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"content": "\u003cp>\u003cem>\u003ca href=\"http://itunes.apple.com/us/podcast/the-california-report-magazine/id1314750545?mt=2\" rel=\"noopener noreferrer\" target=\"_blank\">Listen to this and more in-depth storytelling by subscribing to The California Report Magazine podcast.\u003c/a>\u003c/em>\u003c/p>\n\u003cp>Teachers and parents all over the country are noticing\u003ca href=\"https://www.washingtonpost.com/news/to-your-health/wp/2018/05/10/why-kids-and-teens-may-face-far-more-anxiety-these-days/\"> an increase in mental health issues\u003c/a>, including anxiety, among students.\u003c/p>\n\u003cp>[aside postID=\"mindshift_54144\" label=\"Read the Full Story From Mindshift\"]\u003c/p>\n\u003cp>In 2004, the \u003ca href=\"https://www.nimh.nih.gov/health/statistics/any-anxiety-disorder.shtml#part_155096\">National Institute of Mental Health estimated \u003c/a>that about a third of adolescents (ages 13-18) have been or will be seriously affected by anxiety in their lifetimes. More recently, a study published in the \u003ca href=\"https://journals.lww.com/jrnldbp/Citation/2018/06000/Epidemiology_and_Impact_of_Health_Care.6.aspx\">Journal of Developmental and Behavioral Pediatrics \u003c/a>concluded that more than one in twenty U.S. children (ages 6-17) had anxiety or depression in 2011-2012. And a \u003ca href=\"https://www.heri.ucla.edu/monographs/TheAmericanFreshman2017.pdf\">UCLA survey of college freshman\u003c/a> conducted each year, found in 2017 that close to 39 percent frequently felt “overwhelmed by all I had to do.”\u003c/p>\n\u003cp>Parents and educators are scrambling to understand why kids seem to be more anxious and how to help them.\u003c/p>\n\u003cp>[ad fullwidth]\u003c/p>\n\u003cp>This week, The California Report Magazine welcomes Katrina Schwartz to share findings from her recent time spent reporting on student anxiety for the \u003ca href=\"https://www.kqed.org/mindshift\">MindShift podcast.\u003c/a>\u003c/p>\n\u003cp>\u003cstrong>Sasha Khokha: Why did you guys decide to focus on anxiety?\u003cbr>\n\u003c/strong>\u003cbr>\nKatrina Schwartz: This season we asked our audience what they were interested in and what mattered most to them, and anxiety kept coming up over and over. Teachers and parents are genuinely confused about why so many kids are struggling with anxiety. They want some tips on how to deal with it. It seems like the problem is growing.\u003c/p>\n\u003cp>\u003cstrong>SK: I’m married to someone who’s a teacher, who comes home all the time with stories about how anxious high school kids seem to be these days. Do we know why anxiety seems to be such a problem for kids?\u003cbr>\n\u003c/strong>\u003cbr>\nKS: It’s really hard to say. Adults love to blame it on social media – and I’m sure that that does play a role – but it’s worth noting that there are all kinds of reasons that kids experience anxiety no matter what socio-economic situation they come from.\u003c/p>\n\u003cp>\u003cstrong>SK: So whether it’s violence in the home, or struggling to have enough food to eat, or AP tests or stress about college applications?\u003c/strong>\u003c/p>\n\u003cp>KS: Yeah, totally. One thing we do know is that anxiety is way more debilitating than just plain old stress. It’s actually a condition that can get in the way of relationships and stuff like work and school.\u003c/p>\n\u003cp>\u003cstrong>SK: This high school you visited for your story, El Cerrito High School, it sounds like they actually have a lot of resources to help students dealing with anxiety?\u003cbr>\n\u003c/strong>\u003cbr>\nKS: They have this center called the James Morehouse Project. It’s their wellness center. They’ve been trying to look at the problem holistically and support students with all kinds of problems. One way they’re able to do that, is they host a clinical social work internship program, which gives them a lot more adults in the building to be doing therapy, and running groups.\u003c/p>\n\u003cp>\u003cstrong>SK: So what are some specific things they’re doing to help kids with anxiety?\u003c/strong>\u003c/p>\n\u003cp>KS: There’s some big macro things. Stuff like giving kids more time between classes, so it’s a little less frenetic, or changing up the way the schedule works, so kids are on a block schedule and only have four classes instead of seven. But then, at a more specific level, they’re doing things like running these anxiety groups where they’re giving students specific strategies to cope with their own anxiety.\u003c/p>\n\u003cp>\u003cstrong>SK: Is mindfulness part of it? I know that’s a big push now in schools these days.\u003c/strong>\u003c/p>\n\u003cp>KS: Yeah. With anxiety there’s this bodily response, this physical response, and then there’s what’s going on in your head. So the mindfulness stuff really helps ground students, get them to calm down, so then they can challenge their thoughts. Many students describe [anxiety] as overthinking or negative thinking. Social workers are trying to get them to tell themselves a different story about what’s going on.\u003c/p>\n\u003cp>\u003cstrong>SK: What can parents do to help kids who are dealing with anxiety?\u003c/strong>\u003c/p>\n\u003cp>KS: The first one is kind of obvious, but hard to do — try not to put a ton of pressure on your kids. They’re probably already feeling it, so don’t add to it. If they are struggling, don’t be judgmental. I think a lot of times parents see the behaviors that come from anxiety, like procrastination or not doing their work, and they jump in and get on a kid’s case without stopping to think, “Where is this coming from?” And if you can approach it with a little more curiosity and ask your kid whats going on, they might be more willing to share what’s at the root of the problem.\u003c/p>\n\u003cp>\u003cstrong>SK: So back off. Easier said than done!\u003c/strong>\u003c/p>\n\u003cp>KS: If you do that work up front you can do the hardest part, which is helping kids face their anxiety. It’s trying to control them. Sometimes the role of the parents is to push back against the anxiety and ask kids to face it.\u003c/p>\n\u003cp>\u003c/p>\n\u003cp>\u003cem>Hear the stories of two students working through their problems with anxiety by pressing play at the top of this page. Or, read the full web story from MindShift, \u003ca href=\"https://www.kqed.org/mindshift/54144/how-can-schools-help-kids-with-anxiety\">“How Can Schools Help Kids With Anxiety?”\u003c/a> You can also subscribe MindShift on \u003ca href=\"https://podcasts.apple.com/us/podcast/mindshift-podcast/id1078765985?mt=2\">Apple Podcasts\u003c/a>, \u003ca href=\"https://one.npr.org/?sharedMediaId=750851136:750851138\">NPR One\u003c/a>, or wherever you get your podcasts.\u003c/em>\u003c/p>\n\n",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>This week, The California Report Magazine welcomes Katrina Schwartz to share findings from her recent time spent reporting on student anxiety for the \u003ca href=\"https://www.kqed.org/mindshift\">MindShift podcast.\u003c/a>\u003c/p>\n\u003cp>\u003cstrong>Sasha Khokha: Why did you guys decide to focus on anxiety?\u003cbr>\n\u003c/strong>\u003cbr>\nKatrina Schwartz: This season we asked our audience what they were interested in and what mattered most to them, and anxiety kept coming up over and over. Teachers and parents are genuinely confused about why so many kids are struggling with anxiety. They want some tips on how to deal with it. It seems like the problem is growing.\u003c/p>\n\u003cp>\u003cstrong>SK: I’m married to someone who’s a teacher, who comes home all the time with stories about how anxious high school kids seem to be these days. Do we know why anxiety seems to be such a problem for kids?\u003cbr>\n\u003c/strong>\u003cbr>\nKS: It’s really hard to say. Adults love to blame it on social media – and I’m sure that that does play a role – but it’s worth noting that there are all kinds of reasons that kids experience anxiety no matter what socio-economic situation they come from.\u003c/p>\n\u003cp>\u003cstrong>SK: So whether it’s violence in the home, or struggling to have enough food to eat, or AP tests or stress about college applications?\u003c/strong>\u003c/p>\n\u003cp>KS: Yeah, totally. One thing we do know is that anxiety is way more debilitating than just plain old stress. It’s actually a condition that can get in the way of relationships and stuff like work and school.\u003c/p>\n\u003cp>\u003cstrong>SK: This high school you visited for your story, El Cerrito High School, it sounds like they actually have a lot of resources to help students dealing with anxiety?\u003cbr>\n\u003c/strong>\u003cbr>\nKS: They have this center called the James Morehouse Project. It’s their wellness center. They’ve been trying to look at the problem holistically and support students with all kinds of problems. One way they’re able to do that, is they host a clinical social work internship program, which gives them a lot more adults in the building to be doing therapy, and running groups.\u003c/p>\n\u003cp>\u003cstrong>SK: So what are some specific things they’re doing to help kids with anxiety?\u003c/strong>\u003c/p>\n\u003cp>KS: There’s some big macro things. Stuff like giving kids more time between classes, so it’s a little less frenetic, or changing up the way the schedule works, so kids are on a block schedule and only have four classes instead of seven. But then, at a more specific level, they’re doing things like running these anxiety groups where they’re giving students specific strategies to cope with their own anxiety.\u003c/p>\n\u003cp>\u003cstrong>SK: Is mindfulness part of it? I know that’s a big push now in schools these days.\u003c/strong>\u003c/p>\n\u003cp>KS: Yeah. With anxiety there’s this bodily response, this physical response, and then there’s what’s going on in your head. So the mindfulness stuff really helps ground students, get them to calm down, so then they can challenge their thoughts. Many students describe [anxiety] as overthinking or negative thinking. Social workers are trying to get them to tell themselves a different story about what’s going on.\u003c/p>\n\u003cp>\u003cstrong>SK: What can parents do to help kids who are dealing with anxiety?\u003c/strong>\u003c/p>\n\u003cp>KS: The first one is kind of obvious, but hard to do — try not to put a ton of pressure on your kids. They’re probably already feeling it, so don’t add to it. If they are struggling, don’t be judgmental. I think a lot of times parents see the behaviors that come from anxiety, like procrastination or not doing their work, and they jump in and get on a kid’s case without stopping to think, “Where is this coming from?” And if you can approach it with a little more curiosity and ask your kid whats going on, they might be more willing to share what’s at the root of the problem.\u003c/p>\n\u003cp>\u003cstrong>SK: So back off. Easier said than done!\u003c/strong>\u003c/p>\n\u003cp>KS: If you do that work up front you can do the hardest part, which is helping kids face their anxiety. It’s trying to control them. Sometimes the role of the parents is to push back against the anxiety and ask kids to face it.\u003c/p>\n\u003cp>\u003c/p>\n\u003cp>\u003cem>Hear the stories of two students working through their problems with anxiety by pressing play at the top of this page. Or, read the full web story from MindShift, \u003ca href=\"https://www.kqed.org/mindshift/54144/how-can-schools-help-kids-with-anxiety\">“How Can Schools Help Kids With Anxiety?”\u003c/a> You can also subscribe MindShift on \u003ca href=\"https://podcasts.apple.com/us/podcast/mindshift-podcast/id1078765985?mt=2\">Apple Podcasts\u003c/a>, \u003ca href=\"https://one.npr.org/?sharedMediaId=750851136:750851138\">NPR One\u003c/a>, or wherever you get your podcasts.\u003c/em>\u003c/p>\n\n\u003c/div>\u003c/p>",
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"disqusTitle": "From Pain to Purpose: 5 Ways to Cope in the Wake Of Trauma",
"title": "From Pain to Purpose: 5 Ways to Cope in the Wake Of Trauma",
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"content": "\u003cp>Could it happen here? It's a question a lot of people ask in the wake of a traumatic event.\u003c/p>\n\u003cp>Even if you're not directly connected to the events in El Paso, Gilroy or Dayton, chances are you've felt the weight of them.\u003c/p>\n\u003cp>\"People do feel traumatized,\" says family therapist \u003ca href=\"https://www.cedars-sinai.org/blog/faces-of-cedars-sinai-share-care-counselor-jonathan-vickburg.html\">Jonathan Vickburg\u003c/a>, of Cedars Sinai in Los Angeles. The idea that an act of violence could happen anywhere makes us anxious. People may \u003ca href=\"https://www.kqed.org/arts/13863343/music-festival-safety-mass-shootings\">think twice\u003c/a> about attending a music festival or walking into a WalMart.\u003c/p>\n\u003cp>But, there are strategies to counter the fear — and move forward.\u003c/p>\n\u003cp>Rian Finney, 16, knows the feeling of vulnerability all too well. He's never witnessed a mass shooting, but he's grown up surrounded by violence.\u003c/p>\n\u003cp>As a young kid in west Baltimore, he'd fall asleep to the sound of fireworks — or at least that's what he thought. Then, one day his parents told him he was hearing gunshots.\u003c/p>\n\u003cp>\"It was just shock, that those [shootings were] happening right outside my house,\" Finney says. Living amid violence began to take its toll, especially in moments when he felt threatened. \"I just felt this sense of, like, fear and anxiety going through my entire body,\" he says.\u003c/p>\n\u003cp>When you're in survival mode, there's a loss of hope, he says. \"It's just an overwhelming sense of nothingness, like I can't do anything.\"\u003c/p>\n\u003cp>But after events such as the \u003ca href=\"https://www.npr.org/sections/codeswitch/2016/04/20/474668796/reflecting-on-the-death-of-freddie-gray-one-year-later\">death of Freddie Gray\u003c/a>, Finney — with the help of his parents and mentors — turned his fear into purpose.\u003c/p>\n\u003cp>\"It does give me a sense of purpose to realize I can do something to combat this [violence],\" Finney says.\u003c/p>\n\u003cp>\u003cspan style=\"font-weight: 400\">[aside tag='trauma' label='Coping with Trauma']\u003c/span>\u003c/p>\n\u003cp>He's gotten involved in groups including, \u003ca href=\"https://blavity.com/good-kids-mad-city-is-a-new-group-led-by-students-of-color-who-like-kendrick-know-the-power-of-their-voices\">Good Kids Mad City\u003c/a>, which among other things, advocates for more safe spaces in the city for teens, and a network of advocates he met this summer at \u003ca href=\"https://www.jhsph.edu/research/centers-and-institutes/johns-hopkins-center-for-gun-policy-and-research/education/\">a Summer Youth Institute\u003c/a> at Johns Hopkins. He advocates for changes such as new gun laws and social equality. He's about to begin 11th grade at Baltimore Polytechnic Institute and has interned in the law offices of Murphy, Falcon & Murphy this summer.\u003c/p>\n\u003cp>He's now seen as a leader among his peers — motivating others to get involved. \"If we continually lead people down the path of goodness, then stuff can actually change,\" he says.\u003c/p>\n\u003cp>Finney's ability to make meaning out of the misery of violence is an effective way to cope, says Vickburg, whether you have a personal connection to the recent mass shootings, have other experiences with trauma, or are just feeling distressed by the climate of violence today.\u003c/p>\n\u003cp>\"What happens in trauma is we feel helpless,\" says Vickburg. \"But if we can find purpose again ... we have a path forward and a path to help others.\"\u003c/p>\n\u003cp>Vickburg and other counselors and psychologists we spoke to offered advice for processing the repercussions of violence and trauma. They say trying these things can make you feel better — and might help make your community safer and more peaceful too.\u003c/p>\n\u003cp>[ad fullwidth]\u003c/p>\n\u003cp>\u003cstrong>1. Give yourself time to build resiliency\u003c/strong>\u003c/p>\n\u003cp>When you're ready, try to reframe your thinking about the traumatic event. Instead of re-playing the trauma and saying to yourself, \"this is horrific,\" try to imagine something good that could come from it, suggests Vicksburg. When you can make this shift (from pain to purpose), it can help you begin to bounce back.\u003c/p>\n\u003cp>\"This is resiliency,\" Vickburg says. This process may take a while. After a traumatic event it can take time to feel safer and to slowly notice what helps you feel better.\u003c/p>\n\u003cp>\u003cstrong>2. Find a circle of support \u003c/strong>\u003c/p>\n\u003cp>It's helpful to talk and connect with others as part of the healing process. \"When you hold things in, it bubbles over and leads to worse outcomes,\" says Finney. Find peers who share your beliefs an values.\u003c/p>\n\u003cp>When it comes to your family — and your children — it's important to communicate during times of trauma.\u003c/p>\n\u003cp>\"Sit down and start a conversation,\" says \u003ca href=\"https://psychiatry.duke.edu/gurwitch-robin\">Robin Gurwitch\u003c/a>, a psychologist and child trauma expert at Duke University Medical Center. You want to encourage questions and validate others' feelings by listening without judgment. If children are confused by violent events, you can help interpret or clear up misinformation. You can also assure them, that while there's pain, you'll get through it together.\u003c/p>\n\u003cp>Gurwitch says one way to dial back the stress of these events is to talk to your family and friends about the ideologies or the misconceptions that may give rise to hateful acts.\u003c/p>\n\u003cp>From there, think about ways to counter them. The days and weeks following national tragedies offer an opportunity because people are paying attention.\u003c/p>\n\u003cp>\u003cstrong>3. Make time for positive feelings\u003c/strong>\u003c/p>\n\u003cp>\"Find ways to take care of yourself,\" says Vickburg. One idea is to set a regular time to go to the gym, perhaps for a group class, or to take a walk. Exercise has been shown to \u003ca href=\"https://www.npr.org/sections/health-shots/2018/10/22/656594050/a-new-prescription-for-depression-join-a-team-and-get-sweaty\">tamp down stress\u003c/a>. Consider creative outlets such as painting or poetry, just for fun. Finney says he listens to music to unwind.\u003c/p>\n\u003cp>Another idea: Keep a journal and write or repeat positive affirmations. Finney has several affirmations that he shared with other teens during the Hopkins seminar. \"These [positive messages] give me an extra push if I'm feeling down,\" Finney says.\u003c/p>\n\u003cp>It's important to note that if you begin to feel that coping is too difficult it may be useful to seek professional help.\u003c/p>\n\u003cp>\u003cstrong>4. Find daily moments for reflection \u003c/strong>\u003c/p>\n\u003cp>Amani Surges Martorella, a clinical social worker at Johns Hopkins University, says we can change our feelings by taking moments during our day to be in the present without worry about the past or future.\u003c/p>\n\u003cp>She helped lead Finney and his fellow participants at the Johns Hopkins' summer institute through a series of what she calls \"micro-practices.\" They're based on a book called \u003ca href=\"https://lindagraham-mft.net/new-book-bouncing-back/\">\u003cem>Bouncing Back\u003c/em>\u003c/a>\u003cem>. \u003c/em>\u003c/p>\n\u003cp>\"Micro-practices are exercises that require minimal time ... and allow you to, over time, increase your own resiliency to the stress of day-to-day life as well as to traumatic adverse events, should they occur,\" says Martorella.\u003c/p>\n\u003cp>One practice is to reflect on gratitude. Here's how: First, begin with a few moments of quiet reflection and focus on just your breath. Then, shift your focus to a simple interaction that you've been part of today. Did someone hold open a door for you or greet you warmly? Notice and embrace how this act of kindness makes you feel. Then, shift your focus more broadly to think of any family member, teacher, or mentors who has been supportive. Then, expand your thoughts more globally to leaders who inspire you. Take time to notice at each step how those thoughts make you feel in the moment.\u003c/p>\n\u003cp>\u003cstrong>5. Become a change-maker \u003c/strong>\u003c/p>\n\u003cp>Just as Finney threw himself to action, look for opportunities to get involved.\u003c/p>\n\u003cp>\"Meaning-making [can be] important to the healing process, says Gurwitch.\u003c/p>\n\u003cp>Pushing for change can start with small steps — within your schools or community. \"If you see someone being harassed or put down, think: what can you do?\" says Gurwitch. You can offer support to the person and offer your own beliefs to counter unkind or bigoted thinking.\u003c/p>\n\u003cp>\"Most people are good and want to do right,\" Gurwitch says.\u003c/p>\n\u003cp>Gurwitch says, you can also get involved in issues you care about. Look for groups in your community that look to address issues you may care about, whether it's gun violence, mental illness or traumatized youth.\u003c/p>\n\u003cp>She points to the efforts that have sprung from prior tragedies, such as the advocacy that has followed Parkland or the passion of parents of victims of Sandy Hook to establish foundations to honor their children or to pursue actions to prevent future tragedies.\u003c/p>\n\u003cp>\"Taking action, whether it be political action, community-based work, or advocacy, allows a person who may feel powerless to begin to reclaim a sense of agency,\" says Martorella. \"Making change and seeing change happen is a way to move forward. In turn, moving forward encourages others to do the same.\"\u003c/p>\n\u003cdiv class=\"fullattribution\">Copyright 2019 NPR. To see more, visit https://www.npr.org.\u003cimg src=\"https://www.google-analytics.com/__utm.gif?utmac=UA-5828686-4&utmdt=From+Pain+To+Purpose%3A+5+Ways+To+Cope+In+The+Wake+Of+Trauma&utme=8(APIKey)9(MDAxOTAwOTE4MDEyMTkxMDAzNjczZDljZA004)\">\u003c/div>\n\u003cp>[ad floatright]\u003c/p>\n",
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"excerpt": "If recent violent events have left you upset or scared, you're not alone. But psychologists say there are ways to help yourselves and those you love overcome fear and move forward.",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003cp>Could it happen here? It's a question a lot of people ask in the wake of a traumatic event.\u003c/p>\n\u003cp>Even if you're not directly connected to the events in El Paso, Gilroy or Dayton, chances are you've felt the weight of them.\u003c/p>\n\u003cp>\"People do feel traumatized,\" says family therapist \u003ca href=\"https://www.cedars-sinai.org/blog/faces-of-cedars-sinai-share-care-counselor-jonathan-vickburg.html\">Jonathan Vickburg\u003c/a>, of Cedars Sinai in Los Angeles. The idea that an act of violence could happen anywhere makes us anxious. People may \u003ca href=\"https://www.kqed.org/arts/13863343/music-festival-safety-mass-shootings\">think twice\u003c/a> about attending a music festival or walking into a WalMart.\u003c/p>\n\u003cp>But, there are strategies to counter the fear — and move forward.\u003c/p>\n\u003cp>Rian Finney, 16, knows the feeling of vulnerability all too well. He's never witnessed a mass shooting, but he's grown up surrounded by violence.\u003c/p>\n\u003cp>As a young kid in west Baltimore, he'd fall asleep to the sound of fireworks — or at least that's what he thought. Then, one day his parents told him he was hearing gunshots.\u003c/p>\n\u003cp>\"It was just shock, that those [shootings were] happening right outside my house,\" Finney says. Living amid violence began to take its toll, especially in moments when he felt threatened. \"I just felt this sense of, like, fear and anxiety going through my entire body,\" he says.\u003c/p>\n\u003cp>When you're in survival mode, there's a loss of hope, he says. \"It's just an overwhelming sense of nothingness, like I can't do anything.\"\u003c/p>\n\u003cp>But after events such as the \u003ca href=\"https://www.npr.org/sections/codeswitch/2016/04/20/474668796/reflecting-on-the-death-of-freddie-gray-one-year-later\">death of Freddie Gray\u003c/a>, Finney — with the help of his parents and mentors — turned his fear into purpose.\u003c/p>\n\u003cp>\"It does give me a sense of purpose to realize I can do something to combat this [violence],\" Finney says.\u003c/p>\n\u003cp>\u003cspan style=\"font-weight: 400\">\u003c/p>\u003c/div>",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003c/span>\u003c/p>\n\u003cp>He's gotten involved in groups including, \u003ca href=\"https://blavity.com/good-kids-mad-city-is-a-new-group-led-by-students-of-color-who-like-kendrick-know-the-power-of-their-voices\">Good Kids Mad City\u003c/a>, which among other things, advocates for more safe spaces in the city for teens, and a network of advocates he met this summer at \u003ca href=\"https://www.jhsph.edu/research/centers-and-institutes/johns-hopkins-center-for-gun-policy-and-research/education/\">a Summer Youth Institute\u003c/a> at Johns Hopkins. He advocates for changes such as new gun laws and social equality. He's about to begin 11th grade at Baltimore Polytechnic Institute and has interned in the law offices of Murphy, Falcon & Murphy this summer.\u003c/p>\n\u003cp>He's now seen as a leader among his peers — motivating others to get involved. \"If we continually lead people down the path of goodness, then stuff can actually change,\" he says.\u003c/p>\n\u003cp>Finney's ability to make meaning out of the misery of violence is an effective way to cope, says Vickburg, whether you have a personal connection to the recent mass shootings, have other experiences with trauma, or are just feeling distressed by the climate of violence today.\u003c/p>\n\u003cp>\"What happens in trauma is we feel helpless,\" says Vickburg. \"But if we can find purpose again ... we have a path forward and a path to help others.\"\u003c/p>\n\u003cp>Vickburg and other counselors and psychologists we spoke to offered advice for processing the repercussions of violence and trauma. They say trying these things can make you feel better — and might help make your community safer and more peaceful too.\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>\u003cstrong>1. Give yourself time to build resiliency\u003c/strong>\u003c/p>\n\u003cp>When you're ready, try to reframe your thinking about the traumatic event. Instead of re-playing the trauma and saying to yourself, \"this is horrific,\" try to imagine something good that could come from it, suggests Vicksburg. When you can make this shift (from pain to purpose), it can help you begin to bounce back.\u003c/p>\n\u003cp>\"This is resiliency,\" Vickburg says. This process may take a while. After a traumatic event it can take time to feel safer and to slowly notice what helps you feel better.\u003c/p>\n\u003cp>\u003cstrong>2. Find a circle of support \u003c/strong>\u003c/p>\n\u003cp>It's helpful to talk and connect with others as part of the healing process. \"When you hold things in, it bubbles over and leads to worse outcomes,\" says Finney. Find peers who share your beliefs an values.\u003c/p>\n\u003cp>When it comes to your family — and your children — it's important to communicate during times of trauma.\u003c/p>\n\u003cp>\"Sit down and start a conversation,\" says \u003ca href=\"https://psychiatry.duke.edu/gurwitch-robin\">Robin Gurwitch\u003c/a>, a psychologist and child trauma expert at Duke University Medical Center. You want to encourage questions and validate others' feelings by listening without judgment. If children are confused by violent events, you can help interpret or clear up misinformation. You can also assure them, that while there's pain, you'll get through it together.\u003c/p>\n\u003cp>Gurwitch says one way to dial back the stress of these events is to talk to your family and friends about the ideologies or the misconceptions that may give rise to hateful acts.\u003c/p>\n\u003cp>From there, think about ways to counter them. The days and weeks following national tragedies offer an opportunity because people are paying attention.\u003c/p>\n\u003cp>\u003cstrong>3. Make time for positive feelings\u003c/strong>\u003c/p>\n\u003cp>\"Find ways to take care of yourself,\" says Vickburg. One idea is to set a regular time to go to the gym, perhaps for a group class, or to take a walk. Exercise has been shown to \u003ca href=\"https://www.npr.org/sections/health-shots/2018/10/22/656594050/a-new-prescription-for-depression-join-a-team-and-get-sweaty\">tamp down stress\u003c/a>. Consider creative outlets such as painting or poetry, just for fun. Finney says he listens to music to unwind.\u003c/p>\n\u003cp>Another idea: Keep a journal and write or repeat positive affirmations. Finney has several affirmations that he shared with other teens during the Hopkins seminar. \"These [positive messages] give me an extra push if I'm feeling down,\" Finney says.\u003c/p>\n\u003cp>It's important to note that if you begin to feel that coping is too difficult it may be useful to seek professional help.\u003c/p>\n\u003cp>\u003cstrong>4. Find daily moments for reflection \u003c/strong>\u003c/p>\n\u003cp>Amani Surges Martorella, a clinical social worker at Johns Hopkins University, says we can change our feelings by taking moments during our day to be in the present without worry about the past or future.\u003c/p>\n\u003cp>She helped lead Finney and his fellow participants at the Johns Hopkins' summer institute through a series of what she calls \"micro-practices.\" They're based on a book called \u003ca href=\"https://lindagraham-mft.net/new-book-bouncing-back/\">\u003cem>Bouncing Back\u003c/em>\u003c/a>\u003cem>. \u003c/em>\u003c/p>\n\u003cp>\"Micro-practices are exercises that require minimal time ... and allow you to, over time, increase your own resiliency to the stress of day-to-day life as well as to traumatic adverse events, should they occur,\" says Martorella.\u003c/p>\n\u003cp>One practice is to reflect on gratitude. Here's how: First, begin with a few moments of quiet reflection and focus on just your breath. Then, shift your focus to a simple interaction that you've been part of today. Did someone hold open a door for you or greet you warmly? Notice and embrace how this act of kindness makes you feel. Then, shift your focus more broadly to think of any family member, teacher, or mentors who has been supportive. Then, expand your thoughts more globally to leaders who inspire you. Take time to notice at each step how those thoughts make you feel in the moment.\u003c/p>\n\u003cp>\u003cstrong>5. Become a change-maker \u003c/strong>\u003c/p>\n\u003cp>Just as Finney threw himself to action, look for opportunities to get involved.\u003c/p>\n\u003cp>\"Meaning-making [can be] important to the healing process, says Gurwitch.\u003c/p>\n\u003cp>Pushing for change can start with small steps — within your schools or community. \"If you see someone being harassed or put down, think: what can you do?\" says Gurwitch. You can offer support to the person and offer your own beliefs to counter unkind or bigoted thinking.\u003c/p>\n\u003cp>\"Most people are good and want to do right,\" Gurwitch says.\u003c/p>\n\u003cp>Gurwitch says, you can also get involved in issues you care about. Look for groups in your community that look to address issues you may care about, whether it's gun violence, mental illness or traumatized youth.\u003c/p>\n\u003cp>She points to the efforts that have sprung from prior tragedies, such as the advocacy that has followed Parkland or the passion of parents of victims of Sandy Hook to establish foundations to honor their children or to pursue actions to prevent future tragedies.\u003c/p>\n\u003cp>\"Taking action, whether it be political action, community-based work, or advocacy, allows a person who may feel powerless to begin to reclaim a sense of agency,\" says Martorella. \"Making change and seeing change happen is a way to move forward. In turn, moving forward encourages others to do the same.\"\u003c/p>\n\u003cdiv class=\"fullattribution\">Copyright 2019 NPR. To see more, visit https://www.npr.org.\u003cimg src=\"https://www.google-analytics.com/__utm.gif?utmac=UA-5828686-4&utmdt=From+Pain+To+Purpose%3A+5+Ways+To+Cope+In+The+Wake+Of+Trauma&utme=8(APIKey)9(MDAxOTAwOTE4MDEyMTkxMDAzNjczZDljZA004)\">\u003c/div>\n\u003cp>\u003c/p>\u003c/div>",
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"content": "\u003cp>Kaiser Permanente therapists held a one-day strike on Wednesday to protest what they said were conditions that make it difficult for children and adults in San Francisco to access mental health care services, including staffing shortages and weeks-long waits for appointments.\u003c/p>\n\u003cp>Chanting “What’s this about? Patient care!” a few dozen people, including psychiatrists, psychologists and social workers, protested outside Kaiser’s mental health clinic on Geary Boulevard— the health system's only one in San Francisco. Several city supervisors attended, including board president Norman Yee.\u003c/p>\n\u003cp>“Our clinics are suffering. We are overworked. We are understaffed. And mental health is in a crisis time, certainly here in this clinic and certainly in the Kaiser mental health clinics all over California,” said James Beauford, who has worked as a clinical psychologist at the Kaiser clinic for 23 years.\u003c/p>\n\u003cp>“We've written letters to management. We've petitioned. We've written grievances. Kaiser is not listening. This is a last resort. Our clinic is dying,” Beauford added.\u003c/p>\n\u003cp>[aside tag='mental-health' label='More Coverage of Mental Health Care']Kaiser has been in bargaining talks with the National Union of Healthcare Workers (NUHW), which represents these Kaiser workers, for over a year, said Ron Groepper, senior vice president at Kaiser Permanente Greater San Francisco.\u003c/p>\n\u003cp>Groepper said Kaiser has been working on ways to meet growing demand for mental health services and has committed $50 million to support increasing the number of people entering and remaining in the mental health profession. He also said Kaiser expects to add more than 60 new offices for mental health providers in Northern California and denied the union’s assertion that group therapy sessions were overcrowded.\u003c/p>\n\u003cfigure id=\"attachment_11760379\" class=\"wp-caption alignnone\" style=\"max-width: 800px\">\u003cimg class=\"size-medium wp-image-11760379\" src=\"https://ww2.kqed.org/news/wp-content/uploads/sites/10/2019/07/07092019_kaiser-permanente_mental-health_National-Union-of-Healthcare-Workers_staffing_Beauford-qut-800x600.jpg\" alt=\"James Beauford is a clinical psychologist who has worked at Kaiser Permanente’s San Francisco Medical Center for 23 years. He said his clinic is “significantly understaffed.”\" width=\"800\" height=\"600\" srcset=\"https://ww2.kqed.org/app/uploads/sites/10/2019/07/07092019_kaiser-permanente_mental-health_National-Union-of-Healthcare-Workers_staffing_Beauford-qut-800x600.jpg 800w, https://ww2.kqed.org/app/uploads/sites/10/2019/07/07092019_kaiser-permanente_mental-health_National-Union-of-Healthcare-Workers_staffing_Beauford-qut-160x120.jpg 160w, https://ww2.kqed.org/app/uploads/sites/10/2019/07/07092019_kaiser-permanente_mental-health_National-Union-of-Healthcare-Workers_staffing_Beauford-qut-1020x765.jpg 1020w, https://ww2.kqed.org/app/uploads/sites/10/2019/07/07092019_kaiser-permanente_mental-health_National-Union-of-Healthcare-Workers_staffing_Beauford-qut-1200x900.jpg 1200w, https://ww2.kqed.org/app/uploads/sites/10/2019/07/07092019_kaiser-permanente_mental-health_National-Union-of-Healthcare-Workers_staffing_Beauford-qut.jpg 1920w, https://ww2.kqed.org/app/uploads/sites/10/2019/07/07092019_kaiser-permanente_mental-health_National-Union-of-Healthcare-Workers_staffing_Beauford-qut-1832x1374.jpg 1832w, https://ww2.kqed.org/app/uploads/sites/10/2019/07/07092019_kaiser-permanente_mental-health_National-Union-of-Healthcare-Workers_staffing_Beauford-qut-1376x1032.jpg 1376w, https://ww2.kqed.org/app/uploads/sites/10/2019/07/07092019_kaiser-permanente_mental-health_National-Union-of-Healthcare-Workers_staffing_Beauford-qut-1044x783.jpg 1044w, https://ww2.kqed.org/app/uploads/sites/10/2019/07/07092019_kaiser-permanente_mental-health_National-Union-of-Healthcare-Workers_staffing_Beauford-qut-632x474.jpg 632w, https://ww2.kqed.org/app/uploads/sites/10/2019/07/07092019_kaiser-permanente_mental-health_National-Union-of-Healthcare-Workers_staffing_Beauford-qut-536x402.jpg 536w\" sizes=\"(max-width: 800px) 100vw, 800px\">\u003cfigcaption class=\"wp-caption-text\">James Beauford is a clinical psychologist who has worked at Kaiser Permanente’s San Francisco Medical Center for 23 years. He said his clinic is “significantly understaffed.” \u003ccite>(Laura Klivans/KQED)\u003c/cite>\u003c/figcaption>\u003c/figure>\n\u003cp>“Meeting the increased demand for mental health services is a national challenge that faces all health care providers, not just Kaiser Permanente,” Groepper said in a statement.\u003c/p>\n\u003cp>In June, the union \u003ca href=\"https://nuhw.org/wp-content/uploads/NUHW-Complaint_DMHC-SF-ChildAdolescent_06-28-19.pdf\" target=\"_blank\" rel=\"noopener\">filed a complaint\u003c/a> with the California Department of Managed Health Care seeking an investigation into understaffing at the San Francisco clinic.\u003c/p>\n\u003cp>[ad fullwidth]\u003c/p>\n\u003cp>\u003c/p>\n",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003cp>Kaiser Permanente therapists held a one-day strike on Wednesday to protest what they said were conditions that make it difficult for children and adults in San Francisco to access mental health care services, including staffing shortages and weeks-long waits for appointments.\u003c/p>\n\u003cp>Chanting “What’s this about? Patient care!” a few dozen people, including psychiatrists, psychologists and social workers, protested outside Kaiser’s mental health clinic on Geary Boulevard— the health system's only one in San Francisco. Several city supervisors attended, including board president Norman Yee.\u003c/p>\n\u003cp>“Our clinics are suffering. We are overworked. We are understaffed. And mental health is in a crisis time, certainly here in this clinic and certainly in the Kaiser mental health clinics all over California,” said James Beauford, who has worked as a clinical psychologist at the Kaiser clinic for 23 years.\u003c/p>\n\u003cp>“We've written letters to management. We've petitioned. We've written grievances. Kaiser is not listening. This is a last resort. Our clinic is dying,” Beauford added.\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"content": "\u003cdiv class=\"post-body\">\u003cp>Kaiser has been in bargaining talks with the National Union of Healthcare Workers (NUHW), which represents these Kaiser workers, for over a year, said Ron Groepper, senior vice president at Kaiser Permanente Greater San Francisco.\u003c/p>\n\u003cp>Groepper said Kaiser has been working on ways to meet growing demand for mental health services and has committed $50 million to support increasing the number of people entering and remaining in the mental health profession. He also said Kaiser expects to add more than 60 new offices for mental health providers in Northern California and denied the union’s assertion that group therapy sessions were overcrowded.\u003c/p>\n\u003cfigure id=\"attachment_11760379\" class=\"wp-caption alignnone\" style=\"max-width: 800px\">\u003cimg class=\"size-medium wp-image-11760379\" src=\"https://ww2.kqed.org/news/wp-content/uploads/sites/10/2019/07/07092019_kaiser-permanente_mental-health_National-Union-of-Healthcare-Workers_staffing_Beauford-qut-800x600.jpg\" alt=\"James Beauford is a clinical psychologist who has worked at Kaiser Permanente’s San Francisco Medical Center for 23 years. He said his clinic is “significantly understaffed.”\" width=\"800\" height=\"600\" srcset=\"https://ww2.kqed.org/app/uploads/sites/10/2019/07/07092019_kaiser-permanente_mental-health_National-Union-of-Healthcare-Workers_staffing_Beauford-qut-800x600.jpg 800w, https://ww2.kqed.org/app/uploads/sites/10/2019/07/07092019_kaiser-permanente_mental-health_National-Union-of-Healthcare-Workers_staffing_Beauford-qut-160x120.jpg 160w, https://ww2.kqed.org/app/uploads/sites/10/2019/07/07092019_kaiser-permanente_mental-health_National-Union-of-Healthcare-Workers_staffing_Beauford-qut-1020x765.jpg 1020w, https://ww2.kqed.org/app/uploads/sites/10/2019/07/07092019_kaiser-permanente_mental-health_National-Union-of-Healthcare-Workers_staffing_Beauford-qut-1200x900.jpg 1200w, https://ww2.kqed.org/app/uploads/sites/10/2019/07/07092019_kaiser-permanente_mental-health_National-Union-of-Healthcare-Workers_staffing_Beauford-qut.jpg 1920w, https://ww2.kqed.org/app/uploads/sites/10/2019/07/07092019_kaiser-permanente_mental-health_National-Union-of-Healthcare-Workers_staffing_Beauford-qut-1832x1374.jpg 1832w, https://ww2.kqed.org/app/uploads/sites/10/2019/07/07092019_kaiser-permanente_mental-health_National-Union-of-Healthcare-Workers_staffing_Beauford-qut-1376x1032.jpg 1376w, https://ww2.kqed.org/app/uploads/sites/10/2019/07/07092019_kaiser-permanente_mental-health_National-Union-of-Healthcare-Workers_staffing_Beauford-qut-1044x783.jpg 1044w, https://ww2.kqed.org/app/uploads/sites/10/2019/07/07092019_kaiser-permanente_mental-health_National-Union-of-Healthcare-Workers_staffing_Beauford-qut-632x474.jpg 632w, https://ww2.kqed.org/app/uploads/sites/10/2019/07/07092019_kaiser-permanente_mental-health_National-Union-of-Healthcare-Workers_staffing_Beauford-qut-536x402.jpg 536w\" sizes=\"(max-width: 800px) 100vw, 800px\">\u003cfigcaption class=\"wp-caption-text\">James Beauford is a clinical psychologist who has worked at Kaiser Permanente’s San Francisco Medical Center for 23 years. He said his clinic is “significantly understaffed.” \u003ccite>(Laura Klivans/KQED)\u003c/cite>\u003c/figcaption>\u003c/figure>\n\u003cp>“Meeting the increased demand for mental health services is a national challenge that faces all health care providers, not just Kaiser Permanente,” Groepper said in a statement.\u003c/p>\n\u003cp>In June, the union \u003ca href=\"https://nuhw.org/wp-content/uploads/NUHW-Complaint_DMHC-SF-ChildAdolescent_06-28-19.pdf\" target=\"_blank\" rel=\"noopener\">filed a complaint\u003c/a> with the California Department of Managed Health Care seeking an investigation into understaffing at the San Francisco clinic.\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"content": "\u003cp>A \u003ca href=\"https://www.documentcloud.org/documents/6178921-Detention-of-Immigrant-Children.html\" target=\"_blank\" rel=\"noopener\">report\u003c/a> from the largest disability rights group in the country says that immigration facilities across the state are failing to provide enough care or education to children with disabilities in their custody.\u003c/p>\n\u003cp>Investigators with \u003ca href=\"https://www.disabilityrightsca.org/\">Disability Rights California\u003c/a> (DRC), who are authorized by the state to monitor conditions at any facility that houses individuals with disabilities, spent the past year visiting sites in California where the federal government is holding undocumented minors.\u003c/p>\n\u003cp>Those nine facilities are run by the Office of Refugee Resettlement (ORR), the federal agency responsible for the welfare of migrant children who arrive at the U.S. border without a parent or are separated from them.\u003c/p>\n\u003cp>DRC staff attorneys interviewed 150 children and found many were suffering from symptoms of trauma, post-traumatic stress disorder and other mental health disabilities, but were not getting counseling or medication. The DRC also faulted the facilities for failing to provide proper levels of education to their wards.\u003c/p>\n\u003cp>In a statement, ORR said the safety of unaccompanied children is their \"top priority\" and that \"each shelter has medical providers and mental health counselors on site 24/7.\" ORR added that unaccompanied children \"receive medical and mental health screenings, vaccinations, and any follow up care needed for injuries or illnesses they had when they were arrived. Children who have health conditions that cannot be treated on site are taken to local hospitals.\"\u003c/p>\n\u003ch3>'The Most Restrictive Settings'\u003c/h3>\n\u003cp>According to the \u003ca href=\"https://www.acf.hhs.gov/orr/resource/children-entering-the-united-states-unaccompanied\">ORR Guide for Children Entering the United States Unaccompanied\u003c/a>, children with special needs should be placed in a facility with \"the general population but that is able to provide services and treatment for special needs\" while striving for \"the least restrictive setting in the best interests of the child.\"\u003c/p>\n\u003cp>[ad fullwidth]\u003c/p>\n\u003cp>However, the DRC found that 81% of the teenagers placed at the Yolo County Juvenile Detention Facility were placed there because of suicidal ideation (suicidal thoughts) or other mental health concerns.\u003c/p>\n\u003cp>The immigrant children housed in this location are, according to the DRC’s report, \"held in similarly or more restrictive settings as compared to the juvenile delinquency system.\"\u003c/p>\n\u003cp>For example, migrant kids were living in isolated cellblock units, subject to pepper spray and other forms of force or discipline, and allowed outside only for limited periods of time.\u003c/p>\n\u003cp>[aside postID='news_11754887,news_11739785,news_11736531' label='More Immigration Detention Coverage']\u003c/p>\n\u003cp>\"A lot of these children have self-injurious behavior, suicidal ideation or have behavioral issues and then, therefore, are placed in that most restrictive setting,\" said DRC staff attorney Katherine Mathews.\u003c/p>\n\u003cp>The report says five of the 11 children interviewed at the Yolo County facility reported being sprayed with a chemical agent.\u003c/p>\n\u003cp>\"This is what was going on for children with disabilities,\" Mathews said.\u003c/p>\n\u003cp>At BCFS, another secure facility in Fairfield, clinical staff told DRC they had \"often served children with mental health disabilities such as PTSD, anxiety and depression,\" and recalled at least one child with autism in their care.\u003c/p>\n\u003ch3>Inadequate Education\u003c/h3>\n\u003cp>According to the \u003ca href=\"https://www2.ed.gov/parents/needs/speced/iepguide/index.html\">California Department of Education\u003c/a>, each child in public school who receives special education must have an Individualized Education Program (IEP), documenting their educational abilities and outlining what services the child might be eligible for.\u003c/p>\n\u003cp>\"What we found overwhelmingly is that, besides Yolo, none of these children were receiving any kind of in-depth Individualized Education Programs,\" Mathews said.\u003c/p>\n\u003cp>The ORR manual requires that care facilities conduct \u003ca href=\"https://www.acf.hhs.gov/orr/resource/children-entering-the-united-states-unaccompanied-section-3#3.3.5\">educational assessments\u003c/a> within 72 hours of admission and requires each child to receive at least six hours of \"structured education, Monday through Friday, throughout the entire year in basic academic areas.\"\u003c/p>\n\u003cp>[pullquote size='medium' align='right' citation='Disability Rights California staff attorney Katherine Mathews']'We really want to make sure that the Legislature and the public are aware of what's going on. And also to make sure that these children are protected, and they're receiving the same treatment, the same education and the same level of safety and concern that the rest of California children are receiving.'[/pullquote]\u003c/p>\n\u003cp>The Trump administration has announced it will \u003ca href=\"https://www.npr.org/2019/06/05/730082911/administration-cuts-education-and-legal-services-for-unaccompanied-minors\">cut funding\u003c/a> from these educational programs.\u003c/p>\n\u003cp>However, according to the DRC report, ORR does not \"require any type of screening for special education or any development of IEPs.\"\u003c/p>\n\u003cp>It also allows caregivers to \"adapt or modify local educational standards to develop curricula and assessments, based on the average length of stay\" of each child.\u003c/p>\n\u003cp>During interviews with children in California facilities, DRC investigators found students with vastly different educational backgrounds being placed in classes together. For example, a teenager who had completed 11 years of school was in the same classroom as a teenager who had completed four.\u003c/p>\n\u003cp>\"It really was placing a bunch of kids — coming from all different kinds of educational backgrounds — in the same large classroom,\" Mathews said.\u003c/p>\n\u003ch3>Lacking Medical and Mental Health Care\u003c/h3>\n\u003cp>Through the course of the DRC's investigation, the group alleges that ORR's vague and inconsistent policies regarding health care for immigrant children led to wide variation between care facilities.\u003c/p>\n\u003cp>Along with inconsistent medical examination standards, DRC found that children housed in ORR facilities also \"suffer from a lack of comprehensive medical and dental care.\"\u003c/p>\n\u003cp>In light of these findings, Mathews said DRC will be pushing for greater government oversight of the facilities and increased public awareness.\u003c/p>\n\u003cp>\"We really want to make sure that the Legislature and the public are aware of what's going on,\" Mathews said. \"And also to make sure that these children are protected, and they're receiving the same treatment, the same education and the same level of safety and concern that the rest of California children are receiving.\"\u003c/p>\n\u003cp>\u003c/p>\n\u003cp>\u003cem>KQED's Angela Corral contributed to this report.\u003c/em>\u003c/p>\n\n",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>However, the DRC found that 81% of the teenagers placed at the Yolo County Juvenile Detention Facility were placed there because of suicidal ideation (suicidal thoughts) or other mental health concerns.\u003c/p>\n\u003cp>The immigrant children housed in this location are, according to the DRC’s report, \"held in similarly or more restrictive settings as compared to the juvenile delinquency system.\"\u003c/p>\n\u003cp>For example, migrant kids were living in isolated cellblock units, subject to pepper spray and other forms of force or discipline, and allowed outside only for limited periods of time.\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>\"A lot of these children have self-injurious behavior, suicidal ideation or have behavioral issues and then, therefore, are placed in that most restrictive setting,\" said DRC staff attorney Katherine Mathews.\u003c/p>\n\u003cp>The report says five of the 11 children interviewed at the Yolo County facility reported being sprayed with a chemical agent.\u003c/p>\n\u003cp>\"This is what was going on for children with disabilities,\" Mathews said.\u003c/p>\n\u003cp>At BCFS, another secure facility in Fairfield, clinical staff told DRC they had \"often served children with mental health disabilities such as PTSD, anxiety and depression,\" and recalled at least one child with autism in their care.\u003c/p>\n\u003ch3>Inadequate Education\u003c/h3>\n\u003cp>According to the \u003ca href=\"https://www2.ed.gov/parents/needs/speced/iepguide/index.html\">California Department of Education\u003c/a>, each child in public school who receives special education must have an Individualized Education Program (IEP), documenting their educational abilities and outlining what services the child might be eligible for.\u003c/p>\n\u003cp>\"What we found overwhelmingly is that, besides Yolo, none of these children were receiving any kind of in-depth Individualized Education Programs,\" Mathews said.\u003c/p>\n\u003cp>The ORR manual requires that care facilities conduct \u003ca href=\"https://www.acf.hhs.gov/orr/resource/children-entering-the-united-states-unaccompanied-section-3#3.3.5\">educational assessments\u003c/a> within 72 hours of admission and requires each child to receive at least six hours of \"structured education, Monday through Friday, throughout the entire year in basic academic areas.\"\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"content": "\u003cp>Last December, Brighid FitzGibbon’s son, Evan, entered a catatonic state. Acute psychosis had hit suddenly a few weeks earlier, toward the end of fall semester of his sophomore year at Bard College in upstate New York. Gripped by terrifying delusions, his body began to shut down.\u003c/p>\n\u003cp>FitzGibbon and her husband, Taylor, rushed their 20-year-old son to a hospital in Sonoma County, where they live. An acquaintance told them about a promising program for young people experiencing early psychosis. But the family quickly discovered a problem: the program didn’t exist in their county.\u003c/p>\n\u003cp>In California, geography creates significant barriers to people getting early psychosis treatment, as it does for array of other evidence-based mental health treatments. That’s partly because California’s 58 counties have 58 different public mental health programs, each with their own set of covered services.\u003c/p>\n\u003cp>[aside tag='mental-health' label='more on mental health']“If you get on a bus in Northern California and take it to Southern California, you get different services depending on where you step out,” said Carmela Coyle, president and CEO of the California Hospital Association, a lobbying group for the state’s hospitals. “That’s just inequitable.”\u003c/p>\n\u003cp>Dr. Tom Insel, whom Gov. Gavin Newsom recently appointed as his top mental health advisor, has likened the fragmented system to playing the piano with \u003cu>\u003ca href=\"https://calmatters.org/articles/if-you-think-the-system-works-youre-dead-wrong-a-discussion-on-californias-mental-health-system/\" target=\"_blank\" rel=\"noopener\">58 fingers\u003c/a>\u003c/u>.\u003c/p>\n\u003cp>“There’s no central leadership, really,” said Insel, the former director of the National Institute of Mental Health. “If you ask, ‘What are the counties trying to accomplish? What are their goals? What is their North Star?’ I can’t tell you that. There’s a North Star in L.A. County, in San Mateo, in Alameda. They’re not the same.”\u003c/p>\n\u003cp>Insel and many other mental health experts say California offers too little guidance and oversight to ensure fair access to mental health treatment, missing opportunities to spread best practices from individual counties statewide.\u003c/p>\n\u003cp>He wants the state to identify specific goals for mental health outcomes, such as reducing suicides and the incarceration of people with mental illness. He also wants the state to help counties achieve those goals. Among his top priorities: early psychosis intervention.\u003c/p>\n\u003cp>“For most kids who can get that kind of treatment soon after the onset, they’ll do quite well,” Insel said. “They can go on to really have a life that does not happen today with a diagnosis of schizophrenia.”\u003c/p>\n\u003chr>\n\u003cp> \u003c/p>\n\u003cp>[dropcap]A[/dropcap]bout 100,000 adolescents and young adults nationwide experience first-episode psychosis each year, \u003cu>\u003ca href=\"https://www.nimh.nih.gov/health/topics/schizophrenia/raise/fact-sheet-first-episode-psychosis.shtml\" target=\"_blank\" rel=\"noopener\">according to federal figures\u003c/a>\u003c/u>—and three out of 100 people will experience psychosis at some point in their lives.\u003c/p>\n\u003cp>In recent years, policymakers and mental health providers have grown enthusiastic about early psychosis intervention programs, which typically involve intensive counseling, psychiatric treatment and peer and family support, with trained providers working closely together to coordinate each patient’s care.\u003c/p>\n\u003cp>In 2016, the federal government set aside 10% of states’ Community Mental Health Block Grants for early psychosis programming; in California, that totals $9.5 million. Legislators this year have proposed allocating $20 million for early psychosis programming in California’s new budget, which is $5 million less than the governor sought.\u003c/p>\n\u003cfigure id=\"attachment_11756756\" class=\"wp-caption alignleft\" style=\"max-width: 350px\">\u003cimg loading=\"lazy\" decoding=\"async\" class=\"wp-image-11756756\" src=\"https://ww2.kqed.org/news/wp-content/uploads/sites/10/2019/06/Dennison17_1-400x600.jpg\" alt=\"\" width=\"350\" height=\"525\" srcset=\"https://cdn.kqed.org/wp-content/uploads/sites/10/2019/06/Dennison17_1-400x600.jpg 400w, https://cdn.kqed.org/wp-content/uploads/sites/10/2019/06/Dennison17_1-400x600-160x240.jpg 160w\" sizes=\"auto, (max-width: 350px) 100vw, 350px\">\u003cfigcaption class=\"wp-caption-text\">Christine Marie Frey, 18, attended an early psychosis program in San Diego after she began to hear demons as a 12-year-old. She’s the author of “Brain XP: Living with Mental Illness, A Young Teenager’s Perspective.” \u003ccite>(Family photo)\u003c/cite>\u003c/figcaption>\u003c/figure>\n\u003cp>Done right, research shows, the programs can dramatically help young people experiencing psychotic symptoms, with lasting benefits. The converse is also true: The longer psychosis goes untreated, the worse the outcome. People with an initial diagnosis of psychosis are approximately \u003cu>\u003ca href=\"https://jamanetwork.com/journals/jamapsychiatry/fullarticle/2670697\" target=\"_blank\" rel=\"noopener\">eight times\u003c/a>\u003c/u> as likely to die during the year following their diagnosis as people in the general population. The cause is often suicide.\u003c/p>\n\u003cp>According to one national study, clients in early psychosis programs stay in treatment longer, experience fewer symptoms are more involved in work or school, compared with patients in other care settings—provided they get into treatment fast. \u003ca href=\"https://ajp.psychiatryonline.org/doi/10.1176/appi.ajp.2017.17050480\" target=\"_blank\" rel=\"noopener\">A Canadian study\u003c/a> published last year in the American Journal of Psychiatry showed that people who participated in early psychosis intervention after their first episode were four times less likely to die.\u003c/p>\n\u003cp>In the United States, on average, individuals experiencing psychosis went without treatment for 74 weeks. Other countries have dramatically reduced this number.\u003c/p>\n\u003cp>Christine Marie Frey, now 18, attended a program in San Diego after she began to hear demons as a 12-year-old. It offered personal and occupational therapy, as well as help with mindfulness, medication and school. Frey found comfort in talking with peers in similar circumstances.\u003c/p>\n\u003cp>“They helped me realize, not just how to cope—they helped me feel like my own self again,” she said. “I went in there ready to give up.”\u003c/p>\n\u003cp>Early psychosis interventions can target young people with symptoms that put them at high risk for psychosis, or those who have had their first experience of psychosis. Those in the first group might hear whispers and wonder if their brain is playing tricks on them; the second group is more likely to believe the voices are real.\u003c/p>\n\u003cp>In California, only about two dozen counties have early psychosis programs. Most lack the money or capacity to make them available to all county residents. Often, the only people eligible are those without insurance or on Medi-Cal for low-income Californians, though in some cases private insurers pay for patients.\u003c/p>\n\u003chr>\n\u003cp> \u003c/p>\n\u003cp>[dropcap]G[/dropcap]rowing up, Evan had always been a strong student, and a talented musician and athlete, his mother said. But as he approached the end of his fall sophomore semester, he became increasingly worried about choosing a major and meeting music deadlines.\u003c/p>\n\u003cp>For several nights, he stopped sleeping. On his 20\u003csup>th\u003c/sup> birthday, a friend rushed him to the emergency room. He received medication to help him sleep, but continued to get worse. His father raced across the country to bring him back to Sebastopol, assuming the comfort of home would help. Then the delusions started.\u003c/p>\n\u003cp>After his parents heard about the early psychosis program, they said they begged their insurance provider, Kaiser Permanente, for a referral, but Kaiser refused.\u003c/p>\n\u003cp>In an emailed statement, Dr. Sameer Awsare, associate executive director of Kaiser’s Northern California medical group, said Kaiser is not simply an ‘insurer’” that pays for outside services.\u003c/p>\n\u003cp>“Kaiser Permanente is an integrated health care system that provides expert, evidence-based medical care for our members, including in the area of psychosis,” Awsare said. He added that Kaiser follows federal “best practices” for cognitive behavioral treatment of psychosis and multi-family group treatment, and when clinically appropriate, Kaiser does refer members to outside programs.\u003c/p>\n\u003cp>He cited patient confidentiality in declining to discuss Evan’s case.\u003c/p>\n\u003cfigure id=\"attachment_11756762\" class=\"wp-caption alignnone\" style=\"max-width: 800px\">\u003cimg loading=\"lazy\" decoding=\"async\" class=\"size-medium wp-image-11756762\" src=\"https://ww2.kqed.org/news/wp-content/uploads/sites/10/2019/06/CALMatters-FitzGibbon_015-2880x1800-800x500.jpg\" alt=\"\" width=\"800\" height=\"500\" srcset=\"https://cdn.kqed.org/wp-content/uploads/sites/10/2019/06/CALMatters-FitzGibbon_015-2880x1800-800x500.jpg 800w, https://cdn.kqed.org/wp-content/uploads/sites/10/2019/06/CALMatters-FitzGibbon_015-2880x1800-160x100.jpg 160w, https://cdn.kqed.org/wp-content/uploads/sites/10/2019/06/CALMatters-FitzGibbon_015-2880x1800-1020x638.jpg 1020w, https://cdn.kqed.org/wp-content/uploads/sites/10/2019/06/CALMatters-FitzGibbon_015-2880x1800-1200x750.jpg 1200w, https://cdn.kqed.org/wp-content/uploads/sites/10/2019/06/CALMatters-FitzGibbon_015-2880x1800-1920x1200.jpg 1920w, https://cdn.kqed.org/wp-content/uploads/sites/10/2019/06/CALMatters-FitzGibbon_015-2880x1800.jpg 2048w\" sizes=\"auto, (max-width: 800px) 100vw, 800px\">\u003cfigcaption class=\"wp-caption-text\">Brighid Fitzgibbon with her son, Evan, who was a sophomore at Bard College when acute psychosis hit. \u003ccite>(Penni Gladstone/CALmatters)\u003c/cite>\u003c/figcaption>\u003c/figure>\n\u003cp>But Evan’s parents didn’t feel that what they said Kaiser was offering—a general intensive outpatient program in which most patients didn’t have psychosis, a meeting with a psychiatrist every few weeks, and therapy every week or so—was enough.\u003c/p>\n\u003cp>So Evan’s father drove him every week or so to the UC Davis Early Diagnosis and Preventive Treatment Clinic, a state-of-the-art program in Sacramento. The drive was about four hours round-trip, and the family paid thousands of dollars for his care, with the help of a GoFundMe account set up by his elementary school teacher.\u003c/p>\n\u003cp>Evan stabilized and began to improve, his mother said. But the long drives wore on her son and his father, who had severe back pain. And the out-of-pocket costs became prohibitive. Coming from so far away, it was difficult for Evan to participate in the peer groups. Although Brighid FitzGibbon said they would have liked to continue, they made the difficult choice to stop a few months into the program in May.\u003c/p>\n\u003cp>“I don’t know,” said FitzGibbon, whose son gave permission for her to share his story. “It’s just disheartening to see how broken the system is. I think we did the best we could.”\u003c/p>\n\u003chr>\n\u003cp> \u003c/p>\n\u003cp>[dropcap]B[/dropcap]ill Carter, who recently became Sonoma County’s mental health director, said he is committed to bringing an early psychosis program there, calling it “one of the best things going.”\u003c/p>\n\u003cp>“It’s the kind of thing we in the mental health field have been waiting for,” he said. “Historically, schizophrenia and other thought disorders have the potential really just to ravage someone’s life.”\u003c/p>\n\u003cp>Carter previously worked for the California Institute of Mental Health, leading efforts to disseminate evidence-based practices, including early psychosis treatment. He also served as mental health director of Napa County, which beginning in 2014 has made early psychosis treatment available to any county resident who needed it, regardless of insurance.\u003c/p>\n\u003cp>[pullquote size='medium' align='right' citation='Sonoma County mental health director Bill Carter']‘Historically, schizophrenia and other thought disorders have the potential really just to ravage someone’s life.’[/pullquote]Napa managed this in part due to funding from One Mind, a nonprofit founded by the local Staglin family, whose son, Brandon, recovered from schizophrenia in the 1990s and is now the president. The Napa program also receives support from local vintners, a large charity auction and a variety of federal and state funding sources.\u003c/p>\n\u003cp>But despite Carter’s commitment to bringing early psychosis programming to Sonoma County, he has encountered significant obstacles. After 2017’s wildfires, the county is facing huge budget shortfalls—and making steep cuts to mental health care.\u003c/p>\n\u003cp>Convincing the public to invest significantly in a prevention program for relatively few people is challenging, Carter said, especially when so many very sick people are going without care. He’d prefer that the state provide centralized leadership and support to help counties fund and build early psychosis programs.\u003c/p>\n\u003chr>\n\u003cp> \u003c/p>\n\u003cp>[dropcap]W[/dropcap]hy doesn’t that exist? Why do 58 counties do things 58 ways? By design. Back in 1991, the state faced a budget crisis, and in a process known as “realignment,” it shifted responsibility for mental health delivery to counties.\u003c/p>\n\u003cp>It also assigned counties dedicated funding from sales taxes and vehicle license fees, creating formulas based on how much each county was spending at the time. Over the years, these funds have neither kept pace with need nor been adjusted to account for changing populations.\u003c/p>\n\u003cp>In 2004, California voters passed the Mental Health Services Act initiative, levying a tax on the state’s millionaires. It has pumped in about \u003cu>\u003ca href=\"https://mhsoac.ca.gov/act\">$15 billio\u003c/a>\u003ca href=\"https://mhsoac.ca.gov/act\">n more for mental health\u003c/a>\u003c/u>, which the stated doles out to counties to promote flexibility.\u003c/p>\n\u003cp>Counties say they need to be nimble. In a state as vast and varied as California, the issues facing rural Trinity County differ from those of urban Los Angeles. But the approach has disadvantages.\u003c/p>\n\u003cp>[aside tag='kaiser-permanente-mental-health' label='mental healthcare access']“There’s not necessarily rhyme or reason to why a county chooses to provide some services and not others,” said Sheree Lowe, vice president of behavioral health for the California Hospital Association. “The best way to describe it is, it’s a broken delivery system.”\u003c/p>\n\u003cp>What the state needs, Lowe contends, is core services available in every community. Now, she says, the state doesn’t track what services are provided in each county.\u003c/p>\n\u003cp>In 2012, the state shuttered its Department of Mental Health, and moved many of its staff members to the Department of Health Care Services. Some feel the move further sidelined mental health.\u003c/p>\n\u003cp>“I think counties have been cast adrift, really,” said Randall Hagar, government relations director for the California Psychiatric Association, which represents the interests of the state’s psychiatrists. “I would agree with the assessment that there is still no state leadership.”\u003c/p>\n\u003cp>This isn’t true everywhere. Oregon has a comprehensive, state-run early psychosis program. New York state created \u003cu>\u003ca href=\"https://www.ontrackny.org/\">OnTrackNY,\u003c/a>\u003c/u> a state-led effort to provide coordinated early psychosis care to young people. Dr. Insel said he would like to see California implement a similar effort.\u003c/p>\n\u003chr>\n\u003cp> \u003c/p>\n\u003cp>[dropcap]M[/dropcap]any people see hope for the future of early psychosis intervention in California because of the UC Davis clinic that Brighid FitzGibbon’s son Evan attended—and its director, Tara Niendam. In 2008, Dr. Cameron Carter, a prominent psychiatrist with a strong interest in early psychosis, recruited her to the Sacramento clinic he’d founded.\u003c/p>\n\u003cp>Today, the staff includes psychiatrists, therapists, a family advocate and a specialist in education and employment, as well as a worker dedicated to meeting patients’ social needs, such as housing. Patients participate in peer and family support groups.\u003c/p>\n\u003cp>Too often, Niendam says, individuals “just float around in our system receiving sometimes inadequate care.” Effective mental health care doesn’t simply make symptoms go away, she said. It gives individuals and families the tools to pursue meaningful lives.\u003c/p>\n\u003cp>“That’s more than a pill can do,” she said.\u003c/p>\n\u003cp>One of the clinic’s patients, Meheretab — who asked that his last name not be used — began attending Niendam’s clinic after suicidal thoughts and hallucinations. Meheretab, who has Medi-Cal, said the infrequent treatment he was receiving through Kaiser wasn’t working. Niendam’s clinic felt safe. With a combination of medication, counseling, job support and a peer group, he said, his depression subsided and the hallucinations ended.\u003c/p>\n\u003cp>“I feel like I’m in a better place right now,” he said.\u003c/p>\n\u003cp>Niendam helped Napa and Solano counties start early psychosis programs and is currently doing the same with Yolo County. Small counties can struggle to hire and train the staff necessary for a full early psychosis program, so she is developing a way for them to contract with larger counties or use telemedicine. She wants to expand the treatment model statewide.\u003c/p>\n\u003cp>Watching people who have been hospitalized 10 times return to school or hold a fulltime job, and showing them they can recover, “are the things that keep me going every day,” she said. “It’s game-changing for everyone. It’s super exciting to be part of that.”\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>\u003cp>Last December, Brighid FitzGibbon’s son, Evan, entered a catatonic state. Acute psychosis had hit suddenly a few weeks earlier, toward the end of fall semester of his sophomore year at Bard College in upstate New York. Gripped by terrifying delusions, his body began to shut down.\u003c/p>\n\u003cp>FitzGibbon and her husband, Taylor, rushed their 20-year-old son to a hospital in Sonoma County, where they live. An acquaintance told them about a promising program for young people experiencing early psychosis. But the family quickly discovered a problem: the program didn’t exist in their county.\u003c/p>\n\u003cp>In California, geography creates significant barriers to people getting early psychosis treatment, as it does for array of other evidence-based mental health treatments. That’s partly because California’s 58 counties have 58 different public mental health programs, each with their own set of covered services.\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"content": "\u003cdiv class=\"post-body\">\u003cp>“If you get on a bus in Northern California and take it to Southern California, you get different services depending on where you step out,” said Carmela Coyle, president and CEO of the California Hospital Association, a lobbying group for the state’s hospitals. “That’s just inequitable.”\u003c/p>\n\u003cp>Dr. Tom Insel, whom Gov. Gavin Newsom recently appointed as his top mental health advisor, has likened the fragmented system to playing the piano with \u003cu>\u003ca href=\"https://calmatters.org/articles/if-you-think-the-system-works-youre-dead-wrong-a-discussion-on-californias-mental-health-system/\" target=\"_blank\" rel=\"noopener\">58 fingers\u003c/a>\u003c/u>.\u003c/p>\n\u003cp>“There’s no central leadership, really,” said Insel, the former director of the National Institute of Mental Health. “If you ask, ‘What are the counties trying to accomplish? What are their goals? What is their North Star?’ I can’t tell you that. There’s a North Star in L.A. County, in San Mateo, in Alameda. They’re not the same.”\u003c/p>\n\u003cp>Insel and many other mental health experts say California offers too little guidance and oversight to ensure fair access to mental health treatment, missing opportunities to spread best practices from individual counties statewide.\u003c/p>\n\u003cp>He wants the state to identify specific goals for mental health outcomes, such as reducing suicides and the incarceration of people with mental illness. He also wants the state to help counties achieve those goals. Among his top priorities: early psychosis intervention.\u003c/p>\n\u003cp>“For most kids who can get that kind of treatment soon after the onset, they’ll do quite well,” Insel said. “They can go on to really have a life that does not happen today with a diagnosis of schizophrenia.”\u003c/p>\n\u003chr>\n\u003cp> \u003c/p>\n\u003cp>\u003c/p>\u003cp>\u003cspan class=\"utils-parseShortcode-shortcodes-__dropcapShortcode__dropcap\">A\u003c/span>\u003c/p>\u003cp>bout 100,000 adolescents and young adults nationwide experience first-episode psychosis each year, \u003cu>\u003ca href=\"https://www.nimh.nih.gov/health/topics/schizophrenia/raise/fact-sheet-first-episode-psychosis.shtml\" target=\"_blank\" rel=\"noopener\">according to federal figures\u003c/a>\u003c/u>—and three out of 100 people will experience psychosis at some point in their lives.\u003c/p>\n\u003cp>In recent years, policymakers and mental health providers have grown enthusiastic about early psychosis intervention programs, which typically involve intensive counseling, psychiatric treatment and peer and family support, with trained providers working closely together to coordinate each patient’s care.\u003c/p>\n\u003cp>In 2016, the federal government set aside 10% of states’ Community Mental Health Block Grants for early psychosis programming; in California, that totals $9.5 million. Legislators this year have proposed allocating $20 million for early psychosis programming in California’s new budget, which is $5 million less than the governor sought.\u003c/p>\n\u003cfigure id=\"attachment_11756756\" class=\"wp-caption alignleft\" style=\"max-width: 350px\">\u003cimg loading=\"lazy\" decoding=\"async\" class=\"wp-image-11756756\" src=\"https://ww2.kqed.org/news/wp-content/uploads/sites/10/2019/06/Dennison17_1-400x600.jpg\" alt=\"\" width=\"350\" height=\"525\" srcset=\"https://cdn.kqed.org/wp-content/uploads/sites/10/2019/06/Dennison17_1-400x600.jpg 400w, https://cdn.kqed.org/wp-content/uploads/sites/10/2019/06/Dennison17_1-400x600-160x240.jpg 160w\" sizes=\"auto, (max-width: 350px) 100vw, 350px\">\u003cfigcaption class=\"wp-caption-text\">Christine Marie Frey, 18, attended an early psychosis program in San Diego after she began to hear demons as a 12-year-old. She’s the author of “Brain XP: Living with Mental Illness, A Young Teenager’s Perspective.” \u003ccite>(Family photo)\u003c/cite>\u003c/figcaption>\u003c/figure>\n\u003cp>Done right, research shows, the programs can dramatically help young people experiencing psychotic symptoms, with lasting benefits. The converse is also true: The longer psychosis goes untreated, the worse the outcome. People with an initial diagnosis of psychosis are approximately \u003cu>\u003ca href=\"https://jamanetwork.com/journals/jamapsychiatry/fullarticle/2670697\" target=\"_blank\" rel=\"noopener\">eight times\u003c/a>\u003c/u> as likely to die during the year following their diagnosis as people in the general population. The cause is often suicide.\u003c/p>\n\u003cp>According to one national study, clients in early psychosis programs stay in treatment longer, experience fewer symptoms are more involved in work or school, compared with patients in other care settings—provided they get into treatment fast. \u003ca href=\"https://ajp.psychiatryonline.org/doi/10.1176/appi.ajp.2017.17050480\" target=\"_blank\" rel=\"noopener\">A Canadian study\u003c/a> published last year in the American Journal of Psychiatry showed that people who participated in early psychosis intervention after their first episode were four times less likely to die.\u003c/p>\n\u003cp>In the United States, on average, individuals experiencing psychosis went without treatment for 74 weeks. Other countries have dramatically reduced this number.\u003c/p>\n\u003cp>Christine Marie Frey, now 18, attended a program in San Diego after she began to hear demons as a 12-year-old. It offered personal and occupational therapy, as well as help with mindfulness, medication and school. Frey found comfort in talking with peers in similar circumstances.\u003c/p>\n\u003cp>“They helped me realize, not just how to cope—they helped me feel like my own self again,” she said. “I went in there ready to give up.”\u003c/p>\n\u003cp>Early psychosis interventions can target young people with symptoms that put them at high risk for psychosis, or those who have had their first experience of psychosis. Those in the first group might hear whispers and wonder if their brain is playing tricks on them; the second group is more likely to believe the voices are real.\u003c/p>\n\u003cp>In California, only about two dozen counties have early psychosis programs. Most lack the money or capacity to make them available to all county residents. Often, the only people eligible are those without insurance or on Medi-Cal for low-income Californians, though in some cases private insurers pay for patients.\u003c/p>\n\u003chr>\n\u003cp> \u003c/p>\n\u003cp>\u003c/p>\u003cp>\u003cspan class=\"utils-parseShortcode-shortcodes-__dropcapShortcode__dropcap\">G\u003c/span>\u003c/p>\u003cp>rowing up, Evan had always been a strong student, and a talented musician and athlete, his mother said. But as he approached the end of his fall sophomore semester, he became increasingly worried about choosing a major and meeting music deadlines.\u003c/p>\n\u003cp>For several nights, he stopped sleeping. On his 20\u003csup>th\u003c/sup> birthday, a friend rushed him to the emergency room. He received medication to help him sleep, but continued to get worse. His father raced across the country to bring him back to Sebastopol, assuming the comfort of home would help. Then the delusions started.\u003c/p>\n\u003cp>After his parents heard about the early psychosis program, they said they begged their insurance provider, Kaiser Permanente, for a referral, but Kaiser refused.\u003c/p>\n\u003cp>In an emailed statement, Dr. Sameer Awsare, associate executive director of Kaiser’s Northern California medical group, said Kaiser is not simply an ‘insurer’” that pays for outside services.\u003c/p>\n\u003cp>“Kaiser Permanente is an integrated health care system that provides expert, evidence-based medical care for our members, including in the area of psychosis,” Awsare said. He added that Kaiser follows federal “best practices” for cognitive behavioral treatment of psychosis and multi-family group treatment, and when clinically appropriate, Kaiser does refer members to outside programs.\u003c/p>\n\u003cp>He cited patient confidentiality in declining to discuss Evan’s case.\u003c/p>\n\u003cfigure id=\"attachment_11756762\" class=\"wp-caption alignnone\" style=\"max-width: 800px\">\u003cimg loading=\"lazy\" decoding=\"async\" class=\"size-medium wp-image-11756762\" src=\"https://ww2.kqed.org/news/wp-content/uploads/sites/10/2019/06/CALMatters-FitzGibbon_015-2880x1800-800x500.jpg\" alt=\"\" width=\"800\" height=\"500\" srcset=\"https://cdn.kqed.org/wp-content/uploads/sites/10/2019/06/CALMatters-FitzGibbon_015-2880x1800-800x500.jpg 800w, https://cdn.kqed.org/wp-content/uploads/sites/10/2019/06/CALMatters-FitzGibbon_015-2880x1800-160x100.jpg 160w, https://cdn.kqed.org/wp-content/uploads/sites/10/2019/06/CALMatters-FitzGibbon_015-2880x1800-1020x638.jpg 1020w, https://cdn.kqed.org/wp-content/uploads/sites/10/2019/06/CALMatters-FitzGibbon_015-2880x1800-1200x750.jpg 1200w, https://cdn.kqed.org/wp-content/uploads/sites/10/2019/06/CALMatters-FitzGibbon_015-2880x1800-1920x1200.jpg 1920w, https://cdn.kqed.org/wp-content/uploads/sites/10/2019/06/CALMatters-FitzGibbon_015-2880x1800.jpg 2048w\" sizes=\"auto, (max-width: 800px) 100vw, 800px\">\u003cfigcaption class=\"wp-caption-text\">Brighid Fitzgibbon with her son, Evan, who was a sophomore at Bard College when acute psychosis hit. \u003ccite>(Penni Gladstone/CALmatters)\u003c/cite>\u003c/figcaption>\u003c/figure>\n\u003cp>But Evan’s parents didn’t feel that what they said Kaiser was offering—a general intensive outpatient program in which most patients didn’t have psychosis, a meeting with a psychiatrist every few weeks, and therapy every week or so—was enough.\u003c/p>\n\u003cp>So Evan’s father drove him every week or so to the UC Davis Early Diagnosis and Preventive Treatment Clinic, a state-of-the-art program in Sacramento. The drive was about four hours round-trip, and the family paid thousands of dollars for his care, with the help of a GoFundMe account set up by his elementary school teacher.\u003c/p>\n\u003cp>Evan stabilized and began to improve, his mother said. But the long drives wore on her son and his father, who had severe back pain. And the out-of-pocket costs became prohibitive. Coming from so far away, it was difficult for Evan to participate in the peer groups. Although Brighid FitzGibbon said they would have liked to continue, they made the difficult choice to stop a few months into the program in May.\u003c/p>\n\u003cp>“I don’t know,” said FitzGibbon, whose son gave permission for her to share his story. “It’s just disheartening to see how broken the system is. I think we did the best we could.”\u003c/p>\n\u003chr>\n\u003cp> \u003c/p>\n\u003cp>\u003c/p>\u003cp>\u003cspan class=\"utils-parseShortcode-shortcodes-__dropcapShortcode__dropcap\">B\u003c/span>\u003c/p>\u003cp>ill Carter, who recently became Sonoma County’s mental health director, said he is committed to bringing an early psychosis program there, calling it “one of the best things going.”\u003c/p>\n\u003cp>“It’s the kind of thing we in the mental health field have been waiting for,” he said. “Historically, schizophrenia and other thought disorders have the potential really just to ravage someone’s life.”\u003c/p>\n\u003cp>Carter previously worked for the California Institute of Mental Health, leading efforts to disseminate evidence-based practices, including early psychosis treatment. He also served as mental health director of Napa County, which beginning in 2014 has made early psychosis treatment available to any county resident who needed it, regardless of insurance.\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"content": "\u003cdiv class=\"post-body\">\u003cp>Napa managed this in part due to funding from One Mind, a nonprofit founded by the local Staglin family, whose son, Brandon, recovered from schizophrenia in the 1990s and is now the president. The Napa program also receives support from local vintners, a large charity auction and a variety of federal and state funding sources.\u003c/p>\n\u003cp>But despite Carter’s commitment to bringing early psychosis programming to Sonoma County, he has encountered significant obstacles. After 2017’s wildfires, the county is facing huge budget shortfalls—and making steep cuts to mental health care.\u003c/p>\n\u003cp>Convincing the public to invest significantly in a prevention program for relatively few people is challenging, Carter said, especially when so many very sick people are going without care. He’d prefer that the state provide centralized leadership and support to help counties fund and build early psychosis programs.\u003c/p>\n\u003chr>\n\u003cp> \u003c/p>\n\u003cp>\u003c/p>\u003cp>\u003cspan class=\"utils-parseShortcode-shortcodes-__dropcapShortcode__dropcap\">W\u003c/span>\u003c/p>\u003cp>hy doesn’t that exist? Why do 58 counties do things 58 ways? By design. Back in 1991, the state faced a budget crisis, and in a process known as “realignment,” it shifted responsibility for mental health delivery to counties.\u003c/p>\n\u003cp>It also assigned counties dedicated funding from sales taxes and vehicle license fees, creating formulas based on how much each county was spending at the time. Over the years, these funds have neither kept pace with need nor been adjusted to account for changing populations.\u003c/p>\n\u003cp>In 2004, California voters passed the Mental Health Services Act initiative, levying a tax on the state’s millionaires. It has pumped in about \u003cu>\u003ca href=\"https://mhsoac.ca.gov/act\">$15 billio\u003c/a>\u003ca href=\"https://mhsoac.ca.gov/act\">n more for mental health\u003c/a>\u003c/u>, which the stated doles out to counties to promote flexibility.\u003c/p>\n\u003cp>Counties say they need to be nimble. In a state as vast and varied as California, the issues facing rural Trinity County differ from those of urban Los Angeles. But the approach has disadvantages.\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"content": "\u003cdiv class=\"post-body\">\u003cp>“There’s not necessarily rhyme or reason to why a county chooses to provide some services and not others,” said Sheree Lowe, vice president of behavioral health for the California Hospital Association. “The best way to describe it is, it’s a broken delivery system.”\u003c/p>\n\u003cp>What the state needs, Lowe contends, is core services available in every community. Now, she says, the state doesn’t track what services are provided in each county.\u003c/p>\n\u003cp>In 2012, the state shuttered its Department of Mental Health, and moved many of its staff members to the Department of Health Care Services. Some feel the move further sidelined mental health.\u003c/p>\n\u003cp>“I think counties have been cast adrift, really,” said Randall Hagar, government relations director for the California Psychiatric Association, which represents the interests of the state’s psychiatrists. “I would agree with the assessment that there is still no state leadership.”\u003c/p>\n\u003cp>This isn’t true everywhere. Oregon has a comprehensive, state-run early psychosis program. New York state created \u003cu>\u003ca href=\"https://www.ontrackny.org/\">OnTrackNY,\u003c/a>\u003c/u> a state-led effort to provide coordinated early psychosis care to young people. Dr. Insel said he would like to see California implement a similar effort.\u003c/p>\n\u003chr>\n\u003cp> \u003c/p>\n\u003cp>\u003c/p>\u003cp>\u003cspan class=\"utils-parseShortcode-shortcodes-__dropcapShortcode__dropcap\">M\u003c/span>\u003c/p>\u003cp>any people see hope for the future of early psychosis intervention in California because of the UC Davis clinic that Brighid FitzGibbon’s son Evan attended—and its director, Tara Niendam. In 2008, Dr. Cameron Carter, a prominent psychiatrist with a strong interest in early psychosis, recruited her to the Sacramento clinic he’d founded.\u003c/p>\n\u003cp>Today, the staff includes psychiatrists, therapists, a family advocate and a specialist in education and employment, as well as a worker dedicated to meeting patients’ social needs, such as housing. Patients participate in peer and family support groups.\u003c/p>\n\u003cp>Too often, Niendam says, individuals “just float around in our system receiving sometimes inadequate care.” Effective mental health care doesn’t simply make symptoms go away, she said. It gives individuals and families the tools to pursue meaningful lives.\u003c/p>\n\u003cp>“That’s more than a pill can do,” she said.\u003c/p>\n\u003cp>One of the clinic’s patients, Meheretab — who asked that his last name not be used — began attending Niendam’s clinic after suicidal thoughts and hallucinations. Meheretab, who has Medi-Cal, said the infrequent treatment he was receiving through Kaiser wasn’t working. Niendam’s clinic felt safe. With a combination of medication, counseling, job support and a peer group, he said, his depression subsided and the hallucinations ended.\u003c/p>\n\u003cp>“I feel like I’m in a better place right now,” he said.\u003c/p>\n\u003cp>Niendam helped Napa and Solano counties start early psychosis programs and is currently doing the same with Yolo County. Small counties can struggle to hire and train the staff necessary for a full early psychosis program, so she is developing a way for them to contract with larger counties or use telemedicine. She wants to expand the treatment model statewide.\u003c/p>\n\u003cp>Watching people who have been hospitalized 10 times return to school or hold a fulltime job, and showing them they can recover, “are the things that keep me going every day,” she said. “It’s game-changing for everyone. It’s super exciting to be part of that.”\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"content": "\u003cp>Amanda Bacon’s eating disorder was growing worse. She had lost 60% of her body weight and was consuming only about 100 calories a day.\u003c/p>\n\u003cp>But that wasn’t sick enough for her Medicaid managed-care company to cover an inpatient treatment program. She was told in 2017 that unless she weighed 10 pounds less — which would have put her at 5-foot-7 and 90 pounds — or was admitted to a psychiatric unit, she wasn’t eligible for coverage.\u003c/p>\n\u003cp>“I remember thinking, ‘I’m going to die,’ ” the Las Cruces, N.M., resident recalls.\u003c/p>\n\u003cp>Eventually, Bacon, now 35, switched to a plan that paid for treatment, although she says it was still an arduous process getting the services approved.\u003c/p>\n\u003cp>Many patients, like Bacon, struggle to get insurance coverage for their mental health treatment, even though two federal laws were designed to bring parity between mental and physical health care coverage. Recent studies and a legal case suggest serious disparities remain.\u003c/p>\n\u003cp>\u003cspan style=\"font-weight: 400\">[aside tag='stress' label='Related Coverage']\u003c/span>\u003c/p>\n\u003cp>The 2008 \u003ca href=\"https://www.cms.gov/cciio/programs-and-initiatives/other-insurance-protections/mhpaea_factsheet.html\">Mental Health Parity and Addiction Equity Act\u003c/a> required large group health plans that provide benefits for mental health problems to put that coverage on an equal footing with physical illness. Two years later, the Affordable Care Act required small-group and individual health plans sold on the insurance marketplaces \u003ca href=\"https://aspe.hhs.gov/report/affordable-care-act-expands-mental-health-and-substance-use-disorder-benefits-and-federal-parity-protections-62-million-americans\">to cover mental health services\u003c/a>, and do so at levels comparable with medical services. (In 2016, parity rules \u003ca href=\"https://www.medicaid.gov/medicaid/benefits/downloads/fact-sheet-cms-2333-f.pdf\">were also applied to Medicaid\u003c/a> managed-care plans, which cover the majority of people in that federal-state health program for low-income residents.)\u003c/p>\n\u003cp>The laws have been partially successful. Insurers are no longer permitted to write policies that charge higher copays or deductibles for mental health care, nor can they set annual or lifetime upper-limits on how much they will pay for such care. But advocates for patients say insurance companies still interpret mental health claims more stringently than those for physical illness.\u003c/p>\n\u003cp>“Insurance companies can easily circumvent mental health parity mandates by imposing restrictive standards of medical necessity,” says \u003ca href=\"https://www.psych-appeal.com/meiram-bendat/\">Meiram Bendat\u003c/a>, a lawyer leading a class-action lawsuit against a mental health subsidiary of UnitedHealthcare.\u003c/p>\n\u003cp>In a closely watched ruling, a \u003ca href=\"https://www.nytimes.com/2019/03/05/health/unitedhealth-mental-health-parity.html\">federal court in March sided with Bendat\u003c/a> and patients who alleged the insurer was deliberately shortchanging mental health claims. Chief Magistrate Judge \u003ca href=\"https://drive.google.com/file/d/1XuzFQV4Z6vClFnpYpTaoS4vBT_RPhQsN/view\">Joseph Spero of the U.S. District Court for the Northern District of California ruled\u003c/a> that United Behavioral Health wrote its \u003ca href=\"https://www.manatt.com/Insights/Newsletters/Health-Update/Level-of-Care-Criteria-Ruled-Inconsistent\">guidelines for treatment\u003c/a> much more narrowly than common medical standards, covering only enough care to stabilize patients “while ignoring the effective treatment of members’ underlying conditions.”\u003c/p>\n\u003cp>UnitedHealthcare works to “ensure our products meet the needs of our members and comply with state and federal law,” says spokeswoman Tracey Lempner.\u003c/p>\n\u003cp>Several studies, though, have found evidence of disparities in insurers’ decisions.\u003c/p>\n\u003cp>[ad fullwidth]\u003c/p>\n\u003cp>\u003cstrong>Growing gap in coverage in hospitals\u003c/strong>\u003c/p>\n\u003cp>In February, researchers at the \u003ca href=\"https://www.healthaffairs.org/doi/abs/10.1377/hlthaff.2018.05226\">Congressional Budget Office\u003c/a> reported that private insurance companies are paying 13% to 14% less for mental health care than Medicare does.\u003c/p>\n\u003cp>The insurance industry’s own data shows a \u003ca href=\"https://www.healthcostinstitute.org/images/easyblog_articles/276/HCCI-2017-Health-Care-Cost-and-Utilization-Report-02.12.19.pdf\">growing gap\u003c/a> between coverage of mental and physical care in hospitals and skilled nursing facilities. For the five years ending in 2017, out-of-pocket spending on inpatient mental health care grew nearly 13 times faster than all inpatient care, according to inpatient data reported in February by the \u003ca href=\"https://www.healthcostinstitute.org/about-hcci\">Health Care Cost Institute\u003c/a>, a research group funded by the insurance companies Aetna, Humana, UnitedHealthcare and Kaiser Permanente. (Kaiser Health News is not affiliated with Kaiser Permanente.)\u003c/p>\n\u003cp>And a \u003ca href=\"http://www.milliman.com/uploadedFiles/insight/2017/NQTLDisparityAnalysis.pdf\">2017 report\u003c/a> by the actuarial firm Milliman found that an office visit with a therapist is five times as likely to be out-of-network, and thus more expensive, than a primary care appointment.\u003c/p>\n\u003cp>\u003cspan style=\"font-weight: 400\">[aside tag='health' label='Related Coverage']\u003c/span>\u003c/p>\n\u003cp>In this environment, \u003ca href=\"https://journalistsresource.org/studies/government/health-care/mental-health-untreated-children-research/\">only half of the nearly 8 million children\u003c/a> who have been diagnosed with depression, anxiety or attention deficit hyperactivity disorder receive treatment, \u003ca href=\"https://jamanetwork.com/journals/jamapediatrics/fullarticle/2724377\">according to a February research letter\u003c/a> in the medical journal \u003cem>JAMA Pediatrics\u003c/em>. \u003ca href=\"https://www.samhsa.gov/data/sites/default/files/NSDUH-FFR1-2016/NSDUH-FFR1-2016.htm#tx\">Fewer than 1 in 5 people\u003c/a> with substance use disorder are treated, a national survey suggests, and, overall, \u003ca href=\"https://www.nimh.nih.gov/health/statistics/mental-illness.shtml\">nearly 6 in 10\u003c/a> people with mental illness get no treatment or medication, according to the National Institute Of Mental Health.\u003c/p>\n\u003cp>Amanda Bacon, who is still receiving care for her eating disorder, remembers fearing that she wouldn’t get treatment. She was at one point rushed to an emergency room for care, but after several days in the hospital she was sent home, no closer to getting well.\u003c/p>\n\u003cp>Today, because of her disability, Bacon’s primary medical insurance is through Medicare, which has paid for treatment that her earlier Medicaid provider, Molina Healthcare, refused. She has been treated in four inpatient programs in the past two years — twice through Presbyterian Centennial Care, a Medicaid plan she switched to after Molina, and twice though her current Medicare plan. Bacon is also enrolled in a state-run Medicaid plan.\u003c/p>\n\u003cp>Molina says it can’t comment on Bacon’s case. “Molina complies with mental health parity laws,” say spokeswoman Danielle Smith, and it “applies industry-recognized medical necessity criteria in any medical determinations affecting mental health.”\u003c/p>\n\u003cp>\u003cstrong>The ‘wrong criteria’\u003c/strong>\u003c/p>\n\u003cp>\u003ca href=\"https://www.austenriggs.org/staff/eric-m-plakun\">Dr. Eric Plakun\u003c/a>, CEO of the Austen Riggs Center, a psychiatric hospital and residential program in Massachusetts, says that often insurers are “using the wrong criteria” for what makes something medically necessary. They pay enough only to stabilize a patient’s condition, Plakun says, but not enough to improve their underlying illness. He was one of the experts who testified in the case before Judge Spero in California.\u003c/p>\n\u003cp>Insurers say they recognize the importance of mental health care coverage and that they are \u003ca href=\"https://www.ahip.org/mental-health-parity-issue-brief/\">complying with the law\u003c/a>.\u003c/p>\n\u003cp>Cathryn Donaldson, a spokeswoman for the trade group America’s Health Insurance Plans, says the industry supports parity, but that it is also harder to prove when a mental health treatment is needed.\u003c/p>\n\u003cp>Compared with the data on medical and surgical care, she says, the data and standards to measure mental health care “trail far behind.” She cited \u003ca href=\"https://www.mnhospitals.org/Portals/0/Documents/policy-advocacy/mental-health/MHA%20Mental%20Health%20Avoidable%20Days%20Study%20Report%20July%202016.pdf\">a 2016 study\u003c/a> of Minnesota hospitals, where nearly one-fifth of the time patients spent in psychiatric units occurred after they were stabilized and ready to be discharged.\u003c/p>\n\u003cp>“Just like doctors use scientific evidence to determine the safest, most effective treatments,” insurers do the same to cover treatment “consistent with guidelines showing when and where it’s effective for patients,” Donaldson says.\u003c/p>\n\u003cp>Health plans commonly apply several controls that limit their coverage of mental health care. And these strategies by insurers are legal — unless they are applied more strictly for mental health care than medical care.\u003c/p>\n\u003cp>For example, they often require patients to try cheaper options first, a strategy called “fail first.” Patients referred by their doctors to a residential program for opioid addiction, for example, might be denied coverage by their insurers until they try — and fail — to improve at a less expensive part-time out-patient program.\u003c/p>\n\u003cp>Hiring doctors, nurses and pharmacists to review claims is another technique.\u003c/p>\n\u003cp>Dr. Frederick Villars, who reviews mental health claims for Aetna, remembers arguing with insurers to approve treatment when he was a practicing psychiatrist. His team decides what Aetna will cover based on clinical standards, he says. And providers upset about a coverage decision “are well aware of what these guidelines are.”\u003c/p>\n\u003cp>“It’s not a pleasant process,” Villars says, “but it’s the only tool that exists in this setting to try to keep costs under control.”\u003c/p>\n\u003cp>\u003ca href=\"http://khn.org/\">\u003cem>Kaiser Health News\u003c/em>\u003c/a>\u003cem> is a nonprofit, editorially independent program of the Kaiser Family Foundation. It is not affiliated with Kaiser Permanente. \u003c/em>\u003cem>Graison Dangor is a journalist living in Brooklyn.\u003c/em>\u003c/p>\n\u003cdiv class=\"fullattribution\">Copyright 2019 Kaiser Health News. To see more, visit \u003ca href=\"http://www.kaiserhealthnews.org/\">Kaiser Health News\u003c/a>.\u003cimg decoding=\"async\" src=\"https://www.google-analytics.com/__utm.gif?utmac=UA-5828686-4&utmdt=%27Mental+Health+Parity%27+Is+Still+An+Elusive+Goal+In+U.S.+Insurance+Coverage&utme=8(APIKey)9(MDAxOTAwOTE4MDEyMTkxMDAzNjczZDljZA004)\">\u003c/div>\n\u003cp>[ad floatright]\u003c/p>\n",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003cp>Amanda Bacon’s eating disorder was growing worse. She had lost 60% of her body weight and was consuming only about 100 calories a day.\u003c/p>\n\u003cp>But that wasn’t sick enough for her Medicaid managed-care company to cover an inpatient treatment program. She was told in 2017 that unless she weighed 10 pounds less — which would have put her at 5-foot-7 and 90 pounds — or was admitted to a psychiatric unit, she wasn’t eligible for coverage.\u003c/p>\n\u003cp>“I remember thinking, ‘I’m going to die,’ ” the Las Cruces, N.M., resident recalls.\u003c/p>\n\u003cp>Eventually, Bacon, now 35, switched to a plan that paid for treatment, although she says it was still an arduous process getting the services approved.\u003c/p>\n\u003cp>Many patients, like Bacon, struggle to get insurance coverage for their mental health treatment, even though two federal laws were designed to bring parity between mental and physical health care coverage. Recent studies and a legal case suggest serious disparities remain.\u003c/p>\n\u003cp>\u003cspan style=\"font-weight: 400\">\u003c/p>\u003c/div>",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003c/span>\u003c/p>\n\u003cp>The 2008 \u003ca href=\"https://www.cms.gov/cciio/programs-and-initiatives/other-insurance-protections/mhpaea_factsheet.html\">Mental Health Parity and Addiction Equity Act\u003c/a> required large group health plans that provide benefits for mental health problems to put that coverage on an equal footing with physical illness. Two years later, the Affordable Care Act required small-group and individual health plans sold on the insurance marketplaces \u003ca href=\"https://aspe.hhs.gov/report/affordable-care-act-expands-mental-health-and-substance-use-disorder-benefits-and-federal-parity-protections-62-million-americans\">to cover mental health services\u003c/a>, and do so at levels comparable with medical services. (In 2016, parity rules \u003ca href=\"https://www.medicaid.gov/medicaid/benefits/downloads/fact-sheet-cms-2333-f.pdf\">were also applied to Medicaid\u003c/a> managed-care plans, which cover the majority of people in that federal-state health program for low-income residents.)\u003c/p>\n\u003cp>The laws have been partially successful. Insurers are no longer permitted to write policies that charge higher copays or deductibles for mental health care, nor can they set annual or lifetime upper-limits on how much they will pay for such care. But advocates for patients say insurance companies still interpret mental health claims more stringently than those for physical illness.\u003c/p>\n\u003cp>“Insurance companies can easily circumvent mental health parity mandates by imposing restrictive standards of medical necessity,” says \u003ca href=\"https://www.psych-appeal.com/meiram-bendat/\">Meiram Bendat\u003c/a>, a lawyer leading a class-action lawsuit against a mental health subsidiary of UnitedHealthcare.\u003c/p>\n\u003cp>In a closely watched ruling, a \u003ca href=\"https://www.nytimes.com/2019/03/05/health/unitedhealth-mental-health-parity.html\">federal court in March sided with Bendat\u003c/a> and patients who alleged the insurer was deliberately shortchanging mental health claims. Chief Magistrate Judge \u003ca href=\"https://drive.google.com/file/d/1XuzFQV4Z6vClFnpYpTaoS4vBT_RPhQsN/view\">Joseph Spero of the U.S. District Court for the Northern District of California ruled\u003c/a> that United Behavioral Health wrote its \u003ca href=\"https://www.manatt.com/Insights/Newsletters/Health-Update/Level-of-Care-Criteria-Ruled-Inconsistent\">guidelines for treatment\u003c/a> much more narrowly than common medical standards, covering only enough care to stabilize patients “while ignoring the effective treatment of members’ underlying conditions.”\u003c/p>\n\u003cp>UnitedHealthcare works to “ensure our products meet the needs of our members and comply with state and federal law,” says spokeswoman Tracey Lempner.\u003c/p>\n\u003cp>Several studies, though, have found evidence of disparities in insurers’ decisions.\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>\u003cstrong>Growing gap in coverage in hospitals\u003c/strong>\u003c/p>\n\u003cp>In February, researchers at the \u003ca href=\"https://www.healthaffairs.org/doi/abs/10.1377/hlthaff.2018.05226\">Congressional Budget Office\u003c/a> reported that private insurance companies are paying 13% to 14% less for mental health care than Medicare does.\u003c/p>\n\u003cp>The insurance industry’s own data shows a \u003ca href=\"https://www.healthcostinstitute.org/images/easyblog_articles/276/HCCI-2017-Health-Care-Cost-and-Utilization-Report-02.12.19.pdf\">growing gap\u003c/a> between coverage of mental and physical care in hospitals and skilled nursing facilities. For the five years ending in 2017, out-of-pocket spending on inpatient mental health care grew nearly 13 times faster than all inpatient care, according to inpatient data reported in February by the \u003ca href=\"https://www.healthcostinstitute.org/about-hcci\">Health Care Cost Institute\u003c/a>, a research group funded by the insurance companies Aetna, Humana, UnitedHealthcare and Kaiser Permanente. (Kaiser Health News is not affiliated with Kaiser Permanente.)\u003c/p>\n\u003cp>And a \u003ca href=\"http://www.milliman.com/uploadedFiles/insight/2017/NQTLDisparityAnalysis.pdf\">2017 report\u003c/a> by the actuarial firm Milliman found that an office visit with a therapist is five times as likely to be out-of-network, and thus more expensive, than a primary care appointment.\u003c/p>\n\u003cp>\u003cspan style=\"font-weight: 400\">\u003c/p>\u003c/div>",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003c/span>\u003c/p>\n\u003cp>In this environment, \u003ca href=\"https://journalistsresource.org/studies/government/health-care/mental-health-untreated-children-research/\">only half of the nearly 8 million children\u003c/a> who have been diagnosed with depression, anxiety or attention deficit hyperactivity disorder receive treatment, \u003ca href=\"https://jamanetwork.com/journals/jamapediatrics/fullarticle/2724377\">according to a February research letter\u003c/a> in the medical journal \u003cem>JAMA Pediatrics\u003c/em>. \u003ca href=\"https://www.samhsa.gov/data/sites/default/files/NSDUH-FFR1-2016/NSDUH-FFR1-2016.htm#tx\">Fewer than 1 in 5 people\u003c/a> with substance use disorder are treated, a national survey suggests, and, overall, \u003ca href=\"https://www.nimh.nih.gov/health/statistics/mental-illness.shtml\">nearly 6 in 10\u003c/a> people with mental illness get no treatment or medication, according to the National Institute Of Mental Health.\u003c/p>\n\u003cp>Amanda Bacon, who is still receiving care for her eating disorder, remembers fearing that she wouldn’t get treatment. She was at one point rushed to an emergency room for care, but after several days in the hospital she was sent home, no closer to getting well.\u003c/p>\n\u003cp>Today, because of her disability, Bacon’s primary medical insurance is through Medicare, which has paid for treatment that her earlier Medicaid provider, Molina Healthcare, refused. She has been treated in four inpatient programs in the past two years — twice through Presbyterian Centennial Care, a Medicaid plan she switched to after Molina, and twice though her current Medicare plan. Bacon is also enrolled in a state-run Medicaid plan.\u003c/p>\n\u003cp>Molina says it can’t comment on Bacon’s case. “Molina complies with mental health parity laws,” say spokeswoman Danielle Smith, and it “applies industry-recognized medical necessity criteria in any medical determinations affecting mental health.”\u003c/p>\n\u003cp>\u003cstrong>The ‘wrong criteria’\u003c/strong>\u003c/p>\n\u003cp>\u003ca href=\"https://www.austenriggs.org/staff/eric-m-plakun\">Dr. Eric Plakun\u003c/a>, CEO of the Austen Riggs Center, a psychiatric hospital and residential program in Massachusetts, says that often insurers are “using the wrong criteria” for what makes something medically necessary. They pay enough only to stabilize a patient’s condition, Plakun says, but not enough to improve their underlying illness. He was one of the experts who testified in the case before Judge Spero in California.\u003c/p>\n\u003cp>Insurers say they recognize the importance of mental health care coverage and that they are \u003ca href=\"https://www.ahip.org/mental-health-parity-issue-brief/\">complying with the law\u003c/a>.\u003c/p>\n\u003cp>Cathryn Donaldson, a spokeswoman for the trade group America’s Health Insurance Plans, says the industry supports parity, but that it is also harder to prove when a mental health treatment is needed.\u003c/p>\n\u003cp>Compared with the data on medical and surgical care, she says, the data and standards to measure mental health care “trail far behind.” She cited \u003ca href=\"https://www.mnhospitals.org/Portals/0/Documents/policy-advocacy/mental-health/MHA%20Mental%20Health%20Avoidable%20Days%20Study%20Report%20July%202016.pdf\">a 2016 study\u003c/a> of Minnesota hospitals, where nearly one-fifth of the time patients spent in psychiatric units occurred after they were stabilized and ready to be discharged.\u003c/p>\n\u003cp>“Just like doctors use scientific evidence to determine the safest, most effective treatments,” insurers do the same to cover treatment “consistent with guidelines showing when and where it’s effective for patients,” Donaldson says.\u003c/p>\n\u003cp>Health plans commonly apply several controls that limit their coverage of mental health care. And these strategies by insurers are legal — unless they are applied more strictly for mental health care than medical care.\u003c/p>\n\u003cp>For example, they often require patients to try cheaper options first, a strategy called “fail first.” Patients referred by their doctors to a residential program for opioid addiction, for example, might be denied coverage by their insurers until they try — and fail — to improve at a less expensive part-time out-patient program.\u003c/p>\n\u003cp>Hiring doctors, nurses and pharmacists to review claims is another technique.\u003c/p>\n\u003cp>Dr. Frederick Villars, who reviews mental health claims for Aetna, remembers arguing with insurers to approve treatment when he was a practicing psychiatrist. His team decides what Aetna will cover based on clinical standards, he says. And providers upset about a coverage decision “are well aware of what these guidelines are.”\u003c/p>\n\u003cp>“It’s not a pleasant process,” Villars says, “but it’s the only tool that exists in this setting to try to keep costs under control.”\u003c/p>\n\u003cp>\u003ca href=\"http://khn.org/\">\u003cem>Kaiser Health News\u003c/em>\u003c/a>\u003cem> is a nonprofit, editorially independent program of the Kaiser Family Foundation. It is not affiliated with Kaiser Permanente. \u003c/em>\u003cem>Graison Dangor is a journalist living in Brooklyn.\u003c/em>\u003c/p>\n\u003cdiv class=\"fullattribution\">Copyright 2019 Kaiser Health News. To see more, visit \u003ca href=\"http://www.kaiserhealthnews.org/\">Kaiser Health News\u003c/a>.\u003cimg decoding=\"async\" src=\"https://www.google-analytics.com/__utm.gif?utmac=UA-5828686-4&utmdt=%27Mental+Health+Parity%27+Is+Still+An+Elusive+Goal+In+U.S.+Insurance+Coverage&utme=8(APIKey)9(MDAxOTAwOTE4MDEyMTkxMDAzNjczZDljZA004)\">\u003c/div>\n\u003cp>\u003c/p>\u003c/div>",
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"content": "\u003cp>David Singer clicks through iTunes looking for “Ferris Bueller’s Day Off,” a film he watched at least 12 times when it first came out in 1986. He was in his early 20s then.\u003c/p>\n\u003cp>“You’re old,” his younger daughter mutters, as she nudges her dad to choose the HD version.\u003c/p>\n\u003cp>Singer has high hopes as he settles in to watch the film with his wife and their two daughters, Emma, 13, and Elliot, 16, at their home in San Francisco.\u003c/p>\n\u003cp>“I want them to fall in love with it, just the way I did,” he says, as the opening scenes begin to roll. “Getting them to watch a movie from my younger days is always a challenge. They look slower and not as much in focus.”\u003c/p>\n\u003cp>Singer is like so many other people who came of age in the 1980s and idolized Ferris Bueller. For them, it will always be a fun movie about a kid faking being sick and skipping school.\u003c/p>\n\u003cp>“He was just having a load of fun,” Singer says, remembering Ferris at the Cubs game and singing on the float in downtown Chicago. “Everyone has a friend like his buddy, who’s kind of a sad sack.”\u003c/p>\n\u003cp>[pullquote size='small' align='right' citation='Danny Wedding, author of Movies and Mental Illness']‘In the 1980s, there might have been a tendency to see these as just rebellious teenagers misbehaving and causing trouble. Now, we’re more likely to be sensitive to the mental illness themes and to see Cameron as somebody coping with depression.’[/pullquote]But more than 30 years later, Cameron Frye, and his friendship with Ferris, look different through the eyes of today’s teens. They notice different themes and different dynamics. Watching the film from today’s perspective and applying today’s vocabulary, it’s clear that Cameron wasn’t just a sad sack — he was depressed and anxious.\u003c/p>\n\u003cp>“I’m dying,” he groans in his first scene, cocooned in bed, staring at the ceiling. To which Ferris responds, “You’re not dying. You just can’t think of anything good to do.”\u003c/p>\n\u003cp>Throughout the film, Cameron’s fear is the foil to Ferris’ free spirit.\u003c/p>\n\u003cp>When they borrow Cameron’s dad’s precious Ferrari and things go wrong, Cameron “goes berserk,” in Ferris’ words, then spends the next several scenes in a catatonic state.\u003c/p>\n\u003cp>“Maybe he’s really sick,” Ferris says, nibbling an Oreo in a hot tub while Cameron stares straight ahead over the swimming pool. “Maybe he isn’t just torturing himself.”\u003c/p>\n\u003cp>Then Cameron tumbles into the pool, fully clothed, and sinks to the bottom. Ferris dives in to save him. It’s an ambiguous move — in the end, a prank, but with hints of suicide.\u003c/p>\n\u003cp>“Ferris Bueller, you’re my hero,” Cameron says sarcastically.\u003c/p>\n\u003cp>https://www.youtube.com/watch?v=D6gABQFR94U\u003c/p>\n\u003cp>\u003cstrong>From Hero to Jerk\u003c/strong>\u003c/p>\n\u003cp>When David Singer watched this film in the ’80s, he did think of Ferris as a hero. But that wasn’t his daughter Elliot’s first reaction.\u003c/p>\n\u003cp>“I kinda hated him,” she says to her dad. “Ferris kinda sucks.”\u003c/p>\n\u003cp>He orders Cameron to get out of bed and pick him up, forces him to take his dad’s car, then dismisses Cameron’s concerns and blows him off as a worrier.\u003c/p>\n\u003cp>“He’s a very fun character,” Elliot says of Ferris. “But he’s also kind of an asshole.”\u003c/p>\n\u003cp>Plus, this whole taking-a-day-off-from-school business, pretending to be sick — that’s not how it goes down in her world. Elliot is a junior at Lick-Wilmerding, a private high school in San Francisco with a reputation for being high pressure.\u003c/p>\n\u003cp>“People come to school sick because, honestly, at the type of school I’m at, it’s more stressful not to be at school,” she says. “Going and having a fun day is really fun. But it’s also not fun – the amount of stuff you miss in a day.”\u003c/p>\n\u003cp>Elliot has had her own struggles with anxiety. It makes sense that she would pick up on different themes in the film than her dad and his generation.\u003c/p>\n\u003cp>[pullquote size='small' align='right' citation='David Singer, who recently watched the film with his two teenage daughters']‘Anxiety for teenagers, anxiety about the future, where do you go to college. It’s age-old.’[/pullquote]Since “Ferris Bueller” was made, teenage suicide rates have spiked, especially among young girls, according to \u003ca href=\"https://www.cdc.gov/nchs/data/databriefs/db241.pdf\" target=\"_blank\" rel=\"noopener\">CDC data\u003c/a>. And 70% of today’s teens view anxiety and depression as a major problem, according to a recent \u003ca href=\"https://www.pewsocialtrends.org/2019/02/20/most-u-s-teens-see-anxiety-and-depression-as-a-major-problem-among-their-peers/\" target=\"_blank\" rel=\"noopener\">study from the Pew Research Center\u003c/a>.\u003c/p>\n\u003cp>“The viewing public is much more attuned to mental illness and the problems confronting people who are coping with mental illness,” says Danny Wedding, a psychologist from Berkeley, who wrote the \u003ca href=\"https://books.google.com/books/about/Movies_and_Mental_Illness.html?id=20RfAgAAQBAJ\" target=\"_blank\" rel=\"noopener\">textbook “Movies and Mental Illness.”\u003c/a> He is working on the fifth edition now.\u003c/p>\n\u003cp>“In the 1980s, there might have been a tendency to see these as just rebellious teenagers misbehaving and causing trouble,” he says. “Now, we’re more likely to be sensitive to the mental illness themes and to see Cameron as somebody coping with depression.”\u003c/p>\n\u003cp>And the Ferrari? Wedding sees it as a metaphor for all the times his father failed to respond to Cameron’s needs.\u003c/p>\n\u003cp>Film representations began to change in the late 1980s and ’90s with films like “Rain Man,” which started explicitly addressing mental health, Wedding says. As public awareness grew, films got better. As films got better, public awareness grew more.\u003c/p>\n\u003cp>“One of the things that happened is that directors increasingly turned to mental health consultants to advise on films, and that happened in the ’90s,” he says.\u003c/p>\n\u003cp>\u003cstrong>Movie Myths Then and Now\u003c/strong>\u003c/p>\n\u003cp>But before that, movies were rife with subtle, subliminal messages about mental illness, often through sidekick characters like Cameron. All sorts of negative stereotypes were promulgated, Wedding says. He boils them down to three common myths.\u003c/p>\n\u003cp>Myth No. 1: People become mentally ill because their parents treated them badly.\u003c/p>\n\u003cp>[pullquote size='small' align='right' citation='Elliot Singer, 16']‘He’s a very fun character. But he’s also kind of an asshole.’[/pullquote]“Sybil” and “Carrie” are examples of this, as are all the horror films of the ’80s, like “Halloween” and “A Nightmare on Elm Street.” In that film, Freddy Krueger was the villain that slashed people in their dreams. Legend has it he was conceived when a nun at a mental hospital was locked in a room full of criminally insane men.\u003c/p>\n\u003cp>“They said that Freddy is the offspring of a thousand maniacs,” Wedding says.\u003c/p>\n\u003cp>Myth No. 2: People become mentally ill because of some traumatic event that happened.\u003c/p>\n\u003cp>Think of Robin Williams, who plays a character with schizophrenia in “The Fisher King,” Wedding says: “His symptoms develop after a traumatic event in which his girlfriend is killed in a restaurant.”\u003c/p>\n\u003cp>Some myths have persisted, like No. 3: Love will conquer mental illness.\u003c/p>\n\u003cp>You see this everywhere, Wedding says: “A Beautiful Mind,” “Mozart and the Whale,” “Benny & Joon.”\u003c/p>\n\u003cp>https://www.youtube.com/watch?v=LlmtpC2sRC8\u003c/p>\n\u003cp>“You leave the theater thinking that Joon is gonna be OK because she’s found her true love,” he says. “But the fact is that schizophrenia is an illness that is chronic and cyclical, and oftentimes people who are loved very much by their families still have to grapple with the challenges of mental illness. They still get sick. Love is important. It’s not sufficient.”\u003c/p>\n\u003cp>It’s like that in “Ferris Bueller,” too. Cameron has a breakthrough at the end of the film. He decides he is not going to live in fear anymore. He is going to stand up to his dad. And all it took was a day off from school with his best friend.\u003c/p>\n\u003cp>[aside tag='mental-health' label='More Coverage']Today’s teenagers, Emma and Elliot Singer, say, “Yeah right.”\u003c/p>\n\u003cp>“It’s not realistic,” Emma says.\u003c/p>\n\u003cp>“I kind of agree,” Elliot replies. “I think it was like an abrupt romanticized transition for him.”\u003c/p>\n\u003cp>Their dad makes his case, tries to bring them around. He says the themes from the movie back then are the same as they are now.\u003c/p>\n\u003cp>“We have different words and maybe we talk about it more with more specificity or more transparency, but they were all still there, right?” he says. “Anxiety for teenagers, anxiety about the future, where do you go to college. It’s age-old.”\u003c/p>\n\u003cp>Elliot says, I dunno. It was funny. Maybe if she watches it another 11 times, she’ll see what her dad sees.\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>\u003cp>David Singer clicks through iTunes looking for “Ferris Bueller’s Day Off,” a film he watched at least 12 times when it first came out in 1986. He was in his early 20s then.\u003c/p>\n\u003cp>“You’re old,” his younger daughter mutters, as she nudges her dad to choose the HD version.\u003c/p>\n\u003cp>Singer has high hopes as he settles in to watch the film with his wife and their two daughters, Emma, 13, and Elliot, 16, at their home in San Francisco.\u003c/p>\n\u003cp>“I want them to fall in love with it, just the way I did,” he says, as the opening scenes begin to roll. “Getting them to watch a movie from my younger days is always a challenge. They look slower and not as much in focus.”\u003c/p>\n\u003cp>Singer is like so many other people who came of age in the 1980s and idolized Ferris Bueller. For them, it will always be a fun movie about a kid faking being sick and skipping school.\u003c/p>\n\u003cp>“He was just having a load of fun,” Singer says, remembering Ferris at the Cubs game and singing on the float in downtown Chicago. “Everyone has a friend like his buddy, who’s kind of a sad sack.”\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"content": "\u003cdiv class=\"post-body\">\u003cp>But more than 30 years later, Cameron Frye, and his friendship with Ferris, look different through the eyes of today’s teens. They notice different themes and different dynamics. Watching the film from today’s perspective and applying today’s vocabulary, it’s clear that Cameron wasn’t just a sad sack — he was depressed and anxious.\u003c/p>\n\u003cp>“I’m dying,” he groans in his first scene, cocooned in bed, staring at the ceiling. To which Ferris responds, “You’re not dying. You just can’t think of anything good to do.”\u003c/p>\n\u003cp>Throughout the film, Cameron’s fear is the foil to Ferris’ free spirit.\u003c/p>\n\u003cp>When they borrow Cameron’s dad’s precious Ferrari and things go wrong, Cameron “goes berserk,” in Ferris’ words, then spends the next several scenes in a catatonic state.\u003c/p>\n\u003cp>“Maybe he’s really sick,” Ferris says, nibbling an Oreo in a hot tub while Cameron stares straight ahead over the swimming pool. “Maybe he isn’t just torturing himself.”\u003c/p>\n\u003cp>Then Cameron tumbles into the pool, fully clothed, and sinks to the bottom. Ferris dives in to save him. It’s an ambiguous move — in the end, a prank, but with hints of suicide.\u003c/p>\n\u003cp>“Ferris Bueller, you’re my hero,” Cameron says sarcastically.\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/D6gABQFR94U'\n title='//www.youtube.com/embed/D6gABQFR94U'\n allowfullscreen='true'\n style='border:0;'>\u003c/iframe>\n \u003c/span>\n \u003c/span>\u003c/p>\u003cp>\u003cp>\u003cstrong>From Hero to Jerk\u003c/strong>\u003c/p>\n\u003cp>When David Singer watched this film in the ’80s, he did think of Ferris as a hero. But that wasn’t his daughter Elliot’s first reaction.\u003c/p>\n\u003cp>“I kinda hated him,” she says to her dad. “Ferris kinda sucks.”\u003c/p>\n\u003cp>He orders Cameron to get out of bed and pick him up, forces him to take his dad’s car, then dismisses Cameron’s concerns and blows him off as a worrier.\u003c/p>\n\u003cp>“He’s a very fun character,” Elliot says of Ferris. “But he’s also kind of an asshole.”\u003c/p>\n\u003cp>Plus, this whole taking-a-day-off-from-school business, pretending to be sick — that’s not how it goes down in her world. Elliot is a junior at Lick-Wilmerding, a private high school in San Francisco with a reputation for being high pressure.\u003c/p>\n\u003cp>“People come to school sick because, honestly, at the type of school I’m at, it’s more stressful not to be at school,” she says. “Going and having a fun day is really fun. But it’s also not fun – the amount of stuff you miss in a day.”\u003c/p>\n\u003cp>Elliot has had her own struggles with anxiety. It makes sense that she would pick up on different themes in the film than her dad and his generation.\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"content": "\u003cdiv class=\"post-body\">\u003cp>Since “Ferris Bueller” was made, teenage suicide rates have spiked, especially among young girls, according to \u003ca href=\"https://www.cdc.gov/nchs/data/databriefs/db241.pdf\" target=\"_blank\" rel=\"noopener\">CDC data\u003c/a>. And 70% of today’s teens view anxiety and depression as a major problem, according to a recent \u003ca href=\"https://www.pewsocialtrends.org/2019/02/20/most-u-s-teens-see-anxiety-and-depression-as-a-major-problem-among-their-peers/\" target=\"_blank\" rel=\"noopener\">study from the Pew Research Center\u003c/a>.\u003c/p>\n\u003cp>“The viewing public is much more attuned to mental illness and the problems confronting people who are coping with mental illness,” says Danny Wedding, a psychologist from Berkeley, who wrote the \u003ca href=\"https://books.google.com/books/about/Movies_and_Mental_Illness.html?id=20RfAgAAQBAJ\" target=\"_blank\" rel=\"noopener\">textbook “Movies and Mental Illness.”\u003c/a> He is working on the fifth edition now.\u003c/p>\n\u003cp>“In the 1980s, there might have been a tendency to see these as just rebellious teenagers misbehaving and causing trouble,” he says. “Now, we’re more likely to be sensitive to the mental illness themes and to see Cameron as somebody coping with depression.”\u003c/p>\n\u003cp>And the Ferrari? Wedding sees it as a metaphor for all the times his father failed to respond to Cameron’s needs.\u003c/p>\n\u003cp>Film representations began to change in the late 1980s and ’90s with films like “Rain Man,” which started explicitly addressing mental health, Wedding says. As public awareness grew, films got better. As films got better, public awareness grew more.\u003c/p>\n\u003cp>“One of the things that happened is that directors increasingly turned to mental health consultants to advise on films, and that happened in the ’90s,” he says.\u003c/p>\n\u003cp>\u003cstrong>Movie Myths Then and Now\u003c/strong>\u003c/p>\n\u003cp>But before that, movies were rife with subtle, subliminal messages about mental illness, often through sidekick characters like Cameron. All sorts of negative stereotypes were promulgated, Wedding says. He boils them down to three common myths.\u003c/p>\n\u003cp>Myth No. 1: People become mentally ill because their parents treated them badly.\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"content": "\u003cdiv class=\"post-body\">\u003cp>“Sybil” and “Carrie” are examples of this, as are all the horror films of the ’80s, like “Halloween” and “A Nightmare on Elm Street.” In that film, Freddy Krueger was the villain that slashed people in their dreams. Legend has it he was conceived when a nun at a mental hospital was locked in a room full of criminally insane men.\u003c/p>\n\u003cp>“They said that Freddy is the offspring of a thousand maniacs,” Wedding says.\u003c/p>\n\u003cp>Myth No. 2: People become mentally ill because of some traumatic event that happened.\u003c/p>\n\u003cp>Think of Robin Williams, who plays a character with schizophrenia in “The Fisher King,” Wedding says: “His symptoms develop after a traumatic event in which his girlfriend is killed in a restaurant.”\u003c/p>\n\u003cp>Some myths have persisted, like No. 3: Love will conquer mental illness.\u003c/p>\n\u003cp>You see this everywhere, Wedding says: “A Beautiful Mind,” “Mozart and the Whale,” “Benny & Joon.”\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/LlmtpC2sRC8'\n title='//www.youtube.com/embed/LlmtpC2sRC8'\n allowfullscreen='true'\n style='border:0;'>\u003c/iframe>\n \u003c/span>\n \u003c/span>\u003c/p>\u003cp>\u003cp>“You leave the theater thinking that Joon is gonna be OK because she’s found her true love,” he says. “But the fact is that schizophrenia is an illness that is chronic and cyclical, and oftentimes people who are loved very much by their families still have to grapple with the challenges of mental illness. They still get sick. Love is important. It’s not sufficient.”\u003c/p>\n\u003cp>It’s like that in “Ferris Bueller,” too. Cameron has a breakthrough at the end of the film. He decides he is not going to live in fear anymore. He is going to stand up to his dad. And all it took was a day off from school with his best friend.\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"content": "\u003cdiv class=\"post-body\">\u003cp>Today’s teenagers, Emma and Elliot Singer, say, “Yeah right.”\u003c/p>\n\u003cp>“It’s not realistic,” Emma says.\u003c/p>\n\u003cp>“I kind of agree,” Elliot replies. “I think it was like an abrupt romanticized transition for him.”\u003c/p>\n\u003cp>Their dad makes his case, tries to bring them around. He says the themes from the movie back then are the same as they are now.\u003c/p>\n\u003cp>“We have different words and maybe we talk about it more with more specificity or more transparency, but they were all still there, right?” he says. “Anxiety for teenagers, anxiety about the future, where do you go to college. It’s age-old.”\u003c/p>\n\u003cp>Elliot says, I dunno. It was funny. Maybe if she watches it another 11 times, she’ll see what her dad sees.\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"content": "\u003cp>San Francisco Supervisors Hillary Ronen and Matt Haney want the city to offer free mental health care and substance abuse treatment to any city resident in need.\u003c/p>\n\u003cp>The supervisors, along with state Assemblyman Phil Ting (D-San Francisco), on Tuesday are announcing a push for a November ballot measure to create what they say would be the first universal mental health care system in the nation.\u003c/p>\n\u003cp>[pullquote size=“small” align=”right” citation=\"San Francisco Supervisor Hillary Ronen\"]‘Mental health and substance use programs in San Francisco right now are completely uncoordinated and a mess. We all see it … when we walk on the street and see people in misery.’[/pullquote]\u003c/p>\n\u003cp>“We have a crisis of people who are severely addicted to drugs and that have severe mental health illnesses that are wandering the street and that desperately need help,” Ronen said in an interview Tuesday morning.\u003c/p>\n\u003cp>“San Franciscans are ready for a bold and big change. They’re sick of little measures around the edges. They want a fix to this crisis. The status quo is dangerous,” she said. “We can’t keep failing.”\u003c/p>\n\u003cp>The plan, which would be called Mental Health SF, would be similar to the city’s \u003ca href=\"https://healthysanfrancisco.org/\" target=\"_blank\" rel=\"noopener\">Healthy San Francisco\u003c/a> program that offers health care services to uninsured city residents. It would provide treatment to anyone who has a mental health illness or substance addiction and asks for help — even if they have health insurance.\u003c/p>\n\u003cp>The proposal, first reported on by the \u003ca href=\"https://www.sfchronicle.com/bayarea/heatherknight/article/Bold-plan-to-tackle-SF-s-crisis-on-the-streets-13899585.php?psid=34ve\" target=\"_blank\" rel=\"noopener\">San Francisco Chronicle\u003c/a>, would be paid for by state funding and a proposed tax increase on companies that pay their chief executive officers 100 times more than the median compensation paid to their employees.\u003c/p>\n\u003cp>“We have become one of the most unequal cities in the country, with CEOs making hundreds and hundreds times more than their average worker,” Haney said.\u003c/p>\n\u003cp>[aside postID=news_11742865,news_11741821 label='Homelessness and Mental Health']\u003c/p>\n\u003cp>The plan calls for a 24-hour, seven-days-a-week service center that accepts anyone no matter how severe their needs and an office that would coordinate care.\u003c/p>\n\u003cp>“Mental health and substance use programs in San Francisco right now are completely uncoordinated and a mess. We all see it … when we walk on the street and see people in misery,” Ronen said. “Every single day we see people being released onto the street with their hospital bands on who are still clearly in crisis and don’t know what to do and where to go,” she said.\u003c/p>\n\u003cp>The program would also expand residential treatment and housing services already operating in San Francisco for people with severe mental illness and substance abuse.\u003c/p>\n\u003cp>Ronen and Haney plan to put a separate measure on the fall ballot, dubbed the Excessive CEO Salary Tax, that would place an extra surcharge on businesses that have chief executives who make at least 100 times more than the firms’ typical workers. They believe the tax would generate about $80 million a year, adding to the city’s $370 million annual budget for mental health and substance abuse treatment.\u003c/p>\n\u003cp>Mental Health SF would rely on some state money as well. The state Medi-Cal program covers half the cost of services to low-income Californians enrolled in the program. Ronen said San Francisco should draw down more funding from Proposition 63, a tax approved by voters in 2004 to fund services for Californians with serious mental illnesses.\u003c/p>\n\u003cp>[ad fullwidth]\u003c/p>\n\u003cp>The program would also use some funding from an IPO tax recently proposed by Supervisor Gordon Mar to raise the employer payroll tax on stock-based compensation.\u003c/p>\n\u003cp>A representative for a leading business lobbying group raised concerns about the idea.\u003c/p>\n\u003cp>“There’s little question that we need to do a far better job of providing mental health care services. It’s not just a San Francisco issue, it’s an issue across the entire Bay Area and California,” said Rufus Jeffris, a spokesman for the Bay Area Council.\u003c/p>\n\u003cp>“A big danger in this proposal is relying on highly volatile jobs and wealth taxes to fund an ongoing expansion of services. And given criticism about a lack of coordination and coherence in a system that some have described as ‘devastatingly broken,’ voters will need to decide whether spending more money is the right approach,” Jeffris said in an email.\u003c/p>\n\u003cp>Notably absent from the press conference announcing the plan were San Francisco’s mayor, London Breed, and anyone from the city’s department of public health.\u003c/p>\n\u003cp>Both offices said they couldn’t comment on the proposal yet because they both hadn’t seen it until Tuesday, when it was announced to the public.\u003c/p>\n\u003cp>Those offices have been trying to address shortfalls in mental health care. The mayor recently hired the city’s first ever director of mental health reform, Dr. Anton Nigusse Bland, who previously directed psychiatric emergency services at San Francisco General Hospital.\u003c/p>\n\u003cp>He is now tasked with evaluating the city’s mental health and substance abuse treatment services, particularly for homeless people, and making recommendations for changes.\u003c/p>\n\u003cp>The city is also participating in a pilot project overhauling the delivery of drug treatment services through Medi-Cal – a project that includes some features proposed in the Mental Health SF program.\u003c/p>\n\u003cp>But Ronen says it’s not nearly enough.\u003c/p>\n\u003cp>“We haven’t seen a single plan that comes out of the mayor’s office to deal with this crisis at the scale that we’re dealing with,” Ronen said. “We need a massive overhaul.”\u003c/p>\n\u003cp>To staff the program, Ronen believes the city can accomplish what the private health care industry can’t. Kaiser Permanente has been the target of numerous complaints about long wait times for mental health appointments, which clinicians there say is due to under staffing. Their union recently authorized a strike over the issue, following a five-day strike in December. Patients with Blue Shield coverage say when they call therapists listed on the insurer’s network, most are not taking new patients.\u003c/p>\n\u003cp>Both companies routinely explain this by saying there is a shortage of clinicians. But Ronen says this is an excuse.\u003c/p>\n\u003cp>“Part of Mental Health SF is we’re going to pay people what we need to pay them to attract them, and we’re going to have the revenue to do so,” she said.\u003c/p>\n\u003cp>The program will also rely heavily on peer counselors, who don’t carry the same high-level degree that demands such high salaries.\u003c/p>\n\u003cp>“Sometimes the best care, and the best coaching, it comes from people who’ve experienced the illness themselves,” she said.\u003c/p>\n\u003cp>The two supervisors plan to officially introduce the measure at next Tuesday’s board meeting. They need six supervisors to support the proposal, and currently five are backing it. Along with Ronen and Haney, Supervisors Mar, Shamann Walton and Norman Yee are on board. Ronen expects Supervisor Aaron Peskin to back it as well.\u003c/p>\n\u003cp>[ad floatright]\u003c/p>\n",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>“We have a crisis of people who are severely addicted to drugs and that have severe mental health illnesses that are wandering the street and that desperately need help,” Ronen said in an interview Tuesday morning.\u003c/p>\n\u003cp>“San Franciscans are ready for a bold and big change. They’re sick of little measures around the edges. They want a fix to this crisis. The status quo is dangerous,” she said. “We can’t keep failing.”\u003c/p>\n\u003cp>The plan, which would be called Mental Health SF, would be similar to the city’s \u003ca href=\"https://healthysanfrancisco.org/\" target=\"_blank\" rel=\"noopener\">Healthy San Francisco\u003c/a> program that offers health care services to uninsured city residents. It would provide treatment to anyone who has a mental health illness or substance addiction and asks for help — even if they have health insurance.\u003c/p>\n\u003cp>The proposal, first reported on by the \u003ca href=\"https://www.sfchronicle.com/bayarea/heatherknight/article/Bold-plan-to-tackle-SF-s-crisis-on-the-streets-13899585.php?psid=34ve\" target=\"_blank\" rel=\"noopener\">San Francisco Chronicle\u003c/a>, would be paid for by state funding and a proposed tax increase on companies that pay their chief executive officers 100 times more than the median compensation paid to their employees.\u003c/p>\n\u003cp>“We have become one of the most unequal cities in the country, with CEOs making hundreds and hundreds times more than their average worker,” Haney said.\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>The plan calls for a 24-hour, seven-days-a-week service center that accepts anyone no matter how severe their needs and an office that would coordinate care.\u003c/p>\n\u003cp>“Mental health and substance use programs in San Francisco right now are completely uncoordinated and a mess. We all see it … when we walk on the street and see people in misery,” Ronen said. “Every single day we see people being released onto the street with their hospital bands on who are still clearly in crisis and don’t know what to do and where to go,” she said.\u003c/p>\n\u003cp>The program would also expand residential treatment and housing services already operating in San Francisco for people with severe mental illness and substance abuse.\u003c/p>\n\u003cp>Ronen and Haney plan to put a separate measure on the fall ballot, dubbed the Excessive CEO Salary Tax, that would place an extra surcharge on businesses that have chief executives who make at least 100 times more than the firms’ typical workers. They believe the tax would generate about $80 million a year, adding to the city’s $370 million annual budget for mental health and substance abuse treatment.\u003c/p>\n\u003cp>Mental Health SF would rely on some state money as well. The state Medi-Cal program covers half the cost of services to low-income Californians enrolled in the program. Ronen said San Francisco should draw down more funding from Proposition 63, a tax approved by voters in 2004 to fund services for Californians with serious mental illnesses.\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>The program would also use some funding from an IPO tax recently proposed by Supervisor Gordon Mar to raise the employer payroll tax on stock-based compensation.\u003c/p>\n\u003cp>A representative for a leading business lobbying group raised concerns about the idea.\u003c/p>\n\u003cp>“There’s little question that we need to do a far better job of providing mental health care services. It’s not just a San Francisco issue, it’s an issue across the entire Bay Area and California,” said Rufus Jeffris, a spokesman for the Bay Area Council.\u003c/p>\n\u003cp>“A big danger in this proposal is relying on highly volatile jobs and wealth taxes to fund an ongoing expansion of services. And given criticism about a lack of coordination and coherence in a system that some have described as ‘devastatingly broken,’ voters will need to decide whether spending more money is the right approach,” Jeffris said in an email.\u003c/p>\n\u003cp>Notably absent from the press conference announcing the plan were San Francisco’s mayor, London Breed, and anyone from the city’s department of public health.\u003c/p>\n\u003cp>Both offices said they couldn’t comment on the proposal yet because they both hadn’t seen it until Tuesday, when it was announced to the public.\u003c/p>\n\u003cp>Those offices have been trying to address shortfalls in mental health care. The mayor recently hired the city’s first ever director of mental health reform, Dr. Anton Nigusse Bland, who previously directed psychiatric emergency services at San Francisco General Hospital.\u003c/p>\n\u003cp>He is now tasked with evaluating the city’s mental health and substance abuse treatment services, particularly for homeless people, and making recommendations for changes.\u003c/p>\n\u003cp>The city is also participating in a pilot project overhauling the delivery of drug treatment services through Medi-Cal – a project that includes some features proposed in the Mental Health SF program.\u003c/p>\n\u003cp>But Ronen says it’s not nearly enough.\u003c/p>\n\u003cp>“We haven’t seen a single plan that comes out of the mayor’s office to deal with this crisis at the scale that we’re dealing with,” Ronen said. “We need a massive overhaul.”\u003c/p>\n\u003cp>To staff the program, Ronen believes the city can accomplish what the private health care industry can’t. Kaiser Permanente has been the target of numerous complaints about long wait times for mental health appointments, which clinicians there say is due to under staffing. Their union recently authorized a strike over the issue, following a five-day strike in December. Patients with Blue Shield coverage say when they call therapists listed on the insurer’s network, most are not taking new patients.\u003c/p>\n\u003cp>Both companies routinely explain this by saying there is a shortage of clinicians. But Ronen says this is an excuse.\u003c/p>\n\u003cp>“Part of Mental Health SF is we’re going to pay people what we need to pay them to attract them, and we’re going to have the revenue to do so,” she said.\u003c/p>\n\u003cp>The program will also rely heavily on peer counselors, who don’t carry the same high-level degree that demands such high salaries.\u003c/p>\n\u003cp>“Sometimes the best care, and the best coaching, it comes from people who’ve experienced the illness themselves,” she said.\u003c/p>\n\u003cp>The two supervisors plan to officially introduce the measure at next Tuesday’s board meeting. They need six supervisors to support the proposal, and currently five are backing it. Along with Ronen and Haney, Supervisors Mar, Shamann Walton and Norman Yee are on board. Ronen expects Supervisor Aaron Peskin to back it as well.\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"title": "Frequent Assaults on Workers at San Leandro Psychiatric Hospital, Records Show",
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"content": "\u003cp>Staff at a psychiatric hospital in San Leandro were punched, slapped, spit on and kicked — mostly by patients — in at least 80 separate instances over the last year, according to records kept by the agency that operates the facility.\u003c/p>\n\u003cp>[aside label=\"related stories\" tag=\"john-george-psychiatric-hospital\"]\u003c/p>\n\u003cp>In some cases they were also bitten, scratched and had their hair pulled.\u003c/p>\n\u003cp>The union representing workers at John George Psychiatric Hospital has for years called for safer workplace conditions and more staffing, and is now pointing to the new data to cast light on the dangers of the job.\u003c/p>\n\u003cp>Overseen by the Alameda Health System, a public hospital authority that manages John George, the log details a litany of assaults on staff between May 2018 and the beginning of this month. The incidents occurred in several hospital units, including its emergency room, facility hallways and inpatient rooms, according to the log.\u003c/p>\n\u003cp>“It’s an incredible feeling of vulnerability and anxiety and distraction when this kind of thing can happen.” said Rachel Odes, a staff nurse at John George, who has studied workplace violence in healthcare settings.”We are short of staff, perpetually. We don’t have a deep enough bench to bring in replacement staff when someone gets hurt.”\u003c/p>\n\u003cp>The records include the time each assault happened, where in the hospital it occurred, the type of physical force used and whether the “aggressor” was a patient or a coworker. But no names or detailed descriptions are included.\u003c/p>\n\u003cp>“We are committed to providing a safe working environment that supports our staff’s ability to care for our patients, including staffing to state mandated staffing ratios at all facilities,” AHS said in a statement on Thursday.\u003c/p>\n\u003cp>AHS also said it would adhere to new workplace safety law requirements by reporting on a broader set of incidents to state regulators “including inappropriate touching or contact, and patients who resist hands-on staff assistance such as medication administration, restraint, seclusion or redirection.”\u003c/p>\n\u003cp>“In addition to this, we continue to implement various safety measures to ensure we are able to meet our patient needs and support our employees in delivering high quality care,” the statement said.\u003c/p>\n\u003cp>In \u003ca href=\"https://www.kqed.org/news/11692990/state-fines-psychiatric-hospital-in-attack-on-nurse-amid-renewed-staffing-concerns\" target=\"_blank\" rel=\"noopener\">an incident\u003c/a> on Sept. 13, 2017, a patient at the hospital punched a nurse in the face and continued hitting him after he fell down, slamming his head into the ground, fracturing his facial bones and inducing a seizure. David McElveen, the victim of the attack, later suffered from a stroke and short-term memory problems.\u003c/p>\n\u003caside class=\"pullquote alignright\">‘It’s an incredible feeling of vulnerability and anxiety and distraction when this kind of thing can happen.’ \u003ccite>Rachel Odes, staff nurse at John George Psychiatric Hospital\u003c/cite>\u003c/aside>\n\u003cp>California’s Division of Occupational Safety and Health (Cal/OSHA) subsequently fined AHS more than $11,000 in connection with the incident after identifying major shortcomings in the hospital’s mandated injury and illness prevention program.\u003c/p>\n\u003cp>The findings sparked calls by John George workers, represented by Service Employees International Union Local 1021, for additional staffing and more effective safety measures. AHS officials said then that creating and maintaining a safe environment for their workers, patients and visitors was a top priority.\u003c/p>\n\u003cp>But staff and union officials say the dangers are still present.\u003c/p>\n\u003cp>Odes said she witnessed an attack as recently as last weekend, when a nurse was discharging a patient who did not want to leave.\u003c/p>\n\u003cp>“He punched this nurse in the face,” she said.\u003c/p>\n\u003cp>[ad fullwidth]\u003c/p>\n\u003cp>\u003c/p>\n",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>In some cases they were also bitten, scratched and had their hair pulled.\u003c/p>\n\u003cp>The union representing workers at John George Psychiatric Hospital has for years called for safer workplace conditions and more staffing, and is now pointing to the new data to cast light on the dangers of the job.\u003c/p>\n\u003cp>Overseen by the Alameda Health System, a public hospital authority that manages John George, the log details a litany of assaults on staff between May 2018 and the beginning of this month. The incidents occurred in several hospital units, including its emergency room, facility hallways and inpatient rooms, according to the log.\u003c/p>\n\u003cp>“It’s an incredible feeling of vulnerability and anxiety and distraction when this kind of thing can happen.” said Rachel Odes, a staff nurse at John George, who has studied workplace violence in healthcare settings.”We are short of staff, perpetually. We don’t have a deep enough bench to bring in replacement staff when someone gets hurt.”\u003c/p>\n\u003cp>The records include the time each assault happened, where in the hospital it occurred, the type of physical force used and whether the “aggressor” was a patient or a coworker. But no names or detailed descriptions are included.\u003c/p>\n\u003cp>“We are committed to providing a safe working environment that supports our staff’s ability to care for our patients, including staffing to state mandated staffing ratios at all facilities,” AHS said in a statement on Thursday.\u003c/p>\n\u003cp>AHS also said it would adhere to new workplace safety law requirements by reporting on a broader set of incidents to state regulators “including inappropriate touching or contact, and patients who resist hands-on staff assistance such as medication administration, restraint, seclusion or redirection.”\u003c/p>\n\u003cp>“In addition to this, we continue to implement various safety measures to ensure we are able to meet our patient needs and support our employees in delivering high quality care,” the statement said.\u003c/p>\n\u003cp>In \u003ca href=\"https://www.kqed.org/news/11692990/state-fines-psychiatric-hospital-in-attack-on-nurse-amid-renewed-staffing-concerns\" target=\"_blank\" rel=\"noopener\">an incident\u003c/a> on Sept. 13, 2017, a patient at the hospital punched a nurse in the face and continued hitting him after he fell down, slamming his head into the ground, fracturing his facial bones and inducing a seizure. David McElveen, the victim of the attack, later suffered from a stroke and short-term memory problems.\u003c/p>\n\u003caside class=\"pullquote alignright\">‘It’s an incredible feeling of vulnerability and anxiety and distraction when this kind of thing can happen.’ \u003ccite>Rachel Odes, staff nurse at John George Psychiatric Hospital\u003c/cite>\u003c/aside>\n\u003cp>California’s Division of Occupational Safety and Health (Cal/OSHA) subsequently fined AHS more than $11,000 in connection with the incident after identifying major shortcomings in the hospital’s mandated injury and illness prevention program.\u003c/p>\n\u003cp>The findings sparked calls by John George workers, represented by Service Employees International Union Local 1021, for additional staffing and more effective safety measures. AHS officials said then that creating and maintaining a safe environment for their workers, patients and visitors was a top priority.\u003c/p>\n\u003cp>But staff and union officials say the dangers are still present.\u003c/p>\n\u003cp>Odes said she witnessed an attack as recently as last weekend, when a nurse was discharging a patient who did not want to leave.\u003c/p>\n\u003cp>“He punched this nurse in the face,” she said.\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"disqusTitle": "This Beauty Queen Uses Her Platform to Ease Mental Health Stigma in Asian American Community",
"title": "This Beauty Queen Uses Her Platform to Ease Mental Health Stigma in Asian American Community",
"headTitle": "The California Report | KQED News",
"content": "\u003cp>At first glance, Sophia Ng has all the hallmarks of a typical pageant queen: She has beauty, brains and charisma.\u003c/p>\n\u003cp>But last August, when Ng, 27, competed in San Francisco’s\u003ca href=\"https://www.missasianglobal.com/\"> Miss Asian Global & Miss Asian America\u003c/a> pageant, the longest-running Asian beauty pageant in the nation, she surprised her audience with what she revealed on stage.\u003c/p>\n\u003cp>“I was once in a suicide depression, and in my hour of darkness, I believed I was worthless and that life was not worth living,” she told the crowd at Herbst Theatre in San Francisco. The audience that night was mostly Asian.\u003c/p>\n\u003cp>Later that evening, Ng was crowned Miss Asian America. It was the first pageant she had ever competed in.\u003c/p>\n\u003cp>At 5 foot 9 inches tall, Ng never used to wear high heels. But now, she is a pro. Since she has entered the pageant world, she regularly dons a gown, sash and crown to attend charity and community events, like this year’s Lunar New Year Parade in San Francisco.\u003c/p>\n\u003cfigure id=\"attachment_11746925\" class=\"wp-caption aligncenter\" style=\"max-width: 1920px\">\u003cimg class=\"wp-image-11746925 size-full\" src=\"https://ww2.kqed.org/news/wp-content/uploads/sites/10/2019/05/RS37059_IMG_3611-qut.jpg\" alt=\"\" width=\"1920\" height=\"1440\" srcset=\"https://ww2.kqed.org/app/uploads/sites/10/2019/05/RS37059_IMG_3611-qut.jpg 1920w, https://ww2.kqed.org/app/uploads/sites/10/2019/05/RS37059_IMG_3611-qut-160x120.jpg 160w, https://ww2.kqed.org/app/uploads/sites/10/2019/05/RS37059_IMG_3611-qut-800x600.jpg 800w, https://ww2.kqed.org/app/uploads/sites/10/2019/05/RS37059_IMG_3611-qut-1020x765.jpg 1020w, https://ww2.kqed.org/app/uploads/sites/10/2019/05/RS37059_IMG_3611-qut-1200x900.jpg 1200w, https://ww2.kqed.org/app/uploads/sites/10/2019/05/RS37059_IMG_3611-qut-1832x1374.jpg 1832w, https://ww2.kqed.org/app/uploads/sites/10/2019/05/RS37059_IMG_3611-qut-1376x1032.jpg 1376w, https://ww2.kqed.org/app/uploads/sites/10/2019/05/RS37059_IMG_3611-qut-1044x783.jpg 1044w, https://ww2.kqed.org/app/uploads/sites/10/2019/05/RS37059_IMG_3611-qut-632x474.jpg 632w, https://ww2.kqed.org/app/uploads/sites/10/2019/05/RS37059_IMG_3611-qut-536x402.jpg 536w\" sizes=\"(max-width: 1920px) 100vw, 1920px\">\u003cfigcaption class=\"wp-caption-text\">Sophia Ng, second from right, strikes a pose on a Lunar New Year Parade float with some court members of the Miss Asian Global & Miss Asian America pageant, 2019. \u003ccite>(Sonia Paul/KQED)\u003c/cite>\u003c/figcaption>\u003c/figure>\n\u003cp>But along with the networking and modeling opportunities, Ng spends her time doing what inspired her to compete in pageants in the first place: raising awareness about mental health, particularly among the Asian American and Pacific Islander communities.\u003c/p>\n\u003cp>[ad fullwidth]\u003c/p>\n\u003cp>Ng is a mental health therapist, a profession she says offers an impact that’s deep but often struggles with reach. Until recently, she counselled students at elementary and high schools in San Francisco.\u003c/p>\n\u003cp>Earlier this spring, she embarked on a typical work day at Lowell High School — one of the most competitive high schools in the state.\u003c/p>\n\u003cp>As students attended classes and roamed the hallways during breaks, Ng met with her clients at Lowell’s Wellness Center, a place where students can come in for counseling and access community resources, or relax and sip a cup of tea.\u003c/p>\n\u003cfigure id=\"attachment_11747793\" class=\"wp-caption aligncenter\" style=\"max-width: 800px\">\u003cimg class=\"size-medium wp-image-11747793\" src=\"https://ww2.kqed.org/news/wp-content/uploads/sites/10/2019/05/Sophia-Ng-Reading-800x603.jpg\" alt=\"Sophia Ng reviews some paperwork in an office at Lowell High School's Wellness Center. As a mental health therapist, Ng visited schools in San Francisco and counseled students.\" width=\"800\" height=\"603\" srcset=\"https://ww2.kqed.org/app/uploads/sites/10/2019/05/Sophia-Ng-Reading-800x603.jpg 800w, https://ww2.kqed.org/app/uploads/sites/10/2019/05/Sophia-Ng-Reading-160x121.jpg 160w, https://ww2.kqed.org/app/uploads/sites/10/2019/05/Sophia-Ng-Reading-1020x769.jpg 1020w, https://ww2.kqed.org/app/uploads/sites/10/2019/05/Sophia-Ng-Reading-1200x904.jpg 1200w, https://ww2.kqed.org/app/uploads/sites/10/2019/05/Sophia-Ng-Reading.jpg 1736w\" sizes=\"(max-width: 800px) 100vw, 800px\">\u003cfigcaption class=\"wp-caption-text\">Sophia Ng reviews some paperwork in an office at Lowell High School's Wellness Center. As a mental health therapist, Ng visited schools in San Francisco and counseled students. \u003ccite>(Sonia Paul/KQED)\u003c/cite>\u003c/figcaption>\u003c/figure>\n\u003cp>In a small office in the Wellness Center, as a white noise machine hummed nearby to help protect privacy during conversations, one student told Ng about the painful relationship he has with his mom.\u003c/p>\n\u003cp>“She went on a rant,” he told Ng, referring to a recent incident involving him, his brother and his mother, in which their mother told them they were \"useless.\"\u003c/p>\n\u003cp>“She also mention[ed] something like, 'you guys were a waste of giving birth' in Chinese.\"\u003c/p>\n\u003cp>[pullquote size='medium' align='right' citation='Sophia Ng']'I was once in a suicide depression, and in my hour of darkness, I believed I was worthless and that life was not worth living.'[/pullquote]Like this student, and many of the students she works with, Ng is also Chinese, growing up in Hong Kong. She says many students and their parents hesitate to seek out therapy, and that this may trace back to a culture in which shame and honor play an important role.\u003c/p>\n\u003cp>It's also seen in the parenting style, where they use shame and guilt to parent their kid, said Ng, who stressed that not all Asian American moms and dads do this.\u003c/p>\n\u003cp>Parents also worry that if their kids need help, maybe they’ve done something wrong as parents. But, she noted, people in the community are under pressure to present a good face to the world despite whatever their going through.\u003c/p>\n\u003cp>[aside tag='mental-health' label='More Coverage of Mental Health Issues']In fact, Asian Americans are \u003ca href=\"https://www.apa.org/pi/oema/resources/ethnicity-health/asian-american/article-mental-health\">three times less likely\u003c/a> to seek out mental health services than white people. And they make up only \u003ca href=\"https://www.apa.org/workforce/publications/16-demographics/report.pdf\">4%\u003c/a> of the U.S. psychology workforce, which is mostly white. That all influences the reaction Ng gets when students come to her for the first time, she said.\u003c/p>\n\u003cp>\"They're like, ‘Oh, I expected you to be, like, a white person,’” she said.\u003c/p>\n\u003cp>A therapist she had as a teenager inspired Ng to do this work. Ng had been on her way to becoming a competitive athlete, when an accident during a basketball tournament crushed her leg. She was 16, and her whole identity at that time revolved around being an athlete.\u003c/p>\n\u003cp>“While I was still like, recovering physically, my mind definitely began to sort of spiral downwards,” Ng said.\u003c/p>\n\u003cp>Ng had a hard time getting out of bed and didn’t want to hang out with friends.\u003c/p>\n\u003cp>[pullquote size='medium' align='right' citation='Sophia Ng']'My passion is removing the stigma that exists around mental health.'[/pullquote]At her lowest point, Ng said she attempted suicide by taking a bunch of sleeping pills. That’s when she found herself in a therapist’s office, talking with someone who could offer the perspective her family and friends couldn’t.\u003c/p>\n\u003cp>“I think at that time, people in your personal life, they kind of have this ... need or urge to just sort of, like, get you out of that mentality ASAP,” Ng said. “So they tell you to be positive, they tell you to, you know, not think like that, and just, you know, things will get better. And I think those were not the things I needed to hear at the time. Because it didn't make me feel listened to.”\u003c/p>\n\u003cp>The night Ng won the Miss Asian America title and talked openly about her suicide attempt, a common refrain echoed among the audience.\u003c/p>\n\u003cp>“'Whoa, like, you were extremely vulnerable up there,'” Ng said, recalling the conversations she had after the pageant ended. The people she met knew what it meant for her to challenge the cultural pressures to keep those struggles quiet.\u003c/p>\n\u003cfigure id=\"attachment_11746928\" class=\"wp-caption aligncenter\" style=\"max-width: 1920px\">\u003cimg class=\"wp-image-11746928 size-full\" src=\"https://ww2.kqed.org/news/wp-content/uploads/sites/10/2019/05/RS37057_IMG_3777-qut.jpg\" alt=\"\" width=\"1920\" height=\"1440\" srcset=\"https://ww2.kqed.org/app/uploads/sites/10/2019/05/RS37057_IMG_3777-qut.jpg 1920w, https://ww2.kqed.org/app/uploads/sites/10/2019/05/RS37057_IMG_3777-qut-160x120.jpg 160w, https://ww2.kqed.org/app/uploads/sites/10/2019/05/RS37057_IMG_3777-qut-800x600.jpg 800w, https://ww2.kqed.org/app/uploads/sites/10/2019/05/RS37057_IMG_3777-qut-1020x765.jpg 1020w, https://ww2.kqed.org/app/uploads/sites/10/2019/05/RS37057_IMG_3777-qut-1200x900.jpg 1200w, https://ww2.kqed.org/app/uploads/sites/10/2019/05/RS37057_IMG_3777-qut-1832x1374.jpg 1832w, https://ww2.kqed.org/app/uploads/sites/10/2019/05/RS37057_IMG_3777-qut-1376x1032.jpg 1376w, https://ww2.kqed.org/app/uploads/sites/10/2019/05/RS37057_IMG_3777-qut-1044x783.jpg 1044w, https://ww2.kqed.org/app/uploads/sites/10/2019/05/RS37057_IMG_3777-qut-632x474.jpg 632w, https://ww2.kqed.org/app/uploads/sites/10/2019/05/RS37057_IMG_3777-qut-536x402.jpg 536w\" sizes=\"(max-width: 1920px) 100vw, 1920px\">\u003cfigcaption class=\"wp-caption-text\">Sophia Ng started competing in pageants to raise awareness around mental health, especially among the Asian American and Pacific Islander community. Now that she is a pageant titleholder, she often goes to community events, like this Bay Area Chinese Association banquet, that offer her a platform to spread her message. \u003ccite>(Sonia Paul/KQED)\u003c/cite>\u003c/figcaption>\u003c/figure>\n\u003cp>On a Saturday night, Ng was once again out as a beauty queen, this time at a dinner banquet in Pinole that was sponsored by the Chinese Association of Hercules. She was joined by two other winners of the Miss Asian Global & Miss Asian America pageant. The three of them were dolled up for the occasion in long gowns and flawless hair and makeup.\u003c/p>\n\u003cp>When it was time to introduce the women to the banquet attendees, Ng took the mic and spoke in both Cantonese and in English.\u003c/p>\n\u003cp>“My passion is removing the stigma that exists around mental health. And I’m currently doing that by doing a lot of speaking engagements, especially with college students, educating them about this,” she told the dinner guests, knowing the banquet was another platform for her, too. They burst into applause.\u003c/p>\n\u003cp>In the last few weeks, a lot has changed for Ng. She left her job as a school counselor because she is moving back to Hong Kong to be closer to her parents and her fiancé, who got a job in China. She hopes to someday start her own therapy practice, and launch a mental health consulting agency for companies and schools.\u003c/p>\n\u003cp>[ad floatright]\u003c/p>\n\u003cp>Ng's international move fits her new beauty queen title. She recently stepped down as Miss Asian America because she was crowned “\u003ca href=\"https://missglobal.com/\">Miss Global\u003c/a>” in a worldwide competition — the second pageant in which she has ever competed. She says in this new role, she’ll continue to spread her message that it’s \"OK not to be OK.\"\u003c/p>\n\n",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003cp>At first glance, Sophia Ng has all the hallmarks of a typical pageant queen: She has beauty, brains and charisma.\u003c/p>\n\u003cp>But last August, when Ng, 27, competed in San Francisco’s\u003ca href=\"https://www.missasianglobal.com/\"> Miss Asian Global & Miss Asian America\u003c/a> pageant, the longest-running Asian beauty pageant in the nation, she surprised her audience with what she revealed on stage.\u003c/p>\n\u003cp>“I was once in a suicide depression, and in my hour of darkness, I believed I was worthless and that life was not worth living,” she told the crowd at Herbst Theatre in San Francisco. The audience that night was mostly Asian.\u003c/p>\n\u003cp>Later that evening, Ng was crowned Miss Asian America. It was the first pageant she had ever competed in.\u003c/p>\n\u003cp>At 5 foot 9 inches tall, Ng never used to wear high heels. But now, she is a pro. Since she has entered the pageant world, she regularly dons a gown, sash and crown to attend charity and community events, like this year’s Lunar New Year Parade in San Francisco.\u003c/p>\n\u003cfigure id=\"attachment_11746925\" class=\"wp-caption aligncenter\" style=\"max-width: 1920px\">\u003cimg class=\"wp-image-11746925 size-full\" src=\"https://ww2.kqed.org/news/wp-content/uploads/sites/10/2019/05/RS37059_IMG_3611-qut.jpg\" alt=\"\" width=\"1920\" height=\"1440\" srcset=\"https://ww2.kqed.org/app/uploads/sites/10/2019/05/RS37059_IMG_3611-qut.jpg 1920w, https://ww2.kqed.org/app/uploads/sites/10/2019/05/RS37059_IMG_3611-qut-160x120.jpg 160w, https://ww2.kqed.org/app/uploads/sites/10/2019/05/RS37059_IMG_3611-qut-800x600.jpg 800w, https://ww2.kqed.org/app/uploads/sites/10/2019/05/RS37059_IMG_3611-qut-1020x765.jpg 1020w, https://ww2.kqed.org/app/uploads/sites/10/2019/05/RS37059_IMG_3611-qut-1200x900.jpg 1200w, https://ww2.kqed.org/app/uploads/sites/10/2019/05/RS37059_IMG_3611-qut-1832x1374.jpg 1832w, https://ww2.kqed.org/app/uploads/sites/10/2019/05/RS37059_IMG_3611-qut-1376x1032.jpg 1376w, https://ww2.kqed.org/app/uploads/sites/10/2019/05/RS37059_IMG_3611-qut-1044x783.jpg 1044w, https://ww2.kqed.org/app/uploads/sites/10/2019/05/RS37059_IMG_3611-qut-632x474.jpg 632w, https://ww2.kqed.org/app/uploads/sites/10/2019/05/RS37059_IMG_3611-qut-536x402.jpg 536w\" sizes=\"(max-width: 1920px) 100vw, 1920px\">\u003cfigcaption class=\"wp-caption-text\">Sophia Ng, second from right, strikes a pose on a Lunar New Year Parade float with some court members of the Miss Asian Global & Miss Asian America pageant, 2019. \u003ccite>(Sonia Paul/KQED)\u003c/cite>\u003c/figcaption>\u003c/figure>\n\u003cp>But along with the networking and modeling opportunities, Ng spends her time doing what inspired her to compete in pageants in the first place: raising awareness about mental health, particularly among the Asian American and Pacific Islander communities.\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>Ng is a mental health therapist, a profession she says offers an impact that’s deep but often struggles with reach. Until recently, she counselled students at elementary and high schools in San Francisco.\u003c/p>\n\u003cp>Earlier this spring, she embarked on a typical work day at Lowell High School — one of the most competitive high schools in the state.\u003c/p>\n\u003cp>As students attended classes and roamed the hallways during breaks, Ng met with her clients at Lowell’s Wellness Center, a place where students can come in for counseling and access community resources, or relax and sip a cup of tea.\u003c/p>\n\u003cfigure id=\"attachment_11747793\" class=\"wp-caption aligncenter\" style=\"max-width: 800px\">\u003cimg class=\"size-medium wp-image-11747793\" src=\"https://ww2.kqed.org/news/wp-content/uploads/sites/10/2019/05/Sophia-Ng-Reading-800x603.jpg\" alt=\"Sophia Ng reviews some paperwork in an office at Lowell High School's Wellness Center. As a mental health therapist, Ng visited schools in San Francisco and counseled students.\" width=\"800\" height=\"603\" srcset=\"https://ww2.kqed.org/app/uploads/sites/10/2019/05/Sophia-Ng-Reading-800x603.jpg 800w, https://ww2.kqed.org/app/uploads/sites/10/2019/05/Sophia-Ng-Reading-160x121.jpg 160w, https://ww2.kqed.org/app/uploads/sites/10/2019/05/Sophia-Ng-Reading-1020x769.jpg 1020w, https://ww2.kqed.org/app/uploads/sites/10/2019/05/Sophia-Ng-Reading-1200x904.jpg 1200w, https://ww2.kqed.org/app/uploads/sites/10/2019/05/Sophia-Ng-Reading.jpg 1736w\" sizes=\"(max-width: 800px) 100vw, 800px\">\u003cfigcaption class=\"wp-caption-text\">Sophia Ng reviews some paperwork in an office at Lowell High School's Wellness Center. As a mental health therapist, Ng visited schools in San Francisco and counseled students. \u003ccite>(Sonia Paul/KQED)\u003c/cite>\u003c/figcaption>\u003c/figure>\n\u003cp>In a small office in the Wellness Center, as a white noise machine hummed nearby to help protect privacy during conversations, one student told Ng about the painful relationship he has with his mom.\u003c/p>\n\u003cp>“She went on a rant,” he told Ng, referring to a recent incident involving him, his brother and his mother, in which their mother told them they were \"useless.\"\u003c/p>\n\u003cp>“She also mention[ed] something like, 'you guys were a waste of giving birth' in Chinese.\"\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"content": "\u003cdiv class=\"post-body\">\u003cp>Like this student, and many of the students she works with, Ng is also Chinese, growing up in Hong Kong. She says many students and their parents hesitate to seek out therapy, and that this may trace back to a culture in which shame and honor play an important role.\u003c/p>\n\u003cp>It's also seen in the parenting style, where they use shame and guilt to parent their kid, said Ng, who stressed that not all Asian American moms and dads do this.\u003c/p>\n\u003cp>Parents also worry that if their kids need help, maybe they’ve done something wrong as parents. But, she noted, people in the community are under pressure to present a good face to the world despite whatever their going through.\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"content": "\u003cdiv class=\"post-body\">\u003cp>In fact, Asian Americans are \u003ca href=\"https://www.apa.org/pi/oema/resources/ethnicity-health/asian-american/article-mental-health\">three times less likely\u003c/a> to seek out mental health services than white people. And they make up only \u003ca href=\"https://www.apa.org/workforce/publications/16-demographics/report.pdf\">4%\u003c/a> of the U.S. psychology workforce, which is mostly white. That all influences the reaction Ng gets when students come to her for the first time, she said.\u003c/p>\n\u003cp>\"They're like, ‘Oh, I expected you to be, like, a white person,’” she said.\u003c/p>\n\u003cp>A therapist she had as a teenager inspired Ng to do this work. Ng had been on her way to becoming a competitive athlete, when an accident during a basketball tournament crushed her leg. She was 16, and her whole identity at that time revolved around being an athlete.\u003c/p>\n\u003cp>“While I was still like, recovering physically, my mind definitely began to sort of spiral downwards,” Ng said.\u003c/p>\n\u003cp>Ng had a hard time getting out of bed and didn’t want to hang out with friends.\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"content": "\u003cdiv class=\"post-body\">\u003cp>At her lowest point, Ng said she attempted suicide by taking a bunch of sleeping pills. That’s when she found herself in a therapist’s office, talking with someone who could offer the perspective her family and friends couldn’t.\u003c/p>\n\u003cp>“I think at that time, people in your personal life, they kind of have this ... need or urge to just sort of, like, get you out of that mentality ASAP,” Ng said. “So they tell you to be positive, they tell you to, you know, not think like that, and just, you know, things will get better. And I think those were not the things I needed to hear at the time. Because it didn't make me feel listened to.”\u003c/p>\n\u003cp>The night Ng won the Miss Asian America title and talked openly about her suicide attempt, a common refrain echoed among the audience.\u003c/p>\n\u003cp>“'Whoa, like, you were extremely vulnerable up there,'” Ng said, recalling the conversations she had after the pageant ended. The people she met knew what it meant for her to challenge the cultural pressures to keep those struggles quiet.\u003c/p>\n\u003cfigure id=\"attachment_11746928\" class=\"wp-caption aligncenter\" style=\"max-width: 1920px\">\u003cimg class=\"wp-image-11746928 size-full\" src=\"https://ww2.kqed.org/news/wp-content/uploads/sites/10/2019/05/RS37057_IMG_3777-qut.jpg\" alt=\"\" width=\"1920\" height=\"1440\" srcset=\"https://ww2.kqed.org/app/uploads/sites/10/2019/05/RS37057_IMG_3777-qut.jpg 1920w, https://ww2.kqed.org/app/uploads/sites/10/2019/05/RS37057_IMG_3777-qut-160x120.jpg 160w, https://ww2.kqed.org/app/uploads/sites/10/2019/05/RS37057_IMG_3777-qut-800x600.jpg 800w, https://ww2.kqed.org/app/uploads/sites/10/2019/05/RS37057_IMG_3777-qut-1020x765.jpg 1020w, https://ww2.kqed.org/app/uploads/sites/10/2019/05/RS37057_IMG_3777-qut-1200x900.jpg 1200w, https://ww2.kqed.org/app/uploads/sites/10/2019/05/RS37057_IMG_3777-qut-1832x1374.jpg 1832w, https://ww2.kqed.org/app/uploads/sites/10/2019/05/RS37057_IMG_3777-qut-1376x1032.jpg 1376w, https://ww2.kqed.org/app/uploads/sites/10/2019/05/RS37057_IMG_3777-qut-1044x783.jpg 1044w, https://ww2.kqed.org/app/uploads/sites/10/2019/05/RS37057_IMG_3777-qut-632x474.jpg 632w, https://ww2.kqed.org/app/uploads/sites/10/2019/05/RS37057_IMG_3777-qut-536x402.jpg 536w\" sizes=\"(max-width: 1920px) 100vw, 1920px\">\u003cfigcaption class=\"wp-caption-text\">Sophia Ng started competing in pageants to raise awareness around mental health, especially among the Asian American and Pacific Islander community. Now that she is a pageant titleholder, she often goes to community events, like this Bay Area Chinese Association banquet, that offer her a platform to spread her message. \u003ccite>(Sonia Paul/KQED)\u003c/cite>\u003c/figcaption>\u003c/figure>\n\u003cp>On a Saturday night, Ng was once again out as a beauty queen, this time at a dinner banquet in Pinole that was sponsored by the Chinese Association of Hercules. She was joined by two other winners of the Miss Asian Global & Miss Asian America pageant. The three of them were dolled up for the occasion in long gowns and flawless hair and makeup.\u003c/p>\n\u003cp>When it was time to introduce the women to the banquet attendees, Ng took the mic and spoke in both Cantonese and in English.\u003c/p>\n\u003cp>“My passion is removing the stigma that exists around mental health. And I’m currently doing that by doing a lot of speaking engagements, especially with college students, educating them about this,” she told the dinner guests, knowing the banquet was another platform for her, too. They burst into applause.\u003c/p>\n\u003cp>In the last few weeks, a lot has changed for Ng. She left her job as a school counselor because she is moving back to Hong Kong to be closer to her parents and her fiancé, who got a job in China. She hopes to someday start her own therapy practice, and launch a mental health consulting agency for companies and schools.\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>Ng's international move fits her new beauty queen title. She recently stepped down as Miss Asian America because she was crowned “\u003ca href=\"https://missglobal.com/\">Miss Global\u003c/a>” in a worldwide competition — the second pageant in which she has ever competed. She says in this new role, she’ll continue to spread her message that it’s \"OK not to be OK.\"\u003c/p>\n\n\u003c/div>\u003c/p>",
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"content": "\u003cp>The trauma specialists working in Butte County schools knew they'd start seeing kids act out around six months after the deadly Camp Fire, since anniversaries are known to \u003ca href=\"https://www.apa.org/helpcenter/anniversary\" target=\"_blank\" rel=\"noopener\">trigger survivors\u003c/a> into reliving moments of the traumatic event.\u003c/p>\n\u003cp>But there aren't enough counselors to help all of the students, teachers and staff dealing with this second wave of trauma.\u003c/p>\n\u003cp>“We have six schools that have requested help, and we can't bring help to them,” said Roy Applegate, who helps coordinate Recovery Trauma Services for the Butte County Office of Education. “It’s a little bit like rain in the desert in the summer: As soon as it hits the ground, it disappears. We can give our counselors as many hours as they need, and they're full up all the time. They're working to the max.”[pullquote align='right' citation='Roy Applegate, Recovery Trauma Services Co-Coordinator']'We can give our counselors as many hours as they need, and they're full up all the time. They're working to the max.’[/pullquote]Just like during the fire itself, different people are dealing with different levels of trauma.\u003c/p>\n\u003cp>\"It depends on whether or not they've secured some basic levels of need: housing, food, routine access to resources,\" said Dena Kapsalis, director of student services for the Paradise Unified School District.\u003c/p>\n\u003cp>But regardless of their situation, all families may notice their kids exhibiting unusual behavior.\u003c/p>\n\u003cp>[ad fullwidth]\u003c/p>\n\u003cp>\"We're seeing lots and lots of manifestations of trauma,\" Kapsalis said. \"A lot of acting out, tiredness, inability to focus, shutting down, being unable to maintain relationships with adults or peers.”\u003c/p>\n\u003cp>While it may be distressing for parents to see their kids struggling, Kapsalis says counselors try to instead view this acting out as a form of communication.\u003c/p>\n\u003cp>“The gift of being with kids is that they don't second-guess themselves typically. So we're afforded the ability to have more transparent responses and communication from them,” Kapsalis said. “So they're communicating loss, they're communicating a need for help, a need for support.”\u003c/p>\n\u003cfigure id=\"attachment_11745116\" class=\"wp-caption aligncenter\" style=\"max-width: 800px\">\u003cimg class=\"size-medium wp-image-11745116\" src=\"https://ww2.kqed.org/news/wp-content/uploads/sites/10/2019/05/IMG_0356-800x533.jpg\" alt=\"Workers with a backhoe remove debris from the burned down Paradise Elementary.\" width=\"800\" height=\"533\">\u003cfigcaption class=\"wp-caption-text\">Workers use a backhoe to remove debris from the burned-down Paradise Elementary. \u003ccite>(Michelle Wiley/KQED)\u003c/cite>\u003c/figcaption>\u003c/figure>\n\u003cp>But for their teachers — many of whom were also impacted by the fire that erupted on Nov. 8 — it’s much more difficult for support staff to determine how they’re doing.\u003c/p>\n\u003cp>“With adults it's much harder because they have all kinds of systems of coping that often disguise what's really going on with them,” Kapsalis said.\u003c/p>\n\u003cp>To better support their teachers, counselors have started setting up shop in common areas — including staff rooms, hallways and even near copiers — to encourage conversation and help connect them with services.\u003c/p>\n\u003cp>To fill the need for more counselors, the Butte County Office of Education has called several of their workers out of retirement to help out.[pullquote align='right' citation='Dena Kapsalis, Director of Student Services for Paradise Unified']'We're seeing lots and lots of manifestations of trauma. A lot of acting out, tiredness, inability to focus, shutting down, being unable to maintain relationships with adults or peers.'[/pullquote]\"When I got the phone call, I said, 'Oh no, I really don't want to go back to work,' and they said, 'No, we really need you,' \" said Pamela Beeman, who'd been retired for nearly five years when she got the call. \"You can't just say no to that.\"\u003c/p>\n\u003cp>Beeman is currently working as a fire recovery counselor at \u003ca href=\"https://www.chicoer.com/2018/11/28/former-spring-valley-school-site-will-reopen-for-concow-students/\" target=\"_blank\" rel=\"noopener\">Spring Valley School\u003c/a>, but she doesn't know how long she can continue.\u003c/p>\n\u003cp>\u003c/p>\n\u003cp>\"We're just getting started,\" Beeman said. \"This is a long road, and some of the worst symptoms for survivors are starting to emerge. It's really easy to lose heart.\"\u003c/p>\n\n",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>\"We're seeing lots and lots of manifestations of trauma,\" Kapsalis said. \"A lot of acting out, tiredness, inability to focus, shutting down, being unable to maintain relationships with adults or peers.”\u003c/p>\n\u003cp>While it may be distressing for parents to see their kids struggling, Kapsalis says counselors try to instead view this acting out as a form of communication.\u003c/p>\n\u003cp>“The gift of being with kids is that they don't second-guess themselves typically. So we're afforded the ability to have more transparent responses and communication from them,” Kapsalis said. “So they're communicating loss, they're communicating a need for help, a need for support.”\u003c/p>\n\u003cfigure id=\"attachment_11745116\" class=\"wp-caption aligncenter\" style=\"max-width: 800px\">\u003cimg class=\"size-medium wp-image-11745116\" src=\"https://ww2.kqed.org/news/wp-content/uploads/sites/10/2019/05/IMG_0356-800x533.jpg\" alt=\"Workers with a backhoe remove debris from the burned down Paradise Elementary.\" width=\"800\" height=\"533\">\u003cfigcaption class=\"wp-caption-text\">Workers use a backhoe to remove debris from the burned-down Paradise Elementary. \u003ccite>(Michelle Wiley/KQED)\u003c/cite>\u003c/figcaption>\u003c/figure>\n\u003cp>But for their teachers — many of whom were also impacted by the fire that erupted on Nov. 8 — it’s much more difficult for support staff to determine how they’re doing.\u003c/p>\n\u003cp>“With adults it's much harder because they have all kinds of systems of coping that often disguise what's really going on with them,” Kapsalis said.\u003c/p>\n\u003cp>To better support their teachers, counselors have started setting up shop in common areas — including staff rooms, hallways and even near copiers — to encourage conversation and help connect them with services.\u003c/p>\n\u003cp>To fill the need for more counselors, the Butte County Office of Education has called several of their workers out of retirement to help out.\u003c/p>\u003c/div>",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\"When I got the phone call, I said, 'Oh no, I really don't want to go back to work,' and they said, 'No, we really need you,' \" said Pamela Beeman, who'd been retired for nearly five years when she got the call. \"You can't just say no to that.\"\u003c/p>\n\u003cp>Beeman is currently working as a fire recovery counselor at \u003ca href=\"https://www.chicoer.com/2018/11/28/former-spring-valley-school-site-will-reopen-for-concow-students/\" target=\"_blank\" rel=\"noopener\">Spring Valley School\u003c/a>, but she doesn't know how long she can continue.\u003c/p>\n\u003cp>\u003c/p>\n\u003cp>\"We're just getting started,\" Beeman said. \"This is a long road, and some of the worst symptoms for survivors are starting to emerge. It's really easy to lose heart.\"\u003c/p>\n\n\u003c/div>\u003c/p>",
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"content": "\u003cp>When it comes to getting homeless people off the streets and into stable housing, San Francisco politicians face hard choices. Some want to expand a controversial legal process called conservatorship that they say would help homeless people with severe substance abuse problems and mental illness. But so far, implementation has been slow and bumpy.\u003c/p>\n\u003cp>When San Francisco Mayor London Breed went to Sacramento earlier this month to \u003ca href=\"https://www.senate.ca.gov/media/senate-judiciary-committee-20190409/video\" target=\"_blank\" rel=\"noopener\">tell state legislators\u003c/a> about the plight of the city’s most desperate people, she had someone in mind from her former district when she was a supervisor — an older homeless man with a serious substance abuse problem.\u003c/p>\n\u003cp>“When he gets his check at the beginning of the month, his money gets taken by some other individuals in the neighborhood,” she said. “He was well-known to all the neighbors, all the merchants, all of us. We all did our very best to try and assist him but, sadly, he’s still out in the community.”\u003c/p>\n\u003cp>Breed and other San Francisco politicians had hoped that changes to conservatorship rules would allow city health workers to help homeless people with substance abuse and mental health problems by legally and temporarily stepping in to force a mentally ill person into treatment.\u003c/p>\n\u003cp>“We believe that there are 50 to 100 people on our streets who are so severely mentally ill and drug addicted — can’t make decisions for themselves and who are dying — and who could benefit from a conservatorship,” said state Sen. Scott Wiener, who sponsored \u003ca href=\"https://leginfo.legislature.ca.gov/faces/billTextClient.xhtml?bill_id=201720180SB1045\" target=\"_blank\" rel=\"noopener\">Senate Bill 1045\u003c/a>, which became law last year.\u003c/p>\n\u003cp>[ad fullwidth]\u003c/p>\n\u003cp>[pullquote size='medium' align='right' citation='S.F. Supervisor Rafael Mandelman']‘We don’t want to recreate the hospitals of the past but we have a kind of institutionalization today, which is jail.’[/pullquote]\u003c/p>\n\u003cp>The new law established a pilot program in San Francisco, Los Angeles and San Diego to allow conservatorships for severely drug-addicted people. To qualify, a homeless person has to be held involuntarily in a hospital for psychiatric reasons eight times in the past year.\u003c/p>\n\u003cp>But when they began to implement the law, San Francisco officials found that last-minute amendments made it too narrow to apply to many people.\u003c/p>\n\u003cp>“As drafted, SB 1045 would allow us to help fewer than five individuals,” Breed told the state Senate Judiciary Committee on April 9. She said lawmakers needed to make changes to broaden the law.\u003c/p>\n\u003cp>So Wiener wrote new legislation, \u003ca href=\"http://leginfo.legislature.ca.gov/faces/billTextClient.xhtml?bill_id=201920200SB40\" target=\"_blank\" rel=\"noopener\">Senate Bill 40\u003c/a>, which would tweak the conservatorship law in a few ways. Most importantly, it would remove the requirement that someone with a drug problem or severe mental illness try advanced outpatient treatment first. This qualification means someone has to fail out of such treatment, when specialists agree that the drug users who conservatorship is intended to reach aren’t good candidates for that kind of program. Doctors also say such a requirement gets in the way of providing help.\u003c/p>\n\u003cp>The bill does little to address the concerns of advocates for the homeless and mentally ill, who say it could violate the civil rights of the homeless. They protested outside a town hall on April 6 at UC Hastings School of Law, then followed Wiener inside and briefly shut down the meeting with booing and singing.\u003c/p>\n\u003cp>“It’s not progressive to let people die on our streets,” Wiener said.\u003c/p>\n\u003cp>[pullquote size='medium' align='right' citation='Raia Small, community organizer with Senior and Disability Action']‘This expansion of conservatorship doesn’t actually create any new services. There’s no new housing units provided.’[/pullquote]\u003c/p>\n\u003cp>Raia Small, a community organizer with Senior and Disability Action, said conservatorship could violate civil rights without helping people with what they really need.\u003c/p>\n\u003cp>“Our greatest fear is that this law is going to be used to take away the civil liberties of people with mental illnesses and drug users, and that it’s going to do that without providing the care and treatment that people need to be able to access voluntarily,” Small said.\u003c/p>\n\u003cp>Small’s group is part of a coalition, \u003ca href=\"https://sdaction.files.wordpress.com/2019/02/voluntary-services-first-coalition-comments-on-draft-report.pdf\" target=\"_blank\" rel=\"noopener\">Voluntary Services First\u003c/a>, that is organizing against conservatorship. Other members include the Mental Health Association of San Francisco and the Coalition on Homelessness.\u003c/p>\n\u003cp>[aside tag='homelessness' label='More coverage of homelessness in the Bay Area']\u003c/p>\n\u003cp>They say the city should be investing in permanent supportive housing, intensive case management, programs for people with both substance use disorder and serious mental illness, and case managers who can find people when they don’t show up for appointments.\u003c/p>\n\u003cp>“This expansion of conservatorship doesn’t actually create any new services,” Small said. “There’s no funding for it. There’s no new housing units provided.”\u003c/p>\n\u003cp>City Supervisor Rafael Mandelman said critics are overstating their case.\u003c/p>\n\u003cp>“We don’t want to recreate the hospitals of the past but we have a kind of institutionalization today, which is jail, and a lot of these folks are finding themselves in jail, in prison or on the streets,” he said.\u003c/p>\n\u003cp>In the face of contemporary addiction, conservatorship needs to adapt.\u003c/p>\n\u003cp>“It is half a century old. It was not written to address things like meth-induced psychosis or people who suffer from serious meth addiction. We see that as a huge problem in San Francisco every day,” Mandelman added.\u003c/p>\n\u003cp>\u003c/p>\n\u003cp>Because of critics’ concerns, San Francisco has been slow to implement conservatorship — and it could stop altogether. Before anyone in the city can be forced into conservatorship, the Board of Supervisors has to pass an ordinance that spells out how. The supervisors’ Rules Committee could review the proposed ordinance on May 13.\u003c/p>\n\n",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>The new law established a pilot program in San Francisco, Los Angeles and San Diego to allow conservatorships for severely drug-addicted people. To qualify, a homeless person has to be held involuntarily in a hospital for psychiatric reasons eight times in the past year.\u003c/p>\n\u003cp>But when they began to implement the law, San Francisco officials found that last-minute amendments made it too narrow to apply to many people.\u003c/p>\n\u003cp>“As drafted, SB 1045 would allow us to help fewer than five individuals,” Breed told the state Senate Judiciary Committee on April 9. She said lawmakers needed to make changes to broaden the law.\u003c/p>\n\u003cp>So Wiener wrote new legislation, \u003ca href=\"http://leginfo.legislature.ca.gov/faces/billTextClient.xhtml?bill_id=201920200SB40\" target=\"_blank\" rel=\"noopener\">Senate Bill 40\u003c/a>, which would tweak the conservatorship law in a few ways. Most importantly, it would remove the requirement that someone with a drug problem or severe mental illness try advanced outpatient treatment first. This qualification means someone has to fail out of such treatment, when specialists agree that the drug users who conservatorship is intended to reach aren’t good candidates for that kind of program. Doctors also say such a requirement gets in the way of providing help.\u003c/p>\n\u003cp>The bill does little to address the concerns of advocates for the homeless and mentally ill, who say it could violate the civil rights of the homeless. They protested outside a town hall on April 6 at UC Hastings School of Law, then followed Wiener inside and briefly shut down the meeting with booing and singing.\u003c/p>\n\u003cp>“It’s not progressive to let people die on our streets,” Wiener said.\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>Raia Small, a community organizer with Senior and Disability Action, said conservatorship could violate civil rights without helping people with what they really need.\u003c/p>\n\u003cp>“Our greatest fear is that this law is going to be used to take away the civil liberties of people with mental illnesses and drug users, and that it’s going to do that without providing the care and treatment that people need to be able to access voluntarily,” Small said.\u003c/p>\n\u003cp>Small’s group is part of a coalition, \u003ca href=\"https://sdaction.files.wordpress.com/2019/02/voluntary-services-first-coalition-comments-on-draft-report.pdf\" target=\"_blank\" rel=\"noopener\">Voluntary Services First\u003c/a>, that is organizing against conservatorship. Other members include the Mental Health Association of San Francisco and the Coalition on Homelessness.\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>They say the city should be investing in permanent supportive housing, intensive case management, programs for people with both substance use disorder and serious mental illness, and case managers who can find people when they don’t show up for appointments.\u003c/p>\n\u003cp>“This expansion of conservatorship doesn’t actually create any new services,” Small said. “There’s no funding for it. There’s no new housing units provided.”\u003c/p>\n\u003cp>City Supervisor Rafael Mandelman said critics are overstating their case.\u003c/p>\n\u003cp>“We don’t want to recreate the hospitals of the past but we have a kind of institutionalization today, which is jail, and a lot of these folks are finding themselves in jail, in prison or on the streets,” he said.\u003c/p>\n\u003cp>In the face of contemporary addiction, conservatorship needs to adapt.\u003c/p>\n\u003cp>“It is half a century old. It was not written to address things like meth-induced psychosis or people who suffer from serious meth addiction. We see that as a huge problem in San Francisco every day,” Mandelman added.\u003c/p>\n\u003cp>\u003c/p>\n\u003cp>Because of critics’ concerns, San Francisco has been slow to implement conservatorship — and it could stop altogether. Before anyone in the city can be forced into conservatorship, the Board of Supervisors has to pass an ordinance that spells out how. The supervisors’ Rules Committee could review the proposed ordinance on May 13.\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": "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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