shasta, too, and they’d see her panhandling. They didn’t understand her angry outbursts and erratic behavior any better than she did.\u003c/p>\n\u003cp>“They were embarrassed,” Baker said. “They didn’t know what to do with me.”\u003c/p>\n\u003cp>This went on for more than 15 years.\u003c/p>\n\u003ch3>\u003cstrong>‘Not a single crisis bed’\u003c/strong>\u003c/h3>\n\u003cp>Even in big cities, where services are not as hard to come by, people often slip through the cracks of the voluntary mental health system. So, California’s \u003ca href=\"https://leginfo.legislature.ca.gov/faces/codes_displaySection.xhtml?lawCode=WIC§ionNum=5150\">Welfare and Institutions Code 5150\u003c/a> serves as an important tool to help people like Baker, who don’t know that they’re sick. Under that civil statute, anyone deemed a danger to themselves or others, or gravely disabled, can be temporarily committed to a locked psychiatric facility for treatment. There’s just one problem — there \u003ca href=\"https://www.documentcloud.org/documents/20515636-cha-psych-bed-data-report-sept-2018#document/p12/a2022952\">are no facilities like that in Siskiyou County\u003c/a>.\u003c/p>\n\u003cp>“If someone has a psychotic break, they go to a hospital that is hours and hours away,” said Siskiyou County Public Defender Lael Kayfetz. “You have to leave your family. You have to leave your support system.”\u003c/p>\n\u003cp>Baker was hospitalized just once under a 5150 hold: A case worker drove her 260 miles south to Sacramento. Mostly, though, Baker cycled in and out of the jail and back to the streets. Until 2013. \u003c/p>\u003c/div>",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003ch3>\u003cstrong>‘I’m going to kill you’\u003c/strong>\u003c/h3>\n\u003cp>Baker’s family rarely invited her over, but as a gesture of good will, they welcomed her to stay the night after a Thanksgiving meal. They woke up to her screams. She was in a psychosis — delusional and hallucinating. She thought an intruder had sliced her chest with a knife. She didn’t recognize her own family. And, in the chaos, she told her mom, “I’m going to kill you.”\u003c/p>\n\u003cp>“Her mom was scared,” said Kayfetz, who would represent Baker in connection with the incident. “So, they called law enforcement not understanding what they were setting in motion. There was no putting the brakes on that.”\u003c/p>\n\u003cp>The district attorney charged Baker with Penal Code Section 422: making criminal threats. When it’s charged as a felony, as it was in Baker’s case, “it’s a strike under the three strikes law,” Kayfetz said. “It changes everything about how you’re treated in the system, how you’re treated by law enforcement.”\u003c/p>\n\u003cp>A felony conviction can also make it difficult — or impossible — to get government-subsidized housing, for life.\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>Baker was still psychotic. And she was clearly “incompetent to stand trial” — that means you can’t follow the proceedings, understand the charges or help your attorney. The process of regaining competency usually involves a trip to a state mental hospital, often after long waits in a jail cell. But for Baker, there was a hitch: Siskiyou County’s jail has so few beds for women that even those charged with felonies are often quickly set free. Baker was already out, with instructions in court for her first hearing in the case. If she failed to show up, the judge would likely issue a warrant for her arrest.\u003c/p>\n\u003cp>“By some miracle she made it to her next court appearance,” Kayfetz said, “and that is the thing that saved her.”\u003c/p>\n\u003ch3>\u003cstrong>Bending the Rules\u003c/strong>\u003c/h3>\n\u003cp>Sometimes, it takes an exception to create a new rule, and Baker became a test case. The judge, the public defender, county mental health officials and even the prosecutor, came to an agreement. Instead of returning her to jail or sending her to a state hospital hundreds of miles away, they’d try to help Baker on the outside.\u003c/p>\n\u003cp>The two psychologists who had to evaluate her competency arranged to do it at Kayfetz’s office, “something,” she said, “that had never been done before.”\u003c/p>\n\u003cp>Still, how Baker was going to keep complying with court demands — given her lack of housing and the county’s spotty public transportation — was not at all clear. If she had an address, county behavioral health workers could fetch her for her appointments.\u003c/p>\n\u003cp>“Lael told me, ‘You need [to get] off the street,’ ” Baker recalled. “Getting off the street was key to my healing.”\u003c/p>\n\u003cp>Baker’s case worker began to search, placing her first in a series of motels before, finally, a permanent home. It was small and noisy, but with four walls and a door with a lock. On her first night, Baker said, “I had a backpack for a pillow” and a comforter her case worker grabbed from the office. Still, she missed the outdoors.\u003c/p>\n\u003cp>“You breathe all the fresh air all night long, you’re under God’s heavens. It’s hard to stop being homeless,” she said. “You’re free.”\u003c/p>\n\u003cfigure id=\"attachment_11865581\" class=\"wp-caption aligncenter\" style=\"max-width: 1920px\">\u003cimg loading=\"lazy\" decoding=\"async\" class=\"size-full wp-image-11865581\" src=\"https://ww2.kqed.org/app/uploads/sites/10/2021/03/RS47870_MarleneChainlinkFencePantaloons-qut.jpg\" alt=\"\" width=\"1920\" height=\"1440\" srcset=\"https://cdn.kqed.org/wp-content/uploads/sites/10/2021/03/RS47870_MarleneChainlinkFencePantaloons-qut.jpg 1920w, https://cdn.kqed.org/wp-content/uploads/sites/10/2021/03/RS47870_MarleneChainlinkFencePantaloons-qut-800x600.jpg 800w, https://cdn.kqed.org/wp-content/uploads/sites/10/2021/03/RS47870_MarleneChainlinkFencePantaloons-qut-1020x765.jpg 1020w, https://cdn.kqed.org/wp-content/uploads/sites/10/2021/03/RS47870_MarleneChainlinkFencePantaloons-qut-160x120.jpg 160w, https://cdn.kqed.org/wp-content/uploads/sites/10/2021/03/RS47870_MarleneChainlinkFencePantaloons-qut-1536x1152.jpg 1536w\" sizes=\"(max-width: 1920px) 100vw, 1920px\">\u003cfigcaption class=\"wp-caption-text\">Marlene Baker’s tiny studio apartment, in a rundown former motel, is separated from Interstate 5 by a chain-link fence. On this day in September 2019, she shows off the old-fashioned pantaloons she’s hung there to dry. \u003ccite>(Lee Romney)\u003c/cite>\u003c/figcaption>\u003c/figure>\n\u003ch3>\u003cstrong>Freedom \u003c/strong>\u003c/h3>\n\u003cp>Baker had gained a different kind of freedom. But she was still facing a felony charge. To retain her liberty, she’d have to engage fully with treatment — something she had resisted for years. Now though, thanks to Siskiyou County’s only practicing psychiatrist, she built a bond and began to trust. They spoke about medicinal plants and healthy foods, and Baker agreed to long-acting injections of an anti-psychotic medication that cleared her mind.\u003c/p>\n\u003cp>It was time to enter a plea. Kayfetz knew a guilty plea would jeopardize Baker’s housing — and her stability. But there was another option — she could plead \u003ca href=\"https://leginfo.legislature.ca.gov/faces/codes_displaySection.xhtml?sectionNum=1026.&lawCode=PEN\">not guilty by reason of insanity.\u003c/a> That plea almost always means you go to a state mental hospital for a minimum of six months and often much longer. Baker had to stand up in court and say she understood she might spend the rest of her life there. Because Kayfetz had a plan.\u003c/p>\n\u003cp>Her client was thriving. Sending her hundreds of miles away to a state hospital, she argued, wasn’t necessary or humane.\u003c/p>\n\u003cp>Kirk Andrus, the district attorney, balked. But the judge agreed with Kayfetz. If Baker complied with her treatment, the felony charge would eventually be dismissed. For years, though, she’d have to check in regularly with the judge.\u003c/p>\n\u003cp>Her progress exceeded expectations. Four years after that fateful Thanksgiving, Baker received training to work as a peer facilitator for a weekly mental health support group. Dipping into her meager disability checks, she prepped healthy stews and soups for the group in her tiny kitchen and brought in Bingo prizes she bought at the Dollar General.\u003c/p>\n\u003cfigure id=\"attachment_11865582\" class=\"wp-caption aligncenter\" style=\"max-width: 1920px\">\u003cimg loading=\"lazy\" decoding=\"async\" class=\"size-full wp-image-11865582\" src=\"https://ww2.kqed.org/app/uploads/sites/10/2021/03/RS47871_MarleneLentilStew-qut.jpg\" alt=\"\" width=\"1920\" height=\"1440\" srcset=\"https://cdn.kqed.org/wp-content/uploads/sites/10/2021/03/RS47871_MarleneLentilStew-qut.jpg 1920w, https://cdn.kqed.org/wp-content/uploads/sites/10/2021/03/RS47871_MarleneLentilStew-qut-800x600.jpg 800w, https://cdn.kqed.org/wp-content/uploads/sites/10/2021/03/RS47871_MarleneLentilStew-qut-1020x765.jpg 1020w, https://cdn.kqed.org/wp-content/uploads/sites/10/2021/03/RS47871_MarleneLentilStew-qut-160x120.jpg 160w, https://cdn.kqed.org/wp-content/uploads/sites/10/2021/03/RS47871_MarleneLentilStew-qut-1536x1152.jpg 1536w\" sizes=\"(max-width: 1920px) 100vw, 1920px\">\u003cfigcaption class=\"wp-caption-text\">Marlene Baker prepares lentil stew in September 2019 in the tiny kitchen of her studio apartment. \u003ccite>(Lee Romney)\u003c/cite>\u003c/figcaption>\u003c/figure>\n\u003cp>Her relationship with her family healed, too, especially with her mom and sister.\u003c/p>\n\u003cp>Finally, on a sweltering August day in 2019, her case came up on the Siskiyou County Superior Court calendar for the very last time.\u003c/p>\n\u003cp>Marlene Baker got to the courthouse in a crushed velvet spaghetti-strap dress and lavender eye makeup. She hadn’t slept. She was too nervous. The judge congratulated her and declared her “restored” — as in restored to sanity. Within minutes, her long ordeal in the criminal justice system was over.\u003c/p>\n\u003ch3>\u003cstrong>Loss and Hope\u003c/strong>\u003c/h3>\n\u003cp>Sanity cannot stave off hardship. Within months of her court victory, Baker’s longtime case worker died unexpectedly. Then came COVID-19 and deep isolation. Baker’s peer group has technically been allowed to meet. But “nobody wants to go because it’s 6 feet apart and you can’t eat in there,” she said, “and that’s why they always came. I would bring them good food.”\u003c/p>\n\u003cp>Baker’s visits with her psychiatrist are no longer in person, just phone calls. So the long-acting injections are out, too. She has to remember to take her pills each morning. And last fall, more loss.\u003c/p>\n\u003cp>“My mom died, and two months later, my dad died,” she said.\u003c/p>\n\u003cp>Given all that, Kayfetz said, the fact that Baker is still housed and plugged in to mental health services is a victory. Beyond that, Baker’s success has helped bring about broader change.\u003c/p>\n\u003cp>Not long after her six-year fight to shed her felony charge came to an end, Siskiyou County launched what’s known as a behavioral health court. It wipes the criminal charges off the records of participants who complete treatment. Every inmate who arrives at the jail now takes an iPad questionnaire to determine if they need mental health services or would be good candidates for the new court. If they are, they get that treatment right here in the community, with their liberty intact.\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"disqusTitle": "'This Will End': A Message to My Pre-Pandemic Self",
"title": "'This Will End': A Message to My Pre-Pandemic Self",
"headTitle": "KQED News",
"content": "\u003cp>\u003cem>Part of our series \"\u003ca href=\"https://www.kqed.org/yearofcovid\">A Year of COVID\u003c/a>,\" marking a year of the coronavirus pandemic\u003c/em>\u003c/p>\n\u003cp>If you could time travel back to just before the pandemic hit, what would you tell your past self?\u003c/p>\n\u003cp>You might have seen Julie Nolke's \"Explaining the Pandemic to my Past Self\" video series exploring just that notion, in which the actor and comedian delivers words of wisdom to her pre-pandemic self — who of course has no idea about COVID-19 and what's to come.\u003c/p>\n\u003cp>https://www.youtube.com/watch?v=Ms7capx4Cb8\u003c/p>\n\u003cp>\"I was thinking about how every day felt like something unprecedented was happening in my lifetime ... in our lifetime collectively, as the human species,\" Nolke recently told \u003ca href=\"https://www.kqed.org/forum/2010101882500/what-would-you-tell-your-pre-pandemic-self\">KQED Forum.\u003c/a> She also acknowledged the artistic tightrope act of finding comedy in a year that felt \"really, really terrible on multiple fronts\" for so many people.\u003c/p>\n\u003cp>[ad fullwidth]\u003c/p>\n\u003cp>Now, one year after the pandemic — after what she calls \"an emotionally exhausting winter\" — Nolke says this part of the pandemic has been the most challenging for her thus far.\u003c/p>\n\u003cp>\"It just keeps feeling like the finish line is getting farther and farther, or somebody keeps moving it — you know what I mean?\"\u003c/p>\n\u003cp>Inspired by Nolke's appearance on \u003ca href=\"https://www.kqed.org/forum/2010101882500/what-would-you-tell-your-pre-pandemic-self\">KQED Forum's \"What Would You Tell Your Pre-Pandemic Self?\" show\u003c/a>, we asked you — and several of KQED's familiar voices and faces — what \u003cem>you'd\u003c/em> have said.\u003c/p>\n\u003cp>The answers ranged from the humorous to the heartbreaking, taking in everything from fear and loss to growth and resilience. If you got in touch to tell us what you'd have said, scroll down to see if your comment is included.\u003c/p>\n\u003cfigure id=\"attachment_11865228\" class=\"wp-caption alignnone\" style=\"max-width: 1900px\">\u003cimg class=\"size-full wp-image-11865228\" src=\"https://ww2.kqed.org/app/uploads/sites/10/2021/03/Alexis.jpg\" alt=\"\" width=\"1900\" height=\"2099\" srcset=\"https://ww2.kqed.org/app/uploads/sites/10/2021/03/Alexis.jpg 1900w, https://ww2.kqed.org/app/uploads/sites/10/2021/03/Alexis-800x884.jpg 800w, https://ww2.kqed.org/app/uploads/sites/10/2021/03/Alexis-1020x1127.jpg 1020w, https://ww2.kqed.org/app/uploads/sites/10/2021/03/Alexis-160x177.jpg 160w, https://ww2.kqed.org/app/uploads/sites/10/2021/03/Alexis-1390x1536.jpg 1390w, https://ww2.kqed.org/app/uploads/sites/10/2021/03/Alexis-1854x2048.jpg 1854w\" sizes=\"(max-width: 1900px) 100vw, 1900px\">\u003cfigcaption class=\"wp-caption-text\">KQED Forum guest host Alexis Madrigal pictured with his sister on Feb. 29, 2020: \"The last time we could hug.\" \u003ccite>(Alexis Madrigal)\u003c/cite>\u003c/figcaption>\u003c/figure>\n\u003cp>\"This is going to be so hard, but your ancestors came through worse. Humans can adapt to anything. Do your best by your family. Take care of your neighbors. Don't forget those who have it tougher than you do. And remember: This will end\" — \u003cstrong>Alexis Madrigal\u003c/strong>, \u003cem>writer at The Atlantic and guest host of KQED Forum this week \u003c/em>\u003c/p>\n\u003cp>\"I would have told myself to take my wife out of state to see her elderly mother, and give her a hug while she still had the chance. I would have told everyone to do so. So many older people in care homes have died not directly of the pandemic, but due to the disorienting isolation and inability to adapt to teleconferencing and the need for human touch\u003ci>\" — \u003c/i>\u003cstrong>Stephen\u003c/strong>\u003ci>, KQED Forum listener \u003c/i>\u003c/p>\n\u003cp>\"Make time for 45 minutes of walking every day. Tell your favorite co-workers how much you appreciate them...NOW. Prepare to remind yourself how lucky you are. Go see movies and theatre... IN THEATRES... while you can\" — \u003cstrong>Brian Watt, \u003c/strong>\u003cem>KQED Morning Edition host \u003c/em>\u003c/p>\n\u003cfigure id=\"attachment_11865273\" class=\"wp-caption alignnone\" style=\"max-width: 1900px\">\u003cimg class=\"size-full wp-image-11865273\" src=\"https://ww2.kqed.org/app/uploads/sites/10/2021/03/Sam-2.jpg\" alt=\"\" width=\"1900\" height=\"1280\" srcset=\"https://ww2.kqed.org/app/uploads/sites/10/2021/03/Sam-2.jpg 1900w, https://ww2.kqed.org/app/uploads/sites/10/2021/03/Sam-2-800x539.jpg 800w, https://ww2.kqed.org/app/uploads/sites/10/2021/03/Sam-2-1020x687.jpg 1020w, https://ww2.kqed.org/app/uploads/sites/10/2021/03/Sam-2-160x108.jpg 160w, https://ww2.kqed.org/app/uploads/sites/10/2021/03/Sam-2-1536x1035.jpg 1536w\" sizes=\"(max-width: 1900px) 100vw, 1900px\">\u003cfigcaption class=\"wp-caption-text\">Samantha Ovee and her partner (and dog Yogi) pictured before the pandemic. \u003ccite>(Samantha Ovee)\u003c/cite>\u003c/figcaption>\u003c/figure>\n\u003cp>\"You should have bought those disinfecting wipes when you saw them at Costco!\" — \u003cstrong>Samantha Ovee\u003c/strong>, \u003cem>@shizammyo on Instagram\u003c/em>\u003c/p>\n\u003cp>\"Call your doctor and get a prescription for anti-depressants right away. This was something that I did about six or seven months into the pandemic, and I could have benefited from that way sooner. I had a stigma about that for a long time, and it literally changed my life and my response to stress and anxiety\" — \u003cstrong>Angela,\u003c/strong> \u003cem>KQED Forum listener\u003c/em>\u003c/p>\n\u003cfigure id=\"attachment_11865223\" class=\"wp-caption alignnone\" style=\"max-width: 1900px\">\u003cimg class=\"size-full wp-image-11865223\" src=\"https://ww2.kqed.org/app/uploads/sites/10/2021/03/Troy.jpg\" alt=\"\" width=\"1900\" height=\"1183\" srcset=\"https://ww2.kqed.org/app/uploads/sites/10/2021/03/Troy.jpg 1900w, https://ww2.kqed.org/app/uploads/sites/10/2021/03/Troy-800x498.jpg 800w, https://ww2.kqed.org/app/uploads/sites/10/2021/03/Troy-1020x635.jpg 1020w, https://ww2.kqed.org/app/uploads/sites/10/2021/03/Troy-160x100.jpg 160w, https://ww2.kqed.org/app/uploads/sites/10/2021/03/Troy-1536x956.jpg 1536w\" sizes=\"(max-width: 1900px) 100vw, 1900px\">\u003cfigcaption class=\"wp-caption-text\">Troy Niemi, pictured a month before shelter-in-place with wife Bianca and daughter Adelaide at Monterey Bay Aquarium. \"Not a care in the world.\" \u003ccite>(Troy Niemi)\u003c/cite>\u003c/figcaption>\u003c/figure>\n\u003cp>\"Remember how much you said you loved Halloween? Well yeah, now you get to wear a mask every day\" — \u003cstrong>Troy Niemi\u003c/strong>, \u003cem>@41fever on Instagram\u003c/em>\u003c/p>\n\u003cp>\"Get your bike fixed, hug your folks and really remember how good that feels, and do a better job of checking in with people you don’t see often\" — \u003cstrong>Miller Oberlin\u003c/strong>, \u003cem>@oberlinphoto on Instagram\u003c/em>\u003c/p>\n\u003cp>\"It’s going to make everything that much more poignant and painful\" — \u003cstrong>Archer Lossing\u003c/strong>, \u003cem>@archerlossing on Instagram\u003c/em>\u003c/p>\n\u003cfigure id=\"attachment_11865283\" class=\"wp-caption alignnone\" style=\"max-width: 1900px\">\u003cimg class=\"size-full wp-image-11865283\" src=\"https://ww2.kqed.org/app/uploads/sites/10/2021/03/Ella.jpg\" alt=\"\" width=\"1900\" height=\"1280\" srcset=\"https://ww2.kqed.org/app/uploads/sites/10/2021/03/Ella.jpg 1900w, https://ww2.kqed.org/app/uploads/sites/10/2021/03/Ella-800x539.jpg 800w, https://ww2.kqed.org/app/uploads/sites/10/2021/03/Ella-1020x687.jpg 1020w, https://ww2.kqed.org/app/uploads/sites/10/2021/03/Ella-160x108.jpg 160w, https://ww2.kqed.org/app/uploads/sites/10/2021/03/Ella-1536x1035.jpg 1536w\" sizes=\"(max-width: 1900px) 100vw, 1900px\">\u003cfigcaption class=\"wp-caption-text\">Ella Rosenzweig, pictured getting ready to perform at a fashion/talent show in 2019. \u003ccite>(Ella Rosenzweig)\u003c/cite>\u003c/figcaption>\u003c/figure>\n\u003cp>\"Go ahead and stay a little later at the winter carnival. It'll be worth it\" — \u003cstrong>Ella Rosenzweig\u003c/strong>, \u003cem>@ella.rosenzweig on Instagram\u003c/em>\u003c/p>\n\u003cp>\"Embrace the horrible reality once and for all that the things that truly define America are a pathology, reckless cluelessness, getting caught with our pants down and a constitutional incapacity to learn from our prior mistakes\"— \u003cstrong>Greg\u003c/strong>, \u003ci>KQED Forum listener\u003c/i>\u003c/p>\n\u003cfigure id=\"attachment_11865222\" class=\"wp-caption alignnone\" style=\"max-width: 1900px\">\u003cimg class=\"size-full wp-image-11865222\" src=\"https://ww2.kqed.org/app/uploads/sites/10/2021/03/Mina.jpg\" alt=\"\" width=\"1900\" height=\"1791\" srcset=\"https://ww2.kqed.org/app/uploads/sites/10/2021/03/Mina.jpg 1900w, https://ww2.kqed.org/app/uploads/sites/10/2021/03/Mina-800x754.jpg 800w, https://ww2.kqed.org/app/uploads/sites/10/2021/03/Mina-1020x961.jpg 1020w, https://ww2.kqed.org/app/uploads/sites/10/2021/03/Mina-160x151.jpg 160w, https://ww2.kqed.org/app/uploads/sites/10/2021/03/Mina-1536x1448.jpg 1536w\" sizes=\"(max-width: 1900px) 100vw, 1900px\">\u003cfigcaption class=\"wp-caption-text\">KQED Forum host Mina Kim, pictured pre-pandemic \"at my kid’s school fundraiser literally the weekend before, where I bid on activities I never got to do!\" \u003ccite>(Mina Kim)\u003c/cite>\u003c/figcaption>\u003c/figure>\n\u003cp>\"I’d tell myself to smile at people even though it’s behind a face mask and they can’t see it. I stopped for a while after it felt pointless, and realized quickly it wasn’t pointless at all\" — \u003cb>Mina Kim, \u003c/b>\u003cem>host of KQED Forum\u003c/em>\u003c/p>\n\u003cp>\"Call your mom and your brother as much as you possibly can. Tell them you love them. Keep them company and encourage them to rest and take care of themselves at home to stay safe. Insist on seeing their faces in your calls and record them so you can hold on to them. You won't be able to hear their voices again next year\" — \u003cb>Rachel Turner, \u003c/b>\u003cem>@chionearisteia on Instagram\u003c/em>\u003c/p>\n\u003cp>\"Pace yourself with entertaining your kids. Also, get ready for some picnics! Lots & lots of picnics! Also, put down those extra rolls of toilet paper, where are you going to put them?!?\" — \u003cstrong>Marcie Longoria\u003c/strong>, \u003cem>@texicanmama on Instagram\u003c/em>\u003c/p>\n\u003cfigure id=\"attachment_11865299\" class=\"wp-caption alignnone\" style=\"max-width: 1900px\">\u003cimg class=\"size-full wp-image-11865299\" src=\"https://ww2.kqed.org/app/uploads/sites/10/2021/03/Molly.jpg\" alt=\"\" width=\"1900\" height=\"1424\" srcset=\"https://ww2.kqed.org/app/uploads/sites/10/2021/03/Molly.jpg 1900w, https://ww2.kqed.org/app/uploads/sites/10/2021/03/Molly-800x600.jpg 800w, https://ww2.kqed.org/app/uploads/sites/10/2021/03/Molly-1020x764.jpg 1020w, https://ww2.kqed.org/app/uploads/sites/10/2021/03/Molly-160x120.jpg 160w, https://ww2.kqed.org/app/uploads/sites/10/2021/03/Molly-1536x1151.jpg 1536w\" sizes=\"(max-width: 1900px) 100vw, 1900px\">\u003cfigcaption class=\"wp-caption-text\">Molly Hernandez, pictured on a pre-pandemic family trip to the Alameda Flea Market \u003ccite>(Molly Hernandez)\u003c/cite>\u003c/figcaption>\u003c/figure>\n\u003cp>\"You will get past the anxiety of losing your job and actually start to enjoy this family time\" — \u003cstrong>Molly Hernandez\u003c/strong>, \u003cem>@miss_mollyh on Instagram\u003c/em>\u003c/p>\n\u003cp>\"Clear out that spare room and get organized. Buy more yarn, you don't have enough. This is going to be a long haul. Buy TP, wipes and Lysol spray. Go and see your far-flung family members, it's gonna be a while. GO CAMPING NOW!\" — \u003cstrong>Melanie West\u003c/strong>, \u003cem>@melaniew626 on Instagram\u003c/em>\u003c/p>\n\u003cfigure id=\"attachment_11865285\" class=\"wp-caption alignnone\" style=\"max-width: 1900px\">\u003cimg class=\"size-full wp-image-11865285\" src=\"https://ww2.kqed.org/app/uploads/sites/10/2021/03/Kai.jpg\" alt=\"\" width=\"1900\" height=\"2424\" srcset=\"https://ww2.kqed.org/app/uploads/sites/10/2021/03/Kai.jpg 1900w, https://ww2.kqed.org/app/uploads/sites/10/2021/03/Kai-800x1021.jpg 800w, https://ww2.kqed.org/app/uploads/sites/10/2021/03/Kai-1020x1301.jpg 1020w, https://ww2.kqed.org/app/uploads/sites/10/2021/03/Kai-160x204.jpg 160w, https://ww2.kqed.org/app/uploads/sites/10/2021/03/Kai-1204x1536.jpg 1204w, https://ww2.kqed.org/app/uploads/sites/10/2021/03/Kai-1605x2048.jpg 1605w\" sizes=\"(max-width: 1900px) 100vw, 1900px\">\u003cfigcaption class=\"wp-caption-text\">Kai Henthorn, pictured pre-pandemic. \"Never got to use that passport.\" \u003ccite>(Kai Henthorn)\u003c/cite>\u003c/figcaption>\u003c/figure>\n\u003cp>\"You have everything you need. It's all going to be okay. Don't buy Animal Crossing, it's dumb\" — \u003cstrong>Kai Henthorn\u003c/strong>, \u003cem>@kaichickenthorn on Instagram\u003c/em>\u003c/p>\n\u003cp>\"Hug your friends, thank your teachers and don't push everything to the end of senior year\" — \u003cstrong>Jade\u003c/strong>, \u003cem>@jadecostello on Instagram\u003c/em>\u003c/p>\n\u003cfigure id=\"attachment_11865290\" class=\"wp-caption alignnone\" style=\"max-width: 1900px\">\u003cimg class=\"size-full wp-image-11865290\" src=\"https://ww2.kqed.org/app/uploads/sites/10/2021/03/Rachel.jpg\" alt=\"\" width=\"1900\" height=\"1470\" srcset=\"https://ww2.kqed.org/app/uploads/sites/10/2021/03/Rachel.jpg 1900w, https://ww2.kqed.org/app/uploads/sites/10/2021/03/Rachel-800x619.jpg 800w, https://ww2.kqed.org/app/uploads/sites/10/2021/03/Rachel-1020x789.jpg 1020w, https://ww2.kqed.org/app/uploads/sites/10/2021/03/Rachel-160x124.jpg 160w, https://ww2.kqed.org/app/uploads/sites/10/2021/03/Rachel-1536x1188.jpg 1536w\" sizes=\"(max-width: 1900px) 100vw, 1900px\">\u003cfigcaption class=\"wp-caption-text\">Rachel Kovinsky, pictured on her \"last trip to SFMOMA before lockdown.\" \u003ccite>(Rachel Kovinsky)\u003c/cite>\u003c/figcaption>\u003c/figure>\n\u003cp>\"Appreciate the casual interactions and unexpected moments of joy a bit more. They’re about to become a lot less frequent ! Also be a bit more kind and gentle with yourself and others. It’s gonna be a hard year\" — \u003cstrong>Rachel K\u003c/strong>, \u003cem>@rkovinsky on Instagram\u003c/em>\u003c/p>\n\u003cp>[ad floatright]\u003c/p>\n\u003cp>\u003cspan class=\"\">\"Stop overworking yourself. Your job doesn’t love you back and will drop you the second things get hard\" — \u003cstrong>@hater_tot\u003c/strong> \u003cem>on Instagram\u003c/em>\u003c/span>\u003c/p>\n\n",
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"excerpt": "If you could time travel, what would you have told your pre-pandemic self about the year to come? You sent us your words.",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003cp>\u003cem>Part of our series \"\u003ca href=\"https://www.kqed.org/yearofcovid\">A Year of COVID\u003c/a>,\" marking a year of the coronavirus pandemic\u003c/em>\u003c/p>\n\u003cp>If you could time travel back to just before the pandemic hit, what would you tell your past self?\u003c/p>\n\u003cp>You might have seen Julie Nolke's \"Explaining the Pandemic to my Past Self\" video series exploring just that notion, in which the actor and comedian delivers words of wisdom to her pre-pandemic self — who of course has no idea about COVID-19 and what's to come.\u003c/p>\u003c/p>\u003cp>\u003cspan class='utils-parseShortcode-shortcodes-__youtubeShortcode__embedYoutube'>\n \u003cspan class='utils-parseShortcode-shortcodes-__youtubeShortcode__embedYoutubeInside'>\n \u003ciframe\n loading='lazy'\n class='utils-parseShortcode-shortcodes-__youtubeShortcode__youtubePlayer'\n type='text/html'\n src='//www.youtube.com/embed/Ms7capx4Cb8'\n title='//www.youtube.com/embed/Ms7capx4Cb8'\n allowfullscreen='true'\n style='border:0;'>\u003c/iframe>\n \u003c/span>\n \u003c/span>\u003c/p>\u003cp>\u003cp>\"I was thinking about how every day felt like something unprecedented was happening in my lifetime ... in our lifetime collectively, as the human species,\" Nolke recently told \u003ca href=\"https://www.kqed.org/forum/2010101882500/what-would-you-tell-your-pre-pandemic-self\">KQED Forum.\u003c/a> She also acknowledged the artistic tightrope act of finding comedy in a year that felt \"really, really terrible on multiple fronts\" for so many people.\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>Now, one year after the pandemic — after what she calls \"an emotionally exhausting winter\" — Nolke says this part of the pandemic has been the most challenging for her thus far.\u003c/p>\n\u003cp>\"It just keeps feeling like the finish line is getting farther and farther, or somebody keeps moving it — you know what I mean?\"\u003c/p>\n\u003cp>Inspired by Nolke's appearance on \u003ca href=\"https://www.kqed.org/forum/2010101882500/what-would-you-tell-your-pre-pandemic-self\">KQED Forum's \"What Would You Tell Your Pre-Pandemic Self?\" show\u003c/a>, we asked you — and several of KQED's familiar voices and faces — what \u003cem>you'd\u003c/em> have said.\u003c/p>\n\u003cp>The answers ranged from the humorous to the heartbreaking, taking in everything from fear and loss to growth and resilience. If you got in touch to tell us what you'd have said, scroll down to see if your comment is included.\u003c/p>\n\u003cfigure id=\"attachment_11865228\" class=\"wp-caption alignnone\" style=\"max-width: 1900px\">\u003cimg class=\"size-full wp-image-11865228\" src=\"https://ww2.kqed.org/app/uploads/sites/10/2021/03/Alexis.jpg\" alt=\"\" width=\"1900\" height=\"2099\" srcset=\"https://ww2.kqed.org/app/uploads/sites/10/2021/03/Alexis.jpg 1900w, https://ww2.kqed.org/app/uploads/sites/10/2021/03/Alexis-800x884.jpg 800w, https://ww2.kqed.org/app/uploads/sites/10/2021/03/Alexis-1020x1127.jpg 1020w, https://ww2.kqed.org/app/uploads/sites/10/2021/03/Alexis-160x177.jpg 160w, https://ww2.kqed.org/app/uploads/sites/10/2021/03/Alexis-1390x1536.jpg 1390w, https://ww2.kqed.org/app/uploads/sites/10/2021/03/Alexis-1854x2048.jpg 1854w\" sizes=\"(max-width: 1900px) 100vw, 1900px\">\u003cfigcaption class=\"wp-caption-text\">KQED Forum guest host Alexis Madrigal pictured with his sister on Feb. 29, 2020: \"The last time we could hug.\" \u003ccite>(Alexis Madrigal)\u003c/cite>\u003c/figcaption>\u003c/figure>\n\u003cp>\"This is going to be so hard, but your ancestors came through worse. Humans can adapt to anything. Do your best by your family. Take care of your neighbors. Don't forget those who have it tougher than you do. And remember: This will end\" — \u003cstrong>Alexis Madrigal\u003c/strong>, \u003cem>writer at The Atlantic and guest host of KQED Forum this week \u003c/em>\u003c/p>\n\u003cp>\"I would have told myself to take my wife out of state to see her elderly mother, and give her a hug while she still had the chance. I would have told everyone to do so. So many older people in care homes have died not directly of the pandemic, but due to the disorienting isolation and inability to adapt to teleconferencing and the need for human touch\u003ci>\" — \u003c/i>\u003cstrong>Stephen\u003c/strong>\u003ci>, KQED Forum listener \u003c/i>\u003c/p>\n\u003cp>\"Make time for 45 minutes of walking every day. Tell your favorite co-workers how much you appreciate them...NOW. Prepare to remind yourself how lucky you are. Go see movies and theatre... IN THEATRES... while you can\" — \u003cstrong>Brian Watt, \u003c/strong>\u003cem>KQED Morning Edition host \u003c/em>\u003c/p>\n\u003cfigure id=\"attachment_11865273\" class=\"wp-caption alignnone\" style=\"max-width: 1900px\">\u003cimg class=\"size-full wp-image-11865273\" src=\"https://ww2.kqed.org/app/uploads/sites/10/2021/03/Sam-2.jpg\" alt=\"\" width=\"1900\" height=\"1280\" srcset=\"https://ww2.kqed.org/app/uploads/sites/10/2021/03/Sam-2.jpg 1900w, https://ww2.kqed.org/app/uploads/sites/10/2021/03/Sam-2-800x539.jpg 800w, https://ww2.kqed.org/app/uploads/sites/10/2021/03/Sam-2-1020x687.jpg 1020w, https://ww2.kqed.org/app/uploads/sites/10/2021/03/Sam-2-160x108.jpg 160w, https://ww2.kqed.org/app/uploads/sites/10/2021/03/Sam-2-1536x1035.jpg 1536w\" sizes=\"(max-width: 1900px) 100vw, 1900px\">\u003cfigcaption class=\"wp-caption-text\">Samantha Ovee and her partner (and dog Yogi) pictured before the pandemic. \u003ccite>(Samantha Ovee)\u003c/cite>\u003c/figcaption>\u003c/figure>\n\u003cp>\"You should have bought those disinfecting wipes when you saw them at Costco!\" — \u003cstrong>Samantha Ovee\u003c/strong>, \u003cem>@shizammyo on Instagram\u003c/em>\u003c/p>\n\u003cp>\"Call your doctor and get a prescription for anti-depressants right away. This was something that I did about six or seven months into the pandemic, and I could have benefited from that way sooner. I had a stigma about that for a long time, and it literally changed my life and my response to stress and anxiety\" — \u003cstrong>Angela,\u003c/strong> \u003cem>KQED Forum listener\u003c/em>\u003c/p>\n\u003cfigure id=\"attachment_11865223\" class=\"wp-caption alignnone\" style=\"max-width: 1900px\">\u003cimg class=\"size-full wp-image-11865223\" src=\"https://ww2.kqed.org/app/uploads/sites/10/2021/03/Troy.jpg\" alt=\"\" width=\"1900\" height=\"1183\" srcset=\"https://ww2.kqed.org/app/uploads/sites/10/2021/03/Troy.jpg 1900w, https://ww2.kqed.org/app/uploads/sites/10/2021/03/Troy-800x498.jpg 800w, https://ww2.kqed.org/app/uploads/sites/10/2021/03/Troy-1020x635.jpg 1020w, https://ww2.kqed.org/app/uploads/sites/10/2021/03/Troy-160x100.jpg 160w, https://ww2.kqed.org/app/uploads/sites/10/2021/03/Troy-1536x956.jpg 1536w\" sizes=\"(max-width: 1900px) 100vw, 1900px\">\u003cfigcaption class=\"wp-caption-text\">Troy Niemi, pictured a month before shelter-in-place with wife Bianca and daughter Adelaide at Monterey Bay Aquarium. \"Not a care in the world.\" \u003ccite>(Troy Niemi)\u003c/cite>\u003c/figcaption>\u003c/figure>\n\u003cp>\"Remember how much you said you loved Halloween? Well yeah, now you get to wear a mask every day\" — \u003cstrong>Troy Niemi\u003c/strong>, \u003cem>@41fever on Instagram\u003c/em>\u003c/p>\n\u003cp>\"Get your bike fixed, hug your folks and really remember how good that feels, and do a better job of checking in with people you don’t see often\" — \u003cstrong>Miller Oberlin\u003c/strong>, \u003cem>@oberlinphoto on Instagram\u003c/em>\u003c/p>\n\u003cp>\"It’s going to make everything that much more poignant and painful\" — \u003cstrong>Archer Lossing\u003c/strong>, \u003cem>@archerlossing on Instagram\u003c/em>\u003c/p>\n\u003cfigure id=\"attachment_11865283\" class=\"wp-caption alignnone\" style=\"max-width: 1900px\">\u003cimg class=\"size-full wp-image-11865283\" src=\"https://ww2.kqed.org/app/uploads/sites/10/2021/03/Ella.jpg\" alt=\"\" width=\"1900\" height=\"1280\" srcset=\"https://ww2.kqed.org/app/uploads/sites/10/2021/03/Ella.jpg 1900w, https://ww2.kqed.org/app/uploads/sites/10/2021/03/Ella-800x539.jpg 800w, https://ww2.kqed.org/app/uploads/sites/10/2021/03/Ella-1020x687.jpg 1020w, https://ww2.kqed.org/app/uploads/sites/10/2021/03/Ella-160x108.jpg 160w, https://ww2.kqed.org/app/uploads/sites/10/2021/03/Ella-1536x1035.jpg 1536w\" sizes=\"(max-width: 1900px) 100vw, 1900px\">\u003cfigcaption class=\"wp-caption-text\">Ella Rosenzweig, pictured getting ready to perform at a fashion/talent show in 2019. \u003ccite>(Ella Rosenzweig)\u003c/cite>\u003c/figcaption>\u003c/figure>\n\u003cp>\"Go ahead and stay a little later at the winter carnival. It'll be worth it\" — \u003cstrong>Ella Rosenzweig\u003c/strong>, \u003cem>@ella.rosenzweig on Instagram\u003c/em>\u003c/p>\n\u003cp>\"Embrace the horrible reality once and for all that the things that truly define America are a pathology, reckless cluelessness, getting caught with our pants down and a constitutional incapacity to learn from our prior mistakes\"— \u003cstrong>Greg\u003c/strong>, \u003ci>KQED Forum listener\u003c/i>\u003c/p>\n\u003cfigure id=\"attachment_11865222\" class=\"wp-caption alignnone\" style=\"max-width: 1900px\">\u003cimg class=\"size-full wp-image-11865222\" src=\"https://ww2.kqed.org/app/uploads/sites/10/2021/03/Mina.jpg\" alt=\"\" width=\"1900\" height=\"1791\" srcset=\"https://ww2.kqed.org/app/uploads/sites/10/2021/03/Mina.jpg 1900w, https://ww2.kqed.org/app/uploads/sites/10/2021/03/Mina-800x754.jpg 800w, https://ww2.kqed.org/app/uploads/sites/10/2021/03/Mina-1020x961.jpg 1020w, https://ww2.kqed.org/app/uploads/sites/10/2021/03/Mina-160x151.jpg 160w, https://ww2.kqed.org/app/uploads/sites/10/2021/03/Mina-1536x1448.jpg 1536w\" sizes=\"(max-width: 1900px) 100vw, 1900px\">\u003cfigcaption class=\"wp-caption-text\">KQED Forum host Mina Kim, pictured pre-pandemic \"at my kid’s school fundraiser literally the weekend before, where I bid on activities I never got to do!\" \u003ccite>(Mina Kim)\u003c/cite>\u003c/figcaption>\u003c/figure>\n\u003cp>\"I’d tell myself to smile at people even though it’s behind a face mask and they can’t see it. I stopped for a while after it felt pointless, and realized quickly it wasn’t pointless at all\" — \u003cb>Mina Kim, \u003c/b>\u003cem>host of KQED Forum\u003c/em>\u003c/p>\n\u003cp>\"Call your mom and your brother as much as you possibly can. Tell them you love them. Keep them company and encourage them to rest and take care of themselves at home to stay safe. Insist on seeing their faces in your calls and record them so you can hold on to them. You won't be able to hear their voices again next year\" — \u003cb>Rachel Turner, \u003c/b>\u003cem>@chionearisteia on Instagram\u003c/em>\u003c/p>\n\u003cp>\"Pace yourself with entertaining your kids. Also, get ready for some picnics! Lots & lots of picnics! Also, put down those extra rolls of toilet paper, where are you going to put them?!?\" — \u003cstrong>Marcie Longoria\u003c/strong>, \u003cem>@texicanmama on Instagram\u003c/em>\u003c/p>\n\u003cfigure id=\"attachment_11865299\" class=\"wp-caption alignnone\" style=\"max-width: 1900px\">\u003cimg class=\"size-full wp-image-11865299\" src=\"https://ww2.kqed.org/app/uploads/sites/10/2021/03/Molly.jpg\" alt=\"\" width=\"1900\" height=\"1424\" srcset=\"https://ww2.kqed.org/app/uploads/sites/10/2021/03/Molly.jpg 1900w, https://ww2.kqed.org/app/uploads/sites/10/2021/03/Molly-800x600.jpg 800w, https://ww2.kqed.org/app/uploads/sites/10/2021/03/Molly-1020x764.jpg 1020w, https://ww2.kqed.org/app/uploads/sites/10/2021/03/Molly-160x120.jpg 160w, https://ww2.kqed.org/app/uploads/sites/10/2021/03/Molly-1536x1151.jpg 1536w\" sizes=\"(max-width: 1900px) 100vw, 1900px\">\u003cfigcaption class=\"wp-caption-text\">Molly Hernandez, pictured on a pre-pandemic family trip to the Alameda Flea Market \u003ccite>(Molly Hernandez)\u003c/cite>\u003c/figcaption>\u003c/figure>\n\u003cp>\"You will get past the anxiety of losing your job and actually start to enjoy this family time\" — \u003cstrong>Molly Hernandez\u003c/strong>, \u003cem>@miss_mollyh on Instagram\u003c/em>\u003c/p>\n\u003cp>\"Clear out that spare room and get organized. Buy more yarn, you don't have enough. This is going to be a long haul. Buy TP, wipes and Lysol spray. Go and see your far-flung family members, it's gonna be a while. GO CAMPING NOW!\" — \u003cstrong>Melanie West\u003c/strong>, \u003cem>@melaniew626 on Instagram\u003c/em>\u003c/p>\n\u003cfigure id=\"attachment_11865285\" class=\"wp-caption alignnone\" style=\"max-width: 1900px\">\u003cimg class=\"size-full wp-image-11865285\" src=\"https://ww2.kqed.org/app/uploads/sites/10/2021/03/Kai.jpg\" alt=\"\" width=\"1900\" height=\"2424\" srcset=\"https://ww2.kqed.org/app/uploads/sites/10/2021/03/Kai.jpg 1900w, https://ww2.kqed.org/app/uploads/sites/10/2021/03/Kai-800x1021.jpg 800w, https://ww2.kqed.org/app/uploads/sites/10/2021/03/Kai-1020x1301.jpg 1020w, https://ww2.kqed.org/app/uploads/sites/10/2021/03/Kai-160x204.jpg 160w, https://ww2.kqed.org/app/uploads/sites/10/2021/03/Kai-1204x1536.jpg 1204w, https://ww2.kqed.org/app/uploads/sites/10/2021/03/Kai-1605x2048.jpg 1605w\" sizes=\"(max-width: 1900px) 100vw, 1900px\">\u003cfigcaption class=\"wp-caption-text\">Kai Henthorn, pictured pre-pandemic. \"Never got to use that passport.\" \u003ccite>(Kai Henthorn)\u003c/cite>\u003c/figcaption>\u003c/figure>\n\u003cp>\"You have everything you need. It's all going to be okay. Don't buy Animal Crossing, it's dumb\" — \u003cstrong>Kai Henthorn\u003c/strong>, \u003cem>@kaichickenthorn on Instagram\u003c/em>\u003c/p>\n\u003cp>\"Hug your friends, thank your teachers and don't push everything to the end of senior year\" — \u003cstrong>Jade\u003c/strong>, \u003cem>@jadecostello on Instagram\u003c/em>\u003c/p>\n\u003cfigure id=\"attachment_11865290\" class=\"wp-caption alignnone\" style=\"max-width: 1900px\">\u003cimg class=\"size-full wp-image-11865290\" src=\"https://ww2.kqed.org/app/uploads/sites/10/2021/03/Rachel.jpg\" alt=\"\" width=\"1900\" height=\"1470\" srcset=\"https://ww2.kqed.org/app/uploads/sites/10/2021/03/Rachel.jpg 1900w, https://ww2.kqed.org/app/uploads/sites/10/2021/03/Rachel-800x619.jpg 800w, https://ww2.kqed.org/app/uploads/sites/10/2021/03/Rachel-1020x789.jpg 1020w, https://ww2.kqed.org/app/uploads/sites/10/2021/03/Rachel-160x124.jpg 160w, https://ww2.kqed.org/app/uploads/sites/10/2021/03/Rachel-1536x1188.jpg 1536w\" sizes=\"(max-width: 1900px) 100vw, 1900px\">\u003cfigcaption class=\"wp-caption-text\">Rachel Kovinsky, pictured on her \"last trip to SFMOMA before lockdown.\" \u003ccite>(Rachel Kovinsky)\u003c/cite>\u003c/figcaption>\u003c/figure>\n\u003cp>\"Appreciate the casual interactions and unexpected moments of joy a bit more. They’re about to become a lot less frequent ! Also be a bit more kind and gentle with yourself and others. It’s gonna be a hard year\" — \u003cstrong>Rachel K\u003c/strong>, \u003cem>@rkovinsky on Instagram\u003c/em>\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>\u003cspan class=\"\">\"Stop overworking yourself. Your job doesn’t love you back and will drop you the second things get hard\" — \u003cstrong>@hater_tot\u003c/strong> \u003cem>on Instagram\u003c/em>\u003c/span>\u003c/p>\n\n\u003c/div>\u003c/p>",
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"title": "Children's Mental Health Still Big Concern as Schools Begin Reopening",
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"content": "\u003cp>Mental health professionals say the toll of the pandemic on children and teenagers means schools will need extra resources to prepare for an influx of children in crisis as they reopen for in-person instruction.\u003c/p>\n\u003cp>“Reopening schools isn’t the answer,” to addressing the needs of kids experiencing mental health problems during the pandemic, said Marisol Cruz Romero, a psychologist at UCSF Benioff Children’s Hospital Oakland, where the number of suicide attempts coming into the emergency department doubled last fall compared to the previous year. [pullquote size=\"medium\" align=\"right\" citation=\"Marisol Cruz Romero, psychologist at UCSF Benioff Children’s Hospital Oakland\"]‘The stressors of the pandemic don’t go away when schools reopen. Schools need to be ready for dysregulation, depression, kids who can’t focus.’[/pullquote]\u003c/p>\n\u003cp>“The stressors of the pandemic don’t go away when schools reopen. Schools need to be ready for dysregulation, depression, kids who can’t focus,” Romero said.\u003c/p>\n\u003cp>Schools need to prepare and train their teachers and staff to recognize that some kids will need more help as they return to the routines of schooling, because distance learning was taxing and many families have suffered great losses from the virus, Romero said. She argues that schools should provide these mental health resources, but for children who are already in crisis, more targeted counseling services and psychiatric beds are needed.\u003c/p>\n\u003cp>Hospital beds, mental health programs, psychiatric beds and therapy services for young people were hard to find even before the pandemic, Romero said. Now the influx of children in crisis to hospital emergency rooms has put more pressure on a system that was already stretched thin.\u003c/p>\n\u003cp>[ad fullwidth]\u003c/p>\n\u003cp>Romero described a 6-year-old boy who recently spent hours in the emergency room while waiting for a placement in a psychiatric hospital. The waitlist was long and his family became homeless due to the pandemic. The hospital reminded him of the recent death of a family member. Waiting in a small hospital room with loud noises and people coming and going was triggering to the boy and also a challenge for providers, creating “a lot of additional stressors in providers and not knowing really how to access these resources or what to do to improve the system.”\u003c/p>\n\u003cp>Some children in crisis have to wait two months to see a psychiatrist, Romero said. Telehealth is an option but it doesn’t work for many children. Kids are experiencing loss, grief and economic uncertainty as they watch their family members get sick, lose work and even die. Because of social distancing, it’s also harder for children and their caregivers to take breaks by going to a relative’s home.\u003c/p>\n\u003cp>“A lot of kids fall into the gap between needing a couple weeks of inpatient care at a psychiatric hospital or just a weekly therapist visit,” or partial hospitalization or behavioral therapy, Romero said.\u003c/p>\n\u003cp>Many of the programs designed to fill that gap are built around in-person or group therapy, like the hospital’s 30-day after-school program for children recently released from the hospital after experiencing mental health crises. But Romero says those programs are now carried out primarily online, which can be less effective.\u003c/p>\n\u003cp>“The program is still going on, but it’s not as successful via telehealth,” Romero said. “Some kids do well with telehealth, others don’t — just like at school, just like adults at work.”\u003c/p>\n\u003cp>Romero said there is also a need for more psychiatric beds. “I wish we could focus on prevention. But the reality is kids are in crisis and we don’t have enough beds,” she said.\u003c/p>\n\u003cp>With these added stressors, Children’s Hospital emergency room staff have instituted universal screening, to make sure they ask directly about self-harm and suicidal thoughts. That’s something a teacher in an in-person classroom might help identify, but with kids taking online classes, those interactions are happening less frequently.\u003c/p>\n\u003cp>“Many of the primary care providers have expressed concerns and sometimes hesitation around asking about suicide directly because it might put [self-harm] in their head or because it’s a really hard conversation. I want to advocate that it is important to ask. The research does show that it does not increase the risk of suicide. It actually reduces it,” she said. [aside tag=\"education, mental health\" label=\"More Related Stories\"]\u003c/p>\n\u003cp>Romero and her colleagues are bracing themselves for an increase in referrals, which have been delayed because of distance learning. She’s encouraged to see many large school districts finally rolling out plans for children to return to in-person instruction, but there’s already a backlog of children waiting for appointments and services.\u003c/p>\n\u003cp>Schools are in the best position to help the most children, and screen those who need more intensive support. School-based mental health resources can provide “a safe space for kids to address their emotional challenges,” Romero said. Plus, they target some barriers to care, like lack of transportation or insurance. “If kids have trauma or abuse at home, they only say something if someone asks. There’s a space for that at school and with teachers.”\u003c/p>\n\u003cp>Finally, if young people are feeling sadness or overwhelmed, Romero encourages caretakers to find ways to help them stay connected and communicate. “The most important thing to keep note is that communication is key for our youth and providing them a safe space to express their emotions,” she said.\u003c/p>\n\u003cp>\u003c/p>\n\u003cp>\u003cem>To get help for a child or teenager in crisis, call the National Suicide Prevention Lifeline: 1-800-273-8255.\u003c/em>\u003c/p>\n\n",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>Romero described a 6-year-old boy who recently spent hours in the emergency room while waiting for a placement in a psychiatric hospital. The waitlist was long and his family became homeless due to the pandemic. The hospital reminded him of the recent death of a family member. Waiting in a small hospital room with loud noises and people coming and going was triggering to the boy and also a challenge for providers, creating “a lot of additional stressors in providers and not knowing really how to access these resources or what to do to improve the system.”\u003c/p>\n\u003cp>Some children in crisis have to wait two months to see a psychiatrist, Romero said. Telehealth is an option but it doesn’t work for many children. Kids are experiencing loss, grief and economic uncertainty as they watch their family members get sick, lose work and even die. Because of social distancing, it’s also harder for children and their caregivers to take breaks by going to a relative’s home.\u003c/p>\n\u003cp>“A lot of kids fall into the gap between needing a couple weeks of inpatient care at a psychiatric hospital or just a weekly therapist visit,” or partial hospitalization or behavioral therapy, Romero said.\u003c/p>\n\u003cp>Many of the programs designed to fill that gap are built around in-person or group therapy, like the hospital’s 30-day after-school program for children recently released from the hospital after experiencing mental health crises. But Romero says those programs are now carried out primarily online, which can be less effective.\u003c/p>\n\u003cp>“The program is still going on, but it’s not as successful via telehealth,” Romero said. “Some kids do well with telehealth, others don’t — just like at school, just like adults at work.”\u003c/p>\n\u003cp>Romero said there is also a need for more psychiatric beds. “I wish we could focus on prevention. But the reality is kids are in crisis and we don’t have enough beds,” she said.\u003c/p>\n\u003cp>With these added stressors, Children’s Hospital emergency room staff have instituted universal screening, to make sure they ask directly about self-harm and suicidal thoughts. That’s something a teacher in an in-person classroom might help identify, but with kids taking online classes, those interactions are happening less frequently.\u003c/p>\n\u003cp>“Many of the primary care providers have expressed concerns and sometimes hesitation around asking about suicide directly because it might put [self-harm] in their head or because it’s a really hard conversation. I want to advocate that it is important to ask. The research does show that it does not increase the risk of suicide. It actually reduces it,” she said. \u003c/p>\u003c/div>",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>Romero and her colleagues are bracing themselves for an increase in referrals, which have been delayed because of distance learning. She’s encouraged to see many large school districts finally rolling out plans for children to return to in-person instruction, but there’s already a backlog of children waiting for appointments and services.\u003c/p>\n\u003cp>Schools are in the best position to help the most children, and screen those who need more intensive support. School-based mental health resources can provide “a safe space for kids to address their emotional challenges,” Romero said. Plus, they target some barriers to care, like lack of transportation or insurance. “If kids have trauma or abuse at home, they only say something if someone asks. There’s a space for that at school and with teachers.”\u003c/p>\n\u003cp>Finally, if young people are feeling sadness or overwhelmed, Romero encourages caretakers to find ways to help them stay connected and communicate. “The most important thing to keep note is that communication is key for our youth and providing them a safe space to express their emotions,” she said.\u003c/p>\n\u003cp>\u003c/p>\n\u003cp>\u003cem>To get help for a child or teenager in crisis, call the National Suicide Prevention Lifeline: 1-800-273-8255.\u003c/em>\u003c/p>\n\n\u003c/div>\u003c/p>",
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"info": "For decades, the process for how police police themselves has been inconsistent – if not opaque. In some states, like California, these proceedings were completely hidden. After a new police transparency law unsealed scores of internal affairs files, our reporters set out to examine these cases and the shadow world of police discipline. On Our Watch brings listeners into the rooms where officers are questioned and witnesses are interrogated to find out who this system is really protecting. Is it the officers, or the public they've sworn to serve?",
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"info": "Possible is hosted by entrepreneur Reid Hoffman and writer Aria Finger. Together in Possible, Hoffman and Finger lead enlightening discussions about building a brighter collective future. The show features interviews with visionary guests like Trevor Noah, Sam Altman and Janette Sadik-Khan. Possible paints an optimistic portrait of the world we can create through science, policy, business, art and our shared humanity. It asks: What if everything goes right for once? How can we get there? Each episode also includes a short fiction story generated by advanced AI GPT-4, serving as a thought-provoking springboard to speculate how humanity could leverage technology for good.",
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"soldout": {
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"title": "SOLD OUT: Rethinking Housing in America",
"tagline": "A new future for housing",
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"tagline": "True-life supernatural stories",
"info": "",
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