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"content": "\u003cp>Dr. Tiffany Chioma Anaebere doesn’t remember where she was when she heard about George Floyd’s death.\u003c/p>\n\u003cp>She could’ve been at her home in Emeryville, where she lives with her fiance. Or in the car, during one of her many commutes between Stockton and Modesto, where she works in two different hospitals as an emergency medicine physician on the frontlines of the coronavirus pandemic.\u003c/p>\n\u003cp>All she knows is that, at first, she avoided watching the video.\u003c/p>\n\u003cp>“I refused to. Like, I cannot see anything right now. And I’m normally the person that’s like, ‘Girl, did you see this video?’” she said. “I was like ‘No, no, no, no, no, I’m not watching anything.’”\u003c/p>\n\u003cp>But eventually, days after the story of Floyd’s death had permeated the national consciousness and tens of thousands took to the streets to demand justice, Chioma Anaebere finally sat down and watched it.\u003c/p>\n\u003cp>“I remember watching it and just being like, ‘OK, well, I am now debilitatingly depressed,’” she said. “I was already teetering on the edge. And… it was over after that.”\u003c/p>\n\u003cfigure id=\"attachment_11825940\" class=\"wp-caption aligncenter\" style=\"max-width: 1920px\">\u003cimg loading=\"lazy\" decoding=\"async\" class=\"size-full wp-image-11825940\" src=\"https://ww2.kqed.org/app/uploads/sites/10/2020/06/RS43685_013_KQED_Emeryville_TiffanyChiomaAnaebere_06172020-qut.jpg\" alt=\"\" width=\"1920\" height=\"1280\" srcset=\"https://cdn.kqed.org/wp-content/uploads/sites/10/2020/06/RS43685_013_KQED_Emeryville_TiffanyChiomaAnaebere_06172020-qut.jpg 1920w, https://cdn.kqed.org/wp-content/uploads/sites/10/2020/06/RS43685_013_KQED_Emeryville_TiffanyChiomaAnaebere_06172020-qut-800x533.jpg 800w, https://cdn.kqed.org/wp-content/uploads/sites/10/2020/06/RS43685_013_KQED_Emeryville_TiffanyChiomaAnaebere_06172020-qut-1020x680.jpg 1020w, https://cdn.kqed.org/wp-content/uploads/sites/10/2020/06/RS43685_013_KQED_Emeryville_TiffanyChiomaAnaebere_06172020-qut-160x107.jpg 160w, https://cdn.kqed.org/wp-content/uploads/sites/10/2020/06/RS43685_013_KQED_Emeryville_TiffanyChiomaAnaebere_06172020-qut-1536x1024.jpg 1536w\" sizes=\"(max-width: 1920px) 100vw, 1920px\">\u003cfigcaption class=\"wp-caption-text\">Dr. Tiffany Chioma Anaebere removes the medical gear that she uses as an emergency room doctor. \u003ccite>(Beth LaBerge/KQED)\u003c/cite>\u003c/figcaption>\u003c/figure>\n\u003ch3>‘Depression, Anxiety, Insomnia, Distress’\u003c/h3>\n\u003cp>Across the United States, and the world, health care workers are experiencing high levels of anxiety and stress due to the overwhelming workload of the COVID-19 pandemic. \u003ca href=\"https://jamanetwork.com/journals/jamanetworkopen/fullarticle/2763229\">A March study\u003c/a> of over 1,200 health care workers in China found that a large proportion experienced symptoms of “depression, anxiety, insomnia and distress.”\u003c/p>\n\u003cp>And those feelings of stress and anxiety can be compounded for Black health care workers, who make up more than 11% of these types of workers in the United States.\u003c/p>\n\u003cp>Along with reports showing that the coronavirus \u003ca href=\"https://www.npr.org/sections/health-shots/2020/05/30/865413079/what-do-coronavirus-racial-disparities-look-like-state-by-state\">disproportionately impacts\u003c/a> Black, Latino and Indigenous people, workers also leave their long, grueling shifts only to experience racism in many aspects of their daily life — including coming home to news reports and videos of violence. [pullquote size='medium' align='right' citation='Dr. Tiffany Chioma Anaebere, after seeing the video of George Floyd being killed']”OK, well, I am now debilitatingly depressed.’ I was already teetering on the edge. And… it was over after that.’[/pullquote]\u003c/p>\n\u003cp>Dr. Georgia Davies is an emergency medicine physician currently wrapping up her residency at Rutgers Medical School. Davies said she felt the same depression and sadness as her colleagues in the medical field due to COVID-19. But it wasn’t until news about the deaths of George Floyd, Breonna Taylor and numerous others came out that she started noticing the effects on her mental health.\u003c/p>\n\u003cp>“I’m the type of person that, when I’m tired, I can go to sleep immediately. And for the first time ever in my life, like, last week and the week before, I’ve not really been able to,” Davies said.\u003c/p>\n\u003cp>“You have fathers, your brothers, your uncles, you have nephews, … you have significant others that look like someone like George Floyd. And just, getting scared for them and scared for yourself,” she added.\u003c/p>\n\u003cp>“The racism, the police brutality, the [pandemic], the poverty, the inequities and injustices—all of those things are creating this hurricane of violence that’s out there in the community,” said Deborah Burger, president of the California Nurses Association.\u003c/p>\n\u003cp>Burger said health care workers need “some kind of outlet” to help deal with both their stressful work environment and the stressors they’re experiencing every day.\u003c/p>\n\u003ch3>A Crisis Line for Health Care Workers\u003c/h3>\n\u003cp>It was in that spirit that Alameda County mental health workers and advocates began developing a crisis line for health care workers. The line \u003ca href=\"https://sites.google.com/crisissupport.org/ssac19/home\">launched in May\u003c/a> and is designed to encompass workers from all sectors of the health care — including janitorial and maintenance staff.\u003c/p>\n\u003cp>Alice LoCicero, president-elect of the Alameda County Psychological Association, helped craft the program.\u003c/p>\n\u003cp>“Some of the least well-served and most stressed people in the health care settings are not only the health care workers themselves … but all the other workers,” LoCicero said. “Sanitation crews and maintenance people and food service employees and others who are really often unseen, but are having the same kinds of stresses.” [pullquote size='medium' align='right' citation='Binh Au, Crisis Line Program Director']‘Everyday they’re holding a trauma and they’re holding these experiences and grief. And COVID-19 has exacerbated that trauma, has exacerbated that grief’[/pullquote]\u003c/p>\n\u003cp>The line currently has 100 volunteers and 20 paid staff. Workers at the crisis line say callers are expressing feelings of compassion-fatigue and burnout.\u003c/p>\n\u003cp>“When you’re in the helping profession, one way of self care is to have a distance between yourself and the person you’re helping,” said Binh Au, the crisis line program director at Crisis Support Services of Alameda County.\u003c/p>\n\u003cp>But, Au said, during a pandemic it’s difficult to get that distance because workers are experiencing the same conditions as the people they’re serving. And that includes experiencing racism firsthand as well as the secondary trauma of seeing Black people killed by police officers.\u003c/p>\n\u003cp>“Everyday they’re holding a trauma and they’re holding these experiences and grief. And COVID-19 has exacerbated that trauma, has exacerbated that grief,” Au explained.\u003c/p>\n\u003cfigure id=\"attachment_11825941\" class=\"wp-caption aligncenter\" style=\"max-width: 1912px\">\u003cimg loading=\"lazy\" decoding=\"async\" class=\"size-full wp-image-11825941\" src=\"https://ww2.kqed.org/app/uploads/sites/10/2020/06/RS43682_010_KQED_Emeryville_TiffanyChiomaAnaebere_06172020-qut.jpg\" alt=\"\" width=\"1912\" height=\"1403\">\u003cfigcaption class=\"wp-caption-text\">“We’re not getting any reprieve,” Dr. Tiffany Chioma Anaebere said. “We’re not getting any sort of respite from the pandemic. And you’re putting this on our communities as well. Like… have some empathy, have some mercy.” \u003ccite>(Beth LaBerge/KQED)\u003c/cite>\u003c/figcaption>\u003c/figure>\n\u003ch3>Coping with Additive Stress\u003c/h3>\n\u003cp>After watching the video of George Floyd, Chioma Anaebere said she stayed in bed, in the dark, for days. At one point, she considered calling out sick from work.\u003c/p>\n\u003cp>“I feel so overwhelmed and almost as if I can’t pay attention,” she said. “And I don’t want to, you know, put patients at risk cause I literally cannot focus. But then having to [say] like, ‘OK, I need to block this out.’”\u003c/p>\n\u003cfigure id=\"attachment_11825943\" class=\"wp-caption alignright\" style=\"max-width: 1920px\">\u003cimg loading=\"lazy\" decoding=\"async\" class=\"wp-image-11825943 size-full\" src=\"https://ww2.kqed.org/app/uploads/sites/10/2020/06/123_1.jpeg\" alt=\"Dr. Jessica Edwards of Texas said she's been spending even more time with her patients, talking through their feelings in this moment.\" width=\"1920\" height=\"2560\" srcset=\"https://cdn.kqed.org/wp-content/uploads/sites/10/2020/06/123_1.jpeg 1920w, https://cdn.kqed.org/wp-content/uploads/sites/10/2020/06/123_1-800x1067.jpeg 800w, https://cdn.kqed.org/wp-content/uploads/sites/10/2020/06/123_1-1020x1360.jpeg 1020w, https://cdn.kqed.org/wp-content/uploads/sites/10/2020/06/123_1-160x213.jpeg 160w, https://cdn.kqed.org/wp-content/uploads/sites/10/2020/06/123_1-1152x1536.jpeg 1152w, https://cdn.kqed.org/wp-content/uploads/sites/10/2020/06/123_1-1536x2048.jpeg 1536w, https://cdn.kqed.org/wp-content/uploads/sites/10/2020/06/123_1-1122x1496.jpeg 1122w, https://cdn.kqed.org/wp-content/uploads/sites/10/2020/06/123_1-840x1120.jpeg 840w, https://cdn.kqed.org/wp-content/uploads/sites/10/2020/06/123_1-687x916.jpeg 687w, https://cdn.kqed.org/wp-content/uploads/sites/10/2020/06/123_1-414x552.jpeg 414w, https://cdn.kqed.org/wp-content/uploads/sites/10/2020/06/123_1-354x472.jpeg 354w\" sizes=\"(max-width: 1920px) 100vw, 1920px\">\u003cfigcaption class=\"wp-caption-text\">Dr. Jessica Edwards of Texas said she’s been spending even more time with her patients, talking through their feelings in this moment. \u003ccite>(Courtesy of Dr. Jessica Edwards)\u003c/cite>\u003c/figcaption>\u003c/figure>\n\u003cp>But the video sat in the back of her mind. In order to help process what she’d seen, Chioma Anaebere started writing.\u003c/p>\n\u003cp>She drafted an article on the lessons police can learn from health care practitioners, which was recently published in \u003ca href=\"https://www.scientificamerican.com/article/policing-can-take-a-lesson-from-health-care/\">Scientific American\u003c/a>. Finishing it, she said, was the first time she felt “a huge sigh of relief” because it allowed her to work her thoughts and feelings out on the page.\u003c/p>\n\u003cp>Dr. Jessica Edwards, a family physician in Texas, also said writing has helped her process her feelings. She’s written several \u003ca href=\"https://www.straightfactsnochaserpodcast.com/blog\">blog posts\u003c/a> and dedicated an episode of \u003ca href=\"https://www.straightfactsnochaserpodcast.com/podcastepisodes\">her podcast\u003c/a> to social determinants of health and how they impact Black Americans.\u003c/p>\n\u003cp>“For me, those things have been really important for my mental health,” Edwards said.\u003c/p>\n\u003cp>Edwards has also been spending even more time with her patients, talking through their feelings in this moment.\u003c/p>\n\u003cp>But between a pandemic that disproportionately impacts communities of color and ongoing police violence, it’s a lot of weight to carry.\u003c/p>\n\u003cp>“We’re not getting any reprieve,” Chioma Anaebere said. “We’re not getting any sort of respite from the pandemic. And you’re putting this on our communities as well. Like… have some empathy, have some mercy.”\u003c/p>\n\u003cp>And while protesting in a pandemic may be dangerous, Chioma Anaebere says that, for many, this issue is more important than their own personal health. [ad fullwidth]\u003c/p>\n\u003ch3>Other Ways to Cope\u003c/h3>\n\u003cp>Here are some other techniques health care workers recommended for taking care of one’s mental health during this challenging time:\u003c/p>\n\u003cp>\u003cstrong>Dr. Tiffany Chioma Anaebere, Emeryville:\u003c/strong> “Talking to friends and family helps a lot as well. And hearing people feel the same way that you do, and know that you’re not isolated in your own experience.”\u003c/p>\n\u003cp>\u003cstrong>Dr. Georgia Davies, New Jersey:\u003c/strong> “I’m really big on my mental health and physical fitness, and I feel like physical being physically fit kind of helps with your mental health.\u003c/p>\n\u003cp>“One thing I had to do in the last two weeks is, I don’t turn on the TV anymore to really watch the news at all, because I think I was also making me very anxious. … [I]t’s always something new. It’s always something different. So I think shutting that off is, kind of, helping me cope as well.”\u003c/p>\n\u003cp>\u003cstrong>Dr. Jessica Edwards, Texas:\u003c/strong> “…Being able to, you know, donate to an action PAC … volunteering with my local democratic society as a physician, volunteering and, you know, going door to door, knocking on doors … it’s not always a fun experience, but that’s the way that I can sort of get my emotions out now.”\u003c/p>\n\u003cp>\u003cstrong>President-Elect of the Alameda County Psychological Association Alice LoCicero:\u003c/strong> “The big four are: sleep, nutrition, exercise and social connection.”\u003c/p>\n\u003cp>\u003cstrong>Crisis Support Services of Alameda County Director Binh Au:\u003c/strong> “The message that we want to send our workers is that: please reach out for help. Treat yourself with the kindness and care that you would treat your patients, your colleagues, your clients. And think about self care as a necessary part of your job.”\u003c/p>\n\u003ch3>More Resources\u003c/h3>\n\u003cul>\n\u003cli>\u003ca href=\"https://sites.google.com/crisissupport.org/ssac19/home\">Staying Strong Against COVID-19\u003c/a>: The Alameda County Crisis Line for Health Care Workers, 510-420-3222\u003c/li>\n\u003cli>\u003ca href=\"https://www.kqed.org/arts/13881725/where-to-find-affordable-culturally-competent-therapy-in-bay-area-and-beyond\">Where to Find Affordable, Culturally Competent Therapy in Bay Area and Beyond\u003c/a>\u003c/li>\n\u003cli>\u003ca href=\"https://www.kqed.org/news/11808968/coronavirus-is-impacting-the-bay-areas-mental-health-where-can-you-find-help#resources\">Coronavirus Is Impacting the Bay Area’s Mental Health. Where Can You Find Help?\u003c/a>\u003c/li>\n\u003c/ul>\n\u003cp>California state officials also compiled a list of mental health resources \u003ca href=\"https://covid19.ca.gov/resources-for-emotional-support-and-well-being/#top\">here\u003c/a>.\u003c/p>\n\u003cp>[ad floatright]\u003c/p>\n",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003cp>Dr. Tiffany Chioma Anaebere doesn’t remember where she was when she heard about George Floyd’s death.\u003c/p>\n\u003cp>She could’ve been at her home in Emeryville, where she lives with her fiance. Or in the car, during one of her many commutes between Stockton and Modesto, where she works in two different hospitals as an emergency medicine physician on the frontlines of the coronavirus pandemic.\u003c/p>\n\u003cp>All she knows is that, at first, she avoided watching the video.\u003c/p>\n\u003cp>“I refused to. Like, I cannot see anything right now. And I’m normally the person that’s like, ‘Girl, did you see this video?’” she said. “I was like ‘No, no, no, no, no, I’m not watching anything.’”\u003c/p>\n\u003cp>But eventually, days after the story of Floyd’s death had permeated the national consciousness and tens of thousands took to the streets to demand justice, Chioma Anaebere finally sat down and watched it.\u003c/p>\n\u003cp>“I remember watching it and just being like, ‘OK, well, I am now debilitatingly depressed,’” she said. “I was already teetering on the edge. And… it was over after that.”\u003c/p>\n\u003cfigure id=\"attachment_11825940\" class=\"wp-caption aligncenter\" style=\"max-width: 1920px\">\u003cimg loading=\"lazy\" decoding=\"async\" class=\"size-full wp-image-11825940\" src=\"https://ww2.kqed.org/app/uploads/sites/10/2020/06/RS43685_013_KQED_Emeryville_TiffanyChiomaAnaebere_06172020-qut.jpg\" alt=\"\" width=\"1920\" height=\"1280\" srcset=\"https://cdn.kqed.org/wp-content/uploads/sites/10/2020/06/RS43685_013_KQED_Emeryville_TiffanyChiomaAnaebere_06172020-qut.jpg 1920w, https://cdn.kqed.org/wp-content/uploads/sites/10/2020/06/RS43685_013_KQED_Emeryville_TiffanyChiomaAnaebere_06172020-qut-800x533.jpg 800w, https://cdn.kqed.org/wp-content/uploads/sites/10/2020/06/RS43685_013_KQED_Emeryville_TiffanyChiomaAnaebere_06172020-qut-1020x680.jpg 1020w, https://cdn.kqed.org/wp-content/uploads/sites/10/2020/06/RS43685_013_KQED_Emeryville_TiffanyChiomaAnaebere_06172020-qut-160x107.jpg 160w, https://cdn.kqed.org/wp-content/uploads/sites/10/2020/06/RS43685_013_KQED_Emeryville_TiffanyChiomaAnaebere_06172020-qut-1536x1024.jpg 1536w\" sizes=\"(max-width: 1920px) 100vw, 1920px\">\u003cfigcaption class=\"wp-caption-text\">Dr. Tiffany Chioma Anaebere removes the medical gear that she uses as an emergency room doctor. \u003ccite>(Beth LaBerge/KQED)\u003c/cite>\u003c/figcaption>\u003c/figure>\n\u003ch3>‘Depression, Anxiety, Insomnia, Distress’\u003c/h3>\n\u003cp>Across the United States, and the world, health care workers are experiencing high levels of anxiety and stress due to the overwhelming workload of the COVID-19 pandemic. \u003ca href=\"https://jamanetwork.com/journals/jamanetworkopen/fullarticle/2763229\">A March study\u003c/a> of over 1,200 health care workers in China found that a large proportion experienced symptoms of “depression, anxiety, insomnia and distress.”\u003c/p>\n\u003cp>And those feelings of stress and anxiety can be compounded for Black health care workers, who make up more than 11% of these types of workers in the United States.\u003c/p>\n\u003cp>Along with reports showing that the coronavirus \u003ca href=\"https://www.npr.org/sections/health-shots/2020/05/30/865413079/what-do-coronavirus-racial-disparities-look-like-state-by-state\">disproportionately impacts\u003c/a> Black, Latino and Indigenous people, workers also leave their long, grueling shifts only to experience racism in many aspects of their daily life — including coming home to news reports and videos of violence. \u003c/p>\u003c/div>",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>Dr. Georgia Davies is an emergency medicine physician currently wrapping up her residency at Rutgers Medical School. Davies said she felt the same depression and sadness as her colleagues in the medical field due to COVID-19. But it wasn’t until news about the deaths of George Floyd, Breonna Taylor and numerous others came out that she started noticing the effects on her mental health.\u003c/p>\n\u003cp>“I’m the type of person that, when I’m tired, I can go to sleep immediately. And for the first time ever in my life, like, last week and the week before, I’ve not really been able to,” Davies said.\u003c/p>\n\u003cp>“You have fathers, your brothers, your uncles, you have nephews, … you have significant others that look like someone like George Floyd. And just, getting scared for them and scared for yourself,” she added.\u003c/p>\n\u003cp>“The racism, the police brutality, the [pandemic], the poverty, the inequities and injustices—all of those things are creating this hurricane of violence that’s out there in the community,” said Deborah Burger, president of the California Nurses Association.\u003c/p>\n\u003cp>Burger said health care workers need “some kind of outlet” to help deal with both their stressful work environment and the stressors they’re experiencing every day.\u003c/p>\n\u003ch3>A Crisis Line for Health Care Workers\u003c/h3>\n\u003cp>It was in that spirit that Alameda County mental health workers and advocates began developing a crisis line for health care workers. The line \u003ca href=\"https://sites.google.com/crisissupport.org/ssac19/home\">launched in May\u003c/a> and is designed to encompass workers from all sectors of the health care — including janitorial and maintenance staff.\u003c/p>\n\u003cp>Alice LoCicero, president-elect of the Alameda County Psychological Association, helped craft the program.\u003c/p>\n\u003cp>“Some of the least well-served and most stressed people in the health care settings are not only the health care workers themselves … but all the other workers,” LoCicero said. “Sanitation crews and maintenance people and food service employees and others who are really often unseen, but are having the same kinds of stresses.” \u003c/p>\u003c/div>",
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"content": "‘Everyday they’re holding a trauma and they’re holding these experiences and grief. And COVID-19 has exacerbated that trauma, has exacerbated that grief’",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>The line currently has 100 volunteers and 20 paid staff. Workers at the crisis line say callers are expressing feelings of compassion-fatigue and burnout.\u003c/p>\n\u003cp>“When you’re in the helping profession, one way of self care is to have a distance between yourself and the person you’re helping,” said Binh Au, the crisis line program director at Crisis Support Services of Alameda County.\u003c/p>\n\u003cp>But, Au said, during a pandemic it’s difficult to get that distance because workers are experiencing the same conditions as the people they’re serving. And that includes experiencing racism firsthand as well as the secondary trauma of seeing Black people killed by police officers.\u003c/p>\n\u003cp>“Everyday they’re holding a trauma and they’re holding these experiences and grief. And COVID-19 has exacerbated that trauma, has exacerbated that grief,” Au explained.\u003c/p>\n\u003cfigure id=\"attachment_11825941\" class=\"wp-caption aligncenter\" style=\"max-width: 1912px\">\u003cimg loading=\"lazy\" decoding=\"async\" class=\"size-full wp-image-11825941\" src=\"https://ww2.kqed.org/app/uploads/sites/10/2020/06/RS43682_010_KQED_Emeryville_TiffanyChiomaAnaebere_06172020-qut.jpg\" alt=\"\" width=\"1912\" height=\"1403\">\u003cfigcaption class=\"wp-caption-text\">“We’re not getting any reprieve,” Dr. Tiffany Chioma Anaebere said. “We’re not getting any sort of respite from the pandemic. And you’re putting this on our communities as well. Like… have some empathy, have some mercy.” \u003ccite>(Beth LaBerge/KQED)\u003c/cite>\u003c/figcaption>\u003c/figure>\n\u003ch3>Coping with Additive Stress\u003c/h3>\n\u003cp>After watching the video of George Floyd, Chioma Anaebere said she stayed in bed, in the dark, for days. At one point, she considered calling out sick from work.\u003c/p>\n\u003cp>“I feel so overwhelmed and almost as if I can’t pay attention,” she said. “And I don’t want to, you know, put patients at risk cause I literally cannot focus. But then having to [say] like, ‘OK, I need to block this out.’”\u003c/p>\n\u003cfigure id=\"attachment_11825943\" class=\"wp-caption alignright\" style=\"max-width: 1920px\">\u003cimg loading=\"lazy\" decoding=\"async\" class=\"wp-image-11825943 size-full\" src=\"https://ww2.kqed.org/app/uploads/sites/10/2020/06/123_1.jpeg\" alt=\"Dr. Jessica Edwards of Texas said she's been spending even more time with her patients, talking through their feelings in this moment.\" width=\"1920\" height=\"2560\" srcset=\"https://cdn.kqed.org/wp-content/uploads/sites/10/2020/06/123_1.jpeg 1920w, https://cdn.kqed.org/wp-content/uploads/sites/10/2020/06/123_1-800x1067.jpeg 800w, https://cdn.kqed.org/wp-content/uploads/sites/10/2020/06/123_1-1020x1360.jpeg 1020w, https://cdn.kqed.org/wp-content/uploads/sites/10/2020/06/123_1-160x213.jpeg 160w, https://cdn.kqed.org/wp-content/uploads/sites/10/2020/06/123_1-1152x1536.jpeg 1152w, https://cdn.kqed.org/wp-content/uploads/sites/10/2020/06/123_1-1536x2048.jpeg 1536w, https://cdn.kqed.org/wp-content/uploads/sites/10/2020/06/123_1-1122x1496.jpeg 1122w, https://cdn.kqed.org/wp-content/uploads/sites/10/2020/06/123_1-840x1120.jpeg 840w, https://cdn.kqed.org/wp-content/uploads/sites/10/2020/06/123_1-687x916.jpeg 687w, https://cdn.kqed.org/wp-content/uploads/sites/10/2020/06/123_1-414x552.jpeg 414w, https://cdn.kqed.org/wp-content/uploads/sites/10/2020/06/123_1-354x472.jpeg 354w\" sizes=\"(max-width: 1920px) 100vw, 1920px\">\u003cfigcaption class=\"wp-caption-text\">Dr. Jessica Edwards of Texas said she’s been spending even more time with her patients, talking through their feelings in this moment. \u003ccite>(Courtesy of Dr. Jessica Edwards)\u003c/cite>\u003c/figcaption>\u003c/figure>\n\u003cp>But the video sat in the back of her mind. In order to help process what she’d seen, Chioma Anaebere started writing.\u003c/p>\n\u003cp>She drafted an article on the lessons police can learn from health care practitioners, which was recently published in \u003ca href=\"https://www.scientificamerican.com/article/policing-can-take-a-lesson-from-health-care/\">Scientific American\u003c/a>. Finishing it, she said, was the first time she felt “a huge sigh of relief” because it allowed her to work her thoughts and feelings out on the page.\u003c/p>\n\u003cp>Dr. Jessica Edwards, a family physician in Texas, also said writing has helped her process her feelings. She’s written several \u003ca href=\"https://www.straightfactsnochaserpodcast.com/blog\">blog posts\u003c/a> and dedicated an episode of \u003ca href=\"https://www.straightfactsnochaserpodcast.com/podcastepisodes\">her podcast\u003c/a> to social determinants of health and how they impact Black Americans.\u003c/p>\n\u003cp>“For me, those things have been really important for my mental health,” Edwards said.\u003c/p>\n\u003cp>Edwards has also been spending even more time with her patients, talking through their feelings in this moment.\u003c/p>\n\u003cp>But between a pandemic that disproportionately impacts communities of color and ongoing police violence, it’s a lot of weight to carry.\u003c/p>\n\u003cp>“We’re not getting any reprieve,” Chioma Anaebere said. “We’re not getting any sort of respite from the pandemic. And you’re putting this on our communities as well. Like… have some empathy, have some mercy.”\u003c/p>\n\u003cp>And while protesting in a pandemic may be dangerous, Chioma Anaebere says that, for many, this issue is more important than their own personal health. \u003c/p>\u003c/div>",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003ch3>Other Ways to Cope\u003c/h3>\n\u003cp>Here are some other techniques health care workers recommended for taking care of one’s mental health during this challenging time:\u003c/p>\n\u003cp>\u003cstrong>Dr. Tiffany Chioma Anaebere, Emeryville:\u003c/strong> “Talking to friends and family helps a lot as well. And hearing people feel the same way that you do, and know that you’re not isolated in your own experience.”\u003c/p>\n\u003cp>\u003cstrong>Dr. Georgia Davies, New Jersey:\u003c/strong> “I’m really big on my mental health and physical fitness, and I feel like physical being physically fit kind of helps with your mental health.\u003c/p>\n\u003cp>“One thing I had to do in the last two weeks is, I don’t turn on the TV anymore to really watch the news at all, because I think I was also making me very anxious. … [I]t’s always something new. It’s always something different. So I think shutting that off is, kind of, helping me cope as well.”\u003c/p>\n\u003cp>\u003cstrong>Dr. Jessica Edwards, Texas:\u003c/strong> “…Being able to, you know, donate to an action PAC … volunteering with my local democratic society as a physician, volunteering and, you know, going door to door, knocking on doors … it’s not always a fun experience, but that’s the way that I can sort of get my emotions out now.”\u003c/p>\n\u003cp>\u003cstrong>President-Elect of the Alameda County Psychological Association Alice LoCicero:\u003c/strong> “The big four are: sleep, nutrition, exercise and social connection.”\u003c/p>\n\u003cp>\u003cstrong>Crisis Support Services of Alameda County Director Binh Au:\u003c/strong> “The message that we want to send our workers is that: please reach out for help. Treat yourself with the kindness and care that you would treat your patients, your colleagues, your clients. And think about self care as a necessary part of your job.”\u003c/p>\n\u003ch3>More Resources\u003c/h3>\n\u003cul>\n\u003cli>\u003ca href=\"https://sites.google.com/crisissupport.org/ssac19/home\">Staying Strong Against COVID-19\u003c/a>: The Alameda County Crisis Line for Health Care Workers, 510-420-3222\u003c/li>\n\u003cli>\u003ca href=\"https://www.kqed.org/arts/13881725/where-to-find-affordable-culturally-competent-therapy-in-bay-area-and-beyond\">Where to Find Affordable, Culturally Competent Therapy in Bay Area and Beyond\u003c/a>\u003c/li>\n\u003cli>\u003ca href=\"https://www.kqed.org/news/11808968/coronavirus-is-impacting-the-bay-areas-mental-health-where-can-you-find-help#resources\">Coronavirus Is Impacting the Bay Area’s Mental Health. Where Can You Find Help?\u003c/a>\u003c/li>\n\u003c/ul>\n\u003cp>California state officials also compiled a list of mental health resources \u003ca href=\"https://covid19.ca.gov/resources-for-emotional-support-and-well-being/#top\">here\u003c/a>.\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"disqusTitle": "'It Was Hell': When Both Parents Get COVID-19",
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"content": "\u003cp>In early April, as coronavirus outbreaks spread rapidly across the San Francisco Bay Area, Lorena found herself trapped in her apartment obsessively disinfecting surfaces, wearing gloves to cook meals and abstaining from holding her own two children.\u003c/p>\n\u003cp>Both Lorena and her husband, Jorge, had tested positive for COVID-19.\u003c/p>\n\u003cp>“It was hell, to be honest with you,” said Lorena, 30, who works as a receptionist at a doctor’s office.\u003c/p>\n\u003cp>KQED is only using Lorena's first name because she worries her daughter will be bullied if classmates learn both of her parents were diagnosed with the disease.\u003c/p>\n\u003cp>Lorena was terrified of transmitting the coronavirus to their 1-year-old son, who wheezes and needs an inhaler if he gets sick with a simple cold.\u003c/p>\n\u003cp>[ad fullwidth]\u003c/p>\n\u003cp>But a doctor told Lorena and Jorge that their baby and 8-year-old daughter had likely already been exposed to the virus and they must quarantine together. The normally active family who loves spending weekends at parks suddenly found themselves confined to their three-bedroom apartment in Richmond.\u003c/p>\n\u003cp>The pandemic’s toll has disproportionately impacted Latinos statewide, who comprise more than half of all confirmed COVID-19 cases, according to the \u003ca href=\"https://www.cdph.ca.gov/Programs/CID/DCDC/Pages/COVID-19/Race-Ethnicity.aspx\" target=\"_blank\" rel=\"noopener noreferrer\">California Department of Public Health\u003c/a>. Lorena’s story is one family’s nightmarish experience with recovering from the disease. But it also points to vulnerabilities many Latinos and others face as they get sick with the coronavirus.\u003c/p>\n\u003cp>\u003cstrong>The Ordeal Begins\u003c/strong>\u003c/p>\n\u003cp>On March 21, Jorge came down with a bad cough, high fever and intense headaches. His sweat soaked through the bed sheets at night. Lorena's worry for her husband grew. [pullquote size=\"medium\" align=\"right\" citation=\"Lorena\"]\"It was hell, to be honest with you.\"[/pullquote]\u003c/p>\n\u003cp>Doctors at Kaiser Permanente initially declined to test Jorge, 34, for COVID-19. At the time only a limited number of test kits were available in the Bay Area, and Contra Costa County public health officials \u003ca href=\"https://cchealth.org/coronavirus/pdf/Health-Alert-Coronavirus-2020-0320.pdf\" target=\"_blank\" rel=\"noopener noreferrer\">recommended\u003c/a> tests be prioritized for the most vulnerable symptomatic patients, including those who were hospitalized.\u003c/p>\n\u003cp>Six days later, Jorge’s symptoms worsened. He landed in the emergency room at the Kaiser Permanente Richmond Medical Center. He was tested and confirmed positive for COVID-19. But doctors believed Jorge would recover on his own and sent him home.\u003c/p>\n\u003cp>“I did worry a lot because he had to sleep almost sitting down, he couldn't breathe when he would lay on his back,” said Lorena, a legal permanent resident originally from Mexico. “He'd cough so much that his chest wouldn't stop hurting all day.”\u003c/p>\n\u003cp>Lorena’s symptoms were relatively mild compared to her husband’s: light headaches, exhaustion and a loss of sense of smell and taste. She was able to cook and keep an eye on her kids at home. And she avoided hospitalization, as well as a potentially costly health care bill down the road.\u003c/p>\n\u003cp>Unlike her husband, Lorena doesn’t have health insurance. Her employer, a workers' compensation doctor, doesn’t offer the benefit to her 12 employees, Lorena said. Under the Affordable Care Act, only businesses with 50 or more full-time employees may be \u003ca href=\"https://www.coveredca.com/forsmallbusiness/mandate/\" target=\"_blank\" rel=\"noopener noreferrer\">financially penalized\u003c/a> if they don’t offer health coverage.[aside tag=\"coronavirus,covid-19\" label=\"More coronavirus coverage\"]\u003c/p>\n\u003cp>While Jorge has insurance through his maintenance job at a seniors apartment complex in San Francisco, Lorena is not on his plan because the premiums are too expensive, she said.\u003c/p>\n\u003cp>But her family’s income, about $60,000 per year, means Lorena earns too much to qualify for Medi-Cal, the state’s coverage for low-income people.\u003c/p>\n\u003cp>\u003cstrong>Latinos Have Highest Uninsured Rates\u003c/strong>\u003c/p>\n\u003cp>Lorena's story is not uncommon. Latinos are more than twice as likely to be uninsured than other racial or ethnic groups in the state, according to a \u003ca href=\"https://healthpolicy.ucla.edu/publications/Documents/PDF/2019/LatinoInsurance-policybrief-aug2019.pdf\" target=\"_blank\" rel=\"noopener noreferrer\">study\u003c/a> by the UCLA Center for Health Policy Research. That’s in part because only about a third of Latinos get their health coverage through an employer, the lowest job-based coverage of all racial or ethnic groups.\u003c/p>\n\u003cp>As the pandemic continues, the state has committed to covering the cost of COVID-19 testing and treatment for uninsured Californians who need it. The demand for that safety net may increase as the pandemic ravages the economy, and millions of Californians lose their jobs and health coverage for themselves, their \u003ca href=\"http://laborcenter.berkeley.edu/health-coverage-ca-workers-at-risk-of-job-loss-covid-19/\" target=\"_blank\" rel=\"noopener noreferrer\">spouses and their children\u003c/a>.\u003c/p>\n\u003cp>Still, it’s unclear how much medical treatment related to COVID-19 the state would ultimately pay for those who lack full coverage, said Anthony Wright, executive director of the consumer advocacy coalition \u003ca href=\"https://health-access.org/\" target=\"_blank\" rel=\"noopener noreferrer\">Health Access California\u003c/a>.\u003c/p>\n\u003cp>“Frankly, if you end up in the ICU on a ventilator for a week, it may not cover the follow-up care afterwards,” Wright said.\u003c/p>\n\u003cp>Lorena said she used to be covered by Medi-Cal in the past. She has received medical care for years at the Lifelong Brookside \u003ca href=\"https://www.lifelongmedical.org/locations/our-locations/brookside-san-pablo-health-center.html\" target=\"_blank\" rel=\"noopener noreferrer\">San Pablo Health Center\u003c/a>. Now that she’s uninsured, she pays for medical visits at the community clinic on a sliding scale. That's where she, and eventually her children, were tested for COVID-19 free of charge.\u003c/p>\n\u003cp>In retrospect, Lorena said the risks of being uninsured weren’t top of mind while she was sick with the coronavirus, as her symptoms didn’t deteriorate.\u003c/p>\n\u003cp>During the nearly three weeks it took for Lorena and Jorge to recover, they tried to stay away from their kids at home to avoid getting them infected. Their 8-year-old girl took on more responsibilities, helping to feed the baby, change his diapers and carry him.\u003c/p>\n\u003cp>“Having to do things that she shouldn't be doing ‘cause she's a kid,” Lorena said.\u003c/p>\n\u003cp>Lorena said she was overcome with sadness as the baby would stare out of the window and then come towards her and ask to be picked up, holding his little arms up. She told herself, as emotionally hurtful as it may be, she would not touch or hold her children, even when they were afraid, sad or worried.[pullquote size=\"medium\" align=\"right\" citation=\"Anthony Wright, executive director of Health Access California\"]\"Frankly, if you end up in the ICU on a ventilator for a week, it may not cover the follow-up care afterwards.\"[/pullquote]\u003c/p>\n\u003cp>“My daughter was scared when she heard that I was positive, too. And of course, she needed a hug,” she said. As she spoke, Lorena started to cry, and said, “We couldn’t give it to her. Not being able to hold the baby, it was just ... bad.”\u003c/p>\n\u003cp>The family got by with Jorge’s paid leave from work. Lorena filed for disability. Her parents, both diabetics in their 50s, left bags of groceries at her door. While grateful for the help, she worried her mom and dad would contract the virus while at grocery stores or streets.\u003c/p>\n\u003cp>“This whole experience drains you mentally,” she said.\u003c/p>\n\u003cp>\u003cstrong>Recovered and Relieved\u003c/strong>\u003c/p>\n\u003cp>Lorena and Jorge are back at work. Both kids tested negative for COVID-19, Lorena said with relief.\u003c/p>\n\u003cp>But in some ways, the family is still dealing with the trauma of their experience. When Lorena and Jorge were finally able to touch their children without fear of getting them sick, their son wouldn’t let his parents hug him.\u003c/p>\n\u003cp>“I don’t know if the baby was mad, but he wouldn't want to come to us,” Lorena said. “I felt so bad. Like, ‘Hey, it wasn’t our fault.' \"\u003c/p>\n\u003cp>Their daughter is recovering emotionally from her fear her dad wasn’t going to make it. She recently told Lorena that she’d stay up at night, hearing her father’s labored breathing and coughing fits.\u003c/p>\n\u003cp>[ad floatright]\u003c/p>\n\u003cp>“I'm so happy my dad got better because I was really scared,” Lorena's daughter said.\u003c/p>\n\n",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003cp>In early April, as coronavirus outbreaks spread rapidly across the San Francisco Bay Area, Lorena found herself trapped in her apartment obsessively disinfecting surfaces, wearing gloves to cook meals and abstaining from holding her own two children.\u003c/p>\n\u003cp>Both Lorena and her husband, Jorge, had tested positive for COVID-19.\u003c/p>\n\u003cp>“It was hell, to be honest with you,” said Lorena, 30, who works as a receptionist at a doctor’s office.\u003c/p>\n\u003cp>KQED is only using Lorena's first name because she worries her daughter will be bullied if classmates learn both of her parents were diagnosed with the disease.\u003c/p>\n\u003cp>Lorena was terrified of transmitting the coronavirus to their 1-year-old son, who wheezes and needs an inhaler if he gets sick with a simple cold.\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>But a doctor told Lorena and Jorge that their baby and 8-year-old daughter had likely already been exposed to the virus and they must quarantine together. The normally active family who loves spending weekends at parks suddenly found themselves confined to their three-bedroom apartment in Richmond.\u003c/p>\n\u003cp>The pandemic’s toll has disproportionately impacted Latinos statewide, who comprise more than half of all confirmed COVID-19 cases, according to the \u003ca href=\"https://www.cdph.ca.gov/Programs/CID/DCDC/Pages/COVID-19/Race-Ethnicity.aspx\" target=\"_blank\" rel=\"noopener noreferrer\">California Department of Public Health\u003c/a>. Lorena’s story is one family’s nightmarish experience with recovering from the disease. But it also points to vulnerabilities many Latinos and others face as they get sick with the coronavirus.\u003c/p>\n\u003cp>\u003cstrong>The Ordeal Begins\u003c/strong>\u003c/p>\n\u003cp>On March 21, Jorge came down with a bad cough, high fever and intense headaches. His sweat soaked through the bed sheets at night. Lorena's worry for her husband grew. \u003c/p>\u003c/div>",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>Doctors at Kaiser Permanente initially declined to test Jorge, 34, for COVID-19. At the time only a limited number of test kits were available in the Bay Area, and Contra Costa County public health officials \u003ca href=\"https://cchealth.org/coronavirus/pdf/Health-Alert-Coronavirus-2020-0320.pdf\" target=\"_blank\" rel=\"noopener noreferrer\">recommended\u003c/a> tests be prioritized for the most vulnerable symptomatic patients, including those who were hospitalized.\u003c/p>\n\u003cp>Six days later, Jorge’s symptoms worsened. He landed in the emergency room at the Kaiser Permanente Richmond Medical Center. He was tested and confirmed positive for COVID-19. But doctors believed Jorge would recover on his own and sent him home.\u003c/p>\n\u003cp>“I did worry a lot because he had to sleep almost sitting down, he couldn't breathe when he would lay on his back,” said Lorena, a legal permanent resident originally from Mexico. “He'd cough so much that his chest wouldn't stop hurting all day.”\u003c/p>\n\u003cp>Lorena’s symptoms were relatively mild compared to her husband’s: light headaches, exhaustion and a loss of sense of smell and taste. She was able to cook and keep an eye on her kids at home. And she avoided hospitalization, as well as a potentially costly health care bill down the road.\u003c/p>\n\u003cp>Unlike her husband, Lorena doesn’t have health insurance. Her employer, a workers' compensation doctor, doesn’t offer the benefit to her 12 employees, Lorena said. Under the Affordable Care Act, only businesses with 50 or more full-time employees may be \u003ca href=\"https://www.coveredca.com/forsmallbusiness/mandate/\" target=\"_blank\" rel=\"noopener noreferrer\">financially penalized\u003c/a> if they don’t offer health coverage.\u003c/p>\u003c/div>",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>While Jorge has insurance through his maintenance job at a seniors apartment complex in San Francisco, Lorena is not on his plan because the premiums are too expensive, she said.\u003c/p>\n\u003cp>But her family’s income, about $60,000 per year, means Lorena earns too much to qualify for Medi-Cal, the state’s coverage for low-income people.\u003c/p>\n\u003cp>\u003cstrong>Latinos Have Highest Uninsured Rates\u003c/strong>\u003c/p>\n\u003cp>Lorena's story is not uncommon. Latinos are more than twice as likely to be uninsured than other racial or ethnic groups in the state, according to a \u003ca href=\"https://healthpolicy.ucla.edu/publications/Documents/PDF/2019/LatinoInsurance-policybrief-aug2019.pdf\" target=\"_blank\" rel=\"noopener noreferrer\">study\u003c/a> by the UCLA Center for Health Policy Research. That’s in part because only about a third of Latinos get their health coverage through an employer, the lowest job-based coverage of all racial or ethnic groups.\u003c/p>\n\u003cp>As the pandemic continues, the state has committed to covering the cost of COVID-19 testing and treatment for uninsured Californians who need it. The demand for that safety net may increase as the pandemic ravages the economy, and millions of Californians lose their jobs and health coverage for themselves, their \u003ca href=\"http://laborcenter.berkeley.edu/health-coverage-ca-workers-at-risk-of-job-loss-covid-19/\" target=\"_blank\" rel=\"noopener noreferrer\">spouses and their children\u003c/a>.\u003c/p>\n\u003cp>Still, it’s unclear how much medical treatment related to COVID-19 the state would ultimately pay for those who lack full coverage, said Anthony Wright, executive director of the consumer advocacy coalition \u003ca href=\"https://health-access.org/\" target=\"_blank\" rel=\"noopener noreferrer\">Health Access California\u003c/a>.\u003c/p>\n\u003cp>“Frankly, if you end up in the ICU on a ventilator for a week, it may not cover the follow-up care afterwards,” Wright said.\u003c/p>\n\u003cp>Lorena said she used to be covered by Medi-Cal in the past. She has received medical care for years at the Lifelong Brookside \u003ca href=\"https://www.lifelongmedical.org/locations/our-locations/brookside-san-pablo-health-center.html\" target=\"_blank\" rel=\"noopener noreferrer\">San Pablo Health Center\u003c/a>. Now that she’s uninsured, she pays for medical visits at the community clinic on a sliding scale. That's where she, and eventually her children, were tested for COVID-19 free of charge.\u003c/p>\n\u003cp>In retrospect, Lorena said the risks of being uninsured weren’t top of mind while she was sick with the coronavirus, as her symptoms didn’t deteriorate.\u003c/p>\n\u003cp>During the nearly three weeks it took for Lorena and Jorge to recover, they tried to stay away from their kids at home to avoid getting them infected. Their 8-year-old girl took on more responsibilities, helping to feed the baby, change his diapers and carry him.\u003c/p>\n\u003cp>“Having to do things that she shouldn't be doing ‘cause she's a kid,” Lorena said.\u003c/p>\n\u003cp>Lorena said she was overcome with sadness as the baby would stare out of the window and then come towards her and ask to be picked up, holding his little arms up. She told herself, as emotionally hurtful as it may be, she would not touch or hold her children, even when they were afraid, sad or worried.\u003c/p>\u003c/div>",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>“My daughter was scared when she heard that I was positive, too. And of course, she needed a hug,” she said. As she spoke, Lorena started to cry, and said, “We couldn’t give it to her. Not being able to hold the baby, it was just ... bad.”\u003c/p>\n\u003cp>The family got by with Jorge’s paid leave from work. Lorena filed for disability. Her parents, both diabetics in their 50s, left bags of groceries at her door. While grateful for the help, she worried her mom and dad would contract the virus while at grocery stores or streets.\u003c/p>\n\u003cp>“This whole experience drains you mentally,” she said.\u003c/p>\n\u003cp>\u003cstrong>Recovered and Relieved\u003c/strong>\u003c/p>\n\u003cp>Lorena and Jorge are back at work. Both kids tested negative for COVID-19, Lorena said with relief.\u003c/p>\n\u003cp>But in some ways, the family is still dealing with the trauma of their experience. When Lorena and Jorge were finally able to touch their children without fear of getting them sick, their son wouldn’t let his parents hug him.\u003c/p>\n\u003cp>“I don’t know if the baby was mad, but he wouldn't want to come to us,” Lorena said. “I felt so bad. Like, ‘Hey, it wasn’t our fault.' \"\u003c/p>\n\u003cp>Their daughter is recovering emotionally from her fear her dad wasn’t going to make it. She recently told Lorena that she’d stay up at night, hearing her father’s labored breathing and coughing fits.\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"content": "\u003cp>Doctors and women’s health advocates say they are “alarmed” and “disheartened” by Gov. Gavin Newsom’s decision to rollback his promise of health coverage for low-income women who are diagnosed with postpartum depression or anxiety.\u003c/p>\n\u003cp>It was one of many cuts to mental health funding the governor proposed in his \u003ca href=\"http://www.ebudget.ca.gov/2020-21/pdf/Revised/BudgetSummary/HealthandHumanServices.pdf\" target=\"_blank\" rel=\"noopener noreferrer\">revised budget\u003c/a> to close the $54 billion shortfall created by the coronavirus pandemic, which psychologists now say will likely be followed by a mental health pandemic.\u003c/p>\n\u003cp>“Two-thirds of minimum wage jobs are held by women, who are at risk of losing those jobs and childcare and are under enormous distress,” said Joy Burkhard, executive director of \u003ca href=\"https://www.2020mom.org/\" target=\"_blank\" rel=\"noopener noreferrer\">2020 Mom\u003c/a>, an advocacy group for maternal mental health. “We know that this population is at extreme risk for maternal mental health disorders.”\u003c/p>\n\u003cp>Burkhard’s group helped pass a state law in 2018 that now requires doctors to \u003ca href=\"https://www.kqed.org/stateofhealth/362850/to-screen-or-not-to-screen-doctors-debate-post-partum-depression-testing\" target=\"_blank\" rel=\"noopener noreferrer\">screen new moms\u003c/a> for postpartum depression and anxiety. Obstetricians soon noticed that the moms who were most vulnerable to the conditions were low-income women covered by Medi-Cal – \u003ca href=\"https://www.chcf.org/publication/2019-medi-cal-facts-figures-crucial-coverage/\" target=\"_blank\" rel=\"noopener noreferrer\">half of all births\u003c/a> in California are covered by the state’s Medicaid program.\u003c/p>\n\u003cp>But pregnancy-related Medicaid coverage ends six weeks after the baby is born.\u003c/p>\n\u003cp>[ad fullwidth]\u003c/p>\n\u003cp>“Doctors were left in a precarious position to not be able to treat the disorder that they were identifying,” Burkhard said. [pullquote size=\"medium\" align=\"right\" citation=\"Michelle Doty Cabrera, executive director of the County Behavioral Health Directors Association\"]“With all the signs of a behavioral health pandemic now on the horizon, our state must summon the resources and the resolve to ensure the very same vulnerable Californians we spared from the coronavirus now have our support to recover from its emotional aftermath.”[/pullquote] \u003c/p>\n\u003cp>Last year, Governor Gavin Newsom agreed to change that. He allotted $34 million for the 2020 fiscal year budget so that women who were diagnosed with a maternal mental health disorder could stay on Medi-Cal for up to 12 months to get treated.\u003c/p>\n\u003cp>Now he’s taking it back.\u003c/p>\n\u003cp>“Nothing breaks my heart more than making budget cuts,” Newsom said at a press conference discussing his revised budget proposal on Thursday. “Because one thing I know about cuts: there’s a human being behind every single number.”\u003c/p>\n\u003cp>Legislators will now negotiate with the governor on how to balance the state’s finances, with a final budget due in June.\u003c/p>\n\u003cp>Doctors who lobbied for the extended Medi-Cal benefits are already urging the governor to reconsider the cuts, particularly in light of the nation’s longstanding and “unacceptable” maternal mortality crisis.\u003c/p>\n\u003cp>“Denying postpartum Medicaid coverage to new moms who face mental health concerns will exacerbate that crisis,” said Dr. Laura Sirott, state chair of the American College of Obstetricians and Gynecologists, or ACOG.\u003c/p>\n\u003cp>“With all the signs of a behavioral health pandemic now on the horizon, our state must summon the resources and the resolve to ensure the very same vulnerable Californians we spared from the coronavirus now have our support to recover from its emotional aftermath.” [aside tag=\"health, coronavirus\" label=\"More Related Coverage\"]\u003c/p>\n\u003cp>Mental health problems are one of the \u003ca href=\"https://www.kqed.org/news/11710961/she-strived-to-be-the-perfect-mom-and-landed-in-the-psych-ward\" target=\"_blank\" rel=\"noopener noreferrer\">leading causes of maternal mortality\u003c/a>. Sirott points to CDC data that shows all pregnancy-related suicides and unintentional drug overdoses were deemed preventable.\u003c/p>\n\u003cp>The looming mental health crisis is preventable, too, advocates say, if the state is willing to ensure safety net programs can meet the increased demand for depression, anxiety and substance abuse treatment.\u003c/p>\n\u003cp>\u003c/p>\n\u003cp>“To get ready for the COVID-19 pandemic, California took unprecedented action to prepare our hospitals, shelter in place, and mobilize a massive public health response,” said Michelle Doty Cabrera, executive director of the County Behavioral Health Directors Association. “With all the signs of a behavioral health pandemic now on the horizon, our state must summon the resources and the resolve to ensure the very same vulnerable Californians we spared from the coronavirus now have our support to recover from its emotional aftermath.”\u003c/p>\n\n",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003cp>Doctors and women’s health advocates say they are “alarmed” and “disheartened” by Gov. Gavin Newsom’s decision to rollback his promise of health coverage for low-income women who are diagnosed with postpartum depression or anxiety.\u003c/p>\n\u003cp>It was one of many cuts to mental health funding the governor proposed in his \u003ca href=\"http://www.ebudget.ca.gov/2020-21/pdf/Revised/BudgetSummary/HealthandHumanServices.pdf\" target=\"_blank\" rel=\"noopener noreferrer\">revised budget\u003c/a> to close the $54 billion shortfall created by the coronavirus pandemic, which psychologists now say will likely be followed by a mental health pandemic.\u003c/p>\n\u003cp>“Two-thirds of minimum wage jobs are held by women, who are at risk of losing those jobs and childcare and are under enormous distress,” said Joy Burkhard, executive director of \u003ca href=\"https://www.2020mom.org/\" target=\"_blank\" rel=\"noopener noreferrer\">2020 Mom\u003c/a>, an advocacy group for maternal mental health. “We know that this population is at extreme risk for maternal mental health disorders.”\u003c/p>\n\u003cp>Burkhard’s group helped pass a state law in 2018 that now requires doctors to \u003ca href=\"https://www.kqed.org/stateofhealth/362850/to-screen-or-not-to-screen-doctors-debate-post-partum-depression-testing\" target=\"_blank\" rel=\"noopener noreferrer\">screen new moms\u003c/a> for postpartum depression and anxiety. Obstetricians soon noticed that the moms who were most vulnerable to the conditions were low-income women covered by Medi-Cal – \u003ca href=\"https://www.chcf.org/publication/2019-medi-cal-facts-figures-crucial-coverage/\" target=\"_blank\" rel=\"noopener noreferrer\">half of all births\u003c/a> in California are covered by the state’s Medicaid program.\u003c/p>\n\u003cp>But pregnancy-related Medicaid coverage ends six weeks after the baby is born.\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"content": "“With all the signs of a behavioral health pandemic now on the horizon, our state must summon the resources and the resolve to ensure the very same vulnerable Californians we spared from the coronavirus now have our support to recover from its emotional aftermath.”",
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"content": "\u003cdiv class=\"post-body\">\u003cp> \u003c/p>\n\u003cp>Last year, Governor Gavin Newsom agreed to change that. He allotted $34 million for the 2020 fiscal year budget so that women who were diagnosed with a maternal mental health disorder could stay on Medi-Cal for up to 12 months to get treated.\u003c/p>\n\u003cp>Now he’s taking it back.\u003c/p>\n\u003cp>“Nothing breaks my heart more than making budget cuts,” Newsom said at a press conference discussing his revised budget proposal on Thursday. “Because one thing I know about cuts: there’s a human being behind every single number.”\u003c/p>\n\u003cp>Legislators will now negotiate with the governor on how to balance the state’s finances, with a final budget due in June.\u003c/p>\n\u003cp>Doctors who lobbied for the extended Medi-Cal benefits are already urging the governor to reconsider the cuts, particularly in light of the nation’s longstanding and “unacceptable” maternal mortality crisis.\u003c/p>\n\u003cp>“Denying postpartum Medicaid coverage to new moms who face mental health concerns will exacerbate that crisis,” said Dr. Laura Sirott, state chair of the American College of Obstetricians and Gynecologists, or ACOG.\u003c/p>\n\u003cp>“With all the signs of a behavioral health pandemic now on the horizon, our state must summon the resources and the resolve to ensure the very same vulnerable Californians we spared from the coronavirus now have our support to recover from its emotional aftermath.” \u003c/p>\u003c/div>",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>Mental health problems are one of the \u003ca href=\"https://www.kqed.org/news/11710961/she-strived-to-be-the-perfect-mom-and-landed-in-the-psych-ward\" target=\"_blank\" rel=\"noopener noreferrer\">leading causes of maternal mortality\u003c/a>. Sirott points to CDC data that shows all pregnancy-related suicides and unintentional drug overdoses were deemed preventable.\u003c/p>\n\u003cp>The looming mental health crisis is preventable, too, advocates say, if the state is willing to ensure safety net programs can meet the increased demand for depression, anxiety and substance abuse treatment.\u003c/p>\n\u003cp>\u003c/p>\n\u003cp>“To get ready for the COVID-19 pandemic, California took unprecedented action to prepare our hospitals, shelter in place, and mobilize a massive public health response,” said Michelle Doty Cabrera, executive director of the County Behavioral Health Directors Association. “With all the signs of a behavioral health pandemic now on the horizon, our state must summon the resources and the resolve to ensure the very same vulnerable Californians we spared from the coronavirus now have our support to recover from its emotional aftermath.”\u003c/p>\n\n\u003c/div>\u003c/p>",
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"content": "\u003cp>Gov. Gavin Newsom opened his daily briefing Tuesday on the status of the coronavirus pandemic in California a bit differently than normal: With a mantra he says his mother used to repeat.\u003c/p>\n\u003cp>“She said, ‘Stand guard at the door of your mind,'” Newsom said.\u003c/p>\n\u003cp>“Honestly, it took me a decade-plus to figure out what she was ultimately saying. But she was focused on, more than anything else, our capacity to be resilient and to meet challenges head-on, our capacity as human beings to refocus our energies, a sense of purpose, and a sense of optimism and faith that will get through times of challenges — times like today.”\u003c/p>\n\u003cp>[pullquote size=\"medium\" align=\"right\" citation=\"California Surgeon General Nadine Burke Harris\"]‘The health impacts of coronavirus go beyond infection and COVID disease.’[/pullquote]\u003c/p>\n\u003cp>But Newsom said he knows that Californians can’t do it alone. So he asked California’s Surgeon General, Dr. Nadine Burke Harris, to create a \u003ca href=\"https://covid19.ca.gov/manage-stress-for-health/#top\">series of guides to help people manage stress\u003c/a> during this time of crisis.\u003c/p>\n\u003cp>Burke Harris said millions of Californians who aren’t sick with COVID-19 are still managing a ton of stress — and that stress can manifest in real, physical pain.\u003c/p>\n\u003cp>“The health impacts of coronavirus go beyond infection and COVID disease,” she said. “It’s important to know that these changes aren’t just in your head, and to begin to identify how stress shows up for you — physically, emotionally and behaviorally.”\u003c/p>\n\u003cp>[ad fullwidth]\u003c/p>\n\u003cp>Burke Harris, whose expertise is in childhood trauma and its long-term health impacts, said the way people manifest this stress is different for everyone. Some people drink too much. Some can’t sleep. Some get headaches or other physical symptoms. And some may get violent, or be the victim of violence.\u003c/p>\n\u003cp>The state’s website includes \u003ca href=\"https://covid19.ca.gov/resources-for-emotional-support-and-well-being/#top\">a series of hotlines people can call\u003c/a> — including for people who are struggling with depression and suicidal thoughts, are victims of violence, or if they are worried about the safety of a child.\u003c/p>\n\u003cp>Additionally, Burke Harris said, there are things people can do at home to help manage this difficult period.\u003c/p>\n\u003cp>“While we keep our physical distance, our social supports to maintain emotional and spiritual connection are more important than ever for our physical and mental health,” she said.\u003c/p>\n\u003cp>[aside postID=news_11808968,news_11807639 label='More Resources']Burke Harris urged Californians to exercise, eat right, get enough sleep and try to still connect — albeit virtually — to their social support networks.\u003c/p>\n\u003cp>“Safe, stable and nurturing relationships help to protect our brains and bodies from the harmful effects of stress and adversity,” she said.\u003c/p>\n\u003cp>She announced two “\u003ca href=\"https://covid19.ca.gov/manage-stress-for-health/#top\">playbooks\u003c/a>” that rely on evidence-based guidance for how to relieve stress. One is for everyone; the second is for parents and caregivers.\u003c/p>\n\u003cul>\n\u003cli>\u003ca href=\"https://covid19.ca.gov/img/wp/california-surgeon-general_stress-busting-playbook_draft-v2clean_ada-04072020.pdf\">Stress Relief During COVID-19\u003c/a>\u003c/li>\n\u003cli>\u003ca href=\"https://covid19.ca.gov/pdf/caregivers_and_kids_california_surgeon_general_stress_busting_playbook_draft_v2_clean_ada_04072020v2.pdf\">Stress Relief for Caregivers and Kids During COVID-19\u003c/a>\u003c/li>\n\u003c/ul>\n\u003cp>Newsom urged Californians to stay optimistic — and to help themselves by helping others.\u003c/p>\n\u003cp>“Reach out to people. If there was ever a time when you wanted to call Aunt Margie — you hadn’t called her in two years, this is the time,” he said.\u003c/p>\n\u003cp>“I had a beautiful letter … it was sitting there at the gate of my home, right outside, and a note attached from a neighbor down the block, who just wanted to put in a good word,” Newsom added.\u003c/p>\n\u003cp>“Just dropping a note by — it made my day, look at me, it made my week. You can do the same, reach out to neighbors, reach out to loved ones, reach out to strangers.”\u003c/p>\n\u003cp>\u003cem>\u003ca href=\"https://www.kqed.org/education/collection/above-the-noise\">Above the Noise\u003c/a>, KQED Education’s video series, talks to a UCSF psychologist about coping tips for teenagers:\u003c/em>\u003c/p>\n\u003cp>https://www.youtube.com/watch?v=cT77fQ57IP4&feature=youtu.be\u003c/p>\n\u003cp>\u003c/p>\n",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>But Newsom said he knows that Californians can’t do it alone. So he asked California’s Surgeon General, Dr. Nadine Burke Harris, to create a \u003ca href=\"https://covid19.ca.gov/manage-stress-for-health/#top\">series of guides to help people manage stress\u003c/a> during this time of crisis.\u003c/p>\n\u003cp>Burke Harris said millions of Californians who aren’t sick with COVID-19 are still managing a ton of stress — and that stress can manifest in real, physical pain.\u003c/p>\n\u003cp>“The health impacts of coronavirus go beyond infection and COVID disease,” she said. “It’s important to know that these changes aren’t just in your head, and to begin to identify how stress shows up for you — physically, emotionally and behaviorally.”\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"content": "\u003cdiv class=\"post-body\">\u003cp>Burke Harris urged Californians to exercise, eat right, get enough sleep and try to still connect — albeit virtually — to their social support networks.\u003c/p>\n\u003cp>“Safe, stable and nurturing relationships help to protect our brains and bodies from the harmful effects of stress and adversity,” she said.\u003c/p>\n\u003cp>She announced two “\u003ca href=\"https://covid19.ca.gov/manage-stress-for-health/#top\">playbooks\u003c/a>” that rely on evidence-based guidance for how to relieve stress. One is for everyone; the second is for parents and caregivers.\u003c/p>\n\u003cul>\n\u003cli>\u003ca href=\"https://covid19.ca.gov/img/wp/california-surgeon-general_stress-busting-playbook_draft-v2clean_ada-04072020.pdf\">Stress Relief During COVID-19\u003c/a>\u003c/li>\n\u003cli>\u003ca href=\"https://covid19.ca.gov/pdf/caregivers_and_kids_california_surgeon_general_stress_busting_playbook_draft_v2_clean_ada_04072020v2.pdf\">Stress Relief for Caregivers and Kids During COVID-19\u003c/a>\u003c/li>\n\u003c/ul>\n\u003cp>Newsom urged Californians to stay optimistic — and to help themselves by helping others.\u003c/p>\n\u003cp>“Reach out to people. If there was ever a time when you wanted to call Aunt Margie — you hadn’t called her in two years, this is the time,” he said.\u003c/p>\n\u003cp>“I had a beautiful letter … it was sitting there at the gate of my home, right outside, and a note attached from a neighbor down the block, who just wanted to put in a good word,” Newsom added.\u003c/p>\n\u003cp>“Just dropping a note by — it made my day, look at me, it made my week. You can do the same, reach out to neighbors, reach out to loved ones, reach out to strangers.”\u003c/p>\n\u003cp>\u003cem>\u003ca href=\"https://www.kqed.org/education/collection/above-the-noise\">Above the Noise\u003c/a>, KQED Education’s video series, talks to a UCSF psychologist about coping tips for teenagers:\u003c/em>\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/cT77fQ57IP4'\n title='//www.youtube.com/embed/cT77fQ57IP4'\n allowfullscreen='true'\n style='border:0;'>\u003c/iframe>\n \u003c/span>\n \u003c/span>\u003c/p>\u003cp>\u003cp>\u003c/p>\n\u003c/div>\u003c/p>",
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"disqusTitle": "Coronavirus Is Impacting the Bay Area's Mental Health. Where Can You Find Help?",
"title": "Coronavirus Is Impacting the Bay Area's Mental Health. Where Can You Find Help?",
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"content": "\u003cp>\u003ci>This post has been updated\u003c/i>\u003c/p>\n\u003cp>\u003cem>For a list of resources and who to contact if you're in crisis, \u003ca href=\"#resources\">jump to the bottom of this story.\u003c/a> \u003c/em>\u003c/p>\n\u003cp>On an average day, workers staffing the phones at Crisis Support Services of Alameda County (CSS) might receive around 100 calls. But on March 16, the day Bay Area officials announced that shelter-in-place orders would be issued, those calls jumped by 50%.\u003c/p>\n\u003cp>The agency's executive director, Narges Zohoury Dillon, said many of the people calling in aren't necessarily experiencing suicidal ideation but, instead, anxiety.\u003c/p>\n\u003cp>\"We're getting a lot more folks who are in a lot of distress and have a lot of anxiety about what this means — especially considering the fact that it's open-ended,\" said Dillon. \"We really don't know what it's going to look like in a few weeks.\"\u003c/p>\n\u003cp>[ad fullwidth]\u003c/p>\n\u003cp>Crisis centers often take calls from people struggling with mental health issues, from anxiety to depression to suicidal ideation. And across the United States, calls from people in crisis have risen, including reported increases in \u003ca href=\"https://www.portlandmercury.com/blogtown/2020/03/26/28196873/portland-clinicians-prepare-for-uptick-in-mental-health-crises-due-to-covid-19\">Oregon\u003c/a>, \u003ca href=\"https://www.bostonglobe.com/2020/03/24/metro/amid-coronavirus-surge-calls-massachusetts-suicide-prevention-hotline/\">Massachusetts\u003c/a> and \u003ca href=\"https://wskg.org/news/crisis-line-calls-soar-as-coronavirus-spreads/\">New York\u003c/a>.\u003c/p>\n\u003cp>Since California's shelter-in-place order took effect, the calls to CSS have remained around 120 to 130 calls daily.\u003c/p>\n\u003cp>For some, the isolation and uncertainly of COVID-19 can exacerbate existing mental health issues, and some people are even experiencing virus-like symptoms induced by their anxiety.\u003c/p>\n\u003cp>Daniella Bermudez, a crisis counselor at CSS, said helping callers determine if they are experiencing symptoms is the first step.\u003c/p>\n\u003cp>\"Are they feeling very winded, like they just sprinted and even at rest, they can't catch their breath? — which is, you know, a good way to tell if somebody is having difficulty breathing. Or is the breathing connected to anxiety? Are they getting more anxiety from feeling like they can't breathe?\" she said.\u003c/p>\n\u003cp>The next step is helping a caller figure out what to do next.\u003c/p>\n\u003cp>\"Some people are like, 'Should I go to the hospital?' And right now we know that we don't want to put more people at risk by going to the hospital. So, what are the alternatives?\" said Bermudez. \"Who else can they involve in their care right now?\"\u003c/p>\n\u003cp>Bermudez said she tries to refer callers to speak with an advice nurse, family members or friends — essentially, people who can help make choices about health care. She also provides them with factual information from the Centers for Disease Control and Prevention, which can help put their minds at ease.\u003c/p>\n\u003cp>Other organizations in the Bay Area say they haven't seen the same uptick in people reaching out for help, but they expect that as people continue sheltering in place, those numbers will rise.\u003c/p>\n\u003ch3>Danger at Home\u003c/h3>\n\u003cp>Some providers said one reason calls may not yet have increased is that people could be afraid to call from where they're sheltering, which may not be a safe or accepting place.\u003c/p>\n\u003cp>Aaron Almanza is the executive director of the San Francisco-based Lesbian, Gay, Bisexual and Transgender National Help Center. He said they've seen an uptick in online chats since the outbreak — about 55 to 60 per day, up from an average of 40 — but not yet an increase in calls. Almanza theorized that may be due, in part, to the nature of his organization's call center, where a lot of callers are closeted or in the process of coming out.\u003c/p>\n\u003cp>\"They're stuck at home with people who are transphobic, biphobic, homophobic,\" Almanza explained. \"So they can't really call us and talk to us on the phone like they normally can.\"\u003c/p>\n\u003cp>Some may even be experiencing \u003ca href=\"https://www.kqed.org/news/11807639/how-to-shelter-in-place-if-you-live-with-domestic-abuse\">domestic violence\u003c/a> and are unable to make calls safely.\u003c/p>\n\u003cp>The Trevor Project, a nationwide suicide prevention and crisis intervention nonprofit focused on LGBTQ youth, reported increased mentions of COVID-19 from the youth who have reached out for support.\u003c/p>\n\u003cp>\"For LGBTQ young people, many of whom already face unique mental health challenges due to increased experiences with discrimination and harassment, social isolation can mean being forced back into the closet or unsupportive, even abusive home environments,\" said Tia Dole, chief clinical operations officer for the nonprofit.\u003c/p>\n\u003ch3>Finding Ways to Cope\u003c/h3>\n\u003cp>It can be hard to emotionally navigate an unprecedented event like the COVID-19 pandemic. And Bermudez, who works the night shift for Alameda County's CSS, said she tries to remind callers that there's no \"right\" way to react.\u003c/p>\n\u003cp>\"Really, all responses are OK and valid and appropriate,\" said Bermudez. \"We're having our valid, true, genuine, appropriate responses to a very atypical, not-expected situation.\"\u003c/p>\n\u003cp>https://www.youtube.com/watch?v=cT77fQ57IP4&feature=youtu.be\u003c/p>\n\u003cp>During his daily briefing on April 7, Gov. Gavin Newsom announced a \u003ca href=\"https://www.kqed.org/news/11811110/not-just-in-your-head-california-rolls-out-mental-health-guides-for-coping-with-coronavirus\">series of guides\u003c/a> to help people manage stress during the pandemic.\u003c/p>\n\u003cp>\"The health impacts of coronavirus go beyond infection and COVID disease,\" said California Surgeon General, Dr. Nadine Burke Harris. \"It’s important to know that these changes aren't just in your head, and to begin to identify how stress shows up for you – physically, emotionally and behaviorally.\"\u003c/p>\n\u003cp>The two \"playbooks\" rely on evidence-based guidance for how to relieve stress. One is for everyone; the other is specifically designed for parents and caregivers.\u003c/p>\n\u003cul>\n\u003cli>\u003ca href=\"https://covid19.ca.gov/img/wp/california-surgeon-general_stress-busting-playbook_draft-v2clean_ada-04072020.pdf\">Stress Relief During COVID-19\u003c/a>\u003c/li>\n\u003cli>\u003ca href=\"https://covid19.ca.gov/pdf/caregivers_and_kids_california_surgeon_general_stress_busting_playbook_draft_v2_clean_ada_04072020v2.pdf\">Stress Relief for Caregivers and Kids During COVID-19\u003c/a>\u003c/li>\n\u003c/ul>\n\u003cp>Here are a few other things you can do to help address the anxiety:\u003c/p>\n\u003cp>\u003cstrong>Acknowledge your feelings \u003c/strong>\u003c/p>\n\u003cp>Be it a loss of our jobs, routines or just a feeling of normalcy, CSS's Dillon said it's important to set aside some intentional time to identify and acknowledge our feelings.\u003c/p>\n\u003cp>\"[To] actually name that, and give it space and allow ourselves to be upset as opposed to try and put on a brave face can actually help the negative feelings pass with less pain, as opposed to when we're trying to hold everything and pretend that we're going to get through this strongly,\" said Dillon.\u003c/p>\n\u003cp>\u003cstrong>Reduce your news consumption\u003c/strong>\u003c/p>\n\u003cp>\"One of the ways that people can manage their anxiety would be to give themselves an allotment, [like]: 'I will check in X amount of times per day for X amount of minutes' so I can stay informed without becoming overwhelmed,\" Dillon said.\u003c/p>\n\u003cp>\u003cstrong>Connect with loved ones\u003c/strong>\u003c/p>\n\u003cp>Whether it's a phone call or FaceTime, finding ways to connect with friends and family can help alleviate moments of crisis.\u003c/p>\n\u003cp>\"Even if you can't talk to people face to face, [it's] finding those different routes to finding the support that you deserve to have in your life,\" said LGBT National Help Center's Almanza.\u003c/p>\n\u003cp>\u003cstrong>Find ways to spend your time\u003c/strong>\u003c/p>\n\u003cp>Whether it's going for a walk, watching a movie, practicing yoga or meditation, or just listening to music — finding a way to get your mind off what's going on can help you mitigate your stress.\u003c/p>\n\u003cp>\u003ca id=\"#resources\">\u003c/a>\u003cstrong>Reach out\u003c/strong>\u003c/p>\n\u003cp>Whether you're in crisis, or just feeling anxious and overwhelmed, you can reach out for help.\u003c/p>\n\u003cp>\"You don't have to be in crisis to call us,\" said Dillon. \"We want people to call us when they're having a bad day as a way for us to \u003cem>prevent\u003c/em> them ultimately being in crisis.\"\u003c/p>\n\u003cp>Here's a few organizations you can reach out to:\u003c/p>\n\u003cul>\n\u003cli>\u003cstrong>\u003ca href=\"https://suicidepreventionlifeline.org\">The National Suicide Prevention Lifeline\u003c/a>: \u003c/strong>Call 1-800-273-8255 or chat online with a counselor \u003ca href=\"https://suicidepreventionlifeline.org/chat/\">here\u003c/a>. They've also compiled ways to care for your emotional well-being \u003ca href=\"https://suicidepreventionlifeline.org/current-events/supporting-your-emotional-well-being-during-the-covid-19-outbreak/\">here\u003c/a>.\u003c/li>\n\u003cli>\u003cstrong>\u003ca href=\"https://www.thetrevorproject.org\">The Trevor Project\u003c/a>:\u003c/strong> Call the TrevorLifeline at 1-866-488-7386, chat online \u003ca href=\"https://www.thetrevorproject.org/get-help-now/\">here,\u003c/a> or send a text to 678-678. They've also compiled tips on how to cope with stress and anxiety during the outbreak \u003ca href=\"https://www.thetrevorproject.org/2020/03/26/how-lgbtq-youth-can-cope-with-anxiety-and-stress-during-covid-19/\">here\u003c/a>.\u003c/li>\n\u003cli>\u003ca href=\"https://www.glbthotline.org\">\u003cstrong>LGBT National Help Center\u003c/strong>\u003c/a>: You can call the national hotline at 888-843-4564, the youth talkline at 800-246-7743 or the senior hotline at 888-234-7243. You can also chat online via their homepage.\u003c/li>\n\u003cli>\u003ca href=\"https://www.crisissupport.org\">\u003cstrong>Crisis Support Services of Alameda County\u003c/strong>\u003c/a>: Call the 24-hour crisis line at 1-800-309-2131. The organization is also taking applications for call center volunteers \u003ca href=\"https://www.crisissupport.org/get-involved/volunteering/online-volunteer-application/\">here\u003c/a>.\u003c/li>\n\u003cli>\u003ca href=\"https://www.sfsuicide.org\">\u003cstrong>San Francisco Suicide Prevention\u003c/strong>\u003c/a>: You can call the crisis hotline at 415-781-0500 or text 'MYLIFE' to 741-741\u003c/li>\n\u003cli>\u003cstrong>\u003ca href=\"https://www.crisis-center.org\">Contra Costa Crisis Center\u003c/a>\u003c/strong>: Area residents can call 211 or 800-833-2900. You can also text 'HOPE' to 20121.\u003c/li>\n\u003cli>\u003ca href=\"https://namisonomacounty.org\">\u003cstrong>National Alliance on Mental Illness (NAMI) Sonoma County\u003c/strong>\u003c/a>: To be connected with the emotional support hotline, or \"warmline,\" call or text 866-960-6264. They've also compiled a guide of what to do \u003ca href=\"https://static1.squarespace.com/static/5c410dd5f407b4f80cdb4afd/t/5e751d5e1bb0c10992c334af/1584733534920/COVID-19-Updated-Guide-1.pdf\">here\u003c/a>.\u003c/li>\n\u003cli>\u003ca href=\"https://namisantaclara.org\">\u003cstrong>NAMI Santa Clara\u003c/strong>\u003c/a>: Connect with the warm line at 1-408-453-0400, option 1.\u003c/li>\n\u003c/ul>\n\u003cp>[ad floatright]\u003c/p>\n\u003cp>The state has also compiled a list of mental health resources, which you can find \u003ca href=\"https://covid19.ca.gov/resources-for-emotional-support-and-well-being/#top\">here\u003c/a>.\u003c/p>\n\n",
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"excerpt": "Some Bay Area organizations are already seeing increased calls, while others say they expect numbers to rise as people continue sheltering in place. ",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003cp>\u003ci>This post has been updated\u003c/i>\u003c/p>\n\u003cp>\u003cem>For a list of resources and who to contact if you're in crisis, \u003ca href=\"#resources\">jump to the bottom of this story.\u003c/a> \u003c/em>\u003c/p>\n\u003cp>On an average day, workers staffing the phones at Crisis Support Services of Alameda County (CSS) might receive around 100 calls. But on March 16, the day Bay Area officials announced that shelter-in-place orders would be issued, those calls jumped by 50%.\u003c/p>\n\u003cp>The agency's executive director, Narges Zohoury Dillon, said many of the people calling in aren't necessarily experiencing suicidal ideation but, instead, anxiety.\u003c/p>\n\u003cp>\"We're getting a lot more folks who are in a lot of distress and have a lot of anxiety about what this means — especially considering the fact that it's open-ended,\" said Dillon. \"We really don't know what it's going to look like in a few weeks.\"\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>Crisis centers often take calls from people struggling with mental health issues, from anxiety to depression to suicidal ideation. And across the United States, calls from people in crisis have risen, including reported increases in \u003ca href=\"https://www.portlandmercury.com/blogtown/2020/03/26/28196873/portland-clinicians-prepare-for-uptick-in-mental-health-crises-due-to-covid-19\">Oregon\u003c/a>, \u003ca href=\"https://www.bostonglobe.com/2020/03/24/metro/amid-coronavirus-surge-calls-massachusetts-suicide-prevention-hotline/\">Massachusetts\u003c/a> and \u003ca href=\"https://wskg.org/news/crisis-line-calls-soar-as-coronavirus-spreads/\">New York\u003c/a>.\u003c/p>\n\u003cp>Since California's shelter-in-place order took effect, the calls to CSS have remained around 120 to 130 calls daily.\u003c/p>\n\u003cp>For some, the isolation and uncertainly of COVID-19 can exacerbate existing mental health issues, and some people are even experiencing virus-like symptoms induced by their anxiety.\u003c/p>\n\u003cp>Daniella Bermudez, a crisis counselor at CSS, said helping callers determine if they are experiencing symptoms is the first step.\u003c/p>\n\u003cp>\"Are they feeling very winded, like they just sprinted and even at rest, they can't catch their breath? — which is, you know, a good way to tell if somebody is having difficulty breathing. Or is the breathing connected to anxiety? Are they getting more anxiety from feeling like they can't breathe?\" she said.\u003c/p>\n\u003cp>The next step is helping a caller figure out what to do next.\u003c/p>\n\u003cp>\"Some people are like, 'Should I go to the hospital?' And right now we know that we don't want to put more people at risk by going to the hospital. So, what are the alternatives?\" said Bermudez. \"Who else can they involve in their care right now?\"\u003c/p>\n\u003cp>Bermudez said she tries to refer callers to speak with an advice nurse, family members or friends — essentially, people who can help make choices about health care. She also provides them with factual information from the Centers for Disease Control and Prevention, which can help put their minds at ease.\u003c/p>\n\u003cp>Other organizations in the Bay Area say they haven't seen the same uptick in people reaching out for help, but they expect that as people continue sheltering in place, those numbers will rise.\u003c/p>\n\u003ch3>Danger at Home\u003c/h3>\n\u003cp>Some providers said one reason calls may not yet have increased is that people could be afraid to call from where they're sheltering, which may not be a safe or accepting place.\u003c/p>\n\u003cp>Aaron Almanza is the executive director of the San Francisco-based Lesbian, Gay, Bisexual and Transgender National Help Center. He said they've seen an uptick in online chats since the outbreak — about 55 to 60 per day, up from an average of 40 — but not yet an increase in calls. Almanza theorized that may be due, in part, to the nature of his organization's call center, where a lot of callers are closeted or in the process of coming out.\u003c/p>\n\u003cp>\"They're stuck at home with people who are transphobic, biphobic, homophobic,\" Almanza explained. \"So they can't really call us and talk to us on the phone like they normally can.\"\u003c/p>\n\u003cp>Some may even be experiencing \u003ca href=\"https://www.kqed.org/news/11807639/how-to-shelter-in-place-if-you-live-with-domestic-abuse\">domestic violence\u003c/a> and are unable to make calls safely.\u003c/p>\n\u003cp>The Trevor Project, a nationwide suicide prevention and crisis intervention nonprofit focused on LGBTQ youth, reported increased mentions of COVID-19 from the youth who have reached out for support.\u003c/p>\n\u003cp>\"For LGBTQ young people, many of whom already face unique mental health challenges due to increased experiences with discrimination and harassment, social isolation can mean being forced back into the closet or unsupportive, even abusive home environments,\" said Tia Dole, chief clinical operations officer for the nonprofit.\u003c/p>\n\u003ch3>Finding Ways to Cope\u003c/h3>\n\u003cp>It can be hard to emotionally navigate an unprecedented event like the COVID-19 pandemic. And Bermudez, who works the night shift for Alameda County's CSS, said she tries to remind callers that there's no \"right\" way to react.\u003c/p>\n\u003cp>\"Really, all responses are OK and valid and appropriate,\" said Bermudez. \"We're having our valid, true, genuine, appropriate responses to a very atypical, not-expected situation.\"\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/cT77fQ57IP4'\n title='//www.youtube.com/embed/cT77fQ57IP4'\n allowfullscreen='true'\n style='border:0;'>\u003c/iframe>\n \u003c/span>\n \u003c/span>\u003c/p>\u003cp>\u003cp>During his daily briefing on April 7, Gov. Gavin Newsom announced a \u003ca href=\"https://www.kqed.org/news/11811110/not-just-in-your-head-california-rolls-out-mental-health-guides-for-coping-with-coronavirus\">series of guides\u003c/a> to help people manage stress during the pandemic.\u003c/p>\n\u003cp>\"The health impacts of coronavirus go beyond infection and COVID disease,\" said California Surgeon General, Dr. Nadine Burke Harris. \"It’s important to know that these changes aren't just in your head, and to begin to identify how stress shows up for you – physically, emotionally and behaviorally.\"\u003c/p>\n\u003cp>The two \"playbooks\" rely on evidence-based guidance for how to relieve stress. One is for everyone; the other is specifically designed for parents and caregivers.\u003c/p>\n\u003cul>\n\u003cli>\u003ca href=\"https://covid19.ca.gov/img/wp/california-surgeon-general_stress-busting-playbook_draft-v2clean_ada-04072020.pdf\">Stress Relief During COVID-19\u003c/a>\u003c/li>\n\u003cli>\u003ca href=\"https://covid19.ca.gov/pdf/caregivers_and_kids_california_surgeon_general_stress_busting_playbook_draft_v2_clean_ada_04072020v2.pdf\">Stress Relief for Caregivers and Kids During COVID-19\u003c/a>\u003c/li>\n\u003c/ul>\n\u003cp>Here are a few other things you can do to help address the anxiety:\u003c/p>\n\u003cp>\u003cstrong>Acknowledge your feelings \u003c/strong>\u003c/p>\n\u003cp>Be it a loss of our jobs, routines or just a feeling of normalcy, CSS's Dillon said it's important to set aside some intentional time to identify and acknowledge our feelings.\u003c/p>\n\u003cp>\"[To] actually name that, and give it space and allow ourselves to be upset as opposed to try and put on a brave face can actually help the negative feelings pass with less pain, as opposed to when we're trying to hold everything and pretend that we're going to get through this strongly,\" said Dillon.\u003c/p>\n\u003cp>\u003cstrong>Reduce your news consumption\u003c/strong>\u003c/p>\n\u003cp>\"One of the ways that people can manage their anxiety would be to give themselves an allotment, [like]: 'I will check in X amount of times per day for X amount of minutes' so I can stay informed without becoming overwhelmed,\" Dillon said.\u003c/p>\n\u003cp>\u003cstrong>Connect with loved ones\u003c/strong>\u003c/p>\n\u003cp>Whether it's a phone call or FaceTime, finding ways to connect with friends and family can help alleviate moments of crisis.\u003c/p>\n\u003cp>\"Even if you can't talk to people face to face, [it's] finding those different routes to finding the support that you deserve to have in your life,\" said LGBT National Help Center's Almanza.\u003c/p>\n\u003cp>\u003cstrong>Find ways to spend your time\u003c/strong>\u003c/p>\n\u003cp>Whether it's going for a walk, watching a movie, practicing yoga or meditation, or just listening to music — finding a way to get your mind off what's going on can help you mitigate your stress.\u003c/p>\n\u003cp>\u003ca id=\"#resources\">\u003c/a>\u003cstrong>Reach out\u003c/strong>\u003c/p>\n\u003cp>Whether you're in crisis, or just feeling anxious and overwhelmed, you can reach out for help.\u003c/p>\n\u003cp>\"You don't have to be in crisis to call us,\" said Dillon. \"We want people to call us when they're having a bad day as a way for us to \u003cem>prevent\u003c/em> them ultimately being in crisis.\"\u003c/p>\n\u003cp>Here's a few organizations you can reach out to:\u003c/p>\n\u003cul>\n\u003cli>\u003cstrong>\u003ca href=\"https://suicidepreventionlifeline.org\">The National Suicide Prevention Lifeline\u003c/a>: \u003c/strong>Call 1-800-273-8255 or chat online with a counselor \u003ca href=\"https://suicidepreventionlifeline.org/chat/\">here\u003c/a>. They've also compiled ways to care for your emotional well-being \u003ca href=\"https://suicidepreventionlifeline.org/current-events/supporting-your-emotional-well-being-during-the-covid-19-outbreak/\">here\u003c/a>.\u003c/li>\n\u003cli>\u003cstrong>\u003ca href=\"https://www.thetrevorproject.org\">The Trevor Project\u003c/a>:\u003c/strong> Call the TrevorLifeline at 1-866-488-7386, chat online \u003ca href=\"https://www.thetrevorproject.org/get-help-now/\">here,\u003c/a> or send a text to 678-678. They've also compiled tips on how to cope with stress and anxiety during the outbreak \u003ca href=\"https://www.thetrevorproject.org/2020/03/26/how-lgbtq-youth-can-cope-with-anxiety-and-stress-during-covid-19/\">here\u003c/a>.\u003c/li>\n\u003cli>\u003ca href=\"https://www.glbthotline.org\">\u003cstrong>LGBT National Help Center\u003c/strong>\u003c/a>: You can call the national hotline at 888-843-4564, the youth talkline at 800-246-7743 or the senior hotline at 888-234-7243. You can also chat online via their homepage.\u003c/li>\n\u003cli>\u003ca href=\"https://www.crisissupport.org\">\u003cstrong>Crisis Support Services of Alameda County\u003c/strong>\u003c/a>: Call the 24-hour crisis line at 1-800-309-2131. The organization is also taking applications for call center volunteers \u003ca href=\"https://www.crisissupport.org/get-involved/volunteering/online-volunteer-application/\">here\u003c/a>.\u003c/li>\n\u003cli>\u003ca href=\"https://www.sfsuicide.org\">\u003cstrong>San Francisco Suicide Prevention\u003c/strong>\u003c/a>: You can call the crisis hotline at 415-781-0500 or text 'MYLIFE' to 741-741\u003c/li>\n\u003cli>\u003cstrong>\u003ca href=\"https://www.crisis-center.org\">Contra Costa Crisis Center\u003c/a>\u003c/strong>: Area residents can call 211 or 800-833-2900. You can also text 'HOPE' to 20121.\u003c/li>\n\u003cli>\u003ca href=\"https://namisonomacounty.org\">\u003cstrong>National Alliance on Mental Illness (NAMI) Sonoma County\u003c/strong>\u003c/a>: To be connected with the emotional support hotline, or \"warmline,\" call or text 866-960-6264. They've also compiled a guide of what to do \u003ca href=\"https://static1.squarespace.com/static/5c410dd5f407b4f80cdb4afd/t/5e751d5e1bb0c10992c334af/1584733534920/COVID-19-Updated-Guide-1.pdf\">here\u003c/a>.\u003c/li>\n\u003cli>\u003ca href=\"https://namisantaclara.org\">\u003cstrong>NAMI Santa Clara\u003c/strong>\u003c/a>: Connect with the warm line at 1-408-453-0400, option 1.\u003c/li>\n\u003c/ul>\n\u003cp>\u003c/p>\u003c/div>",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>The state has also compiled a list of mental health resources, which you can find \u003ca href=\"https://covid19.ca.gov/resources-for-emotional-support-and-well-being/#top\">here\u003c/a>.\u003c/p>\n\n\u003c/div>\u003c/p>",
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"disqusTitle": "Coronavirus Has Upended Our World. It's OK to Grieve",
"title": "Coronavirus Has Upended Our World. It's OK to Grieve",
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"content": "\u003cp>On weekday evenings, sisters Lesley Laine and Lisa Ingle stage online happy hours from the Southern California home they share. It's something they've been enjoying with local and faraway friends during this period of social distancing and self-isolation. And on a recent evening, I shared a toast with them.\u003c/p>\n\u003cp>We laughed and had fun during our half-hour Facetime meetup. But unlike our pre-pandemic visits, we now worried out loud about a lot of things – like our millennial-aged kids: their health and jobs. And what about the fragile elders, the economy? Will life ever return to \"normal?\"\u003c/p>\n\u003cp>\"It feels like a free-fall,\" says \u003ca href=\"https://www.francisweller.net/\">Francis Weller\u003c/a>, a Santa Rosa psychotherapist. \"What we once held as solid is no longer something we can rely upon.\"\u003c/p>\n\u003cp>The coronavirus pandemic sweeping the globe has not only left many anxious about life and death issues, it's also left people struggling with a host of less obvious, existential losses as they heed stay-home warnings and wonder how bad all of this is going to get.\u003c/p>\n\u003cp>To weather these uncertain times, it's important to acknowledge and grieve lost routines, social connections, family structures and our sense of security — and then create new ways to move forward — says interfaith chaplain and trauma counselor \u003ca href=\"https://www.spiritualityandgrief.com/\">Terri Daniel\u003c/a>.\u003c/p>\n\u003cp>[pullquote size=\"medium\" align=\"right\" citation=\" Francis Weller, a Santa Rosa psychotherapist\"]'Grief is not a problem to be solved. It's a presence in the psyche awaiting, witnessing.'[/pullquote]\u003c/p>\n\u003cp>\"We need to recognize that mixed in with all the feelings we're having of anger, disappointment, perhaps rage, blame and powerlessness — is grief,\" says Daniel, who works with the dying and bereaved.\u003c/p>\n\u003cp>Left unrecognized and unattended, grief can negatively impact \"every aspect of our being — physically, cognitively, emotionally spiritually,\" says \u003ca href=\"https://drsonyalott.com/\">Sonya Lott\u003c/a>, a Philadelphia-based psychologist specializing in grief counseling.\u003c/p>\n\u003cp>Yet with our national focus on the daily turn of events as the coronavirus spreads and with the chaos it's brought, these underlying or secondary losses may escape us. People who are physically well may not feel entitled to their emotional upset over the disruption of normal life. Yet, Lott argues, it's important to honor our own losses even if those losses seem small compared to others.\u003c/p>\n\u003cp>\"We can't heal what we don't have an awareness of,\" says Lott.\u003c/p>\n\u003cp>[ad fullwidth]\u003c/p>\n\u003ch3>Recognize Our Losses\u003c/h3>\n\u003cp>Whether we've named them are not, these are some of the community-wide losses many of us are grieving. Consider how you feel when you think of these.\u003c/p>\n\u003cp>\u003cstrong>Social Connections \u003c/strong>\u003c/p>\n\u003cp>Perhaps the most impactful of the immediate losses as we hunker down at home is the separation from close friends and family. \"Children aren't able to play together. There's no in-person social engagement, no hugging, no touching which is disruptive to our emotional well-being,\" says Daniel.\u003c/p>\n\u003cp>Separation from our colleagues and officemates also creates significant loss. \"Our work environment is like a second family. Even if we don't love all the people we work with, we still depend on each other,\" says Lott.\u003c/p>\n\u003cp>\u003cstrong>Habits and Habitat\u003c/strong>\u003c/p>\n\u003cp>\u003cstrong> \u003c/strong>With the world outside our homes no longer safe to inhabit the way we once did, Daniel says we've lost our \"habits and habitats,\" as we can no longer engage in our usual routines and rituals. And no matter how mundane they may have seemed — whether grabbing a morning coffee at the local café, driving to work or picking up the kids from school — routines help define your sense of self in the world. Losing them, Daniel says, \"shocks your system.\"\u003c/p>\n\u003cp>\u003cstrong>Assumptions and Security\u003c/strong>\u003c/p>\n\u003cp>We go to sleep assuming we'll wake up the next morning, \"that the sun will be there and your friends will all be alive and you'll be healthy,\" Weller says. But the spread of the virus has shaken nearly every assumption we once counted on. \"And so we're losing our sense of safety in the world and our assumptions about ourselves,\" he says.\u003c/p>\n\u003cp>\u003cstrong>Trust in Our Systems\u003c/strong>\u003c/p>\n\u003cp>When government leaders, government agencies, medical systems, religious bodies, the stock market and corporations fail to meet public expectations, it can leave citizens feeling betrayed and emotionally unmoored. \"We are all grieving this loss,\" Daniel says.\u003c/p>\n\u003cp>\u003cstrong>Sympathetic Loss for Others\u003c/strong>\u003c/p>\n\u003cp>Even if you're not directly affected by a particular loss, you may be feeling the grief of others, including those of displaced workers, of health care workers on the frontlines, of people barred from visiting elderly relatives in nursing homes, of those who have already lost friends and family to the virus and to those who will.\u003c/p>\n\u003ch3>4 Ways to Honor Your Grief\u003c/h3>\n\u003cp>Once you identify the losses you're feeling, look for ways to honor the grief surrounding you, grief experts urge.\u003c/p>\n\u003cp>\u003cstrong>Bear Witness and Communicate\u003c/strong>\u003c/p>\n\u003cp>Sharing our stories is an essential step, Daniel says.\u003c/p>\n\u003cp>\"If you can't talk about what's happened to you and you can't share it, you can't really start working on it,\" Daniel says. \"So, communicate with your friends and family about your experience.\"\u003c/p>\n\u003cp>It can be as simple as picking up the phone and calling a friend or family member, says Weller. He suggests simply asking for and offering a space in which to share your feelings without either of you offering advice or trying to fix anything for the other.\u003c/p>\n\u003cp>\"Grief is not a problem to be solved,\" he says. \"It's a presence in the psyche awaiting, witnessing.\"\u003c/p>\n\u003cp>For those with robust social networks, Daniel suggests gathering a group of friends virtually to share these losses together. Using apps, such as Zoom, Skype, FaceTime or Facebook Live, virtual meetups are easy to set up on a daily or weekly basis.\u003c/p>\n\u003cp>\u003cstrong>Write, Create, Express \u003c/strong>\u003c/p>\n\u003cp>Whether you're an extrovert or introvert, keeping a written or recorded journal of these days offers another way to express, to identify and to acknowledge loss and grief.\u003c/p>\n\u003cp>[aside postID=\"news_11807751\" label=\"Self-Care During Coronavirus\" hero=\"https://cdn.kqed.org/wp-content/uploads/sites/10/2020/03/not-today-covid19-sign-on-wooden-stool-3952231-1020x657.jpg\"]\u003c/p>\n\u003cp>And then there's art therapy, which can be especially helpful for children unable to express well with words, for teens and even for many adults.\u003c/p>\n\u003cp>\"Make a sculpture, draw a picture or create a ceremonial object,\" says Daniel, who often incorporates shamanic ceremonies into grief workshops she conducts.\u003c/p>\n\u003cp>Another exercise she often uses in grief workshops is a simple one in which participants use their breath to blow their sadness, fear and anger into a rock that they then throw away.\u003c/p>\n\u003cp>\"What this does is takes all that intense, painful energy out of your body and into an inanimate object that they symbolically throw far away from themselves,\" Daniel says.\u003c/p>\n\u003cp>\u003cstrong>Meditate \u003c/strong>\u003c/p>\n\u003cp>Regular meditation and just taking time to slow down and take several deep, calming breaths throughout the day also works to lower stress and is available to everyone, Lott says. For beginners who want guidance she suggests downloading a meditation app onto your smart phone or computer.\u003c/p>\n\u003cp>\u003cstrong>Be Open to Joy\u003c/strong>\u003c/p>\n\u003cp>And finally, Lott urges, make sure to let joy and gratitude into your life during these challenging times. Whether it's a virtual happy hour, tea time or dance party, reach out to others, she says.\u003c/p>\n\u003cp>\"If we can find gratitude in the creative ways that we connect with each other and help somebody,\" she says, \"then we can hold our grief better and move through it with less difficulty and more grace.\"\u003c/p>\n\u003cp>\u003cem>This story was produced in partnership with Kaiser Health News.\u003c/em>\u003c/p>\n\u003cdiv class=\"fullattribution\">\u003cem>Copyright 2020 NPR. To see more, visit\u003ca href=\"https://www.npr.org\"> npr.org\u003c/a>.\u003cimg src=\"https://www.google-analytics.com/__utm.gif?utmac=UA-5828686-4&utmdt=Coronavirus+Has+Upended+Our+World.+It%27s+OK+To+Grieve&utme=8(APIKey)9(MDAxOTAwOTE4MDEyMTkxMDAzNjczZDljZA004)\">\u003c/em>\u003c/div>\n\u003cp>[ad floatright]\u003c/p>\n",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003cp>On weekday evenings, sisters Lesley Laine and Lisa Ingle stage online happy hours from the Southern California home they share. It's something they've been enjoying with local and faraway friends during this period of social distancing and self-isolation. And on a recent evening, I shared a toast with them.\u003c/p>\n\u003cp>We laughed and had fun during our half-hour Facetime meetup. But unlike our pre-pandemic visits, we now worried out loud about a lot of things – like our millennial-aged kids: their health and jobs. And what about the fragile elders, the economy? Will life ever return to \"normal?\"\u003c/p>\n\u003cp>\"It feels like a free-fall,\" says \u003ca href=\"https://www.francisweller.net/\">Francis Weller\u003c/a>, a Santa Rosa psychotherapist. \"What we once held as solid is no longer something we can rely upon.\"\u003c/p>\n\u003cp>The coronavirus pandemic sweeping the globe has not only left many anxious about life and death issues, it's also left people struggling with a host of less obvious, existential losses as they heed stay-home warnings and wonder how bad all of this is going to get.\u003c/p>\n\u003cp>To weather these uncertain times, it's important to acknowledge and grieve lost routines, social connections, family structures and our sense of security — and then create new ways to move forward — says interfaith chaplain and trauma counselor \u003ca href=\"https://www.spiritualityandgrief.com/\">Terri Daniel\u003c/a>.\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>\"We need to recognize that mixed in with all the feelings we're having of anger, disappointment, perhaps rage, blame and powerlessness — is grief,\" says Daniel, who works with the dying and bereaved.\u003c/p>\n\u003cp>Left unrecognized and unattended, grief can negatively impact \"every aspect of our being — physically, cognitively, emotionally spiritually,\" says \u003ca href=\"https://drsonyalott.com/\">Sonya Lott\u003c/a>, a Philadelphia-based psychologist specializing in grief counseling.\u003c/p>\n\u003cp>Yet with our national focus on the daily turn of events as the coronavirus spreads and with the chaos it's brought, these underlying or secondary losses may escape us. People who are physically well may not feel entitled to their emotional upset over the disruption of normal life. Yet, Lott argues, it's important to honor our own losses even if those losses seem small compared to others.\u003c/p>\n\u003cp>\"We can't heal what we don't have an awareness of,\" says Lott.\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003ch3>Recognize Our Losses\u003c/h3>\n\u003cp>Whether we've named them are not, these are some of the community-wide losses many of us are grieving. Consider how you feel when you think of these.\u003c/p>\n\u003cp>\u003cstrong>Social Connections \u003c/strong>\u003c/p>\n\u003cp>Perhaps the most impactful of the immediate losses as we hunker down at home is the separation from close friends and family. \"Children aren't able to play together. There's no in-person social engagement, no hugging, no touching which is disruptive to our emotional well-being,\" says Daniel.\u003c/p>\n\u003cp>Separation from our colleagues and officemates also creates significant loss. \"Our work environment is like a second family. Even if we don't love all the people we work with, we still depend on each other,\" says Lott.\u003c/p>\n\u003cp>\u003cstrong>Habits and Habitat\u003c/strong>\u003c/p>\n\u003cp>\u003cstrong> \u003c/strong>With the world outside our homes no longer safe to inhabit the way we once did, Daniel says we've lost our \"habits and habitats,\" as we can no longer engage in our usual routines and rituals. And no matter how mundane they may have seemed — whether grabbing a morning coffee at the local café, driving to work or picking up the kids from school — routines help define your sense of self in the world. Losing them, Daniel says, \"shocks your system.\"\u003c/p>\n\u003cp>\u003cstrong>Assumptions and Security\u003c/strong>\u003c/p>\n\u003cp>We go to sleep assuming we'll wake up the next morning, \"that the sun will be there and your friends will all be alive and you'll be healthy,\" Weller says. But the spread of the virus has shaken nearly every assumption we once counted on. \"And so we're losing our sense of safety in the world and our assumptions about ourselves,\" he says.\u003c/p>\n\u003cp>\u003cstrong>Trust in Our Systems\u003c/strong>\u003c/p>\n\u003cp>When government leaders, government agencies, medical systems, religious bodies, the stock market and corporations fail to meet public expectations, it can leave citizens feeling betrayed and emotionally unmoored. \"We are all grieving this loss,\" Daniel says.\u003c/p>\n\u003cp>\u003cstrong>Sympathetic Loss for Others\u003c/strong>\u003c/p>\n\u003cp>Even if you're not directly affected by a particular loss, you may be feeling the grief of others, including those of displaced workers, of health care workers on the frontlines, of people barred from visiting elderly relatives in nursing homes, of those who have already lost friends and family to the virus and to those who will.\u003c/p>\n\u003ch3>4 Ways to Honor Your Grief\u003c/h3>\n\u003cp>Once you identify the losses you're feeling, look for ways to honor the grief surrounding you, grief experts urge.\u003c/p>\n\u003cp>\u003cstrong>Bear Witness and Communicate\u003c/strong>\u003c/p>\n\u003cp>Sharing our stories is an essential step, Daniel says.\u003c/p>\n\u003cp>\"If you can't talk about what's happened to you and you can't share it, you can't really start working on it,\" Daniel says. \"So, communicate with your friends and family about your experience.\"\u003c/p>\n\u003cp>It can be as simple as picking up the phone and calling a friend or family member, says Weller. He suggests simply asking for and offering a space in which to share your feelings without either of you offering advice or trying to fix anything for the other.\u003c/p>\n\u003cp>\"Grief is not a problem to be solved,\" he says. \"It's a presence in the psyche awaiting, witnessing.\"\u003c/p>\n\u003cp>For those with robust social networks, Daniel suggests gathering a group of friends virtually to share these losses together. Using apps, such as Zoom, Skype, FaceTime or Facebook Live, virtual meetups are easy to set up on a daily or weekly basis.\u003c/p>\n\u003cp>\u003cstrong>Write, Create, Express \u003c/strong>\u003c/p>\n\u003cp>Whether you're an extrovert or introvert, keeping a written or recorded journal of these days offers another way to express, to identify and to acknowledge loss and grief.\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>And then there's art therapy, which can be especially helpful for children unable to express well with words, for teens and even for many adults.\u003c/p>\n\u003cp>\"Make a sculpture, draw a picture or create a ceremonial object,\" says Daniel, who often incorporates shamanic ceremonies into grief workshops she conducts.\u003c/p>\n\u003cp>Another exercise she often uses in grief workshops is a simple one in which participants use their breath to blow their sadness, fear and anger into a rock that they then throw away.\u003c/p>\n\u003cp>\"What this does is takes all that intense, painful energy out of your body and into an inanimate object that they symbolically throw far away from themselves,\" Daniel says.\u003c/p>\n\u003cp>\u003cstrong>Meditate \u003c/strong>\u003c/p>\n\u003cp>Regular meditation and just taking time to slow down and take several deep, calming breaths throughout the day also works to lower stress and is available to everyone, Lott says. For beginners who want guidance she suggests downloading a meditation app onto your smart phone or computer.\u003c/p>\n\u003cp>\u003cstrong>Be Open to Joy\u003c/strong>\u003c/p>\n\u003cp>And finally, Lott urges, make sure to let joy and gratitude into your life during these challenging times. Whether it's a virtual happy hour, tea time or dance party, reach out to others, she says.\u003c/p>\n\u003cp>\"If we can find gratitude in the creative ways that we connect with each other and help somebody,\" she says, \"then we can hold our grief better and move through it with less difficulty and more grace.\"\u003c/p>\n\u003cp>\u003cem>This story was produced in partnership with Kaiser Health News.\u003c/em>\u003c/p>\n\u003cdiv class=\"fullattribution\">\u003cem>Copyright 2020 NPR. To see more, visit\u003ca href=\"https://www.npr.org\"> npr.org\u003c/a>.\u003cimg src=\"https://www.google-analytics.com/__utm.gif?utmac=UA-5828686-4&utmdt=Coronavirus+Has+Upended+Our+World.+It%27s+OK+To+Grieve&utme=8(APIKey)9(MDAxOTAwOTE4MDEyMTkxMDAzNjczZDljZA004)\">\u003c/em>\u003c/div>\n\u003cp>\u003c/p>\u003c/div>",
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"content": "\u003cp>\u003cb>Stay-at-Home Order for All California\u003cbr>\n\u003c/b>\u003cspan style=\"font-weight: 400\">On Thursday, Gov. Gavin Newsom ordered all California residents to stay at home as much as possible ”until further notice.” All nine Bay Area counties had already issued “shelter-in-place” directives to slow the spread of the coronavirus. Non-essential businesses such as gyms and bars have closed as restaurants offer takeout and delivery service only. Grocery stores, pharmacies and gas stations are some of the businesses allowed to stay open. In the Bay Area, Santa Clara County has been the hardest hit by the coronavirus, with at least 196 confirmed cases and eight deaths.\u003c/span>\u003cspan style=\"font-weight: 400\"> \u003c/span>\u003c/p>\n\u003cp>\u003cb>Guest:\u003c/b>\u003c/p>\n\u003cul>\n\u003cli style=\"font-weight: 400\">\u003cspan style=\"font-weight: 400\">Sam Liccardo, mayor of San Jose\u003c/span>\u003c/li>\n\u003c/ul>\n\u003cp>\u003cb>Congressman Ro Khanna on Federal Response to Coronavirus\u003cbr>\n\u003c/b>\u003cspan style=\"font-weight: 400\">The White House is working with Congress on a trillion-dollar stimulus plan to rescue the economy as airlines, hotels and other industries struggle to survive during the coronavirus crisis. Small businesses are also hurting, facing massive layoffs and possible closures. Among the federal aid being considered — corporate tax cuts and direct payments to most Americans. Meanwhile, coronavirus test kits remain out of reach for most people. Only 22 public health labs in California are testing for COVID-19 although private labs such as Quest Diagnostics are now also screening samples for the virus.\u003c/span>\u003c/p>\n\u003cp>\u003cb>Guest:\u003c/b>\u003cspan style=\"font-weight: 400\">–\u003c/span>\u003c/p>\n\u003cul>\n\u003cli style=\"font-weight: 400\">\u003cspan style=\"font-weight: 400\">U.S. Rep. Ro Khanna, D-Santa Clara\u003c/span>\u003c/li>\n\u003c/ul>\n\u003cp>\u003cb>Mental Health in the Age of Social Distancing and Self-Isolating\u003cbr>\n\u003c/b>\u003cspan style=\"font-weight: 400\">Commercial corridors that would normally be buzzing with activity were eerily quiet this week in the Bay Area. “Shelter-in-place” orders, along with a statewide ban on large gatherings, have upended how millions of us live, work and recreate. On top of all this, nearly all schools in California are closed, creating an additional challenge and stress for parents forced to work from home and cancel outings. \u003c/span>\u003c/p>\n\u003cp>[ad fullwidth]\u003c/p>\n\u003cp>\u003c/p>\n\u003cp>\u003cb>Guest:\u003c/b>\u003c/p>\n\u003cul>\n\u003cli style=\"font-weight: 400\">\u003cspan style=\"font-weight: 400\">Chandra Ghosh Ippen, child psychologist and associate director, Child Trauma Research Program, UCSF\u003c/span>\u003c/li>\n\u003c/ul>\n\n",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003cp>\u003cb>Stay-at-Home Order for All California\u003cbr>\n\u003c/b>\u003cspan style=\"font-weight: 400\">On Thursday, Gov. Gavin Newsom ordered all California residents to stay at home as much as possible ”until further notice.” All nine Bay Area counties had already issued “shelter-in-place” directives to slow the spread of the coronavirus. Non-essential businesses such as gyms and bars have closed as restaurants offer takeout and delivery service only. Grocery stores, pharmacies and gas stations are some of the businesses allowed to stay open. In the Bay Area, Santa Clara County has been the hardest hit by the coronavirus, with at least 196 confirmed cases and eight deaths.\u003c/span>\u003cspan style=\"font-weight: 400\"> \u003c/span>\u003c/p>\n\u003cp>\u003cb>Guest:\u003c/b>\u003c/p>\n\u003cul>\n\u003cli style=\"font-weight: 400\">\u003cspan style=\"font-weight: 400\">Sam Liccardo, mayor of San Jose\u003c/span>\u003c/li>\n\u003c/ul>\n\u003cp>\u003cb>Congressman Ro Khanna on Federal Response to Coronavirus\u003cbr>\n\u003c/b>\u003cspan style=\"font-weight: 400\">The White House is working with Congress on a trillion-dollar stimulus plan to rescue the economy as airlines, hotels and other industries struggle to survive during the coronavirus crisis. Small businesses are also hurting, facing massive layoffs and possible closures. Among the federal aid being considered — corporate tax cuts and direct payments to most Americans. Meanwhile, coronavirus test kits remain out of reach for most people. Only 22 public health labs in California are testing for COVID-19 although private labs such as Quest Diagnostics are now also screening samples for the virus.\u003c/span>\u003c/p>\n\u003cp>\u003cb>Guest:\u003c/b>\u003cspan style=\"font-weight: 400\">–\u003c/span>\u003c/p>\n\u003cul>\n\u003cli style=\"font-weight: 400\">\u003cspan style=\"font-weight: 400\">U.S. Rep. Ro Khanna, D-Santa Clara\u003c/span>\u003c/li>\n\u003c/ul>\n\u003cp>\u003cb>Mental Health in the Age of Social Distancing and Self-Isolating\u003cbr>\n\u003c/b>\u003cspan style=\"font-weight: 400\">Commercial corridors that would normally be buzzing with activity were eerily quiet this week in the Bay Area. “Shelter-in-place” orders, along with a statewide ban on large gatherings, have upended how millions of us live, work and recreate. On top of all this, nearly all schools in California are closed, creating an additional challenge and stress for parents forced to work from home and cancel outings. \u003c/span>\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"content": "\u003cp>“The richest state in the richest nation” is failing to properly address homelessness, said Gov. Gavin Newsom in his second \u003ca href=\"http://bit.ly/fiorehomelesssots\">state of the state speech\u003c/a> on Wednesday.\u003c/p>\n\u003cp>Newsom put California’s inequity on full display in a singularly focused speech that put homelessness and the state’s housing crisis front and center.\u003c/p>\n\u003cp>The world’s fifth largest economy can surely do much more to get an estimated 151,000 homeless people off the streets.\u003c/p>\n\u003cp>It’s encouraging that Newsom devoted so much attention to homelessness – I sure hope that focus remains and turns into results.\u003c/p>\n\u003cp>[ad fullwidth]\u003c/p>\n\u003cp>\u003c/p>\n",
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"content": "\u003cp>Years later, Rudy Coronado still refers to what happened as “that day.” He thinks about what he said, what he didn’t say and what he wishes he could take back. The signs he missed – and the signs he saw, but ignored.\u003c/p>\n\u003cp>“That day, Carol was acting kind of weird,” he stammered. “She was just different.”\u003c/p>\n\u003cp>Not different the way his wife was usually different, the traits that charmed Rudy when they first met at a doughnut shop in Carson: her simple, no makeup, no celebrity gossip style; her book-loving, hard-working focus.\u003c/p>\n\u003cp>Not quirky, the way she was quirky, separating the rice and beans and vegetables on her plate, and always eating one thing first.\u003c/p>\n\u003cp>Not precise and meticulous, the way she learned to be in the military and then later applied to motherhood, keeping spreadsheets on all the daily activities of their three daughters: Sophia, 2, Yazmine, 1, and Xenia, 3 months.\u003c/p>\n\u003cp>“Every time she breast fed, every bottle she gave them – everything was documented,” Rudy said. “Every time they pooped, how they pooped, everything. Everything.”\u003c/p>\n\u003cp>That day, May 20, 2014, was different. Carol seemed to wake up in a panic. She called her mom over and over, leaving one desperate message after another: “Mommy, please call me. Please — Please — Please. I’m tired. I’m exhausted. I’m hungry,” she said, crying and rambling until the voicemail system cut her off four times in a row.\u003c/p>\n\u003cp>By the sixth message, Carol sounded spent: “Mom. Please call me. I love you. Bye.”\u003c/p>\n\u003cp>By the afternoon, Carol was barely saying anything.\u003c/p>\n\u003cp>When Rudy came inside after working on his ’68 Chevy truck across the street from their home in Torrance, Sophia was running around with no diaper on. There was poop on the carpet, poop on the walls, poop on her hands. Carol was lying on the bed. Her eyes were blank, black.\u003c/p>\n\u003cp>Rudy started yelling. And that’s when he said the thing he wishes he hadn’t.\u003c/p>\n\u003cp>“I was like, ‘Carol – to what extreme is this going to get to?’ And I regret telling her that,” he said. “Because I don’t know if that’s what kind of sparked her to do something dumb? To do that?”\u003c/p>\n\u003cp>Rudy went back outside. He was working on his truck when Carol’s mom came over after her shift driving a local school bus. She went into the house, then ran out, screaming.\u003c/p>\n\u003cp>All three girls were dead. Carol had taken a knife from the kitchen and stabbed them each in the throat and through the heart. Then she laid them on the bed, in order from youngest to oldest.\u003c/p>\n\u003cp>“At first glance, it was weird, ’cause I didn’t see no blood. I don’t remember seeing blood. So when I walked up and I touched Sophie, she was cold,” he recalled, his voice catching. “I was like, ‘What’d you do?’ I couldn’t believe my eyes.”\u003c/p>\n\u003cp>Carol looked at Rudy and told him she loved him. Then she pushed the knife into her own chest.\u003c/p>\n\u003ch2>The Victim or the Monster?\u003c/h2>\n\u003cp>Carol did not die that day. If she had, perhaps she would have been mourned, alongside her daughters, as one of the victims of an inexplicable tragedy. But her survival meant that day would have to be explained — in court, by prosecutors, who would cast Carol as a criminal, driven by revenge, and deserving of society’s harshest judgment.\u003c/p>\n\u003cp>[pullquote size='medium' align='right' citation='Carol Coronado, the day she killed her three daughters']‘Mommy, please call me. Please — Please — Please. I’m tired. I’m exhausted.’[/pullquote]Even though several psychiatrists testified that Carol was suffering from postpartum psychosis, a severe mental illness triggered by childbirth, the judge would set that evidence aside: The law used to evaluate these cases was written a century before any doctor had uttered such a diagnosis, and the web of clinical symptoms simply doesn’t fit the legal test for insanity.\u003c/p>\n\u003cp>In California, more than 100 women are in prison for killing their children, data analysis by KQED shows. The state prison system doesn’t track these numbers, so KQED reviewed thousands of court records and news reports to calculate them. Forty percent of these women took their baby’s life before they were a year old. Seventy percent of those women are serving life sentences.\u003c/p>\n\u003cp>This doesn’t happen in other developed countries. \u003ca href=\"http://www.legislation.gov.uk/ukpga/Geo6/1-2/36/section/1\" target=\"_blank\" rel=\"noopener noreferrer\">England\u003c/a>, Canada, Australia, Japan, Brazil, Sweden and \u003ca href=\"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2174580/\" target=\"_blank\" rel=\"noopener noreferrer\">more than a dozen other nations\u003c/a> have specific laws for these cases. Most are modeled after Britain’s Infanticide Act, which says if a woman harms her child within a year of giving birth, it is presumed she suffered from a postpartum mental illness. She is often sentenced to treatment, not incarceration.\u003c/p>\n\u003cp>“There’s an assumption that something was off,” said Diana Lynn Barnes, a psychotherapist in Southern California who frequently serves as an expert witness in infanticide cases. “Most of the time these women are found guilty of manslaughter, and in many cases they don’t even go to prison.”\u003c/p>\n\u003cp>A few states have pushed for similar laws to allow judges to reconsider and lower harsh sentences with evidence of postpartum mental illness in mind. Only one succeeded: \u003ca href=\"http://www.ilga.gov/legislation/publicacts/fulltext.asp?Name=100-0574\" target=\"_blank\" rel=\"noopener noreferrer\">Illinois\u003c/a> in 2018. When California advocates broached the topic that same year, they said lawmakers told them, “No, not now.”\u003c/p>\n\u003cp>Without a uniform standard for these cases in the U.S., judgments have been \u003ca href=\"https://chicagounbound.uchicago.edu/cgi/viewcontent.cgi?article=1060&context=uclf\" target=\"_blank\" rel=\"noopener noreferrer\">arbitrary and variable\u003c/a>, from life without parole to probation, often depending on the sympathies of the judge or jury. Most courts continue to view women who harm their children the same as trained assassins, experts say.\u003c/p>\n\u003cp>Carol Coronado was charged with three counts of first-degree murder. The Los Angeles County District Attorney’s Office considered \u003ca href=\"https://www.dailybreeze.com/2014/05/23/mother-charged-in-daughters-murders-near-carson-could-face-death-penalty/\" target=\"_blank\" rel=\"noopener noreferrer\">seeking the death penalty\u003c/a>.\u003c/p>\n\u003cp>\u003ca href=\"https://ww2.kqed.org/app/uploads/sites/10/2020/02/postpartumfinal3.png\">\u003cimg loading=\"lazy\" decoding=\"async\" class=\"alignnone size-full wp-image-11800379\" src=\"https://ww2.kqed.org/app/uploads/sites/10/2020/02/postpartumfinal3.png\" alt=\"\" width=\"1920\" height=\"1447\" srcset=\"https://cdn.kqed.org/wp-content/uploads/sites/10/2020/02/postpartumfinal3.png 1920w, https://cdn.kqed.org/wp-content/uploads/sites/10/2020/02/postpartumfinal3-160x121.png 160w, https://cdn.kqed.org/wp-content/uploads/sites/10/2020/02/postpartumfinal3-800x603.png 800w, https://cdn.kqed.org/wp-content/uploads/sites/10/2020/02/postpartumfinal3-1020x769.png 1020w\" sizes=\"(max-width: 1920px) 100vw, 1920px\">\u003c/a>\u003c/p>\n\u003ch2>‘It Was the Disease’\u003c/h2>\n\u003cp>The first time Rudy and Carol Coronado ever heard of postpartum psychosis was after Carol was taken to jail.\u003c/p>\n\u003cp>Doctors later told them that Carol’s break from reality was caused by hormonal changes from her last pregnancy, lack of sleep and the relentless cycle of breastfeeding and caring for three babies under three. \u003ca href=\"https://repository.jmls.edu/cgi/viewcontent.cgi?article=1325&context=lawreview\" target=\"_blank\" rel=\"noopener noreferrer\">Two-thirds of women\u003c/a> who kill their children following childbirth suffer from postpartum psychosis, a 2000 study found.\u003c/p>\n\u003cp>“Everybody who saw her, all of the doctors, within hours and days of this event found that she had some kind of a psychotic disorder,” said Barnes, the expert witness in Carol’s case.\u003c/p>\n\u003cp>Carol’s bizarre behavior, her confusion and detachment, she said, these are all symptoms of postpartum psychosis — and they can develop without warning.\u003c/p>\n\u003cp>“She will look disheveled, not just unkempt, but disheveled. She’ll start to look glazed over,” Barnes said. “She may be looking around as though she’s taking things in from the environment that may or may not be there.”\u003c/p>\n\u003cp>Rudy finally had an explanation for Carol’s sudden change in behavior.\u003c/p>\n\u003cp>“I was thinking like a demon possessed her or something because her eyes went black,” he said. “Now I know that it was the disease.”\u003c/p>\n\u003cp>That’s what frustrates Rudy now — knowing there’s treatment that could have cleared Carol’s symptoms and prevented what happened that day. If he had only known what he was seeing and what else to look for.\u003c/p>\n\u003cp>[pullquote size='medium' align='right' citation='Psychotherapist Diana Lynn Barnes, the expert witness in Carol’s case']‘Everybody who saw her, all of the doctors, within hours and days of this event found that she had some kind of a psychotic disorder.’[/pullquote]Postpartum psychosis affects \u003ca href=\"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3109493/\" target=\"_blank\" rel=\"noopener noreferrer\">one to two moms\u003c/a> out of 1,000 births, but many reproductive psychiatrists believe that is an \u003ca href=\"https://www.kqed.org/news/11710961/she-strived-to-be-the-perfect-mom-and-landed-in-the-psych-ward\" target=\"_blank\" rel=\"noopener noreferrer\">underestimate\u003c/a> because the symptoms are easy to miss, and the doctors who most often see new moms are not trained to recognize them.\u003c/p>\n\u003cp>“Postpartum psychosis often presents with delirium-type symptoms, mainly confusion and disorganized thoughts and not classic hallucinations or paranoia,” said Nirmaljit Dhami, a reproductive psychiatrist in Mountain View. “And the symptoms wax and wane. I had one patient who was confused at times and very clear at other times.”\u003c/p>\n\u003cp>Women with postpartum psychosis often experience a mood disturbance, too, either mania or depression. Carol’s lawyer argued she was depressed, but that her doctors missed that, too. Her primary care doctor, Bijan Ghatan, testified at her trial that Carol didn’t “seem depressed” to him, when he saw her six days before the deaths.\u003c/p>\n\u003cp>“She was her usual jovial self,” Ghatan said.\u003c/p>\n\u003cp>This was 2014, four years before the American College of Obstetricians and Gynecologists \u003ca href=\"https://www.acog.org/Clinical-Guidance-and-Publications/Committee-Opinions/Committee-on-Obstetric-Practice/Screening-for-Perinatal-Depression\" target=\"_blank\" rel=\"noopener noreferrer\">rewrote its guidelines\u003c/a> to recommend doctors administer a formal screening test for postpartum depression, and five years before \u003ca href=\"http://leginfo.legislature.ca.gov/faces/billCompareClient.xhtml?bill_id=201720180AB2193\" target=\"_blank\" rel=\"noopener noreferrer\">California law\u003c/a> made the test \u003ca href=\"https://www.kqed.org/stateofhealth/362521/woman-seeks-help-for-post-partum-depression-the-nurse-calls-the-cops\" target=\"_blank\" rel=\"noopener noreferrer\">mandatory\u003c/a>. So Carol’s doctor said he didn’t do one. He said Carol didn’t seem depressed, so he didn’t ask.\u003c/p>\n\u003cp>“When we enter an exam room, we always say, ‘Hey, you look great! Look at the baby! Yay!’ ” said Torie Sepah, a reproductive psychiatrist who has delivered many babies over many years in family practice. “That leaves no room for the mom to not be doing great. To say, ‘Actually, I’m really miserable.’ ”\u003c/p>\n\u003cp>Women are conditioned to act like they’re happy and have it together, Sepah said. To admit otherwise might invite others to believe she’s a bad mom, or, worst of all, \u003ca href=\"https://www.kqed.org/stateofhealth/362521/woman-seeks-help-for-post-partum-depression-the-nurse-calls-the-cops\" target=\"_blank\" rel=\"noopener noreferrer\">trigger a call\u003c/a> to a government agency that might take the baby away. That’s why testing is now required for all new moms, she said, no matter how they present in the doctor’s office.\u003c/p>\n\u003cp>To Sepah, who treated Carol at a Los Angeles jail in the days after her daughters’ deaths, there is no doubt she had postpartum psychosis.\u003c/p>\n\u003cp>Even before the children were killed, Sepah said, there were clinical signs that something was off, in particular, Carol’s weight loss: She weighed less after having her third baby than she did before getting pregnant with her first.\u003c/p>\n\u003cfigure id=\"attachment_11800227\" class=\"wp-caption alignnone\" style=\"max-width: 800px\">\u003cimg loading=\"lazy\" decoding=\"async\" class=\"size-medium wp-image-11800227\" src=\"https://ww2.kqed.org/app/uploads/sites/10/2020/04/postpartum-psychosis_hospital_Carol-Coronado-qut-800x610.jpg\" alt=\"After Carol Coronado was arrested, she was taken to a hospital where she was treated for self-inflicted stab wounds and given anti-psychotic medication.\" width=\"800\" height=\"610\" srcset=\"https://cdn.kqed.org/wp-content/uploads/sites/10/2020/04/postpartum-psychosis_hospital_Carol-Coronado-qut-800x610.jpg 800w, https://cdn.kqed.org/wp-content/uploads/sites/10/2020/04/postpartum-psychosis_hospital_Carol-Coronado-qut-160x122.jpg 160w, https://cdn.kqed.org/wp-content/uploads/sites/10/2020/04/postpartum-psychosis_hospital_Carol-Coronado-qut-1020x778.jpg 1020w, https://cdn.kqed.org/wp-content/uploads/sites/10/2020/04/postpartum-psychosis_hospital_Carol-Coronado-qut.jpg 1920w\" sizes=\"(max-width: 800px) 100vw, 800px\">\u003cfigcaption class=\"wp-caption-text\">After Carol Coronado was arrested, she was taken to a hospital where she was treated for self-inflicted stab wounds and given anti-psychotic medication. \u003ccite>(Evidence file/Compton Courthouse)\u003c/cite>\u003c/figcaption>\u003c/figure>\n\u003ch2>What Carol Remembers\u003c/h2>\n\u003cp>That day, Carol was treated briefly in the hospital for a punctured lung, then taken straight to jail. She was on suicide watch for the next 21 months.\u003c/p>\n\u003cp>That whole time, Carol says she didn’t know what was going on or what had happened. The scar, from plunging the knife into her chest? She had no idea how it got there.\u003c/p>\n\u003cp>[pullquote size='medium' align='right' citation='Rudy Coronado']‘I was thinking like a demon possessed her or something because her eyes went black. Now I know that it was the disease.’[/pullquote]It’s common for people not to remember what happened during a psychotic episode, said Dr. Sepah. Cognitive pathways short circuit and synapses stop firing correctly: “Instead of going A, B, C, they’re going A, D, G,” she said. Those kinds of thought patterns are too disorganized for memories to form.\u003c/p>\n\u003cp>Carol says her memories stop about a week before the killings.\u003c/p>\n\u003cp>“That’s about the time my brain began to stutter and shut off, memory-wise. Before it completely broke,” she says over a scratchy phone connection from prison.\u003c/p>\n\u003cp>She does remember having nightmares.\u003c/p>\n\u003cp>“I was terrified to go to sleep. I wasn’t showering, taking a bath, brushing my teeth. I wasn’t eating. I wasn’t doing anything.”\u003c/p>\n\u003cp>She couldn’t concentrate. She put socks away in the fridge and milk in the dresser. She felt overwhelmed.\u003c/p>\n\u003cp>“Like I was worthless, helpless, hopeless and I’d be better off dead,” she says. “That nobody needed me. That I was nothing.”\u003c/p>\n\u003ch2>Legal Insanity: The Twinkie Defense to Today\u003c/h2>\n\u003cp>Carol was not much help to her defense attorney. At the time, she did not have the insight into her feelings that she is beginning to have now, five years later.\u003c/p>\n\u003cp>Her lawyer’s strategy was an insanity defense. And here the odds were against them: Less than 1% of criminal cases end with a successful insanity defense, according to \u003ca href=\"https://www.researchgate.net/publication/21370218_The_Volume_and_Characteristics_of_Insanity_Defense_Pleas_An_Eight-State_Study\" target=\"_blank\" rel=\"noopener noreferrer\">a seminal study\u003c/a> from 1991.\u003c/p>\n\u003cp>“It’s a very, very hard defense to make,” said Michelle Oberman, a law professor at Santa Clara University School of Law. “It almost never works in postpartum mental health defenses.”\u003c/p>\n\u003cp>This is because of what happened in 1981, when John Hinckley Jr. fired multiple gunshots in his attempt to assassinate President Ronald Reagan. Hinckley, 25, said he was in love with actress Jodie Foster, and he was convinced that she would fall in love with him if he killed the president.\u003c/p>\n\u003cp>Psychiatrists said Hinckley had schizophrenia and the jury found him not guilty by reason of insanity. He spent the next 30 years in a psychiatric hospital.\u003c/p>\n\u003cp>Americans were outraged: The day after the verdict, \u003ca href=\"https://www.amazon.com/gp/product/0879235330/ref=dbs_a_def_rwt_hsch_vapi_taft_p1_i3\" target=\"_blank\" rel=\"noopener noreferrer\">83% said justice\u003c/a> had not been done. Lawmakers from 38 states rewrote their insanity laws to ensure that another Hinckley “would not get off.”\u003c/p>\n\u003cp>[pullquote size='medium' align='right' citation='Michelle Oberman, law professor at Santa Clara University School of Law']‘The test for proving insanity is so out of keeping with the way that we understand how the mind works.’[/pullquote]One of them was \u003ca href=\"https://en.wikipedia.org/wiki/1982_California_Proposition_8\" target=\"_blank\" rel=\"noopener noreferrer\">California\u003c/a>. The state had its own version of the Hinckley case a few years earlier in 1978, when Dan White climbed through a window into San Francisco City Hall and shot and killed Mayor George Moscone and Supervisor Harvey Milk.\u003c/p>\n\u003cp>White’s lawyer argued what would from then on be remembered as the infamous “Twinkie defense.” He said White suffered from depression, which made him periodically obsessed with junk food, and which compromised his capacity to understand or control what he was doing.\u003c/p>\n\u003cp>The jury found White guilty of manslaughter, rather than murder, and sentenced him to eight years in prison. San Francisco erupted in riots.\u003c/p>\n\u003cp>After this, just when the jury delivered the Hinckley verdict, California voters passed a tough-on-crime measure that included an overhaul of the state’s insanity defense law.\u003c/p>\n\u003cp>California is one of \u003ca href=\"https://criminal.findlaw.com/criminal-procedure/the-insanity-defense-among-the-states.html\" target=\"_blank\" rel=\"noopener noreferrer\">25 states\u003c/a> that now uses a strict legal test for insanity established in 1843. It’s focused on whether a person knows the difference between right and wrong — it’s a moral test, not a clinical one.\u003c/p>\n\u003cp>“The test for proving insanity is so out of keeping with the way that we understand how the mind works,” law professor Michelle Oberman said.\u003c/p>\n\u003cp>And it completely ignores the \u003ca href=\"https://via.library.depaul.edu/cgi/viewcontent.cgi?article=1152&context=jhcl\" target=\"_blank\" rel=\"noopener noreferrer\">risk factors\u003c/a> researchers now know are associated with infanticide: isolation and shame. These moms spend long hours alone with their kids with little to no help, Oberman said.\u003c/p>\n\u003cp>Like a lot of moms, they start to feel like a failure, like a bad mom. But with psychosis in the mix, this belief becomes a full-on delusion. Up to \u003ca href=\"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2174580/\" target=\"_blank\" rel=\"noopener noreferrer\">29% of moms\u003c/a> who kill their kids also kill themselves, and even more attempt suicide.\u003c/p>\n\u003cp>“They start to believe that their children would be better off with them in heaven,” Oberman said.\u003c/p>\n\u003cfigure id=\"attachment_11800241\" class=\"wp-caption alignnone\" style=\"max-width: 800px\">\u003cimg loading=\"lazy\" decoding=\"async\" class=\"size-medium wp-image-11800241\" src=\"https://ww2.kqed.org/app/uploads/sites/10/2020/04/postpartum-psychosis-postpartum-depression-coronado-house-800x609.png\" alt=\"Outside the home of Carol and Rudy Coronado after she killed the couple's three daughters.\" width=\"800\" height=\"609\" srcset=\"https://cdn.kqed.org/wp-content/uploads/sites/10/2020/04/postpartum-psychosis-postpartum-depression-coronado-house-800x609.png 800w, https://cdn.kqed.org/wp-content/uploads/sites/10/2020/04/postpartum-psychosis-postpartum-depression-coronado-house-160x122.png 160w, https://cdn.kqed.org/wp-content/uploads/sites/10/2020/04/postpartum-psychosis-postpartum-depression-coronado-house.png 978w\" sizes=\"(max-width: 800px) 100vw, 800px\">\u003cfigcaption class=\"wp-caption-text\">Outside the home of Carol and Rudy Coronado after she killed the couple’s three daughters. \u003ccite>(Evidence file/Compton Courthouse)\u003c/cite>\u003c/figcaption>\u003c/figure>\n\u003ch2>The Trial\u003c/h2>\n\u003cp>When Carol Coronado went on trial in 2015, she said she couldn’t remember anything from the day her daughters died. And even though this is common with psychotic episodes, it was the biggest weakness in her legal defense.\u003c/p>\n\u003cp>To be found insane, Carol would have to prove that she didn’t know what she was doing was wrong.\u003c/p>\n\u003cp>But Carol says she didn’t know what she was doing at all. She had no explanation for why she did what she did — even a psychotic explanation that her babies would be better off in heaven.\u003c/p>\n\u003cp>[pullquote size='medium' align='right' citation='Carol Coronado']‘I literally kept looking for my children, having delusions that they were on the other side of that door, that they were going to walk in at any moment and I would be able to hold them .’[/pullquote]The prosecutor, Emily Spear, exploited this weakness at every turn, filling the void in Carol’s memory with her own narrative of what happened. She said Carol’s motive was revenge. She said Rudy was a jerk, leaving Carol in charge of three little girls with no help. She said Carol had had enough that day and decided to get back at Rudy by killing their daughters.\u003c/p>\n\u003cp>“The marriage was not a good one,” Spear said during her opening statement. “Finances were very, very tough.”\u003c/p>\n\u003cp>This was a crime of rage, of desperation, but not delusion, she said.\u003c/p>\n\u003cp>Spear interpreted all of Carol’s actions from that day according to this revenge narrative. She framed each move as a premeditated moral failing — while the defense reframed everything as a clinical symptom of psychosis.\u003c/p>\n\u003cp>The prosecutor pointed to statements Carol gave to a detective hours after she was arrested, when he asked her if she killed her children to “get back at her husband.”\u003c/p>\n\u003cp>She said: “If that’s true, do I get a better deal?” When the detective asked her, “What do you need from us in order to tell us what happened?” Carol responded: “Bedpan.”\u003c/p>\n\u003cp>“A psychotic mind has a logic all its own,” said defense expert witness Diana Lynn Barnes. “The state is attempting to use rational, logical thought to explain psychosis, which is illogical and delusional.”\u003c/p>\n\u003cp>This is the thing about postpartum psychosis that most often gets confused in court, she added: the way the symptoms wax and wane.\u003c/p>\n\u003cp>“Because if one moment I’m telling you something, but then in the next moment I can’t remember what I just did – that kind of looks like I’m faking it,” Barnes said. “But it’s actually the clinical presentation of postpartum psychosis.”\u003c/p>\n\u003ch2>Calm, Just Like Me\u003c/h2>\n\u003cp>When Carol came into the visiting room at the Central California Women’s Facility in Chowchilla, she looked — four years after the trial — as she did in the courtroom shot of her that ran in the paper over and over: straight brown hair, a little greasy; pale skin and no makeup.\u003c/p>\n\u003cp>[pullquote size='medium' align='right' citation='Defense expert witness, Diana Lynn Barnes']‘A psychotic mind has a logic all its own. The state is attempting to use rational, logical thought to explain psychosis, which is illogical and delusional.’[/pullquote]Carol is getting some treatment here, but it’s hard to tell if it’s working. Conversation with her jumped around. She easily veered off on tangents. Sometimes she said things that didn’t make sense. On other topics, she went deep into detail.\u003c/p>\n\u003cp>Like the last time her family went to the beach together. Rudy and Sophie went straight for the ocean. But Yazi stayed with Carol. She liked to run her little rake through the sand, look at the lines, then wipe them flat and do it again. Sophie is just like Rudy, social and playful. Yazi is Zen, calm. Just like me, she says.\u003c/p>\n\u003cp>Some of these stories about the girls still come out in the present tense. Throughout her trial, Carol said she thought her children were still alive.\u003c/p>\n\u003cp>“I literally kept looking for my children, having delusions that they were on the other side of that door, that they were going to walk in at any moment and I would be able to hold them,” she said.\u003c/p>\n\u003cp>When her family called her in prison and Carol asked after the girls, her mother just said they were “gone.” Rudy said they were “safe.” Carol figured they were at their godparents’ house or her sister’s house.\u003c/p>\n\u003cp>It was her lawyer who told her what happened. The specifics.\u003c/p>\n\u003cp>“I flipped out. I became hysterical and inconsolable. I was screaming,” Carol said. “I did not believe it.”\u003c/p>\n\u003cp>What Carol’s case came down to was what the judge believed. She opted for a bench trial, deciding not to take her chances on a jury.\u003c/p>\n\u003cp>In the end, the judge said he thought Carol did suffer from a mental health condition. He said he believed she needed treatment.\u003c/p>\n\u003cp>But the insanity law is the law. He said she would have to get treatment in prison. He sentenced her to three consecutive life sentences. No parole.\u003c/p>\n\u003ch2>A Successful Insanity Defense\u003c/h2>\n\u003cp>Angela Burling once stood before a judge like Carol did, after she killed her son. There were a lot of similarities between Angela’s case and Carol’s, except the outcome: One went to prison, and the other went home.\u003c/p>\n\u003cp>“I couldn’t have been more fortunate,” Angela said from her home outside Sacramento.\u003c/p>\n\u003cp>In 1983, nine months after Angela gave birth to her second child, Michael, she stopped breastfeeding him abruptly, rather than weaning him gradually as doctors now recommend. She started having strange thoughts.\u003c/p>\n\u003cp>“I felt I had a calling to expunge the world of evil,” she said.\u003c/p>\n\u003cp>She began to believe her husband, Jeff, was Jesus. She was the bride of Christ. And her baby Michael, was the devil.\u003c/p>\n\u003cp>“I felt I needed to drown Michael,” she said. “But then I thought, ‘He’ll come back to life. Jeff will raise him from the dead in three days. Then the world will know: Jeff is Jesus and peace will reign.’ So that’s what I did. I drowned him.”\u003c/p>\n\u003cp>This was the thing that made the difference in Angela’s case – her account of what happened fit the strict legal test for insanity. She believed her son was the devil and that killing him was the right thing to do.\u003c/p>\n\u003cp>The judge found her not guilty by reason of insanity. He sentenced her to outpatient treatment, meaning Angela could go home.\u003c/p>\n\u003cp>Angela recovered. The psychosis went away and Angela has since been doing well taking regular medication for bipolar disorder – doctors now understand women with the disorder have a \u003ca href=\"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3109493/\" target=\"_blank\" rel=\"noopener noreferrer\">30% likelihood\u003c/a> of experiencing postpartum psychosis. Women who have had postpartum psychosis with one pregnancy have a \u003ca href=\"https://www.ncbi.nlm.nih.gov/pubmed/23651079\" target=\"_blank\" rel=\"noopener noreferrer\">50% chance\u003c/a> of having it again with a subsequent pregnancy.\u003c/p>\n\u003cp>[pullquote size='medium' align='right' citation='Angela Burling, who drowned her son while suffering from postpartum psychosis']‘I make a case for understanding how it can happen to anybody. I could be your sister, or your daughter, or your wife.’[/pullquote]So when Angela became pregnant with her third child, she put together a team of top-notch psychiatric providers to be on call. In their care, she was sure the psychosis would not come back, and even if it did, she was certain no harm would come to her baby.\u003c/p>\n\u003cp>“When I found out I was pregnant, I was the happiest woman on earth,” she said. “Because I felt like, I have another chance – to raise another baby. And prove I’m a good mom.”\u003c/p>\n\u003cp>She went back to school for her master’s degree in nursing, and when her first marriage frayed under the tensions of what happened, she remarried. She and her second husband have been together for 25 years.\u003c/p>\n\u003cp>“I feel like what happened to me is what should happen to other women in my situation,” said Angela, now 64. “I make a case for understanding how it can happen to anybody. I could be your sister, or your daughter, or your wife.”\u003c/p>\n\u003cp>Angela believes the way to level the field for all women is for California to adopt a law similar to Britain’s \u003ca href=\"https://en.wikipedia.org/wiki/Infanticide_Act_1938\">Infanticide Act\u003c/a>, which says any woman who kills her baby is presumed to be mentally ill and faces a maximum charge of manslaughter.\u003c/p>\n\u003cp>Back in 1989, a California senator was so moved by Angela’s story that \u003ca href=\"https://www.documentcloud.org/documents/6769000-Senate-Resolution-23-Complete-Apr-4.html\" target=\"_blank\" rel=\"noopener noreferrer\">he recommended California adopt a version of this law\u003c/a>. But it never went anywhere.\u003c/p>\n\u003cp>“It was a pretty bold resolution,” she said. “I don’t know if society was ready for it then.”\u003c/p>\n\u003cp>Illinois, the one state that has managed to make a small change, now allows judges to give women lower sentences if postpartum mental illness was a factor in her baby’s death. For women already convicted, they could get a new hearing and a reduced sentence.\u003c/p>\n\u003cp>It is the first criminal statute in the U.S. that mentions postpartum psychosis by name. Advocates in Massachusetts, Connecticut and New York are considering a similar law.\u003c/p>\n\u003cp>If California were to follow suit, KQED’s data analysis shows more than 40 women currently in prison could have their cases reheard.\u003c/p>\n\u003cp>“We can’t fail these moms twice,” said Joy Burkhard, executive director of \u003ca href=\"https://www.2020mom.org/\" target=\"_blank\" rel=\"noopener noreferrer\">2020 Mom\u003c/a>, an advocacy group seeking a sponsor for a similar law in California. “They’re failed by the health care system, then again by the legal system.”\u003c/p>\n\u003cfigure id=\"attachment_11800250\" class=\"wp-caption alignnone\" style=\"max-width: 800px\">\u003cimg loading=\"lazy\" decoding=\"async\" class=\"size-medium wp-image-11800250\" src=\"https://ww2.kqed.org/app/uploads/sites/10/2020/04/Edited_Rudy-Coronado-3-reading-letter-qut-800x600.jpg\" alt=\"Rudy Coronado reading a letter from Carol.\" width=\"800\" height=\"600\" srcset=\"https://cdn.kqed.org/wp-content/uploads/sites/10/2020/04/Edited_Rudy-Coronado-3-reading-letter-qut-800x600.jpg 800w, https://cdn.kqed.org/wp-content/uploads/sites/10/2020/04/Edited_Rudy-Coronado-3-reading-letter-qut-160x120.jpg 160w, https://cdn.kqed.org/wp-content/uploads/sites/10/2020/04/Edited_Rudy-Coronado-3-reading-letter-qut-1020x765.jpg 1020w, https://cdn.kqed.org/wp-content/uploads/sites/10/2020/04/Edited_Rudy-Coronado-3-reading-letter-qut.jpg 1920w, https://cdn.kqed.org/wp-content/uploads/sites/10/2020/04/Edited_Rudy-Coronado-3-reading-letter-qut-1832x1374.jpg 1832w, https://cdn.kqed.org/wp-content/uploads/sites/10/2020/04/Edited_Rudy-Coronado-3-reading-letter-qut-1376x1032.jpg 1376w, https://cdn.kqed.org/wp-content/uploads/sites/10/2020/04/Edited_Rudy-Coronado-3-reading-letter-qut-1044x783.jpg 1044w, https://cdn.kqed.org/wp-content/uploads/sites/10/2020/04/Edited_Rudy-Coronado-3-reading-letter-qut-632x474.jpg 632w, https://cdn.kqed.org/wp-content/uploads/sites/10/2020/04/Edited_Rudy-Coronado-3-reading-letter-qut-536x402.jpg 536w\" sizes=\"(max-width: 800px) 100vw, 800px\">\u003cfigcaption class=\"wp-caption-text\">Rudy Coronado reading a letter from Carol at his home in October 2018. \u003ccite>(April Dembosky/KQED)\u003c/cite>\u003c/figcaption>\u003c/figure>\n\u003ch2>‘Speak to the Dads’\u003c/h2>\n\u003cp>Rudy Coronado packs up oil, anti-freeze and wiper blades from his stall at the Alpine Village flea market in Los Angeles. He’s been selling auto parts here since his girls were born, about eight years ago.\u003c/p>\n\u003cp>“I used to want to get rich, to leave something for my daughters. That was my fire, that was my fuel,” said Rudy, now 41. “Now, my fire is gone.”\u003c/p>\n\u003cp>He still feels guilty that he didn’t know what was happening to Carol. He still thinks about the way he talked to her or if there was something he could have done to stop it.\u003c/p>\n\u003cp>[pullquote size='medium' align='right' citation='Joy Burkhard, executive director of 2020 Mom']‘We can’t fail these moms twice. They’re failed by the health care system, then again by the legal system.’[/pullquote]So when women’s health advocates asked him for help, he said yes. He always says yes. He speaks at rallies and forums and in the state Legislature. His testimony helped pass a package of laws in 2018, including the one requiring mandatory screening of new moms for postpartum mental illness.\u003c/p>\n\u003cp>Hospitals now also have to \u003ca href=\"http://leginfo.legislature.ca.gov/faces/billCompareClient.xhtml?bill_id=201720180AB3032\" target=\"_blank\" rel=\"noopener noreferrer\">train staff\u003c/a> how to recognize symptoms, and the state is \u003ca href=\"http://leginfo.legislature.ca.gov/faces/billTextClient.xhtml?bill_id=201720180AB1893\" target=\"_blank\" rel=\"noopener noreferrer\">applying for more federal money\u003c/a> to do more outreach to families.\u003c/p>\n\u003cp>“I always make it an issue to go and speak to the dads,” Rudy said of his public appearances. “Because no one never talks to the dads.”\u003c/p>\n\u003cp>He tells them: Postpartum mental illness is real. Look for it. Research it. Don’t confuse it with “baby mama drama.”\u003c/p>\n\u003cp>“This is a famous thing,” Rudy explained. ” ‘Aw, my baby mama’s trippin.’ Now I tell them, ‘Your baby mama is not trippin. Your baby mama’s going through it.’ ”\u003c/p>\n\u003cp>The work has helped him to understand what happened to Carol that day, but not necessarily to forgive her.\u003c/p>\n\u003cp>“The way I think about it, like, I blame the disease, not Carol,” he said. “It’s not that I forgive Carol. I’ve kind of, somehow, not really blamed her.”\u003c/p>\n\u003cfigure id=\"attachment_11800253\" class=\"wp-caption alignnone\" style=\"max-width: 800px\">\u003cimg loading=\"lazy\" decoding=\"async\" class=\"size-medium wp-image-11800253\" src=\"https://ww2.kqed.org/app/uploads/sites/10/2020/04/Edited_Carol-drawing-close-up-qut-800x600.jpg\" alt=\"Rudy Coronado reading a letter from Carol.\" width=\"800\" height=\"600\" srcset=\"https://cdn.kqed.org/wp-content/uploads/sites/10/2020/04/Edited_Carol-drawing-close-up-qut-800x600.jpg 800w, https://cdn.kqed.org/wp-content/uploads/sites/10/2020/04/Edited_Carol-drawing-close-up-qut-160x120.jpg 160w, https://cdn.kqed.org/wp-content/uploads/sites/10/2020/04/Edited_Carol-drawing-close-up-qut-1020x765.jpg 1020w, https://cdn.kqed.org/wp-content/uploads/sites/10/2020/04/Edited_Carol-drawing-close-up-qut.jpg 1920w, https://cdn.kqed.org/wp-content/uploads/sites/10/2020/04/Edited_Carol-drawing-close-up-qut-1832x1374.jpg 1832w, https://cdn.kqed.org/wp-content/uploads/sites/10/2020/04/Edited_Carol-drawing-close-up-qut-1376x1032.jpg 1376w, https://cdn.kqed.org/wp-content/uploads/sites/10/2020/04/Edited_Carol-drawing-close-up-qut-1044x783.jpg 1044w, https://cdn.kqed.org/wp-content/uploads/sites/10/2020/04/Edited_Carol-drawing-close-up-qut-632x474.jpg 632w, https://cdn.kqed.org/wp-content/uploads/sites/10/2020/04/Edited_Carol-drawing-close-up-qut-536x402.jpg 536w\" sizes=\"(max-width: 800px) 100vw, 800px\">\u003cfigcaption class=\"wp-caption-text\">Rudy Coronado shows a drawing that Carol sent to him from prison in November 2017. \u003ccite>(April Dembosky/KQED)\u003c/cite>\u003c/figcaption>\u003c/figure>\n\u003ch2>‘Should Have Been in a Hospital’\u003c/h2>\n\u003cp>Last October, the Saturday before Carol’s 36th birthday, her parents, David and Julie Piercey, got up at 4 a.m. and drove their Dodge minivan five hours north from Los Angeles to the prison in Chowchilla.\u003c/p>\n\u003cp>In the visiting room with Carol, they didn’t say much. They just played round after round of dominoes. Later in the parking lot, they both said Carol doesn’t belong here.\u003c/p>\n\u003cp>“She had no business going to prison,” her dad said. “She should have been in a hospital, period.”\u003c/p>\n\u003cp>That’s all they wanted from an insanity defense, for Carol to go to a place where she could get real treatment. Not a place where she says other inmates beat her up and call her a baby killer.\u003c/p>\n\u003cp>Her parents said Carol still says things that don’t make sense.\u003c/p>\n\u003cp>“She tells us, ‘I’m going to be getting out in a couple of weeks or three weeks or a month,’ ” David said. “It’s heart-wrenching because I know it’s never going to happen.”\u003c/p>\n\u003cp>Her dad can’t bring himself to say anything in response. Her mom can’t help but say something.\u003c/p>\n\u003cp>” ‘OK Carol. I’ll be happy when you get out, sweetheart!’ ” she said. ” ‘Mama’s waiting for you.’ ”\u003c/p>\n\u003cp>[aside postID=news_11710961,news_11744174,news_362521]These conversations are too hard for Rudy. He doesn’t visit Carol anymore. He hasn’t talked to her on the phone in three years. He said she’s not the same person.\u003c/p>\n\u003cp>Carol still writes to Rudy. He has stacks and stacks of her letters. But he stopped reading those, too. He said she never mentions what happened. She never writes about the girls.\u003c/p>\n\u003cp>She doesn’t even write their names. Just draws cryptic images of threes: three pumpkins, three stars. Three hearts with three letters inside, the girls’ initials: S, Y, X.\u003c/p>\n\u003cp>\u003cem>April Dembosky is a health correspondent at KQED public radio and The California Report. She is also a recipient of a Rosalynn Carter Fellowship for Mental Health Journalism.\u003c/em>\u003c/p>\n\u003cp>\u003cem>KQED’s Kate Wolffe contributed research for this story.\u003c/em>\u003c/p>\n\u003cp>[ad fullwidth]\u003c/p>\n\u003cp>[ad floatright]\u003c/p>\n",
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"excerpt": "Several psychiatric experts said Carol Coronado was psychotic when she killed her three daughters. But proving insanity comes down to a moral test, not a clinical one.",
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"title": "She Killed Her Children. Can We Forgive Her? | KQED",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003cp>Years later, Rudy Coronado still refers to what happened as “that day.” He thinks about what he said, what he didn’t say and what he wishes he could take back. The signs he missed – and the signs he saw, but ignored.\u003c/p>\n\u003cp>“That day, Carol was acting kind of weird,” he stammered. “She was just different.”\u003c/p>\n\u003cp>Not different the way his wife was usually different, the traits that charmed Rudy when they first met at a doughnut shop in Carson: her simple, no makeup, no celebrity gossip style; her book-loving, hard-working focus.\u003c/p>\n\u003cp>Not quirky, the way she was quirky, separating the rice and beans and vegetables on her plate, and always eating one thing first.\u003c/p>\n\u003cp>Not precise and meticulous, the way she learned to be in the military and then later applied to motherhood, keeping spreadsheets on all the daily activities of their three daughters: Sophia, 2, Yazmine, 1, and Xenia, 3 months.\u003c/p>\n\u003cp>“Every time she breast fed, every bottle she gave them – everything was documented,” Rudy said. “Every time they pooped, how they pooped, everything. Everything.”\u003c/p>\n\u003cp>That day, May 20, 2014, was different. Carol seemed to wake up in a panic. She called her mom over and over, leaving one desperate message after another: “Mommy, please call me. Please — Please — Please. I’m tired. I’m exhausted. I’m hungry,” she said, crying and rambling until the voicemail system cut her off four times in a row.\u003c/p>\n\u003cp>By the sixth message, Carol sounded spent: “Mom. Please call me. I love you. Bye.”\u003c/p>\n\u003cp>By the afternoon, Carol was barely saying anything.\u003c/p>\n\u003cp>When Rudy came inside after working on his ’68 Chevy truck across the street from their home in Torrance, Sophia was running around with no diaper on. There was poop on the carpet, poop on the walls, poop on her hands. Carol was lying on the bed. Her eyes were blank, black.\u003c/p>\n\u003cp>Rudy started yelling. And that’s when he said the thing he wishes he hadn’t.\u003c/p>\n\u003cp>“I was like, ‘Carol – to what extreme is this going to get to?’ And I regret telling her that,” he said. “Because I don’t know if that’s what kind of sparked her to do something dumb? To do that?”\u003c/p>\n\u003cp>Rudy went back outside. He was working on his truck when Carol’s mom came over after her shift driving a local school bus. She went into the house, then ran out, screaming.\u003c/p>\n\u003cp>All three girls were dead. Carol had taken a knife from the kitchen and stabbed them each in the throat and through the heart. Then she laid them on the bed, in order from youngest to oldest.\u003c/p>\n\u003cp>“At first glance, it was weird, ’cause I didn’t see no blood. I don’t remember seeing blood. So when I walked up and I touched Sophie, she was cold,” he recalled, his voice catching. “I was like, ‘What’d you do?’ I couldn’t believe my eyes.”\u003c/p>\n\u003cp>Carol looked at Rudy and told him she loved him. Then she pushed the knife into her own chest.\u003c/p>\n\u003ch2>The Victim or the Monster?\u003c/h2>\n\u003cp>Carol did not die that day. If she had, perhaps she would have been mourned, alongside her daughters, as one of the victims of an inexplicable tragedy. But her survival meant that day would have to be explained — in court, by prosecutors, who would cast Carol as a criminal, driven by revenge, and deserving of society’s harshest judgment.\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"content": "\u003cdiv class=\"post-body\">\u003cp>Even though several psychiatrists testified that Carol was suffering from postpartum psychosis, a severe mental illness triggered by childbirth, the judge would set that evidence aside: The law used to evaluate these cases was written a century before any doctor had uttered such a diagnosis, and the web of clinical symptoms simply doesn’t fit the legal test for insanity.\u003c/p>\n\u003cp>In California, more than 100 women are in prison for killing their children, data analysis by KQED shows. The state prison system doesn’t track these numbers, so KQED reviewed thousands of court records and news reports to calculate them. Forty percent of these women took their baby’s life before they were a year old. Seventy percent of those women are serving life sentences.\u003c/p>\n\u003cp>This doesn’t happen in other developed countries. \u003ca href=\"http://www.legislation.gov.uk/ukpga/Geo6/1-2/36/section/1\" target=\"_blank\" rel=\"noopener noreferrer\">England\u003c/a>, Canada, Australia, Japan, Brazil, Sweden and \u003ca href=\"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2174580/\" target=\"_blank\" rel=\"noopener noreferrer\">more than a dozen other nations\u003c/a> have specific laws for these cases. Most are modeled after Britain’s Infanticide Act, which says if a woman harms her child within a year of giving birth, it is presumed she suffered from a postpartum mental illness. She is often sentenced to treatment, not incarceration.\u003c/p>\n\u003cp>“There’s an assumption that something was off,” said Diana Lynn Barnes, a psychotherapist in Southern California who frequently serves as an expert witness in infanticide cases. “Most of the time these women are found guilty of manslaughter, and in many cases they don’t even go to prison.”\u003c/p>\n\u003cp>A few states have pushed for similar laws to allow judges to reconsider and lower harsh sentences with evidence of postpartum mental illness in mind. Only one succeeded: \u003ca href=\"http://www.ilga.gov/legislation/publicacts/fulltext.asp?Name=100-0574\" target=\"_blank\" rel=\"noopener noreferrer\">Illinois\u003c/a> in 2018. When California advocates broached the topic that same year, they said lawmakers told them, “No, not now.”\u003c/p>\n\u003cp>Without a uniform standard for these cases in the U.S., judgments have been \u003ca href=\"https://chicagounbound.uchicago.edu/cgi/viewcontent.cgi?article=1060&context=uclf\" target=\"_blank\" rel=\"noopener noreferrer\">arbitrary and variable\u003c/a>, from life without parole to probation, often depending on the sympathies of the judge or jury. Most courts continue to view women who harm their children the same as trained assassins, experts say.\u003c/p>\n\u003cp>Carol Coronado was charged with three counts of first-degree murder. The Los Angeles County District Attorney’s Office considered \u003ca href=\"https://www.dailybreeze.com/2014/05/23/mother-charged-in-daughters-murders-near-carson-could-face-death-penalty/\" target=\"_blank\" rel=\"noopener noreferrer\">seeking the death penalty\u003c/a>.\u003c/p>\n\u003cp>\u003ca href=\"https://ww2.kqed.org/app/uploads/sites/10/2020/02/postpartumfinal3.png\">\u003cimg loading=\"lazy\" decoding=\"async\" class=\"alignnone size-full wp-image-11800379\" src=\"https://ww2.kqed.org/app/uploads/sites/10/2020/02/postpartumfinal3.png\" alt=\"\" width=\"1920\" height=\"1447\" srcset=\"https://cdn.kqed.org/wp-content/uploads/sites/10/2020/02/postpartumfinal3.png 1920w, https://cdn.kqed.org/wp-content/uploads/sites/10/2020/02/postpartumfinal3-160x121.png 160w, https://cdn.kqed.org/wp-content/uploads/sites/10/2020/02/postpartumfinal3-800x603.png 800w, https://cdn.kqed.org/wp-content/uploads/sites/10/2020/02/postpartumfinal3-1020x769.png 1020w\" sizes=\"(max-width: 1920px) 100vw, 1920px\">\u003c/a>\u003c/p>\n\u003ch2>‘It Was the Disease’\u003c/h2>\n\u003cp>The first time Rudy and Carol Coronado ever heard of postpartum psychosis was after Carol was taken to jail.\u003c/p>\n\u003cp>Doctors later told them that Carol’s break from reality was caused by hormonal changes from her last pregnancy, lack of sleep and the relentless cycle of breastfeeding and caring for three babies under three. \u003ca href=\"https://repository.jmls.edu/cgi/viewcontent.cgi?article=1325&context=lawreview\" target=\"_blank\" rel=\"noopener noreferrer\">Two-thirds of women\u003c/a> who kill their children following childbirth suffer from postpartum psychosis, a 2000 study found.\u003c/p>\n\u003cp>“Everybody who saw her, all of the doctors, within hours and days of this event found that she had some kind of a psychotic disorder,” said Barnes, the expert witness in Carol’s case.\u003c/p>\n\u003cp>Carol’s bizarre behavior, her confusion and detachment, she said, these are all symptoms of postpartum psychosis — and they can develop without warning.\u003c/p>\n\u003cp>“She will look disheveled, not just unkempt, but disheveled. She’ll start to look glazed over,” Barnes said. “She may be looking around as though she’s taking things in from the environment that may or may not be there.”\u003c/p>\n\u003cp>Rudy finally had an explanation for Carol’s sudden change in behavior.\u003c/p>\n\u003cp>“I was thinking like a demon possessed her or something because her eyes went black,” he said. “Now I know that it was the disease.”\u003c/p>\n\u003cp>That’s what frustrates Rudy now — knowing there’s treatment that could have cleared Carol’s symptoms and prevented what happened that day. If he had only known what he was seeing and what else to look for.\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"content": "\u003cdiv class=\"post-body\">\u003cp>Postpartum psychosis affects \u003ca href=\"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3109493/\" target=\"_blank\" rel=\"noopener noreferrer\">one to two moms\u003c/a> out of 1,000 births, but many reproductive psychiatrists believe that is an \u003ca href=\"https://www.kqed.org/news/11710961/she-strived-to-be-the-perfect-mom-and-landed-in-the-psych-ward\" target=\"_blank\" rel=\"noopener noreferrer\">underestimate\u003c/a> because the symptoms are easy to miss, and the doctors who most often see new moms are not trained to recognize them.\u003c/p>\n\u003cp>“Postpartum psychosis often presents with delirium-type symptoms, mainly confusion and disorganized thoughts and not classic hallucinations or paranoia,” said Nirmaljit Dhami, a reproductive psychiatrist in Mountain View. “And the symptoms wax and wane. I had one patient who was confused at times and very clear at other times.”\u003c/p>\n\u003cp>Women with postpartum psychosis often experience a mood disturbance, too, either mania or depression. Carol’s lawyer argued she was depressed, but that her doctors missed that, too. Her primary care doctor, Bijan Ghatan, testified at her trial that Carol didn’t “seem depressed” to him, when he saw her six days before the deaths.\u003c/p>\n\u003cp>“She was her usual jovial self,” Ghatan said.\u003c/p>\n\u003cp>This was 2014, four years before the American College of Obstetricians and Gynecologists \u003ca href=\"https://www.acog.org/Clinical-Guidance-and-Publications/Committee-Opinions/Committee-on-Obstetric-Practice/Screening-for-Perinatal-Depression\" target=\"_blank\" rel=\"noopener noreferrer\">rewrote its guidelines\u003c/a> to recommend doctors administer a formal screening test for postpartum depression, and five years before \u003ca href=\"http://leginfo.legislature.ca.gov/faces/billCompareClient.xhtml?bill_id=201720180AB2193\" target=\"_blank\" rel=\"noopener noreferrer\">California law\u003c/a> made the test \u003ca href=\"https://www.kqed.org/stateofhealth/362521/woman-seeks-help-for-post-partum-depression-the-nurse-calls-the-cops\" target=\"_blank\" rel=\"noopener noreferrer\">mandatory\u003c/a>. So Carol’s doctor said he didn’t do one. He said Carol didn’t seem depressed, so he didn’t ask.\u003c/p>\n\u003cp>“When we enter an exam room, we always say, ‘Hey, you look great! Look at the baby! Yay!’ ” said Torie Sepah, a reproductive psychiatrist who has delivered many babies over many years in family practice. “That leaves no room for the mom to not be doing great. To say, ‘Actually, I’m really miserable.’ ”\u003c/p>\n\u003cp>Women are conditioned to act like they’re happy and have it together, Sepah said. To admit otherwise might invite others to believe she’s a bad mom, or, worst of all, \u003ca href=\"https://www.kqed.org/stateofhealth/362521/woman-seeks-help-for-post-partum-depression-the-nurse-calls-the-cops\" target=\"_blank\" rel=\"noopener noreferrer\">trigger a call\u003c/a> to a government agency that might take the baby away. That’s why testing is now required for all new moms, she said, no matter how they present in the doctor’s office.\u003c/p>\n\u003cp>To Sepah, who treated Carol at a Los Angeles jail in the days after her daughters’ deaths, there is no doubt she had postpartum psychosis.\u003c/p>\n\u003cp>Even before the children were killed, Sepah said, there were clinical signs that something was off, in particular, Carol’s weight loss: She weighed less after having her third baby than she did before getting pregnant with her first.\u003c/p>\n\u003cfigure id=\"attachment_11800227\" class=\"wp-caption alignnone\" style=\"max-width: 800px\">\u003cimg loading=\"lazy\" decoding=\"async\" class=\"size-medium wp-image-11800227\" src=\"https://ww2.kqed.org/app/uploads/sites/10/2020/04/postpartum-psychosis_hospital_Carol-Coronado-qut-800x610.jpg\" alt=\"After Carol Coronado was arrested, she was taken to a hospital where she was treated for self-inflicted stab wounds and given anti-psychotic medication.\" width=\"800\" height=\"610\" srcset=\"https://cdn.kqed.org/wp-content/uploads/sites/10/2020/04/postpartum-psychosis_hospital_Carol-Coronado-qut-800x610.jpg 800w, https://cdn.kqed.org/wp-content/uploads/sites/10/2020/04/postpartum-psychosis_hospital_Carol-Coronado-qut-160x122.jpg 160w, https://cdn.kqed.org/wp-content/uploads/sites/10/2020/04/postpartum-psychosis_hospital_Carol-Coronado-qut-1020x778.jpg 1020w, https://cdn.kqed.org/wp-content/uploads/sites/10/2020/04/postpartum-psychosis_hospital_Carol-Coronado-qut.jpg 1920w\" sizes=\"(max-width: 800px) 100vw, 800px\">\u003cfigcaption class=\"wp-caption-text\">After Carol Coronado was arrested, she was taken to a hospital where she was treated for self-inflicted stab wounds and given anti-psychotic medication. \u003ccite>(Evidence file/Compton Courthouse)\u003c/cite>\u003c/figcaption>\u003c/figure>\n\u003ch2>What Carol Remembers\u003c/h2>\n\u003cp>That day, Carol was treated briefly in the hospital for a punctured lung, then taken straight to jail. She was on suicide watch for the next 21 months.\u003c/p>\n\u003cp>That whole time, Carol says she didn’t know what was going on or what had happened. The scar, from plunging the knife into her chest? She had no idea how it got there.\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"content": "‘I was thinking like a demon possessed her or something because her eyes went black. Now I know that it was the disease.’",
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"content": "\u003cdiv class=\"post-body\">\u003cp>It’s common for people not to remember what happened during a psychotic episode, said Dr. Sepah. Cognitive pathways short circuit and synapses stop firing correctly: “Instead of going A, B, C, they’re going A, D, G,” she said. Those kinds of thought patterns are too disorganized for memories to form.\u003c/p>\n\u003cp>Carol says her memories stop about a week before the killings.\u003c/p>\n\u003cp>“That’s about the time my brain began to stutter and shut off, memory-wise. Before it completely broke,” she says over a scratchy phone connection from prison.\u003c/p>\n\u003cp>She does remember having nightmares.\u003c/p>\n\u003cp>“I was terrified to go to sleep. I wasn’t showering, taking a bath, brushing my teeth. I wasn’t eating. I wasn’t doing anything.”\u003c/p>\n\u003cp>She couldn’t concentrate. She put socks away in the fridge and milk in the dresser. She felt overwhelmed.\u003c/p>\n\u003cp>“Like I was worthless, helpless, hopeless and I’d be better off dead,” she says. “That nobody needed me. That I was nothing.”\u003c/p>\n\u003ch2>Legal Insanity: The Twinkie Defense to Today\u003c/h2>\n\u003cp>Carol was not much help to her defense attorney. At the time, she did not have the insight into her feelings that she is beginning to have now, five years later.\u003c/p>\n\u003cp>Her lawyer’s strategy was an insanity defense. And here the odds were against them: Less than 1% of criminal cases end with a successful insanity defense, according to \u003ca href=\"https://www.researchgate.net/publication/21370218_The_Volume_and_Characteristics_of_Insanity_Defense_Pleas_An_Eight-State_Study\" target=\"_blank\" rel=\"noopener noreferrer\">a seminal study\u003c/a> from 1991.\u003c/p>\n\u003cp>“It’s a very, very hard defense to make,” said Michelle Oberman, a law professor at Santa Clara University School of Law. “It almost never works in postpartum mental health defenses.”\u003c/p>\n\u003cp>This is because of what happened in 1981, when John Hinckley Jr. fired multiple gunshots in his attempt to assassinate President Ronald Reagan. Hinckley, 25, said he was in love with actress Jodie Foster, and he was convinced that she would fall in love with him if he killed the president.\u003c/p>\n\u003cp>Psychiatrists said Hinckley had schizophrenia and the jury found him not guilty by reason of insanity. He spent the next 30 years in a psychiatric hospital.\u003c/p>\n\u003cp>Americans were outraged: The day after the verdict, \u003ca href=\"https://www.amazon.com/gp/product/0879235330/ref=dbs_a_def_rwt_hsch_vapi_taft_p1_i3\" target=\"_blank\" rel=\"noopener noreferrer\">83% said justice\u003c/a> had not been done. Lawmakers from 38 states rewrote their insanity laws to ensure that another Hinckley “would not get off.”\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"content": "‘The test for proving insanity is so out of keeping with the way that we understand how the mind works.’",
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"content": "\u003cdiv class=\"post-body\">\u003cp>One of them was \u003ca href=\"https://en.wikipedia.org/wiki/1982_California_Proposition_8\" target=\"_blank\" rel=\"noopener noreferrer\">California\u003c/a>. The state had its own version of the Hinckley case a few years earlier in 1978, when Dan White climbed through a window into San Francisco City Hall and shot and killed Mayor George Moscone and Supervisor Harvey Milk.\u003c/p>\n\u003cp>White’s lawyer argued what would from then on be remembered as the infamous “Twinkie defense.” He said White suffered from depression, which made him periodically obsessed with junk food, and which compromised his capacity to understand or control what he was doing.\u003c/p>\n\u003cp>The jury found White guilty of manslaughter, rather than murder, and sentenced him to eight years in prison. San Francisco erupted in riots.\u003c/p>\n\u003cp>After this, just when the jury delivered the Hinckley verdict, California voters passed a tough-on-crime measure that included an overhaul of the state’s insanity defense law.\u003c/p>\n\u003cp>California is one of \u003ca href=\"https://criminal.findlaw.com/criminal-procedure/the-insanity-defense-among-the-states.html\" target=\"_blank\" rel=\"noopener noreferrer\">25 states\u003c/a> that now uses a strict legal test for insanity established in 1843. It’s focused on whether a person knows the difference between right and wrong — it’s a moral test, not a clinical one.\u003c/p>\n\u003cp>“The test for proving insanity is so out of keeping with the way that we understand how the mind works,” law professor Michelle Oberman said.\u003c/p>\n\u003cp>And it completely ignores the \u003ca href=\"https://via.library.depaul.edu/cgi/viewcontent.cgi?article=1152&context=jhcl\" target=\"_blank\" rel=\"noopener noreferrer\">risk factors\u003c/a> researchers now know are associated with infanticide: isolation and shame. These moms spend long hours alone with their kids with little to no help, Oberman said.\u003c/p>\n\u003cp>Like a lot of moms, they start to feel like a failure, like a bad mom. But with psychosis in the mix, this belief becomes a full-on delusion. Up to \u003ca href=\"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2174580/\" target=\"_blank\" rel=\"noopener noreferrer\">29% of moms\u003c/a> who kill their kids also kill themselves, and even more attempt suicide.\u003c/p>\n\u003cp>“They start to believe that their children would be better off with them in heaven,” Oberman said.\u003c/p>\n\u003cfigure id=\"attachment_11800241\" class=\"wp-caption alignnone\" style=\"max-width: 800px\">\u003cimg loading=\"lazy\" decoding=\"async\" class=\"size-medium wp-image-11800241\" src=\"https://ww2.kqed.org/app/uploads/sites/10/2020/04/postpartum-psychosis-postpartum-depression-coronado-house-800x609.png\" alt=\"Outside the home of Carol and Rudy Coronado after she killed the couple's three daughters.\" width=\"800\" height=\"609\" srcset=\"https://cdn.kqed.org/wp-content/uploads/sites/10/2020/04/postpartum-psychosis-postpartum-depression-coronado-house-800x609.png 800w, https://cdn.kqed.org/wp-content/uploads/sites/10/2020/04/postpartum-psychosis-postpartum-depression-coronado-house-160x122.png 160w, https://cdn.kqed.org/wp-content/uploads/sites/10/2020/04/postpartum-psychosis-postpartum-depression-coronado-house.png 978w\" sizes=\"(max-width: 800px) 100vw, 800px\">\u003cfigcaption class=\"wp-caption-text\">Outside the home of Carol and Rudy Coronado after she killed the couple’s three daughters. \u003ccite>(Evidence file/Compton Courthouse)\u003c/cite>\u003c/figcaption>\u003c/figure>\n\u003ch2>The Trial\u003c/h2>\n\u003cp>When Carol Coronado went on trial in 2015, she said she couldn’t remember anything from the day her daughters died. And even though this is common with psychotic episodes, it was the biggest weakness in her legal defense.\u003c/p>\n\u003cp>To be found insane, Carol would have to prove that she didn’t know what she was doing was wrong.\u003c/p>\n\u003cp>But Carol says she didn’t know what she was doing at all. She had no explanation for why she did what she did — even a psychotic explanation that her babies would be better off in heaven.\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"content": "‘I literally kept looking for my children, having delusions that they were on the other side of that door, that they were going to walk in at any moment and I would be able to hold them .’",
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"content": "\u003cdiv class=\"post-body\">\u003cp>The prosecutor, Emily Spear, exploited this weakness at every turn, filling the void in Carol’s memory with her own narrative of what happened. She said Carol’s motive was revenge. She said Rudy was a jerk, leaving Carol in charge of three little girls with no help. She said Carol had had enough that day and decided to get back at Rudy by killing their daughters.\u003c/p>\n\u003cp>“The marriage was not a good one,” Spear said during her opening statement. “Finances were very, very tough.”\u003c/p>\n\u003cp>This was a crime of rage, of desperation, but not delusion, she said.\u003c/p>\n\u003cp>Spear interpreted all of Carol’s actions from that day according to this revenge narrative. She framed each move as a premeditated moral failing — while the defense reframed everything as a clinical symptom of psychosis.\u003c/p>\n\u003cp>The prosecutor pointed to statements Carol gave to a detective hours after she was arrested, when he asked her if she killed her children to “get back at her husband.”\u003c/p>\n\u003cp>She said: “If that’s true, do I get a better deal?” When the detective asked her, “What do you need from us in order to tell us what happened?” Carol responded: “Bedpan.”\u003c/p>\n\u003cp>“A psychotic mind has a logic all its own,” said defense expert witness Diana Lynn Barnes. “The state is attempting to use rational, logical thought to explain psychosis, which is illogical and delusional.”\u003c/p>\n\u003cp>This is the thing about postpartum psychosis that most often gets confused in court, she added: the way the symptoms wax and wane.\u003c/p>\n\u003cp>“Because if one moment I’m telling you something, but then in the next moment I can’t remember what I just did – that kind of looks like I’m faking it,” Barnes said. “But it’s actually the clinical presentation of postpartum psychosis.”\u003c/p>\n\u003ch2>Calm, Just Like Me\u003c/h2>\n\u003cp>When Carol came into the visiting room at the Central California Women’s Facility in Chowchilla, she looked — four years after the trial — as she did in the courtroom shot of her that ran in the paper over and over: straight brown hair, a little greasy; pale skin and no makeup.\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"content": "\u003cdiv class=\"post-body\">\u003cp>Carol is getting some treatment here, but it’s hard to tell if it’s working. Conversation with her jumped around. She easily veered off on tangents. Sometimes she said things that didn’t make sense. On other topics, she went deep into detail.\u003c/p>\n\u003cp>Like the last time her family went to the beach together. Rudy and Sophie went straight for the ocean. But Yazi stayed with Carol. She liked to run her little rake through the sand, look at the lines, then wipe them flat and do it again. Sophie is just like Rudy, social and playful. Yazi is Zen, calm. Just like me, she says.\u003c/p>\n\u003cp>Some of these stories about the girls still come out in the present tense. Throughout her trial, Carol said she thought her children were still alive.\u003c/p>\n\u003cp>“I literally kept looking for my children, having delusions that they were on the other side of that door, that they were going to walk in at any moment and I would be able to hold them,” she said.\u003c/p>\n\u003cp>When her family called her in prison and Carol asked after the girls, her mother just said they were “gone.” Rudy said they were “safe.” Carol figured they were at their godparents’ house or her sister’s house.\u003c/p>\n\u003cp>It was her lawyer who told her what happened. The specifics.\u003c/p>\n\u003cp>“I flipped out. I became hysterical and inconsolable. I was screaming,” Carol said. “I did not believe it.”\u003c/p>\n\u003cp>What Carol’s case came down to was what the judge believed. She opted for a bench trial, deciding not to take her chances on a jury.\u003c/p>\n\u003cp>In the end, the judge said he thought Carol did suffer from a mental health condition. He said he believed she needed treatment.\u003c/p>\n\u003cp>But the insanity law is the law. He said she would have to get treatment in prison. He sentenced her to three consecutive life sentences. No parole.\u003c/p>\n\u003ch2>A Successful Insanity Defense\u003c/h2>\n\u003cp>Angela Burling once stood before a judge like Carol did, after she killed her son. There were a lot of similarities between Angela’s case and Carol’s, except the outcome: One went to prison, and the other went home.\u003c/p>\n\u003cp>“I couldn’t have been more fortunate,” Angela said from her home outside Sacramento.\u003c/p>\n\u003cp>In 1983, nine months after Angela gave birth to her second child, Michael, she stopped breastfeeding him abruptly, rather than weaning him gradually as doctors now recommend. She started having strange thoughts.\u003c/p>\n\u003cp>“I felt I had a calling to expunge the world of evil,” she said.\u003c/p>\n\u003cp>She began to believe her husband, Jeff, was Jesus. She was the bride of Christ. And her baby Michael, was the devil.\u003c/p>\n\u003cp>“I felt I needed to drown Michael,” she said. “But then I thought, ‘He’ll come back to life. Jeff will raise him from the dead in three days. Then the world will know: Jeff is Jesus and peace will reign.’ So that’s what I did. I drowned him.”\u003c/p>\n\u003cp>This was the thing that made the difference in Angela’s case – her account of what happened fit the strict legal test for insanity. She believed her son was the devil and that killing him was the right thing to do.\u003c/p>\n\u003cp>The judge found her not guilty by reason of insanity. He sentenced her to outpatient treatment, meaning Angela could go home.\u003c/p>\n\u003cp>Angela recovered. The psychosis went away and Angela has since been doing well taking regular medication for bipolar disorder – doctors now understand women with the disorder have a \u003ca href=\"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3109493/\" target=\"_blank\" rel=\"noopener noreferrer\">30% likelihood\u003c/a> of experiencing postpartum psychosis. Women who have had postpartum psychosis with one pregnancy have a \u003ca href=\"https://www.ncbi.nlm.nih.gov/pubmed/23651079\" target=\"_blank\" rel=\"noopener noreferrer\">50% chance\u003c/a> of having it again with a subsequent pregnancy.\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"content": "‘I make a case for understanding how it can happen to anybody. I could be your sister, or your daughter, or your wife.’",
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"content": "\u003cdiv class=\"post-body\">\u003cp>So when Angela became pregnant with her third child, she put together a team of top-notch psychiatric providers to be on call. In their care, she was sure the psychosis would not come back, and even if it did, she was certain no harm would come to her baby.\u003c/p>\n\u003cp>“When I found out I was pregnant, I was the happiest woman on earth,” she said. “Because I felt like, I have another chance – to raise another baby. And prove I’m a good mom.”\u003c/p>\n\u003cp>She went back to school for her master’s degree in nursing, and when her first marriage frayed under the tensions of what happened, she remarried. She and her second husband have been together for 25 years.\u003c/p>\n\u003cp>“I feel like what happened to me is what should happen to other women in my situation,” said Angela, now 64. “I make a case for understanding how it can happen to anybody. I could be your sister, or your daughter, or your wife.”\u003c/p>\n\u003cp>Angela believes the way to level the field for all women is for California to adopt a law similar to Britain’s \u003ca href=\"https://en.wikipedia.org/wiki/Infanticide_Act_1938\">Infanticide Act\u003c/a>, which says any woman who kills her baby is presumed to be mentally ill and faces a maximum charge of manslaughter.\u003c/p>\n\u003cp>Back in 1989, a California senator was so moved by Angela’s story that \u003ca href=\"https://www.documentcloud.org/documents/6769000-Senate-Resolution-23-Complete-Apr-4.html\" target=\"_blank\" rel=\"noopener noreferrer\">he recommended California adopt a version of this law\u003c/a>. But it never went anywhere.\u003c/p>\n\u003cp>“It was a pretty bold resolution,” she said. “I don’t know if society was ready for it then.”\u003c/p>\n\u003cp>Illinois, the one state that has managed to make a small change, now allows judges to give women lower sentences if postpartum mental illness was a factor in her baby’s death. For women already convicted, they could get a new hearing and a reduced sentence.\u003c/p>\n\u003cp>It is the first criminal statute in the U.S. that mentions postpartum psychosis by name. Advocates in Massachusetts, Connecticut and New York are considering a similar law.\u003c/p>\n\u003cp>If California were to follow suit, KQED’s data analysis shows more than 40 women currently in prison could have their cases reheard.\u003c/p>\n\u003cp>“We can’t fail these moms twice,” said Joy Burkhard, executive director of \u003ca href=\"https://www.2020mom.org/\" target=\"_blank\" rel=\"noopener noreferrer\">2020 Mom\u003c/a>, an advocacy group seeking a sponsor for a similar law in California. “They’re failed by the health care system, then again by the legal system.”\u003c/p>\n\u003cfigure id=\"attachment_11800250\" class=\"wp-caption alignnone\" style=\"max-width: 800px\">\u003cimg loading=\"lazy\" decoding=\"async\" class=\"size-medium wp-image-11800250\" src=\"https://ww2.kqed.org/app/uploads/sites/10/2020/04/Edited_Rudy-Coronado-3-reading-letter-qut-800x600.jpg\" alt=\"Rudy Coronado reading a letter from Carol.\" width=\"800\" height=\"600\" srcset=\"https://cdn.kqed.org/wp-content/uploads/sites/10/2020/04/Edited_Rudy-Coronado-3-reading-letter-qut-800x600.jpg 800w, https://cdn.kqed.org/wp-content/uploads/sites/10/2020/04/Edited_Rudy-Coronado-3-reading-letter-qut-160x120.jpg 160w, https://cdn.kqed.org/wp-content/uploads/sites/10/2020/04/Edited_Rudy-Coronado-3-reading-letter-qut-1020x765.jpg 1020w, https://cdn.kqed.org/wp-content/uploads/sites/10/2020/04/Edited_Rudy-Coronado-3-reading-letter-qut.jpg 1920w, https://cdn.kqed.org/wp-content/uploads/sites/10/2020/04/Edited_Rudy-Coronado-3-reading-letter-qut-1832x1374.jpg 1832w, https://cdn.kqed.org/wp-content/uploads/sites/10/2020/04/Edited_Rudy-Coronado-3-reading-letter-qut-1376x1032.jpg 1376w, https://cdn.kqed.org/wp-content/uploads/sites/10/2020/04/Edited_Rudy-Coronado-3-reading-letter-qut-1044x783.jpg 1044w, https://cdn.kqed.org/wp-content/uploads/sites/10/2020/04/Edited_Rudy-Coronado-3-reading-letter-qut-632x474.jpg 632w, https://cdn.kqed.org/wp-content/uploads/sites/10/2020/04/Edited_Rudy-Coronado-3-reading-letter-qut-536x402.jpg 536w\" sizes=\"(max-width: 800px) 100vw, 800px\">\u003cfigcaption class=\"wp-caption-text\">Rudy Coronado reading a letter from Carol at his home in October 2018. \u003ccite>(April Dembosky/KQED)\u003c/cite>\u003c/figcaption>\u003c/figure>\n\u003ch2>‘Speak to the Dads’\u003c/h2>\n\u003cp>Rudy Coronado packs up oil, anti-freeze and wiper blades from his stall at the Alpine Village flea market in Los Angeles. He’s been selling auto parts here since his girls were born, about eight years ago.\u003c/p>\n\u003cp>“I used to want to get rich, to leave something for my daughters. That was my fire, that was my fuel,” said Rudy, now 41. “Now, my fire is gone.”\u003c/p>\n\u003cp>He still feels guilty that he didn’t know what was happening to Carol. He still thinks about the way he talked to her or if there was something he could have done to stop it.\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"content": "\u003cdiv class=\"post-body\">\u003cp>So when women’s health advocates asked him for help, he said yes. He always says yes. He speaks at rallies and forums and in the state Legislature. His testimony helped pass a package of laws in 2018, including the one requiring mandatory screening of new moms for postpartum mental illness.\u003c/p>\n\u003cp>Hospitals now also have to \u003ca href=\"http://leginfo.legislature.ca.gov/faces/billCompareClient.xhtml?bill_id=201720180AB3032\" target=\"_blank\" rel=\"noopener noreferrer\">train staff\u003c/a> how to recognize symptoms, and the state is \u003ca href=\"http://leginfo.legislature.ca.gov/faces/billTextClient.xhtml?bill_id=201720180AB1893\" target=\"_blank\" rel=\"noopener noreferrer\">applying for more federal money\u003c/a> to do more outreach to families.\u003c/p>\n\u003cp>“I always make it an issue to go and speak to the dads,” Rudy said of his public appearances. “Because no one never talks to the dads.”\u003c/p>\n\u003cp>He tells them: Postpartum mental illness is real. Look for it. Research it. Don’t confuse it with “baby mama drama.”\u003c/p>\n\u003cp>“This is a famous thing,” Rudy explained. ” ‘Aw, my baby mama’s trippin.’ Now I tell them, ‘Your baby mama is not trippin. Your baby mama’s going through it.’ ”\u003c/p>\n\u003cp>The work has helped him to understand what happened to Carol that day, but not necessarily to forgive her.\u003c/p>\n\u003cp>“The way I think about it, like, I blame the disease, not Carol,” he said. “It’s not that I forgive Carol. I’ve kind of, somehow, not really blamed her.”\u003c/p>\n\u003cfigure id=\"attachment_11800253\" class=\"wp-caption alignnone\" style=\"max-width: 800px\">\u003cimg loading=\"lazy\" decoding=\"async\" class=\"size-medium wp-image-11800253\" src=\"https://ww2.kqed.org/app/uploads/sites/10/2020/04/Edited_Carol-drawing-close-up-qut-800x600.jpg\" alt=\"Rudy Coronado reading a letter from Carol.\" width=\"800\" height=\"600\" srcset=\"https://cdn.kqed.org/wp-content/uploads/sites/10/2020/04/Edited_Carol-drawing-close-up-qut-800x600.jpg 800w, https://cdn.kqed.org/wp-content/uploads/sites/10/2020/04/Edited_Carol-drawing-close-up-qut-160x120.jpg 160w, https://cdn.kqed.org/wp-content/uploads/sites/10/2020/04/Edited_Carol-drawing-close-up-qut-1020x765.jpg 1020w, https://cdn.kqed.org/wp-content/uploads/sites/10/2020/04/Edited_Carol-drawing-close-up-qut.jpg 1920w, https://cdn.kqed.org/wp-content/uploads/sites/10/2020/04/Edited_Carol-drawing-close-up-qut-1832x1374.jpg 1832w, https://cdn.kqed.org/wp-content/uploads/sites/10/2020/04/Edited_Carol-drawing-close-up-qut-1376x1032.jpg 1376w, https://cdn.kqed.org/wp-content/uploads/sites/10/2020/04/Edited_Carol-drawing-close-up-qut-1044x783.jpg 1044w, https://cdn.kqed.org/wp-content/uploads/sites/10/2020/04/Edited_Carol-drawing-close-up-qut-632x474.jpg 632w, https://cdn.kqed.org/wp-content/uploads/sites/10/2020/04/Edited_Carol-drawing-close-up-qut-536x402.jpg 536w\" sizes=\"(max-width: 800px) 100vw, 800px\">\u003cfigcaption class=\"wp-caption-text\">Rudy Coronado shows a drawing that Carol sent to him from prison in November 2017. \u003ccite>(April Dembosky/KQED)\u003c/cite>\u003c/figcaption>\u003c/figure>\n\u003ch2>‘Should Have Been in a Hospital’\u003c/h2>\n\u003cp>Last October, the Saturday before Carol’s 36th birthday, her parents, David and Julie Piercey, got up at 4 a.m. and drove their Dodge minivan five hours north from Los Angeles to the prison in Chowchilla.\u003c/p>\n\u003cp>In the visiting room with Carol, they didn’t say much. They just played round after round of dominoes. Later in the parking lot, they both said Carol doesn’t belong here.\u003c/p>\n\u003cp>“She had no business going to prison,” her dad said. “She should have been in a hospital, period.”\u003c/p>\n\u003cp>That’s all they wanted from an insanity defense, for Carol to go to a place where she could get real treatment. Not a place where she says other inmates beat her up and call her a baby killer.\u003c/p>\n\u003cp>Her parents said Carol still says things that don’t make sense.\u003c/p>\n\u003cp>“She tells us, ‘I’m going to be getting out in a couple of weeks or three weeks or a month,’ ” David said. “It’s heart-wrenching because I know it’s never going to happen.”\u003c/p>\n\u003cp>Her dad can’t bring himself to say anything in response. Her mom can’t help but say something.\u003c/p>\n\u003cp>” ‘OK Carol. I’ll be happy when you get out, sweetheart!’ ” she said. ” ‘Mama’s waiting for you.’ ”\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"content": "\u003cdiv class=\"post-body\">\u003cp>These conversations are too hard for Rudy. He doesn’t visit Carol anymore. He hasn’t talked to her on the phone in three years. He said she’s not the same person.\u003c/p>\n\u003cp>Carol still writes to Rudy. He has stacks and stacks of her letters. But he stopped reading those, too. He said she never mentions what happened. She never writes about the girls.\u003c/p>\n\u003cp>She doesn’t even write their names. Just draws cryptic images of threes: three pumpkins, three stars. Three hearts with three letters inside, the girls’ initials: S, Y, X.\u003c/p>\n\u003cp>\u003cem>April Dembosky is a health correspondent at KQED public radio and The California Report. She is also a recipient of a Rosalynn Carter Fellowship for Mental Health Journalism.\u003c/em>\u003c/p>\n\u003cp>\u003cem>KQED’s Kate Wolffe contributed research for this story.\u003c/em>\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"content": "\u003cp>The state is facing mounting pressure to enforce \u003ca href=\"https://calmatters.org/projects/california-mental-health-care-parity/\" target=\"_blank\" rel=\"noopener noreferrer\">parity laws that are supposed to guarantee equal care for physical and mental health issues\u003c/a>— with a spotlight this week on mental health care problems at health giant Kaiser Permanente.\u003c/p>\n\u003cp>This week, Kaiser mental health clinicians are on a\u003ca href=\"https://www.kqed.org/news/11791527/kaiser-therapists-strike-again-over-long-wait-times\" target=\"_blank\" rel=\"noopener noreferrer\"> five-day strike\u003c/a>, protesting long patient wait times and strenuous working conditions for providers. They say children and adults with serious mental health needs, including schizophrenia, anxiety and severe depression, are often waiting six to eight weeks — sometimes longer — to see a therapist. And they contend that Kaiser’s behavioral health services have in many ways worsened in recent years, despite being under a corrective plan overseen by the state \u003ca href=\"http://www.dmhc.ca.gov/?referral=healthhelp.ca.gov\" target=\"_blank\" rel=\"noopener noreferrer\">Department of Managed Health Care\u003c/a>.\u003c/p>\n\u003cp>[pullquote size=\"medium\" align=\"right\" citation=\"Fred Seavey, research director for the National Union of Healthcare Workers\"]‘If these were cardiac catheterization services that were not functioning, if a health plan was screwing those up, (the state) would jump on that and require those to be fixed right away. Meanwhile they’re just sitting on their hands.’[/pullquote]\u003c/p>\n\u003cp>Striking clinicians on Thursday plan to march from the Capitol to the state agency to protest what they called “the agency’s failure to enforce parity legislation.” They specifically criticized the agency for not releasing reports from an outside monitor that would show whether Kaiser is meeting mental health access benchmarks outlined in a 2017 settlement agreement.\u003c/p>\n\u003cp>“I’m very disappointed with the DMHC — it’s just stunning,” said Fred Seavey, research director for the National Union of Healthcare Workers, which organized the strike. “It’s just criminal in my mind that they’re not holding Kaiser accountable.”\u003c/p>\n\u003cp>“If these were cardiac catheterization services that were not functioning, if a health plan was screwing those up, (the state) would jump on that and require those to be fixed right away,” he said. “Meanwhile they’re just sitting on their hands. We have people who are dying in the course of this failed enforcement by the DMHC.”\u003c/p>\n\u003cp>Seavey criticized Kaiser’s “massive influence” with the department, and said the union may call an open-ended strike in early 2020 if Kaiser does not improve mental health services.\u003c/p>\n\u003cp>After the state’s agreement with Kaiser in 2017, the health plan created a process to ensure that follow-up appointments are available in a timely manner, the state agency said in an emailed statement. Providers who cannot get their patients in for follow-up care are supposed to notify their managers.\u003c/p>\n\u003cp>The department fined Kaiser $4 million in 2013, but the plan did not agree to a settlement with corrective actions until 2017. That \u003ca href=\"https://wpso.dmhc.ca.gov/enfactions/docs/2895/1500394196511.pdf\">settlement agreement\u003c/a> is publicly available. But while the state department receives regular updates about the plan’s progress, it says it keeps that information confidential “in compliance with federal and state laws.”\u003c/p>\n\u003cp>Kaiser spokesman Marc Brown called the strikes “disruptive to patient access, operational care and service and…frankly irresponsible.” In an emailed statement, he said this is the union’s sixth strike this year (Seavey said most of these strikes were done at individual clinics, as opposed to statewide).\u003c/p>\n\u003cp>[aside postID=\"arts_13871243,news_11786202,news_11756742\" label=\"Mental Health Care in California\"]“We take any concern raised about our care very seriously, and always investigate and respond thoroughly,” Brown said. “However, it is inappropriate for the union to file multiple, often unwarranted complaints, and attack Kaiser Permanente’s reputation.”\u003c/p>\n\u003cp>More than a dozen complaints the union has filed with the DMHC in the past year — and sought to publicize — decry violations of network adequacy rules, timely access rules and long appointment wait times, among others. One complaint said patients in Pasadena with schizophrenia, serious major depression and bipolar disorder were waiting three or four months for an appointment. Another complaint said therapists in San Francisco were being told to keep alternative paper wait lists — or tell patients to call back later — to hide its failure to see children in a timely manner.\u003c/p>\n\u003cp>\u003ca href=\"https://calmatters.org/projects/californians-struggle-to-get-mental-health-care/\">Frustration with access to mental health services at Kaiser\u003c/a> extends beyond the HMO as well. According to a\u003ca href=\"https://www.chcf.org/publication/poll-shows-californians-health-priorities-new-governor-legislature/\"> statewide poll\u003c/a> by the Kaiser Family Foundation and the California Health Care Foundation released earlier this year, more than half of those surveyed thought that most people with mental health conditions are unable to get the services they need. A \u003ca href=\"http://www.milliman.com/bowman/\">recent analysis by healthcare consultants Milliman Inc.\u003c/a> showed that California patients were more than five times more likely to have office visits for mental health or addiction problems from providers outside their insurance plan’s network compared with their counterparts seeking medical or surgical care.\u003c/p>\n\u003cp>Concerned about these access problems, State Controller Betty Yee, who sits on the board of the California Public Employees’ Retirement System, wrote a letter to its executive officer requesting a series of hearings with its largest plans: Kaiser, Anthem, Blue Shield and United Healthcare. Kaiser, with more than 640,000 enrollees, has by far the highest membership.\u003c/p>\n\u003cp>“We negotiate contracts; we have leverage,” Yee said Tuesday, as the CalPERS board was conducting its third hearing on the subject. “To the extent that parity is not guaranteed, we need to make sure that our plans are living up to the law.”\u003c/p>\n\u003cp>State Treasurer Fiona Ma, who also sits on the board, said she’s seen firsthand how her own mother and brother have struggled to get adequate, timely care for depression. She’s been writing letters asking plans to explain the long wait times and high cost of care, and the growing numbers of people suffering from mental illnesses. Plans need to get more creative in finding solutions, she said.\u003cbr>\n[pullquote size=\"medium\" align=\"right\" citation=\"Cindy Striegel, a vice president at Kaiser\"]‘This is not an issue or an area that we can solve overnight. We can’t just throw more money at it. We can’t throw more effort at it. We’re doing the things that we feel are the most important.’[/pullquote]\u003c/p>\n\u003cp>“Kaiser is out on strike again today,” she said. “Why is that? Is it because everything is going well? No, it’s because things are not going well in the system and patients are getting sicker and sicker.”\u003c/p>\n\u003cp>Kaiser and the Department of Managed Health Care both sent representatives to speak at a November meeting of the CalPERS Pension and Benefits Committee.\u003c/p>\n\u003cp>DMHC director Shelley Rouillard told board members that day that the department takes its responsibility as a consumer protection agency very seriously, and outlined some of its offerings: a consumer help center, independent medical review process, regular monitoring of plans to ensure they have enough providers and enforcement actions against plans that violate timely access requirements. She said Kaiser has met all of the benchmarks of the 2017 settlement agreement so far.\u003c/p>\n\u003cp>But she also acknowledged that, in some cases, it takes years to correct problems with plans.\u003c/p>\n\u003cp>https://youtu.be/zDuLZ1oJR8k\u003c/p>\n\u003cp>Cindy Striegel, a vice president at Kaiser, said it has hired more than 1,200 full-time therapists or clinicians since 2015, an increase of 30 percent. At the same time, she said, membership has grown about 20 percent. Kaiser is continuing to recruit and currently has about 300 positions posted or in the hiring process.\u003c/p>\n\u003cp>“This is not an issue or an area that we can solve overnight,” she said. “We can’t just throw more money at it. We can’t throw more effort at it. We’re doing the things that we feel are the most important. They just take some time to implement.”\u003c/p>\n\u003cp>Susan Whitney, a psychiatric social worker at the Kern County Kaiser Medical Center in Bakersfield, said she has worked for Kaiser for 15 years. Since the state first cited Kaiser in 2013, she said, “access to care has definitely gotten worse.” She believes that’s because the state has focused its scrutiny on how long it takes to get patients in the door for an initial appointment.\u003c/p>\n\u003cp>“People can get in right away to be seen, but then we’re left saying we don’t have a follow-up appointment for them for 6 to 8 or 12 weeks,’” she said. Whitney, who works with children and teenagers, said those delays in follow-up care exist even for children have anxiety so bad they can’t go to school, or show signs of being suicidal. The network of community providers that Kaiser sometimes outsources care to has been “completely overwhelmed,” she said.\u003c/p>\n\u003cp>“There is no therapy treatment model where you see a provider every 6 to 8 weeks,” she said. “Therapy just doesn’t work that way.”\u003c/p>\n\u003cp>Vicki Hoskins, a psychiatric therapist at Kaiser’s Euclid Medical Offices in Anaheim, said last week she spent the day on the phone telling patients in crisis they can’t get an appointment for a therapist until March.\u003c/p>\n\u003cp>“It’s super stressful,” she said. “Everyone’s frustrated. It’s always been bad, but this is the worst it’s ever been.”\u003c/p>\n\u003cp>She attributes the problem, in part, to Kaiser adding members before they build up their base of clinicians, along with greater awareness of suicidality and depression. A reduced stigma around mental illness also has led more people to seek help.\u003c/p>\n\u003cp>“When someone finally decides to seek help and then are told they can’t get help for 3 months, it makes them feel worse,” she said.\u003c/p>\n\u003cp>[aside tag=\"kaiser-permanente\" label=\"More on Kaiser\"]Des Michel, 27, from Oakland, said they reached out to Kaiser in July of 2018 in crisis, seeking care for gender identity affirming therapy. Michel’s first appointment was at the end of October, at which point they received referrals to Beacon Health Services and then, a few months later to Magellan.\u003c/p>\n\u003cp>“It was overall, and still is, a very negative experience for my mental health,” Michel said. “It’s been a year and a half. I’m probably just going to suck it up and pay privately, but financially and ethically it wasn’t something I wanted to do because I feel strongly that Kaiser has an obligation to their patients to be providing mental health care.”\u003c/p>\n\u003cp>Jeanette Zollinger, 42, of Thousand Oaks, said she, too, ended up paying out of pocket to see an outside therapist when she was having a “pretty rough breakdown.”\u003c/p>\n\u003cp>“It was literally life-saving,” she said. “I really didn’t feel like I had an option to go through Kaiser when I really needed help. They just didn’t have the staffing.”\u003c/p>\n\u003cp>Rouillard at the state Department of Managed Health Care maintains that the state is doing its job, but it is challenging given the shortage of providers.\u003c/p>\n\u003cp>“Access to behavioral health care services is a very high priority for our governor and for the Secretary of the Health and Human Services Agency,” she said. “The department has been working hard to ensure health plans comply with all requirements regarding timely access to care and federal and state mental health law — parity laws.”\u003c/p>\n\u003cp>Critics are unconvinced. Meiram Bendat, a Los Angeles attorney and psychotherapist, won a much-touted case this spring in which a Northern California federal court found that United Behavioral Health had wrongly restricted treatment for patients with mental health and substance abuse disorders in order to cut costs.\u003c/p>\n\u003cp>Kaiser therapists “have every reason to be fed up with the DMHC, which over the years has created an illusion of public service by fining it a few million dollars – trivial penalties that have no actual deterrent effect,” he said. He said Kaiser could compensate for network inadequacies by covering out-of-network mental health treatment at billed charges\u003c/p>\n\u003cp>“If DMHC were truly committed to mental health reforms and not just to its public image, it would have insisted on such measures long ago,” he said.\u003c/p>\n\u003cp>\u003cem>Jocelyn Wiener is a CalMatters contributing writer. Her reporting is made possible by a grant from the California Health Care Foundation.\u003c/em>\u003c/p>\n\u003cp>\u003cem>\u003ca href=\"http://CalMatters.org\" target=\"_blank\" rel=\"noopener noreferrer\">CalMatters.org \u003c/a>is a nonprofit, nonpartisan media venture explaining California policies and politics.\u003c/em>\u003c/p>\n\u003cp>[ad fullwidth]\u003c/p>\n\u003cp>[ad floatright]\u003c/p>\n",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>Striking clinicians on Thursday plan to march from the Capitol to the state agency to protest what they called “the agency’s failure to enforce parity legislation.” They specifically criticized the agency for not releasing reports from an outside monitor that would show whether Kaiser is meeting mental health access benchmarks outlined in a 2017 settlement agreement.\u003c/p>\n\u003cp>“I’m very disappointed with the DMHC — it’s just stunning,” said Fred Seavey, research director for the National Union of Healthcare Workers, which organized the strike. “It’s just criminal in my mind that they’re not holding Kaiser accountable.”\u003c/p>\n\u003cp>“If these were cardiac catheterization services that were not functioning, if a health plan was screwing those up, (the state) would jump on that and require those to be fixed right away,” he said. “Meanwhile they’re just sitting on their hands. We have people who are dying in the course of this failed enforcement by the DMHC.”\u003c/p>\n\u003cp>Seavey criticized Kaiser’s “massive influence” with the department, and said the union may call an open-ended strike in early 2020 if Kaiser does not improve mental health services.\u003c/p>\n\u003cp>After the state’s agreement with Kaiser in 2017, the health plan created a process to ensure that follow-up appointments are available in a timely manner, the state agency said in an emailed statement. Providers who cannot get their patients in for follow-up care are supposed to notify their managers.\u003c/p>\n\u003cp>The department fined Kaiser $4 million in 2013, but the plan did not agree to a settlement with corrective actions until 2017. That \u003ca href=\"https://wpso.dmhc.ca.gov/enfactions/docs/2895/1500394196511.pdf\">settlement agreement\u003c/a> is publicly available. But while the state department receives regular updates about the plan’s progress, it says it keeps that information confidential “in compliance with federal and state laws.”\u003c/p>\n\u003cp>Kaiser spokesman Marc Brown called the strikes “disruptive to patient access, operational care and service and…frankly irresponsible.” In an emailed statement, he said this is the union’s sixth strike this year (Seavey said most of these strikes were done at individual clinics, as opposed to statewide).\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"content": "\u003cdiv class=\"post-body\">\u003cp>“We take any concern raised about our care very seriously, and always investigate and respond thoroughly,” Brown said. “However, it is inappropriate for the union to file multiple, often unwarranted complaints, and attack Kaiser Permanente’s reputation.”\u003c/p>\n\u003cp>More than a dozen complaints the union has filed with the DMHC in the past year — and sought to publicize — decry violations of network adequacy rules, timely access rules and long appointment wait times, among others. One complaint said patients in Pasadena with schizophrenia, serious major depression and bipolar disorder were waiting three or four months for an appointment. Another complaint said therapists in San Francisco were being told to keep alternative paper wait lists — or tell patients to call back later — to hide its failure to see children in a timely manner.\u003c/p>\n\u003cp>\u003ca href=\"https://calmatters.org/projects/californians-struggle-to-get-mental-health-care/\">Frustration with access to mental health services at Kaiser\u003c/a> extends beyond the HMO as well. According to a\u003ca href=\"https://www.chcf.org/publication/poll-shows-californians-health-priorities-new-governor-legislature/\"> statewide poll\u003c/a> by the Kaiser Family Foundation and the California Health Care Foundation released earlier this year, more than half of those surveyed thought that most people with mental health conditions are unable to get the services they need. A \u003ca href=\"http://www.milliman.com/bowman/\">recent analysis by healthcare consultants Milliman Inc.\u003c/a> showed that California patients were more than five times more likely to have office visits for mental health or addiction problems from providers outside their insurance plan’s network compared with their counterparts seeking medical or surgical care.\u003c/p>\n\u003cp>Concerned about these access problems, State Controller Betty Yee, who sits on the board of the California Public Employees’ Retirement System, wrote a letter to its executive officer requesting a series of hearings with its largest plans: Kaiser, Anthem, Blue Shield and United Healthcare. Kaiser, with more than 640,000 enrollees, has by far the highest membership.\u003c/p>\n\u003cp>“We negotiate contracts; we have leverage,” Yee said Tuesday, as the CalPERS board was conducting its third hearing on the subject. “To the extent that parity is not guaranteed, we need to make sure that our plans are living up to the law.”\u003c/p>\n\u003cp>State Treasurer Fiona Ma, who also sits on the board, said she’s seen firsthand how her own mother and brother have struggled to get adequate, timely care for depression. She’s been writing letters asking plans to explain the long wait times and high cost of care, and the growing numbers of people suffering from mental illnesses. Plans need to get more creative in finding solutions, she said.\u003cbr>\n\u003c/p>\u003c/div>",
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"content": "‘This is not an issue or an area that we can solve overnight. We can’t just throw more money at it. We can’t throw more effort at it. We’re doing the things that we feel are the most important.’",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>“Kaiser is out on strike again today,” she said. “Why is that? Is it because everything is going well? No, it’s because things are not going well in the system and patients are getting sicker and sicker.”\u003c/p>\n\u003cp>Kaiser and the Department of Managed Health Care both sent representatives to speak at a November meeting of the CalPERS Pension and Benefits Committee.\u003c/p>\n\u003cp>DMHC director Shelley Rouillard told board members that day that the department takes its responsibility as a consumer protection agency very seriously, and outlined some of its offerings: a consumer help center, independent medical review process, regular monitoring of plans to ensure they have enough providers and enforcement actions against plans that violate timely access requirements. She said Kaiser has met all of the benchmarks of the 2017 settlement agreement so far.\u003c/p>\n\u003cp>But she also acknowledged that, in some cases, it takes years to correct problems with plans.\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/zDuLZ1oJR8k'\n title='//www.youtube.com/embed/zDuLZ1oJR8k'\n allowfullscreen='true'\n style='border:0;'>\u003c/iframe>\n \u003c/span>\n \u003c/span>\u003c/p>\u003cp>\u003cp>Cindy Striegel, a vice president at Kaiser, said it has hired more than 1,200 full-time therapists or clinicians since 2015, an increase of 30 percent. At the same time, she said, membership has grown about 20 percent. Kaiser is continuing to recruit and currently has about 300 positions posted or in the hiring process.\u003c/p>\n\u003cp>“This is not an issue or an area that we can solve overnight,” she said. “We can’t just throw more money at it. We can’t throw more effort at it. We’re doing the things that we feel are the most important. They just take some time to implement.”\u003c/p>\n\u003cp>Susan Whitney, a psychiatric social worker at the Kern County Kaiser Medical Center in Bakersfield, said she has worked for Kaiser for 15 years. Since the state first cited Kaiser in 2013, she said, “access to care has definitely gotten worse.” She believes that’s because the state has focused its scrutiny on how long it takes to get patients in the door for an initial appointment.\u003c/p>\n\u003cp>“People can get in right away to be seen, but then we’re left saying we don’t have a follow-up appointment for them for 6 to 8 or 12 weeks,’” she said. Whitney, who works with children and teenagers, said those delays in follow-up care exist even for children have anxiety so bad they can’t go to school, or show signs of being suicidal. The network of community providers that Kaiser sometimes outsources care to has been “completely overwhelmed,” she said.\u003c/p>\n\u003cp>“There is no therapy treatment model where you see a provider every 6 to 8 weeks,” she said. “Therapy just doesn’t work that way.”\u003c/p>\n\u003cp>Vicki Hoskins, a psychiatric therapist at Kaiser’s Euclid Medical Offices in Anaheim, said last week she spent the day on the phone telling patients in crisis they can’t get an appointment for a therapist until March.\u003c/p>\n\u003cp>“It’s super stressful,” she said. “Everyone’s frustrated. It’s always been bad, but this is the worst it’s ever been.”\u003c/p>\n\u003cp>She attributes the problem, in part, to Kaiser adding members before they build up their base of clinicians, along with greater awareness of suicidality and depression. A reduced stigma around mental illness also has led more people to seek help.\u003c/p>\n\u003cp>“When someone finally decides to seek help and then are told they can’t get help for 3 months, it makes them feel worse,” she said.\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"content": "\u003cdiv class=\"post-body\">\u003cp>Des Michel, 27, from Oakland, said they reached out to Kaiser in July of 2018 in crisis, seeking care for gender identity affirming therapy. Michel’s first appointment was at the end of October, at which point they received referrals to Beacon Health Services and then, a few months later to Magellan.\u003c/p>\n\u003cp>“It was overall, and still is, a very negative experience for my mental health,” Michel said. “It’s been a year and a half. I’m probably just going to suck it up and pay privately, but financially and ethically it wasn’t something I wanted to do because I feel strongly that Kaiser has an obligation to their patients to be providing mental health care.”\u003c/p>\n\u003cp>Jeanette Zollinger, 42, of Thousand Oaks, said she, too, ended up paying out of pocket to see an outside therapist when she was having a “pretty rough breakdown.”\u003c/p>\n\u003cp>“It was literally life-saving,” she said. “I really didn’t feel like I had an option to go through Kaiser when I really needed help. They just didn’t have the staffing.”\u003c/p>\n\u003cp>Rouillard at the state Department of Managed Health Care maintains that the state is doing its job, but it is challenging given the shortage of providers.\u003c/p>\n\u003cp>“Access to behavioral health care services is a very high priority for our governor and for the Secretary of the Health and Human Services Agency,” she said. “The department has been working hard to ensure health plans comply with all requirements regarding timely access to care and federal and state mental health law — parity laws.”\u003c/p>\n\u003cp>Critics are unconvinced. Meiram Bendat, a Los Angeles attorney and psychotherapist, won a much-touted case this spring in which a Northern California federal court found that United Behavioral Health had wrongly restricted treatment for patients with mental health and substance abuse disorders in order to cut costs.\u003c/p>\n\u003cp>Kaiser therapists “have every reason to be fed up with the DMHC, which over the years has created an illusion of public service by fining it a few million dollars – trivial penalties that have no actual deterrent effect,” he said. He said Kaiser could compensate for network inadequacies by covering out-of-network mental health treatment at billed charges\u003c/p>\n\u003cp>“If DMHC were truly committed to mental health reforms and not just to its public image, it would have insisted on such measures long ago,” he said.\u003c/p>\n\u003cp>\u003cem>Jocelyn Wiener is a CalMatters contributing writer. Her reporting is made possible by a grant from the California Health Care Foundation.\u003c/em>\u003c/p>\n\u003cp>\u003cem>\u003ca href=\"http://CalMatters.org\" target=\"_blank\" rel=\"noopener noreferrer\">CalMatters.org \u003c/a>is a nonprofit, nonpartisan media venture explaining California policies and politics.\u003c/em>\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"content": "\u003cp>Four thousand mental health clinicians are walking off their jobs at Kaiser Permanente today, affecting care at more than 100 clinics across the state. The week-long strike is the second in a year, as the workers’ union and Kaiser management remain deadlocked on a new contract.\u003c/p>\n\u003cp>Therapists’ main complaint is long wait times for patients. While industry best practice is to see clients every one to two weeks, the majority of Kaiser clinicians say their patients with anxiety and depression are forced to wait four to eight weeks between appointments.\u003c/p>\n\u003cp>“That is substandard care, that is unethical care and that is dangerous care,” said Mickey Fitzpatrick, a clinical psychologist at Kaiser in Pleasanton. “That increases the risk of suicide and, indeed, people have taken their lives.”\u003c/p>\n\u003cp>They're asking Kaiser to hire more therapists to reduce wait times and ease the workload on employees. They also want higher wages and more time to complete administrative tasks.\u003c/p>\n\u003cp>Under the current contract, Fitzpatrick said he sees four to five new patients every week, in addition to all his current patients. Unlike therapists in private practice, Fitzpatrick can not turn patients away or tell them he doesn’t have room to see them.\u003c/p>\n\u003cp>[ad fullwidth]\u003c/p>\n\u003cp>“There's no cap to my caseload,” he said. “It just grows and grows and grows.”\u003c/p>\n\u003cp>Kaiser executives say they are investing millions of dollars in new facilities and workforce development, including educational programs for new therapists to meet the increasing demand for mental health care.\u003c/p>\n\u003cp>The company says it increased its workforce by 30% in the last three years, including hiring nearly 500 new therapists last year, but patient demand has grown 23% in the same time.\u003c/p>\n\u003cp>“The good news is that the stigma has been removed and people that need care are actually coming forward to get it,” said Michelle Gaskill-Hames, senior vice president for hospital and health plan operations at Kaiser Northern California. But, “it's creating a rise in demand at a time when there is a shortage of workers.”\u003c/p>\n\u003cfigure id=\"attachment_11791582\" class=\"wp-caption aligncenter\" style=\"max-width: 1920px\">\u003ca href=\"https://ww2.kqed.org/news/2019/12/16/kaiser-therapists-strike-again-over-long-wait-times/img_3737/\" rel=\"attachment wp-att-11791582\">\u003cimg src=\"https://ww2.kqed.org/app/uploads/sites/10/2019/12/IMG_3737.jpg\" alt=\"\" width=\"1920\" height=\"1440\" class=\"size-full wp-image-11791582\" srcset=\"https://ww2.kqed.org/app/uploads/sites/10/2019/12/IMG_3737.jpg 1920w, https://ww2.kqed.org/app/uploads/sites/10/2019/12/IMG_3737-160x120.jpg 160w, https://ww2.kqed.org/app/uploads/sites/10/2019/12/IMG_3737-800x600.jpg 800w, https://ww2.kqed.org/app/uploads/sites/10/2019/12/IMG_3737-1020x765.jpg 1020w, https://ww2.kqed.org/app/uploads/sites/10/2019/12/IMG_3737-1200x900.jpg 1200w, https://ww2.kqed.org/app/uploads/sites/10/2019/12/IMG_3737-1832x1374.jpg 1832w, https://ww2.kqed.org/app/uploads/sites/10/2019/12/IMG_3737-1376x1032.jpg 1376w, https://ww2.kqed.org/app/uploads/sites/10/2019/12/IMG_3737-1044x783.jpg 1044w, https://ww2.kqed.org/app/uploads/sites/10/2019/12/IMG_3737-632x474.jpg 632w, https://ww2.kqed.org/app/uploads/sites/10/2019/12/IMG_3737-536x402.jpg 536w\" sizes=\"(max-width: 1920px) 100vw, 1920px\">\u003c/a>\u003cfigcaption class=\"wp-caption-text\">A Kaiser clinician during the previous Dec. 2018 strike. \u003ccite>(April Dembosky/KQED)\u003c/cite>\u003c/figcaption>\u003c/figure>\n\u003cp>Research shows there is a shortage of clinicians in some positions in some regions of the country, particularly for psychiatrists and adolescent psychiatrists in rural areas. But union members say that's not the case in most Kaiser locations, where graduate schools are “pumping out” masters and doctorate level mental health clinicians.\u003c/p>\n\u003cp>“The issue is that few people want to work for Kaiser,” said Fitzpatrick, “because once they’re working for Kaiser, they quickly burn out. They’re overloaded, they're overworked, and so they leave.”\u003c/p>\n\u003cp>California regulators have substantiated some of the therapists’ allegations. In 2013, the state Department of Managed Health Care fined Kaiser $4 million for long wait times for individual appointments and for forcing patients into group therapy who didn’t want it. The agency cited Kaiser again in 2015 and 2017 over wait times.\u003c/p>\n\u003cp>Kaiser executives say the company has improved since then, meeting the state’s standard for timely access 90% of the time in 2019, according to its own data.\u003c/p>\n\u003cp>But therapists say Kaiser is crunching the numbers to make the situation look better than it is on the ground. For example, one of Kaiser’s solutions to improving wait times for initial appointments, which they must provide with 48 hours for urgent needs and 10 days for non-urgent matters under state law, is to do intakes over the phone through its Connect 2 Care program.\u003c/p>\n\u003cp>[aside postID='news_11763856,news_11760375,news_11748021,news_11711317' label='Previous Kaiser Strikes']Clinicians say this means patients get quick access to an initial 30-minute phone appointment, but are still waiting weeks or a month to start therapy in earnest with a clinician who can see them on a regular basis, and are then waiting months between appointments.\u003c/p>\n\u003cp>“It’s mainly giving patients more of the run-around, of needing to talk to multiple providers before getting to their assigned therapist,” said Kirstin Quinn Siegel, a licensed marriage and family therapist at Kaiser’s Richmond clinic, who marched on the picket lines on Monday. “So right now they have improved their initial access, but it hasn't really made a dent in our return access.”\u003c/p>\n\u003cp>During the strike, emergency mental health services will be available and Kaiser is working to minimize disruption to ongoing care, but some appointments may need to be rescheduled.\u003c/p>\n\u003cp>“We have plans in place, but we're really disappointed that we haven't been able to draw this to resolution,” said Kaiser’s Gaskill-Hames. “This is the sixth time that there's been a strike called in 12 months, and each time it can be disruptive to our members.”\u003c/p>\n\u003cp>Two previous strikes were called off, once in June, after state lawmakers asked both sides to return to the bargaining table, and another time in November, after Kaiser CEO Bernard Tyson died unexpectedly.\u003c/p>\n\u003cp>\u003c/p>\n\u003cp>\u003cem>Sara Hossaini contributed reporting.\u003c/em>\u003c/p>\n\n",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003cp>Four thousand mental health clinicians are walking off their jobs at Kaiser Permanente today, affecting care at more than 100 clinics across the state. The week-long strike is the second in a year, as the workers’ union and Kaiser management remain deadlocked on a new contract.\u003c/p>\n\u003cp>Therapists’ main complaint is long wait times for patients. While industry best practice is to see clients every one to two weeks, the majority of Kaiser clinicians say their patients with anxiety and depression are forced to wait four to eight weeks between appointments.\u003c/p>\n\u003cp>“That is substandard care, that is unethical care and that is dangerous care,” said Mickey Fitzpatrick, a clinical psychologist at Kaiser in Pleasanton. “That increases the risk of suicide and, indeed, people have taken their lives.”\u003c/p>\n\u003cp>They're asking Kaiser to hire more therapists to reduce wait times and ease the workload on employees. They also want higher wages and more time to complete administrative tasks.\u003c/p>\n\u003cp>Under the current contract, Fitzpatrick said he sees four to five new patients every week, in addition to all his current patients. Unlike therapists in private practice, Fitzpatrick can not turn patients away or tell them he doesn’t have room to see them.\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>“There's no cap to my caseload,” he said. “It just grows and grows and grows.”\u003c/p>\n\u003cp>Kaiser executives say they are investing millions of dollars in new facilities and workforce development, including educational programs for new therapists to meet the increasing demand for mental health care.\u003c/p>\n\u003cp>The company says it increased its workforce by 30% in the last three years, including hiring nearly 500 new therapists last year, but patient demand has grown 23% in the same time.\u003c/p>\n\u003cp>“The good news is that the stigma has been removed and people that need care are actually coming forward to get it,” said Michelle Gaskill-Hames, senior vice president for hospital and health plan operations at Kaiser Northern California. But, “it's creating a rise in demand at a time when there is a shortage of workers.”\u003c/p>\n\u003cfigure id=\"attachment_11791582\" class=\"wp-caption aligncenter\" style=\"max-width: 1920px\">\u003ca href=\"https://ww2.kqed.org/news/2019/12/16/kaiser-therapists-strike-again-over-long-wait-times/img_3737/\" rel=\"attachment wp-att-11791582\">\u003cimg src=\"https://ww2.kqed.org/app/uploads/sites/10/2019/12/IMG_3737.jpg\" alt=\"\" width=\"1920\" height=\"1440\" class=\"size-full wp-image-11791582\" srcset=\"https://ww2.kqed.org/app/uploads/sites/10/2019/12/IMG_3737.jpg 1920w, https://ww2.kqed.org/app/uploads/sites/10/2019/12/IMG_3737-160x120.jpg 160w, https://ww2.kqed.org/app/uploads/sites/10/2019/12/IMG_3737-800x600.jpg 800w, https://ww2.kqed.org/app/uploads/sites/10/2019/12/IMG_3737-1020x765.jpg 1020w, https://ww2.kqed.org/app/uploads/sites/10/2019/12/IMG_3737-1200x900.jpg 1200w, https://ww2.kqed.org/app/uploads/sites/10/2019/12/IMG_3737-1832x1374.jpg 1832w, https://ww2.kqed.org/app/uploads/sites/10/2019/12/IMG_3737-1376x1032.jpg 1376w, https://ww2.kqed.org/app/uploads/sites/10/2019/12/IMG_3737-1044x783.jpg 1044w, https://ww2.kqed.org/app/uploads/sites/10/2019/12/IMG_3737-632x474.jpg 632w, https://ww2.kqed.org/app/uploads/sites/10/2019/12/IMG_3737-536x402.jpg 536w\" sizes=\"(max-width: 1920px) 100vw, 1920px\">\u003c/a>\u003cfigcaption class=\"wp-caption-text\">A Kaiser clinician during the previous Dec. 2018 strike. \u003ccite>(April Dembosky/KQED)\u003c/cite>\u003c/figcaption>\u003c/figure>\n\u003cp>Research shows there is a shortage of clinicians in some positions in some regions of the country, particularly for psychiatrists and adolescent psychiatrists in rural areas. But union members say that's not the case in most Kaiser locations, where graduate schools are “pumping out” masters and doctorate level mental health clinicians.\u003c/p>\n\u003cp>“The issue is that few people want to work for Kaiser,” said Fitzpatrick, “because once they’re working for Kaiser, they quickly burn out. They’re overloaded, they're overworked, and so they leave.”\u003c/p>\n\u003cp>California regulators have substantiated some of the therapists’ allegations. In 2013, the state Department of Managed Health Care fined Kaiser $4 million for long wait times for individual appointments and for forcing patients into group therapy who didn’t want it. The agency cited Kaiser again in 2015 and 2017 over wait times.\u003c/p>\n\u003cp>Kaiser executives say the company has improved since then, meeting the state’s standard for timely access 90% of the time in 2019, according to its own data.\u003c/p>\n\u003cp>But therapists say Kaiser is crunching the numbers to make the situation look better than it is on the ground. For example, one of Kaiser’s solutions to improving wait times for initial appointments, which they must provide with 48 hours for urgent needs and 10 days for non-urgent matters under state law, is to do intakes over the phone through its Connect 2 Care program.\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"content": "\u003cdiv class=\"post-body\">\u003cp>Clinicians say this means patients get quick access to an initial 30-minute phone appointment, but are still waiting weeks or a month to start therapy in earnest with a clinician who can see them on a regular basis, and are then waiting months between appointments.\u003c/p>\n\u003cp>“It’s mainly giving patients more of the run-around, of needing to talk to multiple providers before getting to their assigned therapist,” said Kirstin Quinn Siegel, a licensed marriage and family therapist at Kaiser’s Richmond clinic, who marched on the picket lines on Monday. “So right now they have improved their initial access, but it hasn't really made a dent in our return access.”\u003c/p>\n\u003cp>During the strike, emergency mental health services will be available and Kaiser is working to minimize disruption to ongoing care, but some appointments may need to be rescheduled.\u003c/p>\n\u003cp>“We have plans in place, but we're really disappointed that we haven't been able to draw this to resolution,” said Kaiser’s Gaskill-Hames. “This is the sixth time that there's been a strike called in 12 months, and each time it can be disruptive to our members.”\u003c/p>\n\u003cp>Two previous strikes were called off, once in June, after state lawmakers asked both sides to return to the bargaining table, and another time in November, after Kaiser CEO Bernard Tyson died unexpectedly.\u003c/p>\n\u003cp>\u003c/p>\n\u003cp>\u003cem>Sara Hossaini contributed reporting.\u003c/em>\u003c/p>\n\n\u003c/div>\u003c/p>",
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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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"info": "Tech Nation is a weekly public radio program, hosted by Dr. Moira Gunn. Founded in 1993, it has grown from a simple interview show to a multi-faceted production, featuring conversations with noted technology and science leaders, and a weekly science and technology-related commentary.",
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"info": "The TED Radio Hour is a journey through fascinating ideas, astonishing inventions, fresh approaches to old problems, and new ways to think and create.",
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"tagline": "Local news to keep you rooted",
"info": "Host Devin Katayama walks you through the biggest story of the day with reporters and newsmakers.",
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