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"content": "\u003cp>[dropcap]W[/dropcap]hen it rolled out last year in eight counties, CARE Court took aim at one of the state’s most vexing challenges: how to treat people whose illness often makes them believe they are not sick and who, if left untreated, can oscillate between jails, hospitals and homelessness.\u003c/p>\n\u003cp>Using the weight of a judge’s black robe to nudge county health departments’ doctors in white coats to provide an array of services, the program sought to reach the hardest-to-treat cases.\u003c/p>\n\u003cp>Now, a year after the program went live in seven counties — San Francisco, Glenn, Tuolumne, Stanislaus, Orange, Riverside, and San Diego — and ten months after it launched in Los Angeles County, petitions appear to be trickling in slower than expected and treatment plans are taking longer to put in place.\u003c/p>\n\u003cp>And, while Gov. Gavin Newsom, who first \u003ca href=\"https://www.gov.ca.gov/2022/03/03/governor-newsom-launches-new-plan-to-help-californians-struggling-with-mental-health-challenges-homelessness/\">introduced the initiative in March 2022\u003c/a>, initially said it would target those “living on our streets with severe mental health and substance use disorders,” the number of unhoused people going through the program varies widely from county to county.\u003c/p>\n\u003cfigure id=\"attachment_12005914\" class=\"wp-caption aligncenter\" style=\"max-width: 2000px\">\u003ca href=\"https://cdn.kqed.org/wp-content/uploads/sites/10/2024/09/092024-Senate-Judiciary-FG-05.jpg\">\u003cimg loading=\"lazy\" decoding=\"async\" class=\"size-full wp-image-12005914\" src=\"https://cdn.kqed.org/wp-content/uploads/sites/10/2024/09/092024-Senate-Judiciary-FG-05.jpg\" alt=\"A white man wearing a suit stands at a podium with a microphone.\" width=\"2000\" height=\"1355\" srcset=\"https://cdn.kqed.org/wp-content/uploads/sites/10/2024/09/092024-Senate-Judiciary-FG-05.jpg 2000w, https://cdn.kqed.org/wp-content/uploads/sites/10/2024/09/092024-Senate-Judiciary-FG-05-800x542.jpg 800w, https://cdn.kqed.org/wp-content/uploads/sites/10/2024/09/092024-Senate-Judiciary-FG-05-1020x691.jpg 1020w, https://cdn.kqed.org/wp-content/uploads/sites/10/2024/09/092024-Senate-Judiciary-FG-05-160x108.jpg 160w, https://cdn.kqed.org/wp-content/uploads/sites/10/2024/09/092024-Senate-Judiciary-FG-05-1536x1041.jpg 1536w, https://cdn.kqed.org/wp-content/uploads/sites/10/2024/09/092024-Senate-Judiciary-FG-05-1920x1301.jpg 1920w\" sizes=\"auto, (max-width: 2000px) 100vw, 2000px\">\u003c/a>\u003cfigcaption class=\"wp-caption-text\">California State Senator Thomas Umberg speaks before the Senate Judiciary Committee about SB1338, the Community Assistance, Recovery, and Empowerment (CARE) Court Program, on April 26, 2022, in Sacramento. \u003ccite>(Fred Greaves/CalMatters)\u003c/cite>\u003c/figcaption>\u003c/figure>\n\u003cp>State Sen. Tom Umberg, who co-authored the \u003ca href=\"https://leginfo.legislature.ca.gov/faces/billTextClient.xhtml?bill_id=202120220SB1338\">legislation\u003c/a> that implemented CARE Court, said the gradual rollout hasn’t come as a complete surprise.\u003c/p>\n\u003cp>[ad fullwidth]\u003c/p>\n\u003cp>“We’re changing the culture here,” he said. “So, that takes a little time.”\u003c/p>\n\u003cp>As of mid-September, at least 692 petitions had been filed across seven of the counties in the first cohort, excluding San Francisco, according to data provided by superior court and county health officials. Of those petitions, a little more than a third, or 245, have been dismissed. And nearly one in five, or 121 petitions, have resulted in a CARE Agreement, an official document that details a voluntary treatment regime. There have been six court-ordered, or involuntary, CARE Plans issued.\u003c/p>\n\u003cp>San Francisco has so far received 42 petitions, said Melanie Kushnir, director of the Collaborative Justice Programs at the San Francisco Superior Courts. Of those, she said roughly half are active, meaning the participant is attending hearings and working toward or enrolled in a CARE Agreement. Citing privacy concerns, Kushnir declined to provide data on the exact number of dismissals or CARE Agreements reached but said there had been no CARE Plans issued.\u003c/p>\n\u003cp>The state had initially estimated that between 7,000 and 12,000 people would qualify for CARE Court each year once the program was fully implemented. But even accounting for the small number of counties that launched last year, court and public health officials agree the number of petitions is far fewer than expected — prompting opponents to argue the program is wasting taxpayers’ dollars.\u003c/p>\n\u003cp>According to the California Department of Finance, the state has already allocated $72 million to counties for start-up costs, along with $12 million for ongoing operations in fiscal year 2024–25, which will increase to $47 million in fiscal year 2026–27.\u003c/p>\n\u003cp>“We feel like the program has already failed,” said Samuel Jain, a senior mental health policy attorney at Disability Rights California, which is among the groups that advocated against CARE Court from the start. “The law doesn’t provide any new services and instead directs the limited resources we have to these expensive court processes.”\u003c/p>\n\u003cp>But supporters say it’s too early to pass judgment on a program that has yet to be fully implemented. The remaining 50 counties are due to open their own programs by Dec. 1.\u003c/p>\n\u003cp>“To really make some grand statement about its efficacy in the first 12 months of it rolling out, I think, is a leap for a state with 40 million people,” Dr. Mark Ghaly, the outgoing Secretary of California’s Health and Human Services Agency, told KQED. “But I do think that’s exactly the question that we have to keep in mind.”\u003c/p>\n\u003ch3>The number of petitions varies widely\u003c/h3>\n\u003cp>In Glenn County, with a population of \u003ca href=\"https://data.census.gov/profile/Glenn_County,_California?g=050XX00US06021\">around 29,000\u003c/a>, just one petition has been filed as of Sept. 12, and it was ultimately dismissed, said Chris Ruhl, executive officer of the Glenn County Superior Court. Ruhl expects one or two more may be submitted soon and that more will follow as word of the program spreads.\u003c/p>\n\u003cp>“We generally anticipate there will be an increase in the number of petitions and filings, but we don’t know that for sure,” he said. “We’ll be watching very closely.”\u003c/p>\n\u003cfigure id=\"attachment_12007228\" class=\"wp-caption aligncenter\" style=\"max-width: 2000px\">\u003ca href=\"https://cdn.kqed.org/wp-content/uploads/sites/10/2024/10/240917-CARECourt-12-BL_qed.jpg\">\u003cimg loading=\"lazy\" decoding=\"async\" class=\"size-full wp-image-12007228\" src=\"https://cdn.kqed.org/wp-content/uploads/sites/10/2024/10/240917-CARECourt-12-BL_qed.jpg\" alt=\"A white man wearing a blue dress suit leans against a wooden divider in a court room.\" width=\"2000\" height=\"1333\" srcset=\"https://cdn.kqed.org/wp-content/uploads/sites/10/2024/10/240917-CARECourt-12-BL_qed.jpg 2000w, https://cdn.kqed.org/wp-content/uploads/sites/10/2024/10/240917-CARECourt-12-BL_qed-800x533.jpg 800w, https://cdn.kqed.org/wp-content/uploads/sites/10/2024/10/240917-CARECourt-12-BL_qed-1020x680.jpg 1020w, https://cdn.kqed.org/wp-content/uploads/sites/10/2024/10/240917-CARECourt-12-BL_qed-160x107.jpg 160w, https://cdn.kqed.org/wp-content/uploads/sites/10/2024/10/240917-CARECourt-12-BL_qed-1536x1024.jpg 1536w, https://cdn.kqed.org/wp-content/uploads/sites/10/2024/10/240917-CARECourt-12-BL_qed-1920x1280.jpg 1920w\" sizes=\"auto, (max-width: 2000px) 100vw, 2000px\">\u003c/a>\u003cfigcaption class=\"wp-caption-text\">Judge Michael Begert, presiding over CARE Court, stands in the San Francisco Superior Court in San Francisco on Sept. 17, 2024. \u003ccite>(Beth LaBerge/KQED)\u003c/cite>\u003c/figcaption>\u003c/figure>\n\u003cp>At the other end of the spectrum is Los Angeles County, which, with a population of around \u003ca href=\"https://data.census.gov/profile/Los_Angeles_County,_California?g=050XX00US06037\">10 million\u003c/a>, has seen the most petitions: 268 as of Sept. 18. There, the number of petitions has been steadily increasing, Los Angeles Superior Court Judge Scott Herin said.\u003c/p>\n\u003cp>“I don’t think it started off like everybody expected, which was an overwhelming flood of cases,” Herin said, adding that the gradual ramp-up was perhaps “more healthy.”\u003c/p>\n\u003cp>That’s allowed some county behavioral health agencies to reappropriate staff assigned to CARE Court to other needs. In Stanislaus County, which has received 47 petitions, 19 of which have been dismissed, Behavioral Health & Recovery Services Director Tony Vartan said some of his CARE Court staff spent the first four to five months doing outreach with police and sheriff departments, hospital workers and others to build awareness.\u003c/p>\n\u003cp>“But as we saw that trend of those petitions, we pulled back some of our staff, and we assigned them to areas that needed more work,” he said. “Our staff emphasize where the cases are, regardless of what program we manage. That way, we make sure that the staff are working and they’ve got cases.”\u003c/p>\n\u003ch3>Cases dismissed\u003c/h3>\n\u003cp>Despite the lower-than-expected number of petitions, county behavioral health and court staff say they weren’t surprised to see that more than a third have been dismissed. Dismissal rates vary across the counties, from just over 90% in Tuolumne County, where 10 of 11 cases were dismissed, to a low of 26% in both Riverside and Los Angeles counties.\u003c/p>\n\u003cp>To be eligible, San Francisco Superior Court Judge Michael Begert said participants need to not only be diagnosed with schizophrenia or another psychotic disorder, but they also must be likely to benefit from services, can’t already be enrolled in services, and must be unlikely to survive without additional support.\u003c/p>\n\u003cp>“And that’s a small eye in a needle to thread,” Begert said.\u003c/p>\n\u003cp>Algenib Collin is trying to thread that needle as she looks for any program that might help for her daughter.\u003c/p>\n\u003cp>Collin applied for CARE Court the day it opened, she said, “I was so desperate.”\u003c/p>\n\u003cp>For roughly 18 months prior, she had seen her daughter, now 27, rapidly deteriorate on San Francisco’s streets. Collin said she would receive a call from the hospital nearly every other week, reporting her daughter had been placed on a 5150, or a temporary mental health hold, only to be rereleased back into homelessness and addiction.\u003c/p>\n\u003cfigure id=\"attachment_11955160\" class=\"wp-caption aligncenter\" style=\"max-width: 2000px\">\u003ca href=\"https://cdn.kqed.org/wp-content/uploads/sites/10/2023/07/230707-ORANGE-COUNTY-CARE-COURT-AD-02-KQED.jpg\">\u003cimg loading=\"lazy\" decoding=\"async\" class=\"size-full wp-image-11955160\" src=\"https://cdn.kqed.org/wp-content/uploads/sites/10/2023/07/230707-ORANGE-COUNTY-CARE-COURT-AD-02-KQED.jpg\" alt=\"A large multi-story building and a driveway alongside it.\" width=\"2000\" height=\"1333\" srcset=\"https://cdn.kqed.org/wp-content/uploads/sites/10/2023/07/230707-ORANGE-COUNTY-CARE-COURT-AD-02-KQED.jpg 2000w, https://cdn.kqed.org/wp-content/uploads/sites/10/2023/07/230707-ORANGE-COUNTY-CARE-COURT-AD-02-KQED-800x533.jpg 800w, https://cdn.kqed.org/wp-content/uploads/sites/10/2023/07/230707-ORANGE-COUNTY-CARE-COURT-AD-02-KQED-1020x680.jpg 1020w, https://cdn.kqed.org/wp-content/uploads/sites/10/2023/07/230707-ORANGE-COUNTY-CARE-COURT-AD-02-KQED-160x107.jpg 160w, https://cdn.kqed.org/wp-content/uploads/sites/10/2023/07/230707-ORANGE-COUNTY-CARE-COURT-AD-02-KQED-1536x1024.jpg 1536w, https://cdn.kqed.org/wp-content/uploads/sites/10/2023/07/230707-ORANGE-COUNTY-CARE-COURT-AD-02-KQED-1920x1280.jpg 1920w\" sizes=\"auto, (max-width: 2000px) 100vw, 2000px\">\u003c/a>\u003cfigcaption class=\"wp-caption-text\">Orange County Superior Court will technically house the local CARE Court, though judges say they will more likely hold meetings with patients at a more neutral site, like a conference room at the county health office. \u003ccite>(April Dembosky/KQED)\u003c/cite>\u003c/figcaption>\u003c/figure>\n\u003cp>High on fentanyl and possibly other drugs, Collin said her daughter would bang her head against the sidewalk or speak to herself in a language only she could understand.\u003c/p>\n\u003cp>“My daughter will die if she doesn’t get help,” Collin said. “Believe me.”\u003c/p>\n\u003cp>However, when it came to determining whether she qualified for CARE Court, the petition was rejected. Collin doesn’t know why, and she may never know. Privacy laws prohibit her from accessing her daughter’s medical records, so she isn’t sure whether her daughter has been formally diagnosed with a psychotic disorder.\u003c/p>\n\u003cp>The legislation doesn’t include any provision that gives petitioners the right to appeal a judge’s denial, though Ghaly said she could potentially refile the case.\u003c/p>\n\u003cp>“It’s frustrating,” Collin said. “I don’t want my daughter to die.”\u003c/p>\n\u003cp>Representatives from the San Francisco Public Health Department declined to be interviewed. Begert said he couldn’t comment on individual cases.\u003c/p>\n\u003cp>Ultimately, it’s up to the judge to hold public health departments accountable for providing appropriate care, Ghaly said, sharing an anecdote about how officials in San Diego frame the program: “They share with clients that CARE is an approach for the individual to … really get the black robe effect to hold the county accountable. And that’s exactly the way that we had hoped.”\u003c/p>\n\u003ch3>Breaking the pattern\u003c/h3>\n\u003cp>Collin’s experience, however, highlights a disconnect between the way the program was initially described — to, in Newsom’s words from 2022, “break the pattern that leaves people without hope and cycling repeatedly through homelessness and incarceration” — and what was actually written into legislation.\u003c/p>\n\u003cp>In the first year of the program’s rollout, success rates of getting people who are also experiencing homelessness into the program have varied. In Stanislaus County, for instance, Vartan said roughly 70% of the participants were unhoused before enrolling.\u003c/p>\n\u003cp>The opposite is true in Los Angeles and Riverside counties, where 30% and 20%–25% of enrollees are experiencing homelessness, respectively, health officials said. In Orange County, the figure is closer to 15%, according to Dr. Veronica Kelley, Director of the Orange County Health Care Agency.\u003c/p>\n\u003cfigure id=\"attachment_12007229\" class=\"wp-caption aligncenter\" style=\"max-width: 1024px\">\u003ca href=\"https://cdn.kqed.org/wp-content/uploads/sites/10/2024/10/GettyImages-1612098398.jpg\">\u003cimg loading=\"lazy\" decoding=\"async\" class=\"size-full wp-image-12007229\" src=\"https://cdn.kqed.org/wp-content/uploads/sites/10/2024/10/GettyImages-1612098398.jpg\" alt=\"A man sits next to three women at a table as he points to something.\" width=\"1024\" height=\"694\" srcset=\"https://cdn.kqed.org/wp-content/uploads/sites/10/2024/10/GettyImages-1612098398.jpg 1024w, https://cdn.kqed.org/wp-content/uploads/sites/10/2024/10/GettyImages-1612098398-800x542.jpg 800w, https://cdn.kqed.org/wp-content/uploads/sites/10/2024/10/GettyImages-1612098398-1020x691.jpg 1020w, https://cdn.kqed.org/wp-content/uploads/sites/10/2024/10/GettyImages-1612098398-160x108.jpg 160w\" sizes=\"auto, (max-width: 1024px) 100vw, 1024px\">\u003c/a>\u003cfigcaption class=\"wp-caption-text\">Dr. Veronica Kelley, director of Behavioral Health Services for Orange County, right, listens as Orange County Superior Judge Ebrahim Baytieh speaks during a CARE court information session at Behavioral Health Training Center on Aug. 16, 2023, in Orange. The county’s behavioral health department and a representative from the public defender’s office is meeting with the public to explain what the CARE Act is. \u003ccite>(Gina Ferazzi / Los Angeles Times via Getty Images)\u003c/cite>\u003c/figcaption>\u003c/figure>\n\u003cp>In the former two counties, the majority of petitions have come from family members, health officials said. In Orange County, Kelley said the figure is closer to 40%.\u003c/p>\n\u003cp>Rather than view this as a failure to reach people who are living outside, Ghaly said he’s actually pleased to see the higher levels of petitions coming from family members on behalf of people who have housing, emphasizing that the goal was not to solve homelessness but to solve the problem of untreated mental illness “upstream.”\u003c/p>\n\u003cp>“It means that we’re getting to meet them earlier,” he said. “Almost anyone with severe schizophrenia or a psychotic disorder may be at risk of homelessness.”\u003c/p>\n\u003cp>But, Ghaly acknowledged that because eligibility is narrowly tailored, it may also mean, “We might not see the kind of outcomes that we wanted to see.”\u003c/p>\n\u003cp>Under the legislation, people whose primary diagnosis is a psychotic disorder are eligible for CARE Court, but those whose psychosis is primarily the result of using drugs are not. Asked whether the state would consider expanding eligibility to include cases of drug-induced psychosis, Ghaly said the question is a “fraught” one.\u003c/p>\n\u003cp>“If you ask most psychiatrists who take care of patients with these diagnoses and in largely these social circumstances, it’s really hard to tell what came first,” he said. “Was it the substance-use disorder that drove the psychosis? Or, were there underlying psychotic features to some disorder — maybe diagnosed, maybe not — that then drove the substance-use disorder?”\u003c/p>\n\u003cp>He continued, “Where the state lands at the moment is, there may be a very important population of people who have significant substance-use disorders and these other mental health conditions, who could benefit from CARE. And as we engage with our county partners and the practitioners who are in CARE, we’re asking exactly this question.”\u003c/p>\n\u003cp>But, even if someone doesn’t end up in CARE Court, health officials say they’re often referred to other programs within the county. And in Orange County, Kelley said 41 out of 95 petitions were dismissed because the client was already receiving services.\u003c/p>\n\u003cp>“And it would be unethical to remove them from that treatment and stick them over here in court and hope that that works better,” she said.\u003c/p>\n\u003cp>Ultimately, Ghaly said, that is also part of the point.\u003c/p>\n\u003cp>“It really is a group of people who didn’t go all the way down the CARE path, but because the CARE pathway was a potential, they got served and supported,” he said.\u003c/p>\n\u003ch3>Building trust\u003c/h3>\n\u003cp>For those who do qualify for CARE Court, the process to reach a voluntary treatment plan or CARE Agreement can be challenging, judges and health officials said. Just building enough trust to get someone to come into court can itself sometimes take two months, Kelley said.\u003c/p>\n\u003cp>“None of us would be open to a stranger coming up to us and telling us, ‘Come with me to court. I can help you,’” she said. “So, to believe that someone who’s severely impacted by a mental illness would be open to that doesn’t make any sense.” [aside postID=\"news_11955211,news_11952228,news_11924117\" label=\"Related Stories\"]\u003c/p>\n\u003cp>Kaitlyn Willison, an attorney with Legal Assistance to the Elderly in San Francisco who represents CARE Court participants, said the first step might involve combing the streets to search for people, which takes time. Once the person is found, the next hurdle is building trust.\u003c/p>\n\u003cp>“That means I need to see them two, three, four times before they go to court,” Willison said. “And the timelines just aren’t set up in a way that allows us as respondents’ counsel enough time to build that really precious trust that we need to best advocate for our clients.”\u003c/p>\n\u003cp>Umberg said he’s looking into further legislation or possible rule changes within the court system to address the challenges Willison and others have experienced so far.\u003c/p>\n\u003cp>But Jain, with Disability Rights California, is skeptical. One of those challenges is baked into the nature of the program itself, he said: that it has the potential to veer away from voluntary agreements and into coerced care.\u003c/p>\n\u003cp>“The bottom line is that the court is a coercive program,” he said.\u003c/p>\n\u003cfigure id=\"attachment_12007227\" class=\"wp-caption aligncenter\" style=\"max-width: 2000px\">\u003ca href=\"https://cdn.kqed.org/wp-content/uploads/sites/10/2024/10/240917-CARECourt-04-BL_qed.jpg\">\u003cimg loading=\"lazy\" decoding=\"async\" class=\"size-full wp-image-12007227\" src=\"https://cdn.kqed.org/wp-content/uploads/sites/10/2024/10/240917-CARECourt-04-BL_qed.jpg\" alt=\"A white man wearing a blue dress suit rests his hand on his face with a calendar in the background.\" width=\"2000\" height=\"1333\" srcset=\"https://cdn.kqed.org/wp-content/uploads/sites/10/2024/10/240917-CARECourt-04-BL_qed.jpg 2000w, https://cdn.kqed.org/wp-content/uploads/sites/10/2024/10/240917-CARECourt-04-BL_qed-800x533.jpg 800w, https://cdn.kqed.org/wp-content/uploads/sites/10/2024/10/240917-CARECourt-04-BL_qed-1020x680.jpg 1020w, https://cdn.kqed.org/wp-content/uploads/sites/10/2024/10/240917-CARECourt-04-BL_qed-160x107.jpg 160w, https://cdn.kqed.org/wp-content/uploads/sites/10/2024/10/240917-CARECourt-04-BL_qed-1536x1024.jpg 1536w, https://cdn.kqed.org/wp-content/uploads/sites/10/2024/10/240917-CARECourt-04-BL_qed-1920x1280.jpg 1920w\" sizes=\"auto, (max-width: 2000px) 100vw, 2000px\">\u003c/a>\u003cfigcaption class=\"wp-caption-text\">Judge Michael Begert, presiding over CARE Court, sits in the San Francisco Superior Court in San Francisco on Sept. 17, 2024. \u003ccite>(Beth LaBerge/KQED)\u003c/cite>\u003c/figcaption>\u003c/figure>\n\u003cp>For Judge Begert in San Francisco, coerced treatment is very much “what we’re trying to avoid.” But, he acknowledged that changing the cultures of both the court system and the mental health care system is no easy task.\u003c/p>\n\u003cp>[ad floatright]\u003c/p>\n\u003cp>“Getting people to change their mindset in a culture that’s very well-formed and static is a hard thing to do,” he said. “You bring the healthcare system into the criminal justice system — or the justice system in general — it starts to act like the justice system. So, that’s always a challenge.”\u003c/p>\n\n",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003cp>\u003c/p>\u003cp>\u003cspan class=\"utils-parseShortcode-shortcodes-__dropcapShortcode__dropcap\">W\u003c/span>\u003c/p>\u003cp>hen it rolled out last year in eight counties, CARE Court took aim at one of the state’s most vexing challenges: how to treat people whose illness often makes them believe they are not sick and who, if left untreated, can oscillate between jails, hospitals and homelessness.\u003c/p>\n\u003cp>Using the weight of a judge’s black robe to nudge county health departments’ doctors in white coats to provide an array of services, the program sought to reach the hardest-to-treat cases.\u003c/p>\n\u003cp>Now, a year after the program went live in seven counties — San Francisco, Glenn, Tuolumne, Stanislaus, Orange, Riverside, and San Diego — and ten months after it launched in Los Angeles County, petitions appear to be trickling in slower than expected and treatment plans are taking longer to put in place.\u003c/p>\n\u003cp>And, while Gov. Gavin Newsom, who first \u003ca href=\"https://www.gov.ca.gov/2022/03/03/governor-newsom-launches-new-plan-to-help-californians-struggling-with-mental-health-challenges-homelessness/\">introduced the initiative in March 2022\u003c/a>, initially said it would target those “living on our streets with severe mental health and substance use disorders,” the number of unhoused people going through the program varies widely from county to county.\u003c/p>\n\u003cfigure id=\"attachment_12005914\" class=\"wp-caption aligncenter\" style=\"max-width: 2000px\">\u003ca href=\"https://cdn.kqed.org/wp-content/uploads/sites/10/2024/09/092024-Senate-Judiciary-FG-05.jpg\">\u003cimg loading=\"lazy\" decoding=\"async\" class=\"size-full wp-image-12005914\" src=\"https://cdn.kqed.org/wp-content/uploads/sites/10/2024/09/092024-Senate-Judiciary-FG-05.jpg\" alt=\"A white man wearing a suit stands at a podium with a microphone.\" width=\"2000\" height=\"1355\" srcset=\"https://cdn.kqed.org/wp-content/uploads/sites/10/2024/09/092024-Senate-Judiciary-FG-05.jpg 2000w, https://cdn.kqed.org/wp-content/uploads/sites/10/2024/09/092024-Senate-Judiciary-FG-05-800x542.jpg 800w, https://cdn.kqed.org/wp-content/uploads/sites/10/2024/09/092024-Senate-Judiciary-FG-05-1020x691.jpg 1020w, https://cdn.kqed.org/wp-content/uploads/sites/10/2024/09/092024-Senate-Judiciary-FG-05-160x108.jpg 160w, https://cdn.kqed.org/wp-content/uploads/sites/10/2024/09/092024-Senate-Judiciary-FG-05-1536x1041.jpg 1536w, https://cdn.kqed.org/wp-content/uploads/sites/10/2024/09/092024-Senate-Judiciary-FG-05-1920x1301.jpg 1920w\" sizes=\"auto, (max-width: 2000px) 100vw, 2000px\">\u003c/a>\u003cfigcaption class=\"wp-caption-text\">California State Senator Thomas Umberg speaks before the Senate Judiciary Committee about SB1338, the Community Assistance, Recovery, and Empowerment (CARE) Court Program, on April 26, 2022, in Sacramento. \u003ccite>(Fred Greaves/CalMatters)\u003c/cite>\u003c/figcaption>\u003c/figure>\n\u003cp>State Sen. Tom Umberg, who co-authored the \u003ca href=\"https://leginfo.legislature.ca.gov/faces/billTextClient.xhtml?bill_id=202120220SB1338\">legislation\u003c/a> that implemented CARE Court, said the gradual rollout hasn’t come as a complete surprise.\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>“We’re changing the culture here,” he said. “So, that takes a little time.”\u003c/p>\n\u003cp>As of mid-September, at least 692 petitions had been filed across seven of the counties in the first cohort, excluding San Francisco, according to data provided by superior court and county health officials. Of those petitions, a little more than a third, or 245, have been dismissed. And nearly one in five, or 121 petitions, have resulted in a CARE Agreement, an official document that details a voluntary treatment regime. There have been six court-ordered, or involuntary, CARE Plans issued.\u003c/p>\n\u003cp>San Francisco has so far received 42 petitions, said Melanie Kushnir, director of the Collaborative Justice Programs at the San Francisco Superior Courts. Of those, she said roughly half are active, meaning the participant is attending hearings and working toward or enrolled in a CARE Agreement. Citing privacy concerns, Kushnir declined to provide data on the exact number of dismissals or CARE Agreements reached but said there had been no CARE Plans issued.\u003c/p>\n\u003cp>The state had initially estimated that between 7,000 and 12,000 people would qualify for CARE Court each year once the program was fully implemented. But even accounting for the small number of counties that launched last year, court and public health officials agree the number of petitions is far fewer than expected — prompting opponents to argue the program is wasting taxpayers’ dollars.\u003c/p>\n\u003cp>According to the California Department of Finance, the state has already allocated $72 million to counties for start-up costs, along with $12 million for ongoing operations in fiscal year 2024–25, which will increase to $47 million in fiscal year 2026–27.\u003c/p>\n\u003cp>“We feel like the program has already failed,” said Samuel Jain, a senior mental health policy attorney at Disability Rights California, which is among the groups that advocated against CARE Court from the start. “The law doesn’t provide any new services and instead directs the limited resources we have to these expensive court processes.”\u003c/p>\n\u003cp>But supporters say it’s too early to pass judgment on a program that has yet to be fully implemented. The remaining 50 counties are due to open their own programs by Dec. 1.\u003c/p>\n\u003cp>“To really make some grand statement about its efficacy in the first 12 months of it rolling out, I think, is a leap for a state with 40 million people,” Dr. Mark Ghaly, the outgoing Secretary of California’s Health and Human Services Agency, told KQED. “But I do think that’s exactly the question that we have to keep in mind.”\u003c/p>\n\u003ch3>The number of petitions varies widely\u003c/h3>\n\u003cp>In Glenn County, with a population of \u003ca href=\"https://data.census.gov/profile/Glenn_County,_California?g=050XX00US06021\">around 29,000\u003c/a>, just one petition has been filed as of Sept. 12, and it was ultimately dismissed, said Chris Ruhl, executive officer of the Glenn County Superior Court. Ruhl expects one or two more may be submitted soon and that more will follow as word of the program spreads.\u003c/p>\n\u003cp>“We generally anticipate there will be an increase in the number of petitions and filings, but we don’t know that for sure,” he said. “We’ll be watching very closely.”\u003c/p>\n\u003cfigure id=\"attachment_12007228\" class=\"wp-caption aligncenter\" style=\"max-width: 2000px\">\u003ca href=\"https://cdn.kqed.org/wp-content/uploads/sites/10/2024/10/240917-CARECourt-12-BL_qed.jpg\">\u003cimg loading=\"lazy\" decoding=\"async\" class=\"size-full wp-image-12007228\" src=\"https://cdn.kqed.org/wp-content/uploads/sites/10/2024/10/240917-CARECourt-12-BL_qed.jpg\" alt=\"A white man wearing a blue dress suit leans against a wooden divider in a court room.\" width=\"2000\" height=\"1333\" srcset=\"https://cdn.kqed.org/wp-content/uploads/sites/10/2024/10/240917-CARECourt-12-BL_qed.jpg 2000w, https://cdn.kqed.org/wp-content/uploads/sites/10/2024/10/240917-CARECourt-12-BL_qed-800x533.jpg 800w, https://cdn.kqed.org/wp-content/uploads/sites/10/2024/10/240917-CARECourt-12-BL_qed-1020x680.jpg 1020w, https://cdn.kqed.org/wp-content/uploads/sites/10/2024/10/240917-CARECourt-12-BL_qed-160x107.jpg 160w, https://cdn.kqed.org/wp-content/uploads/sites/10/2024/10/240917-CARECourt-12-BL_qed-1536x1024.jpg 1536w, https://cdn.kqed.org/wp-content/uploads/sites/10/2024/10/240917-CARECourt-12-BL_qed-1920x1280.jpg 1920w\" sizes=\"auto, (max-width: 2000px) 100vw, 2000px\">\u003c/a>\u003cfigcaption class=\"wp-caption-text\">Judge Michael Begert, presiding over CARE Court, stands in the San Francisco Superior Court in San Francisco on Sept. 17, 2024. \u003ccite>(Beth LaBerge/KQED)\u003c/cite>\u003c/figcaption>\u003c/figure>\n\u003cp>At the other end of the spectrum is Los Angeles County, which, with a population of around \u003ca href=\"https://data.census.gov/profile/Los_Angeles_County,_California?g=050XX00US06037\">10 million\u003c/a>, has seen the most petitions: 268 as of Sept. 18. There, the number of petitions has been steadily increasing, Los Angeles Superior Court Judge Scott Herin said.\u003c/p>\n\u003cp>“I don’t think it started off like everybody expected, which was an overwhelming flood of cases,” Herin said, adding that the gradual ramp-up was perhaps “more healthy.”\u003c/p>\n\u003cp>That’s allowed some county behavioral health agencies to reappropriate staff assigned to CARE Court to other needs. In Stanislaus County, which has received 47 petitions, 19 of which have been dismissed, Behavioral Health & Recovery Services Director Tony Vartan said some of his CARE Court staff spent the first four to five months doing outreach with police and sheriff departments, hospital workers and others to build awareness.\u003c/p>\n\u003cp>“But as we saw that trend of those petitions, we pulled back some of our staff, and we assigned them to areas that needed more work,” he said. “Our staff emphasize where the cases are, regardless of what program we manage. That way, we make sure that the staff are working and they’ve got cases.”\u003c/p>\n\u003ch3>Cases dismissed\u003c/h3>\n\u003cp>Despite the lower-than-expected number of petitions, county behavioral health and court staff say they weren’t surprised to see that more than a third have been dismissed. Dismissal rates vary across the counties, from just over 90% in Tuolumne County, where 10 of 11 cases were dismissed, to a low of 26% in both Riverside and Los Angeles counties.\u003c/p>\n\u003cp>To be eligible, San Francisco Superior Court Judge Michael Begert said participants need to not only be diagnosed with schizophrenia or another psychotic disorder, but they also must be likely to benefit from services, can’t already be enrolled in services, and must be unlikely to survive without additional support.\u003c/p>\n\u003cp>“And that’s a small eye in a needle to thread,” Begert said.\u003c/p>\n\u003cp>Algenib Collin is trying to thread that needle as she looks for any program that might help for her daughter.\u003c/p>\n\u003cp>Collin applied for CARE Court the day it opened, she said, “I was so desperate.”\u003c/p>\n\u003cp>For roughly 18 months prior, she had seen her daughter, now 27, rapidly deteriorate on San Francisco’s streets. Collin said she would receive a call from the hospital nearly every other week, reporting her daughter had been placed on a 5150, or a temporary mental health hold, only to be rereleased back into homelessness and addiction.\u003c/p>\n\u003cfigure id=\"attachment_11955160\" class=\"wp-caption aligncenter\" style=\"max-width: 2000px\">\u003ca href=\"https://cdn.kqed.org/wp-content/uploads/sites/10/2023/07/230707-ORANGE-COUNTY-CARE-COURT-AD-02-KQED.jpg\">\u003cimg loading=\"lazy\" decoding=\"async\" class=\"size-full wp-image-11955160\" src=\"https://cdn.kqed.org/wp-content/uploads/sites/10/2023/07/230707-ORANGE-COUNTY-CARE-COURT-AD-02-KQED.jpg\" alt=\"A large multi-story building and a driveway alongside it.\" width=\"2000\" height=\"1333\" srcset=\"https://cdn.kqed.org/wp-content/uploads/sites/10/2023/07/230707-ORANGE-COUNTY-CARE-COURT-AD-02-KQED.jpg 2000w, https://cdn.kqed.org/wp-content/uploads/sites/10/2023/07/230707-ORANGE-COUNTY-CARE-COURT-AD-02-KQED-800x533.jpg 800w, https://cdn.kqed.org/wp-content/uploads/sites/10/2023/07/230707-ORANGE-COUNTY-CARE-COURT-AD-02-KQED-1020x680.jpg 1020w, https://cdn.kqed.org/wp-content/uploads/sites/10/2023/07/230707-ORANGE-COUNTY-CARE-COURT-AD-02-KQED-160x107.jpg 160w, https://cdn.kqed.org/wp-content/uploads/sites/10/2023/07/230707-ORANGE-COUNTY-CARE-COURT-AD-02-KQED-1536x1024.jpg 1536w, https://cdn.kqed.org/wp-content/uploads/sites/10/2023/07/230707-ORANGE-COUNTY-CARE-COURT-AD-02-KQED-1920x1280.jpg 1920w\" sizes=\"auto, (max-width: 2000px) 100vw, 2000px\">\u003c/a>\u003cfigcaption class=\"wp-caption-text\">Orange County Superior Court will technically house the local CARE Court, though judges say they will more likely hold meetings with patients at a more neutral site, like a conference room at the county health office. \u003ccite>(April Dembosky/KQED)\u003c/cite>\u003c/figcaption>\u003c/figure>\n\u003cp>High on fentanyl and possibly other drugs, Collin said her daughter would bang her head against the sidewalk or speak to herself in a language only she could understand.\u003c/p>\n\u003cp>“My daughter will die if she doesn’t get help,” Collin said. “Believe me.”\u003c/p>\n\u003cp>However, when it came to determining whether she qualified for CARE Court, the petition was rejected. Collin doesn’t know why, and she may never know. Privacy laws prohibit her from accessing her daughter’s medical records, so she isn’t sure whether her daughter has been formally diagnosed with a psychotic disorder.\u003c/p>\n\u003cp>The legislation doesn’t include any provision that gives petitioners the right to appeal a judge’s denial, though Ghaly said she could potentially refile the case.\u003c/p>\n\u003cp>“It’s frustrating,” Collin said. “I don’t want my daughter to die.”\u003c/p>\n\u003cp>Representatives from the San Francisco Public Health Department declined to be interviewed. Begert said he couldn’t comment on individual cases.\u003c/p>\n\u003cp>Ultimately, it’s up to the judge to hold public health departments accountable for providing appropriate care, Ghaly said, sharing an anecdote about how officials in San Diego frame the program: “They share with clients that CARE is an approach for the individual to … really get the black robe effect to hold the county accountable. And that’s exactly the way that we had hoped.”\u003c/p>\n\u003ch3>Breaking the pattern\u003c/h3>\n\u003cp>Collin’s experience, however, highlights a disconnect between the way the program was initially described — to, in Newsom’s words from 2022, “break the pattern that leaves people without hope and cycling repeatedly through homelessness and incarceration” — and what was actually written into legislation.\u003c/p>\n\u003cp>In the first year of the program’s rollout, success rates of getting people who are also experiencing homelessness into the program have varied. In Stanislaus County, for instance, Vartan said roughly 70% of the participants were unhoused before enrolling.\u003c/p>\n\u003cp>The opposite is true in Los Angeles and Riverside counties, where 30% and 20%–25% of enrollees are experiencing homelessness, respectively, health officials said. In Orange County, the figure is closer to 15%, according to Dr. Veronica Kelley, Director of the Orange County Health Care Agency.\u003c/p>\n\u003cfigure id=\"attachment_12007229\" class=\"wp-caption aligncenter\" style=\"max-width: 1024px\">\u003ca href=\"https://cdn.kqed.org/wp-content/uploads/sites/10/2024/10/GettyImages-1612098398.jpg\">\u003cimg loading=\"lazy\" decoding=\"async\" class=\"size-full wp-image-12007229\" src=\"https://cdn.kqed.org/wp-content/uploads/sites/10/2024/10/GettyImages-1612098398.jpg\" alt=\"A man sits next to three women at a table as he points to something.\" width=\"1024\" height=\"694\" srcset=\"https://cdn.kqed.org/wp-content/uploads/sites/10/2024/10/GettyImages-1612098398.jpg 1024w, https://cdn.kqed.org/wp-content/uploads/sites/10/2024/10/GettyImages-1612098398-800x542.jpg 800w, https://cdn.kqed.org/wp-content/uploads/sites/10/2024/10/GettyImages-1612098398-1020x691.jpg 1020w, https://cdn.kqed.org/wp-content/uploads/sites/10/2024/10/GettyImages-1612098398-160x108.jpg 160w\" sizes=\"auto, (max-width: 1024px) 100vw, 1024px\">\u003c/a>\u003cfigcaption class=\"wp-caption-text\">Dr. Veronica Kelley, director of Behavioral Health Services for Orange County, right, listens as Orange County Superior Judge Ebrahim Baytieh speaks during a CARE court information session at Behavioral Health Training Center on Aug. 16, 2023, in Orange. The county’s behavioral health department and a representative from the public defender’s office is meeting with the public to explain what the CARE Act is. \u003ccite>(Gina Ferazzi / Los Angeles Times via Getty Images)\u003c/cite>\u003c/figcaption>\u003c/figure>\n\u003cp>In the former two counties, the majority of petitions have come from family members, health officials said. In Orange County, Kelley said the figure is closer to 40%.\u003c/p>\n\u003cp>Rather than view this as a failure to reach people who are living outside, Ghaly said he’s actually pleased to see the higher levels of petitions coming from family members on behalf of people who have housing, emphasizing that the goal was not to solve homelessness but to solve the problem of untreated mental illness “upstream.”\u003c/p>\n\u003cp>“It means that we’re getting to meet them earlier,” he said. “Almost anyone with severe schizophrenia or a psychotic disorder may be at risk of homelessness.”\u003c/p>\n\u003cp>But, Ghaly acknowledged that because eligibility is narrowly tailored, it may also mean, “We might not see the kind of outcomes that we wanted to see.”\u003c/p>\n\u003cp>Under the legislation, people whose primary diagnosis is a psychotic disorder are eligible for CARE Court, but those whose psychosis is primarily the result of using drugs are not. Asked whether the state would consider expanding eligibility to include cases of drug-induced psychosis, Ghaly said the question is a “fraught” one.\u003c/p>\n\u003cp>“If you ask most psychiatrists who take care of patients with these diagnoses and in largely these social circumstances, it’s really hard to tell what came first,” he said. “Was it the substance-use disorder that drove the psychosis? Or, were there underlying psychotic features to some disorder — maybe diagnosed, maybe not — that then drove the substance-use disorder?”\u003c/p>\n\u003cp>He continued, “Where the state lands at the moment is, there may be a very important population of people who have significant substance-use disorders and these other mental health conditions, who could benefit from CARE. And as we engage with our county partners and the practitioners who are in CARE, we’re asking exactly this question.”\u003c/p>\n\u003cp>But, even if someone doesn’t end up in CARE Court, health officials say they’re often referred to other programs within the county. And in Orange County, Kelley said 41 out of 95 petitions were dismissed because the client was already receiving services.\u003c/p>\n\u003cp>“And it would be unethical to remove them from that treatment and stick them over here in court and hope that that works better,” she said.\u003c/p>\n\u003cp>Ultimately, Ghaly said, that is also part of the point.\u003c/p>\n\u003cp>“It really is a group of people who didn’t go all the way down the CARE path, but because the CARE pathway was a potential, they got served and supported,” he said.\u003c/p>\n\u003ch3>Building trust\u003c/h3>\n\u003cp>For those who do qualify for CARE Court, the process to reach a voluntary treatment plan or CARE Agreement can be challenging, judges and health officials said. Just building enough trust to get someone to come into court can itself sometimes take two months, Kelley said.\u003c/p>\n\u003cp>“None of us would be open to a stranger coming up to us and telling us, ‘Come with me to court. I can help you,’” she said. “So, to believe that someone who’s severely impacted by a mental illness would be open to that doesn’t make any sense.” \u003c/p>\u003c/div>",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>Kaitlyn Willison, an attorney with Legal Assistance to the Elderly in San Francisco who represents CARE Court participants, said the first step might involve combing the streets to search for people, which takes time. Once the person is found, the next hurdle is building trust.\u003c/p>\n\u003cp>“That means I need to see them two, three, four times before they go to court,” Willison said. “And the timelines just aren’t set up in a way that allows us as respondents’ counsel enough time to build that really precious trust that we need to best advocate for our clients.”\u003c/p>\n\u003cp>Umberg said he’s looking into further legislation or possible rule changes within the court system to address the challenges Willison and others have experienced so far.\u003c/p>\n\u003cp>But Jain, with Disability Rights California, is skeptical. One of those challenges is baked into the nature of the program itself, he said: that it has the potential to veer away from voluntary agreements and into coerced care.\u003c/p>\n\u003cp>“The bottom line is that the court is a coercive program,” he said.\u003c/p>\n\u003cfigure id=\"attachment_12007227\" class=\"wp-caption aligncenter\" style=\"max-width: 2000px\">\u003ca href=\"https://cdn.kqed.org/wp-content/uploads/sites/10/2024/10/240917-CARECourt-04-BL_qed.jpg\">\u003cimg loading=\"lazy\" decoding=\"async\" class=\"size-full wp-image-12007227\" src=\"https://cdn.kqed.org/wp-content/uploads/sites/10/2024/10/240917-CARECourt-04-BL_qed.jpg\" alt=\"A white man wearing a blue dress suit rests his hand on his face with a calendar in the background.\" width=\"2000\" height=\"1333\" srcset=\"https://cdn.kqed.org/wp-content/uploads/sites/10/2024/10/240917-CARECourt-04-BL_qed.jpg 2000w, https://cdn.kqed.org/wp-content/uploads/sites/10/2024/10/240917-CARECourt-04-BL_qed-800x533.jpg 800w, https://cdn.kqed.org/wp-content/uploads/sites/10/2024/10/240917-CARECourt-04-BL_qed-1020x680.jpg 1020w, https://cdn.kqed.org/wp-content/uploads/sites/10/2024/10/240917-CARECourt-04-BL_qed-160x107.jpg 160w, https://cdn.kqed.org/wp-content/uploads/sites/10/2024/10/240917-CARECourt-04-BL_qed-1536x1024.jpg 1536w, https://cdn.kqed.org/wp-content/uploads/sites/10/2024/10/240917-CARECourt-04-BL_qed-1920x1280.jpg 1920w\" sizes=\"auto, (max-width: 2000px) 100vw, 2000px\">\u003c/a>\u003cfigcaption class=\"wp-caption-text\">Judge Michael Begert, presiding over CARE Court, sits in the San Francisco Superior Court in San Francisco on Sept. 17, 2024. \u003ccite>(Beth LaBerge/KQED)\u003c/cite>\u003c/figcaption>\u003c/figure>\n\u003cp>For Judge Begert in San Francisco, coerced treatment is very much “what we’re trying to avoid.” But, he acknowledged that changing the cultures of both the court system and the mental health care system is no easy task.\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>“Getting people to change their mindset in a culture that’s very well-formed and static is a hard thing to do,” he said. “You bring the healthcare system into the criminal justice system — or the justice system in general — it starts to act like the justice system. So, that’s always a challenge.”\u003c/p>\n\n\u003c/div>\u003c/p>",
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"slug": "how-to-talk-with-kids-after-a-traumatic-event",
"title": "How to Talk to Kids of Traumatic News: Expert Tips",
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"headTitle": "How to Talk to Kids of Traumatic News: Expert Tips | KQED",
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"content": "\u003cp>This week, \u003ca href=\"https://www.npr.org/2024/09/05/nx-s1-5101890/apalachee-high-school-shooting-charges-investigation\">a 14-year-old Georgia high school student was charged as an adult\u003c/a> with four counts of felony murder for allegedly using an assault-style rifle to kill two students and two teachers in the hallway outside his algebra classroom, according to authorities.\u003c/p>\n\u003cp>The shooting at Apalachee High School in Winder, about an hour’s drive from Atlanta, is \u003ca href=\"https://projects.apnews.com/features/2023/mass-killings/index.html\">the latest among dozens of school shootings across the U.S. in recent years\u003c/a>, including especially deadly ones in Newtown, Connecticut; Parkland, Florida; and Uvalde, Texas.\u003c/p>\n\u003cp>The media coverage of these events are once again prompting conversations about how to talk with kids about the news — especially \u003ca href=\"https://www.kqed.org/news/11996268/gun-violence-mental-health-support-compensation-bay-area\">gun violence.\u003c/a> Such acts of violence are disturbing for children to witness, but kid also are exposed to scary-sounding news and alarming imagery when similar traumatic events occur around the country.\u003c/p>\n\u003cp>Schools in the United States have become more prepared for mass shootings in recent years, which has meant learning how to talk with kids about active shooters and “bad guys” on school campuses. While \u003ca href=\"https://www.npr.org/sections/ed/2018/08/27/640323347/the-school-shootings-that-werent\">the incidence of on-campus shootings is extremely low\u003c/a>, they’re something many teachers and parents have prepared for.\u003c/p>\n\u003cp>“The most helpful thing for parents to share with their kids is that these events are rare and that adults are there to protect them,” said Stephen Brock, professor of psychology at CSU Sacramento. “We can’t deny the reality of these things, but kids need to be reassured with these facts.”\u003c/p>\n\u003cp>Some kids find out about the news by seeing it themselves or hearing it discussed at school, at home or in their communities. Young children can especially be harmed by this exposure, so experts recommend restricting their access to traumatic news. Kids old enough to have smartphones will likely get misinformation on the internet and social media, so it’s even more important for parents and caregivers to support their kids.\u003c/p>\n\u003cp>Here are some key steps parents and caregivers can take:\u003c/p>\n\u003ch2>Remind kids that they are safe\u003c/h2>\n\u003cp>Children need to be reassured by their caregivers that they are safe. \u003ca href=\"https://www.apa.org/helpcenter/talking-to-children\">The American Psychological Association says, above all, reassure\u003c/a>:\u003c/p>\n\u003cp>“ … reassure your children that you will do everything you know how to do to keep them safe and to watch out for them. Reassure them that you will be available to answer any questions or talk about this topic again in the future. Reassure them that they are loved.”\u003c/p>\n\u003ch2>Limit young children’s exposure to traumatic news\u003c/h2>\n\u003cp>Young children have less developed skills to separate facts from fears, so psychologists recommend minimizing a child’s exposure to traumatic news.\u003c/p>\n\u003cp>“When kids see the news, even if they are not a resident of [the affected place], they have the mistaken perception that they could be shot at any time,” said Brock. “For little ones, turn [the news] off.”\u003c/p>\n\u003cp>And sometimes, that fear is transferred to children through adult behavior. If adults are behaving in an anxious or fearful manner, kids will pick up on that, especially those in primary grades and younger.\u003c/p>\n\u003cp>“Kids will look to adults to see how scared they should be,” said Brock.\u003c/p>\n\u003cp>[ad fullwidth]\u003c/p>\n\u003ch2>Observe your kids for verbal and nonverbal cues\u003c/h2>\n\u003cp>A parent might overhear a child talking about a traumatic news event, or the child might ask about it. If it looks like the child is curious, engage the child in conversation, said Brock, adding, “Let their questions be your guide.”\u003c/p>\n\u003cp>But not all kids can verbalize what they’re feeling, so look for changes in behavior. According to \u003ca href=\"https://www.nasponline.org/resources-and-publications/resources-and-podcasts/school-climate-safety-and-crisis/school-violence-resources/talking-to-children-about-violence-tips-for-parents-and-teachers\">the “Talking to Children About Violence: Tips for Parents and Teachers” report\u003c/a> from the National Association of School Psychologists (NASP), caregivers are advised to:\u003c/p>\n\u003cp>“Watch for clues that they may want to talk, such as hovering around while you do the dishes or yard work. Some children prefer writing, playing music, or doing an art project as an outlet. Young children may need concrete activities (such as drawing, looking at picture books, or imaginative play) to help them identify and express their feelings.”\u003c/p>\n\u003cp>But if the child is not aware or expressing any interest in a traumatic event, it’s best to not bring it up.\u003c/p>\n\u003cp>“You don’t want to interject traumatic events into a child,” said Brock, who co-authored the report.\u003c/p>\n\u003ch2>Talk with your kids in a way that’s developmentally appropriate\u003c/h2>\n\u003cp>Parents can talk with kids about anything, but it must be developmentally appropriate. Communicating with a 15-year-old is going to be different from talking with a 4-year-old. The \u003ca href=\"https://www.nasponline.org/resources-and-publications/resources-and-podcasts/school-climate-safety-and-crisis/school-violence-resources/talking-to-children-about-violence-tips-for-parents-and-teachers\">NASP\u003c/a> has this advice on how to explain traumas, especially in schools, to different age groups:\u003c/p>\n\u003cp>\u003cem>\u003cstrong>Early elementary school children\u003c/strong> need brief, simple information that should be balanced with reassurances that their schools and homes are safe and that adults are there to protect them. Give simple examples of school safety like reminding children about exterior doors being locked, child monitoring efforts on the playground, and emergency drills practiced during the school day.\u003c/em>\u003c/p>\n\u003cp>\u003cem>\u003cstrong>Upper elementary and early middle school children\u003c/strong> will be more vocal in asking questions about whether they truly are safe and what is being done at their school. They may need assistance separating reality from fantasy. Discuss efforts of school and community leaders to provide safe schools.\u003c/em>\u003c/p>\n\u003cp>\u003cem>\u003cstrong>Upper middle school and high school students\u003c/strong> will have strong and varying opinions about the causes of violence in schools and society. They will share concrete suggestions about how to make school safer and how to prevent tragedies in society. Emphasize the role that students have in maintaining safe schools by following school safety guidelines (e.g., not providing building access to strangers, reporting strangers on campus, reporting threats to the school safety made by students or community members, etc.), communicating any personal safety concerns to school administrators, and accessing support for emotional needs.\u003c/em>\u003c/p>\n\u003cp>Teens need guidance from their parents, too, especially since they’re absorbing the chatter on social media networks and direct messages from friends. Kids with phones will likely see graphic images through friends and news updates, which can create added trauma and anxiety. \u003ca href=\"https://www.commonsensemedia.org/blog/explaining-the-news-to-our-kids\">Common Sense Media advises parents to check in\u003c/a> on their teens:\u003c/p>\n\u003cp>“Since, in many instances, teens will have absorbed the news independently of you, talking with them can offer great insights into their developing politics and their senses of justice and morality. It will also help you get a sense of what they already know or have learned about the situation from their own social networks. It will also give you the opportunity to throw your own insights into the mix (just don’t dismiss theirs, since that will shut down the conversation immediately).”\u003c/p>\n\u003ch2>Maintain a normal routine\u003c/h2>\n\u003cp>Brock said, to the extent that it’s possible, maintain a normal routine. This will be helpful for the kid who’s frightened or anxious about a traumatic event.\u003c/p>\n\u003cp>“The more typical the routine, the more reassuring it can be,” he said.\u003c/p>\n\u003cp>\u003cem>This story contains reporting by the Associated Press, and KQED’s Carly Severn and Spencer Whitney also contributed to this story. A previous version of this story was published on July 15, 2024.\u003c/em>\u003c/p>\n\u003cp>[ad floatright]\u003c/p>\n",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003cp>This week, \u003ca href=\"https://www.npr.org/2024/09/05/nx-s1-5101890/apalachee-high-school-shooting-charges-investigation\">a 14-year-old Georgia high school student was charged as an adult\u003c/a> with four counts of felony murder for allegedly using an assault-style rifle to kill two students and two teachers in the hallway outside his algebra classroom, according to authorities.\u003c/p>\n\u003cp>The shooting at Apalachee High School in Winder, about an hour’s drive from Atlanta, is \u003ca href=\"https://projects.apnews.com/features/2023/mass-killings/index.html\">the latest among dozens of school shootings across the U.S. in recent years\u003c/a>, including especially deadly ones in Newtown, Connecticut; Parkland, Florida; and Uvalde, Texas.\u003c/p>\n\u003cp>The media coverage of these events are once again prompting conversations about how to talk with kids about the news — especially \u003ca href=\"https://www.kqed.org/news/11996268/gun-violence-mental-health-support-compensation-bay-area\">gun violence.\u003c/a> Such acts of violence are disturbing for children to witness, but kid also are exposed to scary-sounding news and alarming imagery when similar traumatic events occur around the country.\u003c/p>\n\u003cp>Schools in the United States have become more prepared for mass shootings in recent years, which has meant learning how to talk with kids about active shooters and “bad guys” on school campuses. While \u003ca href=\"https://www.npr.org/sections/ed/2018/08/27/640323347/the-school-shootings-that-werent\">the incidence of on-campus shootings is extremely low\u003c/a>, they’re something many teachers and parents have prepared for.\u003c/p>\n\u003cp>“The most helpful thing for parents to share with their kids is that these events are rare and that adults are there to protect them,” said Stephen Brock, professor of psychology at CSU Sacramento. “We can’t deny the reality of these things, but kids need to be reassured with these facts.”\u003c/p>\n\u003cp>Some kids find out about the news by seeing it themselves or hearing it discussed at school, at home or in their communities. Young children can especially be harmed by this exposure, so experts recommend restricting their access to traumatic news. Kids old enough to have smartphones will likely get misinformation on the internet and social media, so it’s even more important for parents and caregivers to support their kids.\u003c/p>\n\u003cp>Here are some key steps parents and caregivers can take:\u003c/p>\n\u003ch2>Remind kids that they are safe\u003c/h2>\n\u003cp>Children need to be reassured by their caregivers that they are safe. \u003ca href=\"https://www.apa.org/helpcenter/talking-to-children\">The American Psychological Association says, above all, reassure\u003c/a>:\u003c/p>\n\u003cp>“ … reassure your children that you will do everything you know how to do to keep them safe and to watch out for them. Reassure them that you will be available to answer any questions or talk about this topic again in the future. Reassure them that they are loved.”\u003c/p>\n\u003ch2>Limit young children’s exposure to traumatic news\u003c/h2>\n\u003cp>Young children have less developed skills to separate facts from fears, so psychologists recommend minimizing a child’s exposure to traumatic news.\u003c/p>\n\u003cp>“When kids see the news, even if they are not a resident of [the affected place], they have the mistaken perception that they could be shot at any time,” said Brock. “For little ones, turn [the news] off.”\u003c/p>\n\u003cp>And sometimes, that fear is transferred to children through adult behavior. If adults are behaving in an anxious or fearful manner, kids will pick up on that, especially those in primary grades and younger.\u003c/p>\n\u003cp>“Kids will look to adults to see how scared they should be,” said Brock.\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003ch2>Observe your kids for verbal and nonverbal cues\u003c/h2>\n\u003cp>A parent might overhear a child talking about a traumatic news event, or the child might ask about it. If it looks like the child is curious, engage the child in conversation, said Brock, adding, “Let their questions be your guide.”\u003c/p>\n\u003cp>But not all kids can verbalize what they’re feeling, so look for changes in behavior. According to \u003ca href=\"https://www.nasponline.org/resources-and-publications/resources-and-podcasts/school-climate-safety-and-crisis/school-violence-resources/talking-to-children-about-violence-tips-for-parents-and-teachers\">the “Talking to Children About Violence: Tips for Parents and Teachers” report\u003c/a> from the National Association of School Psychologists (NASP), caregivers are advised to:\u003c/p>\n\u003cp>“Watch for clues that they may want to talk, such as hovering around while you do the dishes or yard work. Some children prefer writing, playing music, or doing an art project as an outlet. Young children may need concrete activities (such as drawing, looking at picture books, or imaginative play) to help them identify and express their feelings.”\u003c/p>\n\u003cp>But if the child is not aware or expressing any interest in a traumatic event, it’s best to not bring it up.\u003c/p>\n\u003cp>“You don’t want to interject traumatic events into a child,” said Brock, who co-authored the report.\u003c/p>\n\u003ch2>Talk with your kids in a way that’s developmentally appropriate\u003c/h2>\n\u003cp>Parents can talk with kids about anything, but it must be developmentally appropriate. Communicating with a 15-year-old is going to be different from talking with a 4-year-old. The \u003ca href=\"https://www.nasponline.org/resources-and-publications/resources-and-podcasts/school-climate-safety-and-crisis/school-violence-resources/talking-to-children-about-violence-tips-for-parents-and-teachers\">NASP\u003c/a> has this advice on how to explain traumas, especially in schools, to different age groups:\u003c/p>\n\u003cp>\u003cem>\u003cstrong>Early elementary school children\u003c/strong> need brief, simple information that should be balanced with reassurances that their schools and homes are safe and that adults are there to protect them. Give simple examples of school safety like reminding children about exterior doors being locked, child monitoring efforts on the playground, and emergency drills practiced during the school day.\u003c/em>\u003c/p>\n\u003cp>\u003cem>\u003cstrong>Upper elementary and early middle school children\u003c/strong> will be more vocal in asking questions about whether they truly are safe and what is being done at their school. They may need assistance separating reality from fantasy. Discuss efforts of school and community leaders to provide safe schools.\u003c/em>\u003c/p>\n\u003cp>\u003cem>\u003cstrong>Upper middle school and high school students\u003c/strong> will have strong and varying opinions about the causes of violence in schools and society. They will share concrete suggestions about how to make school safer and how to prevent tragedies in society. Emphasize the role that students have in maintaining safe schools by following school safety guidelines (e.g., not providing building access to strangers, reporting strangers on campus, reporting threats to the school safety made by students or community members, etc.), communicating any personal safety concerns to school administrators, and accessing support for emotional needs.\u003c/em>\u003c/p>\n\u003cp>Teens need guidance from their parents, too, especially since they’re absorbing the chatter on social media networks and direct messages from friends. Kids with phones will likely see graphic images through friends and news updates, which can create added trauma and anxiety. \u003ca href=\"https://www.commonsensemedia.org/blog/explaining-the-news-to-our-kids\">Common Sense Media advises parents to check in\u003c/a> on their teens:\u003c/p>\n\u003cp>“Since, in many instances, teens will have absorbed the news independently of you, talking with them can offer great insights into their developing politics and their senses of justice and morality. It will also help you get a sense of what they already know or have learned about the situation from their own social networks. It will also give you the opportunity to throw your own insights into the mix (just don’t dismiss theirs, since that will shut down the conversation immediately).”\u003c/p>\n\u003ch2>Maintain a normal routine\u003c/h2>\n\u003cp>Brock said, to the extent that it’s possible, maintain a normal routine. This will be helpful for the kid who’s frightened or anxious about a traumatic event.\u003c/p>\n\u003cp>“The more typical the routine, the more reassuring it can be,” he said.\u003c/p>\n\u003cp>\u003cem>This story contains reporting by the Associated Press, and KQED’s Carly Severn and Spencer Whitney also contributed to this story. A previous version of this story was published on July 15, 2024.\u003c/em>\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"title": "PTSD Is Common Among Firefighters — but Workers’ Comp for Treatment Is Hard to Get",
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"content": "\u003cp>Todd Nelson could feel it coming on. And he began to run. He was going dark again, retreating to a place where he would curl into a fetal position with his thumb in his mouth, watching from behind closed eyes as his personal reel of horror unspooled. Sights and sounds from three decades of firefighting cued up — shrieks from behind an impenetrable wall of flame, limbs severed in car accidents and the eyes of the terrified and the dead he was meant to save.\u003c/p>\n\u003cp>Nelson was running on the Foresthill Bridge, \u003ca href=\"https://sierranevadageotourism.org/entries/foresthill-bridge/4123fc95-8a25-4827-baba-fca9c8e4485a\">the highest in California\u003c/a>, fleeing cops and firefighters after his wife reported that he was suicidal. He hurdled a concrete barrier and straddled the railing of the bridge in the Sierra Nevada foothills, staring down at a large rock 730 feet below. As the rescuers closed in, Nelson leaned precariously over the chasm. His strategy — making the fatal plunge appear accidental, allowing his family to collect his life insurance.\u003c/p>\n\u003cp>It was not Nelson’s first suicide attempt — the former Cal Fire captain had tried to take his life many times before. But after that 2021 ordeal, which led to an involuntary 72-hour psychiatric hold, something in him shifted. He was ready to admit that he had a problem and seek medical help.\u003c/p>\n\u003cp>The incident began the firefighter’s arduous, years-long journey toward wellness, threaded through a bureaucratic labyrinth strewn with more obstacles than he’d ever encountered on a California wildfire: finding qualified medical help, battling an insurance company to pay for it and navigating the tangled morass of California’s workers’ comp. All without going broke or returning to his dark place.\u003c/p>\n\u003cp>[ad fullwidth]\u003c/p>\n\u003cp>No one tracks how many of Cal Fire’s 12,000 firefighters and other employees suffer from mental health problems, but department leaders say post-traumatic stress disorder and suicidal thoughts \u003ca href=\"https://calmatters.org/environment/2022/06/california-firefighter-trauma-ptsd/?series=california-firefighters-trauma-wildfires\">have become a silent epidemic\u003c/a>\u003cstrong> \u003c/strong>at the agency responsible for fighting \u003ca href=\"https://calmatters.org/california-wildfire-map-tracker/\">California’s increasingly erratic and destructive wildfires\u003c/a>. In an \u003ca href=\"https://www.researchgate.net/publication/352466544_Wildland_Firefighter_Psychological_and_Behavioral_Health_Preliminary_Data_from_a_National_Sample_of_Current_and_Former_Wildland_Firefighters_in_the_United_States_Conference_session\">online survey\u003c/a> of wildland firefighters nationwide, about a third reported considering suicide and nearly 40% said they had colleagues who had committed suicide; many also reported depression and anxiety.\u003c/p>\n\u003cp>California’s workers’ comp — which is supposed to help people get medical treatment for workplace illnesses and injuries — can be a nightmare for firefighters and other first responders with PTSD.\u003c/p>\n\u003cp>Claims filed by firefighters and law enforcement officers are more likely to involve PTSD than claims by the average worker in California — and they have been \u003ca href=\"https://calmatters.org/wp-content/uploads/2024/06/RAND-PTSD-REPORT.pdf\">denied more often than claims for other medical conditions (PDF)\u003c/a>, according to the research institute RAND.\u003c/p>\n\u003cp>From 2008 to 2019 in California, workers’ comp officials denied PTSD claims filed by firefighters and other first responders at more than twice the rate of their other work-related conditions, such as back injuries and pneumonia, RAND reported. About a quarter of firefighters’ 1,000 PTSD claims were denied, a higher rate than for PTSD claims from other California workers.\u003c/p>\n\u003cp>“It’s a fail-first system. You have to get a broken leg to show you are in need of support. With mental illness, we are constantly having to prove to everybody why we were ill. You have to get to the point of suicide,” said Jessica Cruz, the California chief executive officer of the \u003ca href=\"https://namica.org/\">National Alliance on Mental Illness\u003c/a>.\u003c/p>\n\u003cp>https://www.youtube.com/watch?v=DLvG2Yy34QM&t=1s\u003c/p>\n\u003cp>Jennifer Alexander, Nelson’s therapist, said patients in acute crisis simply don’t have the mental capacity to ride herd on stubborn workers’ comp claims. Alexander said she was once on hold for more than six hours with Cal Fire’s mental health provider attempting to get one of her bills paid, and she has waited years to get paid for treating firefighters.\u003c/p>\n\u003cp>“People give up. It’s a battle … They are not fully functional,” said Alexander, who for 21 years has specialized in treating first responders with trauma and PTSD and has spent an estimated 25,000 hours treating them. “You are not talking about healthy individuals who can sit on the phone for hours.”\u003c/p>\n\u003cp>Cal Fire firefighters and other workers also have trouble finding qualified therapists, especially outside major cities in rural areas, where many are based. In 2021, less than \u003ca href=\"https://www.commonwealthfund.org/publications/explainer/2023/may/understanding-us-behavioral-health-workforce-shortage\">half of people with a mental illness\u003c/a> in the U.S. were able to access timely care. \u003ca href=\"https://calmatters.org/environment/2024/06/california-workers-comp-firefighters-therapists/\">Therapists are reluctant to take workers’ comp\u003c/a>, or sometimes any type of insurance, because they often have to wait months or years to be reimbursed.\u003c/p>\n\u003cfigure id=\"attachment_11992261\" class=\"wp-caption alignnone\" style=\"max-width: 800px\">\u003cimg loading=\"lazy\" decoding=\"async\" class=\"size-medium wp-image-11992261\" src=\"https://cdn.kqed.org/wp-content/uploads/sites/10/2024/06/042424_Therapy_CG-CM-14-copy-800x533.jpg\" alt=\"\" width=\"800\" height=\"533\" srcset=\"https://cdn.kqed.org/wp-content/uploads/sites/10/2024/06/042424_Therapy_CG-CM-14-copy-800x533.jpg 800w, https://cdn.kqed.org/wp-content/uploads/sites/10/2024/06/042424_Therapy_CG-CM-14-copy-1020x680.jpg 1020w, https://cdn.kqed.org/wp-content/uploads/sites/10/2024/06/042424_Therapy_CG-CM-14-copy-160x107.jpg 160w, https://cdn.kqed.org/wp-content/uploads/sites/10/2024/06/042424_Therapy_CG-CM-14-copy-1536x1024.jpg 1536w, https://cdn.kqed.org/wp-content/uploads/sites/10/2024/06/042424_Therapy_CG-CM-14-copy.jpg 1568w\" sizes=\"(max-width: 800px) 100vw, 800px\">\u003cfigcaption class=\"wp-caption-text\">Therapist Jennifer Alexander listens to Nelson during a treatment session. She called workers’ comp a ‘total system breakdown.’ \u003ccite>(Cristian Gonzalez for CalMatters)\u003c/cite>\u003c/figcaption>\u003c/figure>\n\u003cp>Michael Dworsky, a senior economist at the research institute RAND and one of the study’s project leaders, called workers’ comp “challenging and bureaucratic.”\u003c/p>\n\u003cp>“Even if the claim is accepted, there can be disputes about the medical necessity of individual bills. Just because your claim is accepted, doesn’t mean you are done fighting with the insurance company,” he said.\u003c/p>\n\u003ch2>A presumption of pain but still a tangled web\u003c/h2>\n\u003cp>Employers in California must provide workers’ comp insurance that will pay for medical costs when a worker is injured on the job. However, in reality, workers’ comp, which serves 16 million Californians, can be ungainly, confusing and, sometimes, no help at all. The system, administered by the state Department of Industrial Relations, is massive: In 2022, almost \u003ca href=\"https://www.dir.ca.gov/CHSWC/Reports/2023/CHSWC_AnnualReport2023.pdf\">750,000 workers’ comp claims (PDF)\u003c/a> were filed statewide.\u003c/p>\n\u003cp>When a firefighter requests coverage for medical treatment, insurance adjusters review the case to determine if it’s medically necessary. If the claim is denied, delayed or modified, a patient may request an independent medical review by so-called “ghost doctors” who review the case.\u003c/p>\n\u003cp>Systemwide in California, patients who appeal their denied workers’ comp claims, don’t fare well: Last year 3,238 appeals for mental health claims were filed, but workers’ comp officials rejected three-quarters of them, about the same as the 10-year average, according to data from the Department of Industrial Relations requested by CalMatters. (Agency officials said they could not provide data on claims from first responders.)\u003c/p>\n\u003cp>\u003c!-- iframe plugin v.4.3 wordpress.org/plugins/iframe/ -->\u003cbr>\n\u003ciframe loading=\"lazy\" src=\"https://datawrapper.dwcdn.net/9hnJM/4/\" width=\"800\" height=\"600\" scrolling=\"yes\" class=\"iframe-class\" frameborder=\"0\">\u003c/iframe>\u003c/p>\n\u003cp>For decades, the California Legislature has wrestled with how to fix workers’ comp — in one year alone, lawmakers proposed nearly two dozen bills.\u003c/p>\n\u003cp>In 2020 lawmakers took a major step, adding a \u003ca href=\"https://digitaldemocracy.calmatters.org/hearings/256803?t=1347&f=e8036f39579fee812f324253b5cb224b\">legal \u003c/a>\u003ca href=\"https://digitaldemocracy.calmatters.org/bills/ca_202320240sb623\">shortcut or “presumption”\u003c/a> to the\u003cstrong> \u003c/strong>state\u003cstrong> \u003c/strong>labor code, stipulating that firefighters and other first responders are considered at high risk for PTSD in the course of doing their job.\u003c/p>\n\u003cp>That means first responders no longer carry the burden of proving their illness is work-related. However, a claims adjuster can still question the diagnosis or assert that the trauma was caused by other factors, such as military service or family events. A law enacted last year \u003ca href=\"https://digitaldemocracy.calmatters.org/bills/ca_202320240sb623\">extended the presumption to 2029\u003c/a>.\u003c/p>\n\u003cp>In practice, experts say that, despite the law, proving a mental health claim is still almost as difficult to overcome as the psychological injury itself. Break an arm while fighting a wildfire, and, backed up by x-rays, claims are approved. But break your mind after decades of exposure to on-the-job trauma? Prepare for battle.\u003c/p>\n\u003cp>Before enacting the law, state officials asked RAND researchers to report on the scope of the problem. They analyzed nearly 6 million claims filed between 2008 through 2019 and interviewed dozens of experts, including a representative sample of 13 first responders.\u003c/p>\n\u003cp>The researchers found a consistent and troubling trend among the 13: “Nearly all workers said that they had filed a workers’ compensation claim for their mental health conditions — yet almost none received PTSD care paid for by workers’ compensation.”\u003c/p>\n\u003cp>Paying out of pocket “caused severe financial strain in some cases. Some were eventually reimbursed by workers’ compensation, but only after litigation and substantial delay. Some who pursued care through workers’ compensation also noted that claim denials led to delays in the start of mental health treatment,” the RAND researchers wrote.\u003c/p>\n\u003cp>The 13 first responders they surveyed stressed “over and over again about self-pay and barriers,” said \u003ca href=\"https://www.rand.org/about/people/q/quigley_denise_d.html\">Denise D. Quigley, a RAND senior policy researcher\u003c/a> who was a project leader on the study. “It’s not like we heard it once or twice, we heard it over and over again. It’s highly unlikely that we talked to the (only) people in California that had this happen.”\u003c/p>\n\u003cp>Firefighters told of borrowing money from family members and taking out home equity loans to pay for care, Quigley said. The litany of their struggle weighed on her team. “It’s difficult to hear people break down crying while talking to us because of all the things they’ve seen.”\u003c/p>\n\u003cp>According to the RAND research, for the 12-year period from 2008 through 2019, before the new law took effect:\u003c/p>\n\u003cul>\n\u003cli>Firefighters and other first responders were about twice as likely to file PTSD claims as the general workforce — but the numbers are small, under 1% of all workers’ comp claims.\u003c/li>\n\u003c/ul>\n\u003cul>\n\u003cli>Firefighters’ PTSD claims were denied more often than claims of other workers: About 24% were denied, compared to about 19% of PTSD claims for all workers, including those in high-stress occupations. About a quarter of firefighter claims for all mental health conditions were denied.\u003c/li>\n\u003c/ul>\n\u003cul>\n\u003cli>Their PTSD claims were denied at more than twice the rate of their other presumptive medical conditions related to their jobs, such as hernias and back injuries. Even their cancer and heart disease claims were accepted at a higher rate than PTSD.\u003c/li>\n\u003c/ul>\n\u003cul>\n\u003cli>These denial rates were calculated using a sample of only 258 PTSD claims filed by firefighters. But researcher Dworsky said the total number of claims is far higher, about 1,000, with about 230 claims denied, during those 12 years. And countless other firefighters who suffer from PTSD didn’t seek care through workers’ comp.\u003c/li>\n\u003c/ul>\n\u003cp>The RAND report was the most detailed look at the inequities between how physical and mental health are treated among firefighters and how first responders’ claims were handled compared to other workers. However, the researchers struggled with incomplete data and difficulty identifying which claims were from firefighters.\u003c/p>\n\u003cp>Quigley said she is frustrated that no one since has tracked whether the 4-year-old presumption law — known as the Trauma Treatment Act — has helped patients and improved the system.\u003c/p>\n\u003cp>Many therapists say they haven’t seen much, if any, improvement. Nelson’s therapist, Alexander, called workers’ comp a “total system breakdown.”\u003c/p>\n\u003cp>A spokesman for the Department of Industrial Relations refused to grant interview requests from CalMatters or answer questions or provide data about firefighters’ mental health claims.\u003c/p>\n\u003ch2>Navigating the system\u003c/h2>\n\u003cp>During his 28 years with Cal Fire fighting wildfires in combustible regions, such as the Napa Valley and the Sierra Nevada foothills, and responding to other emergencies, Nelson never reported any mental health issues to anyone. Not once. Even as he would regularly pull his truck off the side of the road during wildfires and weep. Even after responding to the scene of traffic accidents, extricating children from crushed cars as their parents fought to get to them. Even after answering a call to a suicide to find a man hanging from the rafters in his barn. Even after the unbidden images began to intrude with greater frequency.\u003c/p>\n\u003cp>Instead, his mantra became “I’m good.”\u003c/p>\n\u003cp>That stoicism, common among first responders, short circuits the insurance system designed to help them — a system that works best with prompt reporting and meticulous documentation.\u003c/p>\n\u003cp>[aside label=\"Related Stories\" postID=\"news_11991959,science_1993253,science_1991079\"]Claims adjusters usually handle clear-cut cases where the date of injury can be pinpointed. More common among PTSD claims, though, is Nelson’s experience with cumulative trauma, with no paper trail of injuries or complaints. He can’t offer a single event as the origin of his trauma and no coherent chronology. Cal Fire folks tend to wait until their dam bursts before asking for the water to be turned off.\u003c/p>\n\u003cp>One Southern California mental health provider told the RAND researchers that firefighters and police officers typically have severe cases of trauma.\u003c/p>\n\u003cp>“On the clinical side, as a mental health provider, it is not realistic to expect a firefighter or a police officer to come in and have had a little trauma or some minor stress condition … Most departments have people with a lot of stress and trauma,” the therapist said. “Just because you had something happen recently, the straw that broke the camel’s back, it is really the cumulative stress that is the issue.”\u003c/p>\n\u003cp>Now retired, Nelson, 54, has been fighting for workers’ compensation for almost three years, since his suicide attempt on the Placer County bridge. He and his wife already have spent more than $10,000 out of pocket for medical care and could face thousands more in legal bills.\u003c/p>\n\u003cp>Nelson’s case is unusually severe and complex, requiring two extended stays in a facility that specifically treats firefighters to diagnose his conditions and finally set him on a treatment path of therapy and multiple medications.\u003c/p>\n\u003cp>Cal Fire Battalion Chief Brad Niven said he has more than a dozen firefighter friends who have had similar experiences.\u003c/p>\n\u003cp>“Talk to anybody that tries to do anything through workers’ comp — it is an absolute nightmare,” he said. “Everybody knows you file your first workers’ comp claim and they will deny it. One guy I worked with went through the works with them. He had to prove beyond a shadow of a doubt that you have problems. You have to relive everything you’ve gone through. It does not make for a friendly system.”\u003c/p>\n\u003cfigure id=\"attachment_11992262\" class=\"wp-caption alignnone\" style=\"max-width: 800px\">\u003cimg loading=\"lazy\" decoding=\"async\" class=\"size-medium wp-image-11992262\" src=\"https://cdn.kqed.org/wp-content/uploads/sites/10/2024/06/060822_BRAD_NIVEN_CALFIRE_JH_CM_37-copy-800x533.jpg\" alt=\"\" width=\"800\" height=\"533\" srcset=\"https://cdn.kqed.org/wp-content/uploads/sites/10/2024/06/060822_BRAD_NIVEN_CALFIRE_JH_CM_37-copy-800x533.jpg 800w, https://cdn.kqed.org/wp-content/uploads/sites/10/2024/06/060822_BRAD_NIVEN_CALFIRE_JH_CM_37-copy-1020x680.jpg 1020w, https://cdn.kqed.org/wp-content/uploads/sites/10/2024/06/060822_BRAD_NIVEN_CALFIRE_JH_CM_37-copy-160x107.jpg 160w, https://cdn.kqed.org/wp-content/uploads/sites/10/2024/06/060822_BRAD_NIVEN_CALFIRE_JH_CM_37-copy-1536x1024.jpg 1536w, https://cdn.kqed.org/wp-content/uploads/sites/10/2024/06/060822_BRAD_NIVEN_CALFIRE_JH_CM_37-copy.jpg 1568w\" sizes=\"(max-width: 800px) 100vw, 800px\">\u003cfigcaption class=\"wp-caption-text\">Cal Fire Battalion Chief Brad Niven, shown at his home in Sonora, said he and more than a dozen firefighter friends have had trouble getting workers’ comp to pay their claims for mental health treatment. \u003ccite>(Julie Hotz for CalMatters)\u003c/cite>\u003c/figcaption>\u003c/figure>\n\u003cp>Niven considered suicide before Cal Fire’s employee support personnel helped him find a therapist, streamlining what had been a hit-and-miss process.\u003c/p>\n\u003cp>“They blasted away the stumbling blocks,” he said. But the fire agency does not make the decision to approve or deny a claim or handle the bureaucratic thicket that is workers’ comp.\u003c/p>\n\u003cp>Scott O’Mara, a \u003ca href=\"https://law1199.com/\">San Diego-based lawyer\u003c/a> whose firm represents first responders, said adjusters’ training is to look for what they can develop to deny the case. “Their goal is to contain and control cost,” he said. “We do a lot of cases where the compensation is nickels.”\u003c/p>\n\u003cp>Although California law now considers PTSD for first responders a presumption, it is a “disputable presumption.” That means claims administrators can consider other traumatic events in a firefighter’s life that may play a role in a PTSD case.\u003c/p>\n\u003cp>“With cumulative trauma, or stress over the course of their entire employment, we need to request more information from the doctor so that we can see it isn’t because they were in the military or they are going through a divorce, etc.,” one claims adjuster told RAND researchers.\u003c/p>\n\u003cp>The complexity of the system wears down the resistance of injured workers, who need a jungle guide to find their way at a time of profound pain and disorientation.\u003c/p>\n\u003cp>“They can’t navigate this on their own, they really can’t. They’ve got professional litigators opposing them,” said Richard Elder, a \u003ca href=\"https://www.elderandberg.com/attorney/richard-e-elder-jr/\">workers’ comp lawyer\u003c/a> in Concord who regularly represents state firefighters. “The average claims adjuster on the job for more than a month knows more about the system than the average firefighter. They’ve got lawyers on speed dial. The injured worker is adrift. It’s like a do-it-yourself heart transplant.”\u003c/p>\n\u003cp>Elder, who has been in practice for 54 years, used to work as an insurance company claims adjuster. The system, he said, has always been adversarial.\u003c/p>\n\u003cp>“It’s against the law for employers to discriminate against a worker who files a psyche claim. But they do discriminate,” said Elder, who said in the past five decades he has pursued about 500 psychiatric claims.\u003c/p>\n\u003cp>“I just filed a psychiatric claim and the response was ‘give us a list of every medical facility that treated the claimant in the last 10 years,’” he said. “The workers’ comp medical treatments system is a stain upon the soul of the politicians and officials of California.”\u003c/p>\n\u003ch2>Diagnosing PTSD is ‘a complicated process’\u003c/h2>\n\u003cp>One day in March, Nelson sat next to his wife, Leticia, in a quiet room in a Nevada City library near their rental home. He was in the grips of a seizure, brought on by retelling his firefighting nightmares to a CalMatters reporter. His hands were clenched and his torso taut. He stuttered, his eyelids fluttering. The episode lasted a few minutes.\u003c/p>\n\u003cp>During the interview, Nelson was fidgety, his thick fingers constantly worrying about the items he had put on the table in front of him. One was a tiny aluminum cylinder containing medication for his seizures, another was a brass medallion, the iconic firefighter symbols of an ax and firehose nozzle stamped on one side and the serenity prayer on the other.\u003c/p>\n\u003cp>The coin was a kind of talisman given to him after graduating from a \u003ca href=\"https://www.iaffrecoverycenter.com/\">specialized rehab clinic \u003c/a>for firefighters, where he was given his daunting medical diagnosi\u003cem>s: \u003c/em>He suffers from complex PTSD, \u003ca href=\"https://my.clevelandclinic.org/health/diseases/24517-psychogenic-nonepileptic-seizure-pnes\">psychogenic non-epileptic seizures\u003c/a> and dissociative identity disorder.\u003c/p>\n\u003cp>Such anxiety-induced seizures are unusual but not rare, his therapist said, and the totality of Nelson’s mental health issues makes his case unusually severe. Weekly therapy sessions and multiple medications have tempered, but not extinguished, his struggle with crippling anxiety.\u003c/p>\n\u003cp>Nelson wears a medical alert wrist bracelet intended to give first responders a bare-bones outline of his conditions and which medications to avoid when he is experiencing an anxiety-induced seizure. In his back pocket, he carries, always, a medical card with his list of red flags, so extensive that it unspools like an accordion.\u003c/p>\n\u003cp>His seizures may occur several times a day. Some last for hours. Nelson’s usually benign aspect changes: His eyes cross, his hands clench into what he calls “spidey fingers.” He stumbles and stutters through sentences and repeats words, often losing his ability to speak at all. At times he drags his head and face along walls. Leticia Nelson describes the seizures as his body undergoing earthquakes.\u003c/p>\n\u003cfigure id=\"attachment_11992264\" class=\"wp-caption alignnone\" style=\"max-width: 800px\">\u003cimg loading=\"lazy\" decoding=\"async\" class=\"size-medium wp-image-11992264\" src=\"https://cdn.kqed.org/wp-content/uploads/sites/10/2024/06/031924_Todd-Nelson_LE_CM-25-copy-800x533.jpg\" alt=\"\" width=\"800\" height=\"533\" srcset=\"https://cdn.kqed.org/wp-content/uploads/sites/10/2024/06/031924_Todd-Nelson_LE_CM-25-copy-800x533.jpg 800w, https://cdn.kqed.org/wp-content/uploads/sites/10/2024/06/031924_Todd-Nelson_LE_CM-25-copy-1020x680.jpg 1020w, https://cdn.kqed.org/wp-content/uploads/sites/10/2024/06/031924_Todd-Nelson_LE_CM-25-copy-160x107.jpg 160w, https://cdn.kqed.org/wp-content/uploads/sites/10/2024/06/031924_Todd-Nelson_LE_CM-25-copy-1536x1024.jpg 1536w, https://cdn.kqed.org/wp-content/uploads/sites/10/2024/06/031924_Todd-Nelson_LE_CM-25-copy.jpg 1568w\" sizes=\"(max-width: 800px) 100vw, 800px\">\u003cfigcaption class=\"wp-caption-text\">The emergency medical ID card that Nelson carries with him. \u003ccite>(Loren Elliott for CalMatters)\u003c/cite>\u003c/figcaption>\u003c/figure>\n\u003cfigure id=\"attachment_11992266\" class=\"wp-caption alignnone\" style=\"max-width: 800px\">\u003cimg loading=\"lazy\" decoding=\"async\" class=\"size-medium wp-image-11992266\" src=\"https://cdn.kqed.org/wp-content/uploads/sites/10/2024/06/031924_Todd-Nelson_LE_CM-14-copy-800x533.jpg\" alt=\"\" width=\"800\" height=\"533\" srcset=\"https://cdn.kqed.org/wp-content/uploads/sites/10/2024/06/031924_Todd-Nelson_LE_CM-14-copy-800x533.jpg 800w, https://cdn.kqed.org/wp-content/uploads/sites/10/2024/06/031924_Todd-Nelson_LE_CM-14-copy-1020x680.jpg 1020w, https://cdn.kqed.org/wp-content/uploads/sites/10/2024/06/031924_Todd-Nelson_LE_CM-14-copy-160x107.jpg 160w, https://cdn.kqed.org/wp-content/uploads/sites/10/2024/06/031924_Todd-Nelson_LE_CM-14-copy-1536x1024.jpg 1536w, https://cdn.kqed.org/wp-content/uploads/sites/10/2024/06/031924_Todd-Nelson_LE_CM-14-copy.jpg 1568w\" sizes=\"(max-width: 800px) 100vw, 800px\">\u003cfigcaption class=\"wp-caption-text\">Nelson alongside his wife, Leticia Nelson, near their Nevada City home. She said it’s been agonizing to see him suffer mental health problems related to his job and have to fight the system to get his treatment paid for. ‘We sacrificed our time with him so that he could help the whole state. And nothing has been there for the family since this happened. Nothing.’ \u003ccite>(Loren Elliott for CalMatters)\u003c/cite>\u003c/figcaption>\u003c/figure>\n\u003cp>Nelson’s unusual body movements during a seizure, his inability to respond to questions and his propensity to run away when confronted puts Nelson in a precarious place in airport lines or with law enforcement, where his non-response has been misconstrued as defiance.\u003c/p>\n\u003cp>Even doctors can misunderstand. Diagnosing and treating PTSD and acute trauma like Nelson’s is notoriously difficult.\u003c/p>\n\u003cp>“Diagnosing PTSD is a complicated process. Diagnostic criteria are complicated,” said Sidra Goldman-Mellor, a \u003ca href=\"https://publichealth.ucmerced.edu/content/sidra-goldman-mellor\">UC Merced psychiatric epidemiologist\u003c/a> who studies depression and suicidal behavior. “Your average primary care clinician is probably not willing to go down that road.”\u003c/p>\n\u003cp>For patients like Nelson, any number of stress-related disorders present themselves and muddy a specific diagnosis that would satisfy a claims adjuster or a workers’ comp review.\u003c/p>\n\u003cp>“That’s the thing with psychiatric disorders, we don’t have a lot of objective measures for a mental health diagnosis. We don’t have blood tests and we don’t have MRIs,” Goldman-Mellor said. “They (mental health issues) are harder to recognize, harder to test for and easier to ignore.”\u003c/p>\n\u003cp>However, firefighters cannot move easily through the workers’ comp or medical insurance system if they don’t have a diagnosis. Constantly proving your pain becomes its own trauma.\u003c/p>\n\u003cp>“He has to prove his world is falling apart,” Leticia Nelson said. “It’s hard to explain to someone that you are broken. They look at you, they think that you look fine. They can’t see in your brain. They can’t see in your mind.”\u003c/p>\n\u003cp>It took four years for Nelson to find the right medical care. One physician’s therapeutic approach was to ask the former firefighter to pray with him.\u003c/p>\n\u003cp>The problem was much more fundamental than finding a compatible therapist: He could not \u003cem>find\u003c/em> one to take his case. Many Cal Fire employees are stationed in rural or remote areas of the state, in communities underserved by health care specialists.\u003c/p>\n\u003cp>Living in rural Nevada County, Nelson faces a barren mental health desert where it’s difficult to find a competent therapist who might have worked with other first responders and understands the specific challenges of the high-stress job.\u003c/p>\n\u003cp>“It’s an absolute specialization. There’s not near enough of us,” said Alexander, Nelson’s therapist. (Nelson granted her permission to speak about his case.) “In the larger Sacramento area, there are less than a dozen competent providers.”\u003c/p>\n\u003cfigure id=\"attachment_11992268\" class=\"wp-caption alignnone\" style=\"max-width: 800px\">\u003cimg loading=\"lazy\" decoding=\"async\" class=\"size-medium wp-image-11992268\" src=\"https://cdn.kqed.org/wp-content/uploads/sites/10/2024/06/042424_Therapy_CG-CM-09-copy-800x533.jpg\" alt=\"\" width=\"800\" height=\"533\" srcset=\"https://cdn.kqed.org/wp-content/uploads/sites/10/2024/06/042424_Therapy_CG-CM-09-copy-800x533.jpg 800w, https://cdn.kqed.org/wp-content/uploads/sites/10/2024/06/042424_Therapy_CG-CM-09-copy-1020x680.jpg 1020w, https://cdn.kqed.org/wp-content/uploads/sites/10/2024/06/042424_Therapy_CG-CM-09-copy-160x107.jpg 160w, https://cdn.kqed.org/wp-content/uploads/sites/10/2024/06/042424_Therapy_CG-CM-09-copy-1536x1024.jpg 1536w, https://cdn.kqed.org/wp-content/uploads/sites/10/2024/06/042424_Therapy_CG-CM-09-copy.jpg 1568w\" sizes=\"(max-width: 800px) 100vw, 800px\">\u003cfigcaption class=\"wp-caption-text\">Nelson recalls memories of his time as a firefighter during a treatment session. \u003ccite>(Cristian Gonzalez for CalMatters)\u003c/cite>\u003c/figcaption>\u003c/figure>\n\u003cp>Cal Fire is self-insured and offers medical coverage through private companies. The agency does not manage medical claims or workers’ comp but does have programs to assist employees in finding care.\u003c/p>\n\u003cp>Rob Wheatley, staff chief of Cal Fire’s Behavioral Health and Wellness Program, told CalMatters in an email that the agency has expanded support for employees who seek help for mental health issues with peer counseling or referrals for treatment. The agency has a staff of 28 assisting about 12,000 employees.\u003c/p>\n\u003cp>But Wheatley and other Cal Fire officials refused to grant an interview and did not answer CalMatters’ questions about the problems that their employees face with workers’ comp and mental health issues.\u003c/p>\n\u003cp>“Any denial of a mental health claim is concerning,” Wheatley said in the email.\u003c/p>\n\u003ch2> Can the system be repaired?\u003c/h2>\n\u003cp>The Nelsons have seen the insurance and workers’ comp system from the inside, been batted around by it and, they would say, abandoned by it. Still, they have few suggestions for fixing it.\u003c/p>\n\u003cp>They are not alone. Lawyers say that the system is based on how to save money, is too often adversarial and deeply entrenched.\u003c/p>\n\u003cp>Even the employers who participate in the workers’ comp system say it’s not working well. In a recent survey, more than half of the respondents said the system performs poorly, while 42% described the system as challenged but adequate.\u003c/p>\n\u003cp>“Nobody believes it’s ideal,” said Jerry Azevedo, a spokesman for the \u003ca href=\"https://www.workcompaction.org/\">Workers’ Compensation Action Network,\u003c/a> a coalition of California insurers, employers and agents advocating to improve the system. “Every constituency has complaints.”\u003c/p>\n\u003cp>Azevedo said California’s workers’ comp system, which has been in place since 1913, is plagued by \u003ca href=\"https://information.auditor.ca.gov/pdfs/reports/2019-106.pdf\">persistent problems\u003c/a>: high costs to operate, huge claim volume, frequent litigation, slow claim resolution and fraud and abusive practices.\u003c/p>\n\u003cp>“The fundamental challenge we all contend with is complexity. California’s system is arguably the most complex in the nation,” Azevedo said. The good news, he said, is that 86% of workers’ comp claims overall are accepted, according to the California Workers’ Compensation Institute.\u003c/p>\n\u003cp>It’s easy to get the sense of a general throwing up of hands. The state Commission on Health & Safety & Workers’ Comp dedicates a \u003ca href=\"https://www.dir.ca.gov/chswc/WCReformsPage1.htm\">webpage to tracking workers’ comp reforms\u003c/a>, but the last entry was in 2012.\u003c/p>\n\u003cp>Sean Cooper, executive vice president and chief actuary of the \u003ca href=\"https://www.wcirb.com/\">Workers’ Compensation Insurance Rating Bureau of California\u003c/a>, said the system is groaning under its own weight — there are a lot of people filing claims and a lot of lawyers on all sides.\u003c/p>\n\u003cp>Administrative costs are high in California: The cost to deliver $1 of medical benefit from California’s workers’ comp system is 46 cents, compared to two cents for Medicare, 19 cents for private group health insurance and 25 cents for the national state median for workers’ comp according to the group’s 2023 report.\u003c/p>\n\u003cp>One way to fix the inequity is to turn the system on its head, said Cruz of the \u003ca href=\"https://namica.org/\">National Alliance on Mental Illness\u003c/a>.\u003c/p>\n\u003cp>“There is a disparity about how we treat, respond and react to behavioral health versus physical health,” she said. “Maybe we need to start talking about that disparity in workers’ comp. When you have (a claims) approval rating that is flipped on its backside, that’s an obvious parity issue.”\u003c/p>\n\u003cp>Legislators, when they turn their gaze to the massive program, chip away at the edges. The law extending the PTSD presumption will be revisited when the state Commission on Health and Safety and Workers’ Compensation presents its report on claims and denials to the Senate Committee on Labor, Public Employment and Retirement and the Assembly Committee on Insurance, by the end of this year.\u003c/p>\n\u003cp>Cruz said there is more legislative focus on behavioral health than ever, but there are limits, beginning with which groups carry the most influence. Managed health care companies are powerful advocates of the status quo, she said. “We are David and Goliath when we come up against these folks.”\u003c/p>\n\u003cp>“So many great people want to do wonderful things and they have big ideas, but it gets chopped down to a Band-Aid once everyone gets what they want,” she said.\u003c/p>\n\u003ch2>‘A slap in the face to all of us’\u003c/h2>\n\u003cp>Leticia Nelson refers to herself, with only slight exaggeration, as her husband’s “service dog.”\u003c/p>\n\u003cp>She’s the keeper of the couple’s appointment schedule; she’s the chauffeur; and the manager of the financial spreadsheet. And it falls to Leticia to devote untold hours on the phone with insurers and medical providers, bird-dogging bills, late payments and coverage lapses.\u003c/p>\n\u003cp>She has watched her husband humiliated, scared and angry. Their two adult daughters, also have been treated for PTSD, after witnessing their father’s anxiety and mania, and knowing about his suicide attempts.\u003c/p>\n\u003cp>At times, Leticia Nelson said, “I’m mad at God.”\u003c/p>\n\u003cfigure id=\"attachment_11992269\" class=\"wp-caption alignnone\" style=\"max-width: 800px\">\u003cimg loading=\"lazy\" decoding=\"async\" class=\"size-medium wp-image-11992269\" src=\"https://cdn.kqed.org/wp-content/uploads/sites/10/2024/06/031924_Todd-Nelson_LE_CM_21-copy-800x533.jpg\" alt=\"\" width=\"800\" height=\"533\" srcset=\"https://cdn.kqed.org/wp-content/uploads/sites/10/2024/06/031924_Todd-Nelson_LE_CM_21-copy-800x533.jpg 800w, https://cdn.kqed.org/wp-content/uploads/sites/10/2024/06/031924_Todd-Nelson_LE_CM_21-copy-1020x680.jpg 1020w, https://cdn.kqed.org/wp-content/uploads/sites/10/2024/06/031924_Todd-Nelson_LE_CM_21-copy-160x107.jpg 160w, https://cdn.kqed.org/wp-content/uploads/sites/10/2024/06/031924_Todd-Nelson_LE_CM_21-copy-1536x1024.jpg 1536w, https://cdn.kqed.org/wp-content/uploads/sites/10/2024/06/031924_Todd-Nelson_LE_CM_21-copy.jpg 1568w\" sizes=\"(max-width: 800px) 100vw, 800px\">\u003cfigcaption class=\"wp-caption-text\">Retired Cal Fire firefighter Todd Nelson walks with his wife in Nevada City. Nelson suffers from post-traumatic stress disorder resulting from the trauma experienced during his firefighting career. \u003ccite>(Loren Elliott for CalMatters)\u003c/cite>\u003c/figcaption>\u003c/figure>\n\u003cp>The Nelsons, lifelong Californians, want to leave the state and its frightening tableau of wildfires. They sold their house, changed their mind about moving and now are financially shut out of the real estate market, especially because of the high cost of fire insurance in the foothills where they live. They are nomads, shuttling between Airbnbs with two large dogs and three cats in tow and their possessions in storage.\u003c/p>\n\u003cp>Money is tight. Leticia would like to go back to work, but she can’t leave Todd alone.\u003c/p>\n\u003cp>Nelson gave up fighting the state over a disability claim after his attorney told him that an appeal would cost $50,000 — and he would lose because he didn’t claim a disability when he retired.\u003c/p>\n\u003cp>“It’s a slap in the face to all of us because we sacrificed as a family,” Leticia Nelson said of Todd’s long career with Cal Fire. “We sacrificed our time with him so that he could help the whole state. And nothing has been there for the family since this happened. Nothing.\u003c/p>\n\u003cp>“I wish that there’s things in place that would guide us that wouldn’t be so hard. But it just seems like we hit every, every obstacle possible. We’re struggling. We need help. We need to be seen. We need to be treated like humans and not criminals.”\u003c/p>\n\u003cp>For his part, Nelson is coming to terms with the devastation his career wrought. Yet, years after retirement, he still listens to an emergency scanner and shows up at fires in his area, wearing his T-shirt, shorts and Birkenstocks. The pull to serve remains strong.\u003c/p>\n\u003cp>“The crazy thing is I miss my job. I miss it every day. I would do it all over again,” he said wistfully. “I loved the job but I didn’t realize the damage being done.”\u003c/p>\n\u003cp>\u003cem>If you are having suicidal thoughts, you can get help from the National Suicide Prevention Lifeline by calling 988 or visiting \u003c/em>\u003ca href=\"https://suicidepreventionlifeline.org/\">\u003cem>https://suicidepreventionlifeline.org\u003c/em>\u003c/a>\u003c/p>\n\u003cp>\u003cem>This story also was made possible in part by a grant from the \u003ca href=\"https://amarkfoundation.org/\">A-Mark Foundation\u003c/a>.\u003c/em>\u003c/p>\n\u003cp>[ad floatright]\u003c/p>\n",
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"excerpt": "Even when suicidal, California firefighters struggle to find medical help and navigate the workers’ comp morass to pay for it. A 2021 analysis showed their claims were more likely to involve PTSD — and were denied more often.",
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"title": "PTSD Is Common Among Firefighters — but Workers’ Comp for Treatment Is Hard to Get | KQED",
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"nprByline": "\u003ca href=\"https://calmatters.org/author/julie-cart/\">Julie Cart\u003c/a>, CalMatters",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003cp>Todd Nelson could feel it coming on. And he began to run. He was going dark again, retreating to a place where he would curl into a fetal position with his thumb in his mouth, watching from behind closed eyes as his personal reel of horror unspooled. Sights and sounds from three decades of firefighting cued up — shrieks from behind an impenetrable wall of flame, limbs severed in car accidents and the eyes of the terrified and the dead he was meant to save.\u003c/p>\n\u003cp>Nelson was running on the Foresthill Bridge, \u003ca href=\"https://sierranevadageotourism.org/entries/foresthill-bridge/4123fc95-8a25-4827-baba-fca9c8e4485a\">the highest in California\u003c/a>, fleeing cops and firefighters after his wife reported that he was suicidal. He hurdled a concrete barrier and straddled the railing of the bridge in the Sierra Nevada foothills, staring down at a large rock 730 feet below. As the rescuers closed in, Nelson leaned precariously over the chasm. His strategy — making the fatal plunge appear accidental, allowing his family to collect his life insurance.\u003c/p>\n\u003cp>It was not Nelson’s first suicide attempt — the former Cal Fire captain had tried to take his life many times before. But after that 2021 ordeal, which led to an involuntary 72-hour psychiatric hold, something in him shifted. He was ready to admit that he had a problem and seek medical help.\u003c/p>\n\u003cp>The incident began the firefighter’s arduous, years-long journey toward wellness, threaded through a bureaucratic labyrinth strewn with more obstacles than he’d ever encountered on a California wildfire: finding qualified medical help, battling an insurance company to pay for it and navigating the tangled morass of California’s workers’ comp. All without going broke or returning to his dark place.\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>No one tracks how many of Cal Fire’s 12,000 firefighters and other employees suffer from mental health problems, but department leaders say post-traumatic stress disorder and suicidal thoughts \u003ca href=\"https://calmatters.org/environment/2022/06/california-firefighter-trauma-ptsd/?series=california-firefighters-trauma-wildfires\">have become a silent epidemic\u003c/a>\u003cstrong> \u003c/strong>at the agency responsible for fighting \u003ca href=\"https://calmatters.org/california-wildfire-map-tracker/\">California’s increasingly erratic and destructive wildfires\u003c/a>. In an \u003ca href=\"https://www.researchgate.net/publication/352466544_Wildland_Firefighter_Psychological_and_Behavioral_Health_Preliminary_Data_from_a_National_Sample_of_Current_and_Former_Wildland_Firefighters_in_the_United_States_Conference_session\">online survey\u003c/a> of wildland firefighters nationwide, about a third reported considering suicide and nearly 40% said they had colleagues who had committed suicide; many also reported depression and anxiety.\u003c/p>\n\u003cp>California’s workers’ comp — which is supposed to help people get medical treatment for workplace illnesses and injuries — can be a nightmare for firefighters and other first responders with PTSD.\u003c/p>\n\u003cp>Claims filed by firefighters and law enforcement officers are more likely to involve PTSD than claims by the average worker in California — and they have been \u003ca href=\"https://calmatters.org/wp-content/uploads/2024/06/RAND-PTSD-REPORT.pdf\">denied more often than claims for other medical conditions (PDF)\u003c/a>, according to the research institute RAND.\u003c/p>\n\u003cp>From 2008 to 2019 in California, workers’ comp officials denied PTSD claims filed by firefighters and other first responders at more than twice the rate of their other work-related conditions, such as back injuries and pneumonia, RAND reported. About a quarter of firefighters’ 1,000 PTSD claims were denied, a higher rate than for PTSD claims from other California workers.\u003c/p>\n\u003cp>“It’s a fail-first system. You have to get a broken leg to show you are in need of support. With mental illness, we are constantly having to prove to everybody why we were ill. You have to get to the point of suicide,” said Jessica Cruz, the California chief executive officer of the \u003ca href=\"https://namica.org/\">National Alliance on Mental Illness\u003c/a>.\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/DLvG2Yy34QM'\n title='//www.youtube.com/embed/DLvG2Yy34QM'\n allowfullscreen='true'\n style='border:0;'>\u003c/iframe>\n \u003c/span>\n \u003c/span>\u003c/p>\u003cp>\u003cp>Jennifer Alexander, Nelson’s therapist, said patients in acute crisis simply don’t have the mental capacity to ride herd on stubborn workers’ comp claims. Alexander said she was once on hold for more than six hours with Cal Fire’s mental health provider attempting to get one of her bills paid, and she has waited years to get paid for treating firefighters.\u003c/p>\n\u003cp>“People give up. It’s a battle … They are not fully functional,” said Alexander, who for 21 years has specialized in treating first responders with trauma and PTSD and has spent an estimated 25,000 hours treating them. “You are not talking about healthy individuals who can sit on the phone for hours.”\u003c/p>\n\u003cp>Cal Fire firefighters and other workers also have trouble finding qualified therapists, especially outside major cities in rural areas, where many are based. In 2021, less than \u003ca href=\"https://www.commonwealthfund.org/publications/explainer/2023/may/understanding-us-behavioral-health-workforce-shortage\">half of people with a mental illness\u003c/a> in the U.S. were able to access timely care. \u003ca href=\"https://calmatters.org/environment/2024/06/california-workers-comp-firefighters-therapists/\">Therapists are reluctant to take workers’ comp\u003c/a>, or sometimes any type of insurance, because they often have to wait months or years to be reimbursed.\u003c/p>\n\u003cfigure id=\"attachment_11992261\" class=\"wp-caption alignnone\" style=\"max-width: 800px\">\u003cimg loading=\"lazy\" decoding=\"async\" class=\"size-medium wp-image-11992261\" src=\"https://cdn.kqed.org/wp-content/uploads/sites/10/2024/06/042424_Therapy_CG-CM-14-copy-800x533.jpg\" alt=\"\" width=\"800\" height=\"533\" srcset=\"https://cdn.kqed.org/wp-content/uploads/sites/10/2024/06/042424_Therapy_CG-CM-14-copy-800x533.jpg 800w, https://cdn.kqed.org/wp-content/uploads/sites/10/2024/06/042424_Therapy_CG-CM-14-copy-1020x680.jpg 1020w, https://cdn.kqed.org/wp-content/uploads/sites/10/2024/06/042424_Therapy_CG-CM-14-copy-160x107.jpg 160w, https://cdn.kqed.org/wp-content/uploads/sites/10/2024/06/042424_Therapy_CG-CM-14-copy-1536x1024.jpg 1536w, https://cdn.kqed.org/wp-content/uploads/sites/10/2024/06/042424_Therapy_CG-CM-14-copy.jpg 1568w\" sizes=\"(max-width: 800px) 100vw, 800px\">\u003cfigcaption class=\"wp-caption-text\">Therapist Jennifer Alexander listens to Nelson during a treatment session. She called workers’ comp a ‘total system breakdown.’ \u003ccite>(Cristian Gonzalez for CalMatters)\u003c/cite>\u003c/figcaption>\u003c/figure>\n\u003cp>Michael Dworsky, a senior economist at the research institute RAND and one of the study’s project leaders, called workers’ comp “challenging and bureaucratic.”\u003c/p>\n\u003cp>“Even if the claim is accepted, there can be disputes about the medical necessity of individual bills. Just because your claim is accepted, doesn’t mean you are done fighting with the insurance company,” he said.\u003c/p>\n\u003ch2>A presumption of pain but still a tangled web\u003c/h2>\n\u003cp>Employers in California must provide workers’ comp insurance that will pay for medical costs when a worker is injured on the job. However, in reality, workers’ comp, which serves 16 million Californians, can be ungainly, confusing and, sometimes, no help at all. The system, administered by the state Department of Industrial Relations, is massive: In 2022, almost \u003ca href=\"https://www.dir.ca.gov/CHSWC/Reports/2023/CHSWC_AnnualReport2023.pdf\">750,000 workers’ comp claims (PDF)\u003c/a> were filed statewide.\u003c/p>\n\u003cp>When a firefighter requests coverage for medical treatment, insurance adjusters review the case to determine if it’s medically necessary. If the claim is denied, delayed or modified, a patient may request an independent medical review by so-called “ghost doctors” who review the case.\u003c/p>\n\u003cp>Systemwide in California, patients who appeal their denied workers’ comp claims, don’t fare well: Last year 3,238 appeals for mental health claims were filed, but workers’ comp officials rejected three-quarters of them, about the same as the 10-year average, according to data from the Department of Industrial Relations requested by CalMatters. (Agency officials said they could not provide data on claims from first responders.)\u003c/p>\n\u003cp>\u003c!-- iframe plugin v.4.3 wordpress.org/plugins/iframe/ -->\u003cbr>\n\u003ciframe loading=\"lazy\" src=\"https://datawrapper.dwcdn.net/9hnJM/4/\" width=\"800\" height=\"600\" scrolling=\"yes\" class=\"iframe-class\" frameborder=\"0\">\u003c/iframe>\u003c/p>\n\u003cp>For decades, the California Legislature has wrestled with how to fix workers’ comp — in one year alone, lawmakers proposed nearly two dozen bills.\u003c/p>\n\u003cp>In 2020 lawmakers took a major step, adding a \u003ca href=\"https://digitaldemocracy.calmatters.org/hearings/256803?t=1347&f=e8036f39579fee812f324253b5cb224b\">legal \u003c/a>\u003ca href=\"https://digitaldemocracy.calmatters.org/bills/ca_202320240sb623\">shortcut or “presumption”\u003c/a> to the\u003cstrong> \u003c/strong>state\u003cstrong> \u003c/strong>labor code, stipulating that firefighters and other first responders are considered at high risk for PTSD in the course of doing their job.\u003c/p>\n\u003cp>That means first responders no longer carry the burden of proving their illness is work-related. However, a claims adjuster can still question the diagnosis or assert that the trauma was caused by other factors, such as military service or family events. A law enacted last year \u003ca href=\"https://digitaldemocracy.calmatters.org/bills/ca_202320240sb623\">extended the presumption to 2029\u003c/a>.\u003c/p>\n\u003cp>In practice, experts say that, despite the law, proving a mental health claim is still almost as difficult to overcome as the psychological injury itself. Break an arm while fighting a wildfire, and, backed up by x-rays, claims are approved. But break your mind after decades of exposure to on-the-job trauma? Prepare for battle.\u003c/p>\n\u003cp>Before enacting the law, state officials asked RAND researchers to report on the scope of the problem. They analyzed nearly 6 million claims filed between 2008 through 2019 and interviewed dozens of experts, including a representative sample of 13 first responders.\u003c/p>\n\u003cp>The researchers found a consistent and troubling trend among the 13: “Nearly all workers said that they had filed a workers’ compensation claim for their mental health conditions — yet almost none received PTSD care paid for by workers’ compensation.”\u003c/p>\n\u003cp>Paying out of pocket “caused severe financial strain in some cases. Some were eventually reimbursed by workers’ compensation, but only after litigation and substantial delay. Some who pursued care through workers’ compensation also noted that claim denials led to delays in the start of mental health treatment,” the RAND researchers wrote.\u003c/p>\n\u003cp>The 13 first responders they surveyed stressed “over and over again about self-pay and barriers,” said \u003ca href=\"https://www.rand.org/about/people/q/quigley_denise_d.html\">Denise D. Quigley, a RAND senior policy researcher\u003c/a> who was a project leader on the study. “It’s not like we heard it once or twice, we heard it over and over again. It’s highly unlikely that we talked to the (only) people in California that had this happen.”\u003c/p>\n\u003cp>Firefighters told of borrowing money from family members and taking out home equity loans to pay for care, Quigley said. The litany of their struggle weighed on her team. “It’s difficult to hear people break down crying while talking to us because of all the things they’ve seen.”\u003c/p>\n\u003cp>According to the RAND research, for the 12-year period from 2008 through 2019, before the new law took effect:\u003c/p>\n\u003cul>\n\u003cli>Firefighters and other first responders were about twice as likely to file PTSD claims as the general workforce — but the numbers are small, under 1% of all workers’ comp claims.\u003c/li>\n\u003c/ul>\n\u003cul>\n\u003cli>Firefighters’ PTSD claims were denied more often than claims of other workers: About 24% were denied, compared to about 19% of PTSD claims for all workers, including those in high-stress occupations. About a quarter of firefighter claims for all mental health conditions were denied.\u003c/li>\n\u003c/ul>\n\u003cul>\n\u003cli>Their PTSD claims were denied at more than twice the rate of their other presumptive medical conditions related to their jobs, such as hernias and back injuries. Even their cancer and heart disease claims were accepted at a higher rate than PTSD.\u003c/li>\n\u003c/ul>\n\u003cul>\n\u003cli>These denial rates were calculated using a sample of only 258 PTSD claims filed by firefighters. But researcher Dworsky said the total number of claims is far higher, about 1,000, with about 230 claims denied, during those 12 years. And countless other firefighters who suffer from PTSD didn’t seek care through workers’ comp.\u003c/li>\n\u003c/ul>\n\u003cp>The RAND report was the most detailed look at the inequities between how physical and mental health are treated among firefighters and how first responders’ claims were handled compared to other workers. However, the researchers struggled with incomplete data and difficulty identifying which claims were from firefighters.\u003c/p>\n\u003cp>Quigley said she is frustrated that no one since has tracked whether the 4-year-old presumption law — known as the Trauma Treatment Act — has helped patients and improved the system.\u003c/p>\n\u003cp>Many therapists say they haven’t seen much, if any, improvement. Nelson’s therapist, Alexander, called workers’ comp a “total system breakdown.”\u003c/p>\n\u003cp>A spokesman for the Department of Industrial Relations refused to grant interview requests from CalMatters or answer questions or provide data about firefighters’ mental health claims.\u003c/p>\n\u003ch2>Navigating the system\u003c/h2>\n\u003cp>During his 28 years with Cal Fire fighting wildfires in combustible regions, such as the Napa Valley and the Sierra Nevada foothills, and responding to other emergencies, Nelson never reported any mental health issues to anyone. Not once. Even as he would regularly pull his truck off the side of the road during wildfires and weep. Even after responding to the scene of traffic accidents, extricating children from crushed cars as their parents fought to get to them. Even after answering a call to a suicide to find a man hanging from the rafters in his barn. Even after the unbidden images began to intrude with greater frequency.\u003c/p>\n\u003cp>Instead, his mantra became “I’m good.”\u003c/p>\n\u003cp>That stoicism, common among first responders, short circuits the insurance system designed to help them — a system that works best with prompt reporting and meticulous documentation.\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"content": "\u003cdiv class=\"post-body\">\u003cp>Claims adjusters usually handle clear-cut cases where the date of injury can be pinpointed. More common among PTSD claims, though, is Nelson’s experience with cumulative trauma, with no paper trail of injuries or complaints. He can’t offer a single event as the origin of his trauma and no coherent chronology. Cal Fire folks tend to wait until their dam bursts before asking for the water to be turned off.\u003c/p>\n\u003cp>One Southern California mental health provider told the RAND researchers that firefighters and police officers typically have severe cases of trauma.\u003c/p>\n\u003cp>“On the clinical side, as a mental health provider, it is not realistic to expect a firefighter or a police officer to come in and have had a little trauma or some minor stress condition … Most departments have people with a lot of stress and trauma,” the therapist said. “Just because you had something happen recently, the straw that broke the camel’s back, it is really the cumulative stress that is the issue.”\u003c/p>\n\u003cp>Now retired, Nelson, 54, has been fighting for workers’ compensation for almost three years, since his suicide attempt on the Placer County bridge. He and his wife already have spent more than $10,000 out of pocket for medical care and could face thousands more in legal bills.\u003c/p>\n\u003cp>Nelson’s case is unusually severe and complex, requiring two extended stays in a facility that specifically treats firefighters to diagnose his conditions and finally set him on a treatment path of therapy and multiple medications.\u003c/p>\n\u003cp>Cal Fire Battalion Chief Brad Niven said he has more than a dozen firefighter friends who have had similar experiences.\u003c/p>\n\u003cp>“Talk to anybody that tries to do anything through workers’ comp — it is an absolute nightmare,” he said. “Everybody knows you file your first workers’ comp claim and they will deny it. One guy I worked with went through the works with them. He had to prove beyond a shadow of a doubt that you have problems. You have to relive everything you’ve gone through. It does not make for a friendly system.”\u003c/p>\n\u003cfigure id=\"attachment_11992262\" class=\"wp-caption alignnone\" style=\"max-width: 800px\">\u003cimg loading=\"lazy\" decoding=\"async\" class=\"size-medium wp-image-11992262\" src=\"https://cdn.kqed.org/wp-content/uploads/sites/10/2024/06/060822_BRAD_NIVEN_CALFIRE_JH_CM_37-copy-800x533.jpg\" alt=\"\" width=\"800\" height=\"533\" srcset=\"https://cdn.kqed.org/wp-content/uploads/sites/10/2024/06/060822_BRAD_NIVEN_CALFIRE_JH_CM_37-copy-800x533.jpg 800w, https://cdn.kqed.org/wp-content/uploads/sites/10/2024/06/060822_BRAD_NIVEN_CALFIRE_JH_CM_37-copy-1020x680.jpg 1020w, https://cdn.kqed.org/wp-content/uploads/sites/10/2024/06/060822_BRAD_NIVEN_CALFIRE_JH_CM_37-copy-160x107.jpg 160w, https://cdn.kqed.org/wp-content/uploads/sites/10/2024/06/060822_BRAD_NIVEN_CALFIRE_JH_CM_37-copy-1536x1024.jpg 1536w, https://cdn.kqed.org/wp-content/uploads/sites/10/2024/06/060822_BRAD_NIVEN_CALFIRE_JH_CM_37-copy.jpg 1568w\" sizes=\"(max-width: 800px) 100vw, 800px\">\u003cfigcaption class=\"wp-caption-text\">Cal Fire Battalion Chief Brad Niven, shown at his home in Sonora, said he and more than a dozen firefighter friends have had trouble getting workers’ comp to pay their claims for mental health treatment. \u003ccite>(Julie Hotz for CalMatters)\u003c/cite>\u003c/figcaption>\u003c/figure>\n\u003cp>Niven considered suicide before Cal Fire’s employee support personnel helped him find a therapist, streamlining what had been a hit-and-miss process.\u003c/p>\n\u003cp>“They blasted away the stumbling blocks,” he said. But the fire agency does not make the decision to approve or deny a claim or handle the bureaucratic thicket that is workers’ comp.\u003c/p>\n\u003cp>Scott O’Mara, a \u003ca href=\"https://law1199.com/\">San Diego-based lawyer\u003c/a> whose firm represents first responders, said adjusters’ training is to look for what they can develop to deny the case. “Their goal is to contain and control cost,” he said. “We do a lot of cases where the compensation is nickels.”\u003c/p>\n\u003cp>Although California law now considers PTSD for first responders a presumption, it is a “disputable presumption.” That means claims administrators can consider other traumatic events in a firefighter’s life that may play a role in a PTSD case.\u003c/p>\n\u003cp>“With cumulative trauma, or stress over the course of their entire employment, we need to request more information from the doctor so that we can see it isn’t because they were in the military or they are going through a divorce, etc.,” one claims adjuster told RAND researchers.\u003c/p>\n\u003cp>The complexity of the system wears down the resistance of injured workers, who need a jungle guide to find their way at a time of profound pain and disorientation.\u003c/p>\n\u003cp>“They can’t navigate this on their own, they really can’t. They’ve got professional litigators opposing them,” said Richard Elder, a \u003ca href=\"https://www.elderandberg.com/attorney/richard-e-elder-jr/\">workers’ comp lawyer\u003c/a> in Concord who regularly represents state firefighters. “The average claims adjuster on the job for more than a month knows more about the system than the average firefighter. They’ve got lawyers on speed dial. The injured worker is adrift. It’s like a do-it-yourself heart transplant.”\u003c/p>\n\u003cp>Elder, who has been in practice for 54 years, used to work as an insurance company claims adjuster. The system, he said, has always been adversarial.\u003c/p>\n\u003cp>“It’s against the law for employers to discriminate against a worker who files a psyche claim. But they do discriminate,” said Elder, who said in the past five decades he has pursued about 500 psychiatric claims.\u003c/p>\n\u003cp>“I just filed a psychiatric claim and the response was ‘give us a list of every medical facility that treated the claimant in the last 10 years,’” he said. “The workers’ comp medical treatments system is a stain upon the soul of the politicians and officials of California.”\u003c/p>\n\u003ch2>Diagnosing PTSD is ‘a complicated process’\u003c/h2>\n\u003cp>One day in March, Nelson sat next to his wife, Leticia, in a quiet room in a Nevada City library near their rental home. He was in the grips of a seizure, brought on by retelling his firefighting nightmares to a CalMatters reporter. His hands were clenched and his torso taut. He stuttered, his eyelids fluttering. The episode lasted a few minutes.\u003c/p>\n\u003cp>During the interview, Nelson was fidgety, his thick fingers constantly worrying about the items he had put on the table in front of him. One was a tiny aluminum cylinder containing medication for his seizures, another was a brass medallion, the iconic firefighter symbols of an ax and firehose nozzle stamped on one side and the serenity prayer on the other.\u003c/p>\n\u003cp>The coin was a kind of talisman given to him after graduating from a \u003ca href=\"https://www.iaffrecoverycenter.com/\">specialized rehab clinic \u003c/a>for firefighters, where he was given his daunting medical diagnosi\u003cem>s: \u003c/em>He suffers from complex PTSD, \u003ca href=\"https://my.clevelandclinic.org/health/diseases/24517-psychogenic-nonepileptic-seizure-pnes\">psychogenic non-epileptic seizures\u003c/a> and dissociative identity disorder.\u003c/p>\n\u003cp>Such anxiety-induced seizures are unusual but not rare, his therapist said, and the totality of Nelson’s mental health issues makes his case unusually severe. Weekly therapy sessions and multiple medications have tempered, but not extinguished, his struggle with crippling anxiety.\u003c/p>\n\u003cp>Nelson wears a medical alert wrist bracelet intended to give first responders a bare-bones outline of his conditions and which medications to avoid when he is experiencing an anxiety-induced seizure. In his back pocket, he carries, always, a medical card with his list of red flags, so extensive that it unspools like an accordion.\u003c/p>\n\u003cp>His seizures may occur several times a day. Some last for hours. Nelson’s usually benign aspect changes: His eyes cross, his hands clench into what he calls “spidey fingers.” He stumbles and stutters through sentences and repeats words, often losing his ability to speak at all. At times he drags his head and face along walls. Leticia Nelson describes the seizures as his body undergoing earthquakes.\u003c/p>\n\u003cfigure id=\"attachment_11992264\" class=\"wp-caption alignnone\" style=\"max-width: 800px\">\u003cimg loading=\"lazy\" decoding=\"async\" class=\"size-medium wp-image-11992264\" src=\"https://cdn.kqed.org/wp-content/uploads/sites/10/2024/06/031924_Todd-Nelson_LE_CM-25-copy-800x533.jpg\" alt=\"\" width=\"800\" height=\"533\" srcset=\"https://cdn.kqed.org/wp-content/uploads/sites/10/2024/06/031924_Todd-Nelson_LE_CM-25-copy-800x533.jpg 800w, https://cdn.kqed.org/wp-content/uploads/sites/10/2024/06/031924_Todd-Nelson_LE_CM-25-copy-1020x680.jpg 1020w, https://cdn.kqed.org/wp-content/uploads/sites/10/2024/06/031924_Todd-Nelson_LE_CM-25-copy-160x107.jpg 160w, https://cdn.kqed.org/wp-content/uploads/sites/10/2024/06/031924_Todd-Nelson_LE_CM-25-copy-1536x1024.jpg 1536w, https://cdn.kqed.org/wp-content/uploads/sites/10/2024/06/031924_Todd-Nelson_LE_CM-25-copy.jpg 1568w\" sizes=\"(max-width: 800px) 100vw, 800px\">\u003cfigcaption class=\"wp-caption-text\">The emergency medical ID card that Nelson carries with him. \u003ccite>(Loren Elliott for CalMatters)\u003c/cite>\u003c/figcaption>\u003c/figure>\n\u003cfigure id=\"attachment_11992266\" class=\"wp-caption alignnone\" style=\"max-width: 800px\">\u003cimg loading=\"lazy\" decoding=\"async\" class=\"size-medium wp-image-11992266\" src=\"https://cdn.kqed.org/wp-content/uploads/sites/10/2024/06/031924_Todd-Nelson_LE_CM-14-copy-800x533.jpg\" alt=\"\" width=\"800\" height=\"533\" srcset=\"https://cdn.kqed.org/wp-content/uploads/sites/10/2024/06/031924_Todd-Nelson_LE_CM-14-copy-800x533.jpg 800w, https://cdn.kqed.org/wp-content/uploads/sites/10/2024/06/031924_Todd-Nelson_LE_CM-14-copy-1020x680.jpg 1020w, https://cdn.kqed.org/wp-content/uploads/sites/10/2024/06/031924_Todd-Nelson_LE_CM-14-copy-160x107.jpg 160w, https://cdn.kqed.org/wp-content/uploads/sites/10/2024/06/031924_Todd-Nelson_LE_CM-14-copy-1536x1024.jpg 1536w, https://cdn.kqed.org/wp-content/uploads/sites/10/2024/06/031924_Todd-Nelson_LE_CM-14-copy.jpg 1568w\" sizes=\"(max-width: 800px) 100vw, 800px\">\u003cfigcaption class=\"wp-caption-text\">Nelson alongside his wife, Leticia Nelson, near their Nevada City home. She said it’s been agonizing to see him suffer mental health problems related to his job and have to fight the system to get his treatment paid for. ‘We sacrificed our time with him so that he could help the whole state. And nothing has been there for the family since this happened. Nothing.’ \u003ccite>(Loren Elliott for CalMatters)\u003c/cite>\u003c/figcaption>\u003c/figure>\n\u003cp>Nelson’s unusual body movements during a seizure, his inability to respond to questions and his propensity to run away when confronted puts Nelson in a precarious place in airport lines or with law enforcement, where his non-response has been misconstrued as defiance.\u003c/p>\n\u003cp>Even doctors can misunderstand. Diagnosing and treating PTSD and acute trauma like Nelson’s is notoriously difficult.\u003c/p>\n\u003cp>“Diagnosing PTSD is a complicated process. Diagnostic criteria are complicated,” said Sidra Goldman-Mellor, a \u003ca href=\"https://publichealth.ucmerced.edu/content/sidra-goldman-mellor\">UC Merced psychiatric epidemiologist\u003c/a> who studies depression and suicidal behavior. “Your average primary care clinician is probably not willing to go down that road.”\u003c/p>\n\u003cp>For patients like Nelson, any number of stress-related disorders present themselves and muddy a specific diagnosis that would satisfy a claims adjuster or a workers’ comp review.\u003c/p>\n\u003cp>“That’s the thing with psychiatric disorders, we don’t have a lot of objective measures for a mental health diagnosis. We don’t have blood tests and we don’t have MRIs,” Goldman-Mellor said. “They (mental health issues) are harder to recognize, harder to test for and easier to ignore.”\u003c/p>\n\u003cp>However, firefighters cannot move easily through the workers’ comp or medical insurance system if they don’t have a diagnosis. Constantly proving your pain becomes its own trauma.\u003c/p>\n\u003cp>“He has to prove his world is falling apart,” Leticia Nelson said. “It’s hard to explain to someone that you are broken. They look at you, they think that you look fine. They can’t see in your brain. They can’t see in your mind.”\u003c/p>\n\u003cp>It took four years for Nelson to find the right medical care. One physician’s therapeutic approach was to ask the former firefighter to pray with him.\u003c/p>\n\u003cp>The problem was much more fundamental than finding a compatible therapist: He could not \u003cem>find\u003c/em> one to take his case. Many Cal Fire employees are stationed in rural or remote areas of the state, in communities underserved by health care specialists.\u003c/p>\n\u003cp>Living in rural Nevada County, Nelson faces a barren mental health desert where it’s difficult to find a competent therapist who might have worked with other first responders and understands the specific challenges of the high-stress job.\u003c/p>\n\u003cp>“It’s an absolute specialization. There’s not near enough of us,” said Alexander, Nelson’s therapist. (Nelson granted her permission to speak about his case.) “In the larger Sacramento area, there are less than a dozen competent providers.”\u003c/p>\n\u003cfigure id=\"attachment_11992268\" class=\"wp-caption alignnone\" style=\"max-width: 800px\">\u003cimg loading=\"lazy\" decoding=\"async\" class=\"size-medium wp-image-11992268\" src=\"https://cdn.kqed.org/wp-content/uploads/sites/10/2024/06/042424_Therapy_CG-CM-09-copy-800x533.jpg\" alt=\"\" width=\"800\" height=\"533\" srcset=\"https://cdn.kqed.org/wp-content/uploads/sites/10/2024/06/042424_Therapy_CG-CM-09-copy-800x533.jpg 800w, https://cdn.kqed.org/wp-content/uploads/sites/10/2024/06/042424_Therapy_CG-CM-09-copy-1020x680.jpg 1020w, https://cdn.kqed.org/wp-content/uploads/sites/10/2024/06/042424_Therapy_CG-CM-09-copy-160x107.jpg 160w, https://cdn.kqed.org/wp-content/uploads/sites/10/2024/06/042424_Therapy_CG-CM-09-copy-1536x1024.jpg 1536w, https://cdn.kqed.org/wp-content/uploads/sites/10/2024/06/042424_Therapy_CG-CM-09-copy.jpg 1568w\" sizes=\"(max-width: 800px) 100vw, 800px\">\u003cfigcaption class=\"wp-caption-text\">Nelson recalls memories of his time as a firefighter during a treatment session. \u003ccite>(Cristian Gonzalez for CalMatters)\u003c/cite>\u003c/figcaption>\u003c/figure>\n\u003cp>Cal Fire is self-insured and offers medical coverage through private companies. The agency does not manage medical claims or workers’ comp but does have programs to assist employees in finding care.\u003c/p>\n\u003cp>Rob Wheatley, staff chief of Cal Fire’s Behavioral Health and Wellness Program, told CalMatters in an email that the agency has expanded support for employees who seek help for mental health issues with peer counseling or referrals for treatment. The agency has a staff of 28 assisting about 12,000 employees.\u003c/p>\n\u003cp>But Wheatley and other Cal Fire officials refused to grant an interview and did not answer CalMatters’ questions about the problems that their employees face with workers’ comp and mental health issues.\u003c/p>\n\u003cp>“Any denial of a mental health claim is concerning,” Wheatley said in the email.\u003c/p>\n\u003ch2> Can the system be repaired?\u003c/h2>\n\u003cp>The Nelsons have seen the insurance and workers’ comp system from the inside, been batted around by it and, they would say, abandoned by it. Still, they have few suggestions for fixing it.\u003c/p>\n\u003cp>They are not alone. Lawyers say that the system is based on how to save money, is too often adversarial and deeply entrenched.\u003c/p>\n\u003cp>Even the employers who participate in the workers’ comp system say it’s not working well. In a recent survey, more than half of the respondents said the system performs poorly, while 42% described the system as challenged but adequate.\u003c/p>\n\u003cp>“Nobody believes it’s ideal,” said Jerry Azevedo, a spokesman for the \u003ca href=\"https://www.workcompaction.org/\">Workers’ Compensation Action Network,\u003c/a> a coalition of California insurers, employers and agents advocating to improve the system. “Every constituency has complaints.”\u003c/p>\n\u003cp>Azevedo said California’s workers’ comp system, which has been in place since 1913, is plagued by \u003ca href=\"https://information.auditor.ca.gov/pdfs/reports/2019-106.pdf\">persistent problems\u003c/a>: high costs to operate, huge claim volume, frequent litigation, slow claim resolution and fraud and abusive practices.\u003c/p>\n\u003cp>“The fundamental challenge we all contend with is complexity. California’s system is arguably the most complex in the nation,” Azevedo said. The good news, he said, is that 86% of workers’ comp claims overall are accepted, according to the California Workers’ Compensation Institute.\u003c/p>\n\u003cp>It’s easy to get the sense of a general throwing up of hands. The state Commission on Health & Safety & Workers’ Comp dedicates a \u003ca href=\"https://www.dir.ca.gov/chswc/WCReformsPage1.htm\">webpage to tracking workers’ comp reforms\u003c/a>, but the last entry was in 2012.\u003c/p>\n\u003cp>Sean Cooper, executive vice president and chief actuary of the \u003ca href=\"https://www.wcirb.com/\">Workers’ Compensation Insurance Rating Bureau of California\u003c/a>, said the system is groaning under its own weight — there are a lot of people filing claims and a lot of lawyers on all sides.\u003c/p>\n\u003cp>Administrative costs are high in California: The cost to deliver $1 of medical benefit from California’s workers’ comp system is 46 cents, compared to two cents for Medicare, 19 cents for private group health insurance and 25 cents for the national state median for workers’ comp according to the group’s 2023 report.\u003c/p>\n\u003cp>One way to fix the inequity is to turn the system on its head, said Cruz of the \u003ca href=\"https://namica.org/\">National Alliance on Mental Illness\u003c/a>.\u003c/p>\n\u003cp>“There is a disparity about how we treat, respond and react to behavioral health versus physical health,” she said. “Maybe we need to start talking about that disparity in workers’ comp. When you have (a claims) approval rating that is flipped on its backside, that’s an obvious parity issue.”\u003c/p>\n\u003cp>Legislators, when they turn their gaze to the massive program, chip away at the edges. The law extending the PTSD presumption will be revisited when the state Commission on Health and Safety and Workers’ Compensation presents its report on claims and denials to the Senate Committee on Labor, Public Employment and Retirement and the Assembly Committee on Insurance, by the end of this year.\u003c/p>\n\u003cp>Cruz said there is more legislative focus on behavioral health than ever, but there are limits, beginning with which groups carry the most influence. Managed health care companies are powerful advocates of the status quo, she said. “We are David and Goliath when we come up against these folks.”\u003c/p>\n\u003cp>“So many great people want to do wonderful things and they have big ideas, but it gets chopped down to a Band-Aid once everyone gets what they want,” she said.\u003c/p>\n\u003ch2>‘A slap in the face to all of us’\u003c/h2>\n\u003cp>Leticia Nelson refers to herself, with only slight exaggeration, as her husband’s “service dog.”\u003c/p>\n\u003cp>She’s the keeper of the couple’s appointment schedule; she’s the chauffeur; and the manager of the financial spreadsheet. And it falls to Leticia to devote untold hours on the phone with insurers and medical providers, bird-dogging bills, late payments and coverage lapses.\u003c/p>\n\u003cp>She has watched her husband humiliated, scared and angry. Their two adult daughters, also have been treated for PTSD, after witnessing their father’s anxiety and mania, and knowing about his suicide attempts.\u003c/p>\n\u003cp>At times, Leticia Nelson said, “I’m mad at God.”\u003c/p>\n\u003cfigure id=\"attachment_11992269\" class=\"wp-caption alignnone\" style=\"max-width: 800px\">\u003cimg loading=\"lazy\" decoding=\"async\" class=\"size-medium wp-image-11992269\" src=\"https://cdn.kqed.org/wp-content/uploads/sites/10/2024/06/031924_Todd-Nelson_LE_CM_21-copy-800x533.jpg\" alt=\"\" width=\"800\" height=\"533\" srcset=\"https://cdn.kqed.org/wp-content/uploads/sites/10/2024/06/031924_Todd-Nelson_LE_CM_21-copy-800x533.jpg 800w, https://cdn.kqed.org/wp-content/uploads/sites/10/2024/06/031924_Todd-Nelson_LE_CM_21-copy-1020x680.jpg 1020w, https://cdn.kqed.org/wp-content/uploads/sites/10/2024/06/031924_Todd-Nelson_LE_CM_21-copy-160x107.jpg 160w, https://cdn.kqed.org/wp-content/uploads/sites/10/2024/06/031924_Todd-Nelson_LE_CM_21-copy-1536x1024.jpg 1536w, https://cdn.kqed.org/wp-content/uploads/sites/10/2024/06/031924_Todd-Nelson_LE_CM_21-copy.jpg 1568w\" sizes=\"(max-width: 800px) 100vw, 800px\">\u003cfigcaption class=\"wp-caption-text\">Retired Cal Fire firefighter Todd Nelson walks with his wife in Nevada City. Nelson suffers from post-traumatic stress disorder resulting from the trauma experienced during his firefighting career. \u003ccite>(Loren Elliott for CalMatters)\u003c/cite>\u003c/figcaption>\u003c/figure>\n\u003cp>The Nelsons, lifelong Californians, want to leave the state and its frightening tableau of wildfires. They sold their house, changed their mind about moving and now are financially shut out of the real estate market, especially because of the high cost of fire insurance in the foothills where they live. They are nomads, shuttling between Airbnbs with two large dogs and three cats in tow and their possessions in storage.\u003c/p>\n\u003cp>Money is tight. Leticia would like to go back to work, but she can’t leave Todd alone.\u003c/p>\n\u003cp>Nelson gave up fighting the state over a disability claim after his attorney told him that an appeal would cost $50,000 — and he would lose because he didn’t claim a disability when he retired.\u003c/p>\n\u003cp>“It’s a slap in the face to all of us because we sacrificed as a family,” Leticia Nelson said of Todd’s long career with Cal Fire. “We sacrificed our time with him so that he could help the whole state. And nothing has been there for the family since this happened. Nothing.\u003c/p>\n\u003cp>“I wish that there’s things in place that would guide us that wouldn’t be so hard. But it just seems like we hit every, every obstacle possible. We’re struggling. We need help. We need to be seen. We need to be treated like humans and not criminals.”\u003c/p>\n\u003cp>For his part, Nelson is coming to terms with the devastation his career wrought. Yet, years after retirement, he still listens to an emergency scanner and shows up at fires in his area, wearing his T-shirt, shorts and Birkenstocks. The pull to serve remains strong.\u003c/p>\n\u003cp>“The crazy thing is I miss my job. I miss it every day. I would do it all over again,” he said wistfully. “I loved the job but I didn’t realize the damage being done.”\u003c/p>\n\u003cp>\u003cem>If you are having suicidal thoughts, you can get help from the National Suicide Prevention Lifeline by calling 988 or visiting \u003c/em>\u003ca href=\"https://suicidepreventionlifeline.org/\">\u003cem>https://suicidepreventionlifeline.org\u003c/em>\u003c/a>\u003c/p>\n\u003cp>\u003cem>This story also was made possible in part by a grant from the \u003ca href=\"https://amarkfoundation.org/\">A-Mark Foundation\u003c/a>.\u003c/em>\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"content": "\u003cp>California’s latest effort to legalize psychedelic substances for therapeutic purposes has tripped up.\u003c/p>\n\u003cp>A \u003ca href=\"https://leginfo.legislature.ca.gov/faces/billTextClient.xhtml?bill_id=202320240SB803\">bipartisan bill\u003c/a> that would have allowed three counties — San Francisco, San Diego and Santa Cruz — to operate facilities for three years where veterans and former first responders could use psilocybin, or psychedelic mushrooms, under the supervision of a licensed physician died in committee on Tuesday.\u003c/p>\n\u003cp>Sen. John Becker (D-Menlo Park) and Sen. Brian Jones (R-San Diego) recently put Senate Bill 803 forward after a \u003ca href=\"https://www.kqed.org/science/1992363/as-california-seeks-to-legalize-psychedelics-for-therapeutic-use-oregon-provides-key-lessons\">broader bill\u003c/a> aiming to legalize psychedelic substances also \u003ca href=\"https://www.kqed.org/science/1992997/advocates-for-legalized-psychedelics-in-california-plan-a-ballot-measure-push\">died in committee last month\u003c/a>. The authors pulled SB 803, titled the \u003cem>Heal Our Heroes Act\u003c/em>, after it appeared headed for a ‘no’ vote.\u003c/p>\n\u003cp>“While the Heal Our Heroes Act will not advance in the Assembly Health Committee, it has raised awareness of the work-related trauma and troubling mental health issues our veterans and first responders face after honorably serving our state and country,” Becker said in a statement to KQED. “More than 17 veterans die by suicide each week. This is unacceptable. Our heroes deserve the best care possible.”\u003c/p>\n\u003cp>SB 803 was the fourth major effort by state lawmakers in recent years to create legal access to psychedelics for therapeutic use.\u003c/p>\n\u003cp>[ad fullwidth]\u003c/p>\n\u003cp>“The Legislature has again failed veterans, first responders and the 130,000 veteran families that have lost a loved one to suicide,” said Jesse Gould, founder of Heroic Hearts Project, a nonprofit which works to further the acceptance of psychedelic therapies for veterans. “We applaud the legislators that supported SB 803 and its previous iterations, and are undeterred in our fight to find effective solutions to reduce veteran suicide and the veteran mental health crisis.”\u003c/p>\n\u003cp>Assembly Health Committee Chair Mia Bonta vowed to keep the issue top-of-mind.\u003c/p>\n\u003cp>“It may well be that psychedelics have the potential to provide significant mental health benefits for those experiencing Post-Traumatic Stress Disorder. However, it is also crucial to provide a medical and therapeutic pathway with robust and meaningful regulation so California can be a beacon of leadership on this form of care,” Bonta said in a prepared statement. “This issue will undoubtedly remain top of mind for me as I seek to ensure all Californians can access the safest and most effective care possible.”\u003c/p>\n\u003cp>At the local level, cities including Berkeley, Oakland, San Francisco and Santa Cruz have voted to effectively decriminalize psychedelic mushrooms by de-prioritizing law enforcement and penalties for possession and use of the substances.\u003c/p>\n\u003cp>But the push to regulate psychedelics has been an uphill battle in the Golden State, where it is illegal to possess, cultivate and sell psilocybin and psilocin.\u003c/p>\n\u003cp>In 2023, Gov. Gavin Newsom vetoed a broad bill aiming to decriminalize psychedelic substances. In his veto, the governor asked lawmakers to come back with a bill \u003ca href=\"https://www.kqed.org/science/1992363/as-california-seeks-to-legalize-psychedelics-for-therapeutic-use-oregon-provides-key-lessons\">similar to a model already used in Oregon\u003c/a>, the first state in the U.S. to pass a regulatory framework for the use of psychedelic mushrooms.\u003c/p>\n\u003cp>The bill lawmakers came back with, authored by Sen. Scott Wiener (D-San Francisco), would have approved service centers where people could use magic mushrooms, MDMA and mescaline for therapeutic purposes. That bill died in committee in May.\u003c/p>\n\u003cp>Advocates for therapeutic uses of psychedelics said they are seeking to put the issue in voters’ hands in 2026.\u003c/p>\n\u003cp>\u003ca href=\"https://www.kqed.org/news/11990945/uc-berkeley-launches-landmark-study-how-exactly-do-magic-mushrooms-alter-the-brain\">A small but growing body of research\u003c/a> shows that using magic mushrooms can help with certain mental health challenges like \u003ca href=\"https://pubmed.ncbi.nlm.nih.gov/37844352/\">anxiety and depression\u003c/a>. However, studies have also shown a small portion of people have negative experiences using psychedelics, including anxiety and suicidal thoughts, particularly with recreational use outside of a controlled setting.\u003c/p>\n\u003cp>\u003c/p>\n\u003cp>\u003cem>This story has been updated.\u003c/em>\u003c/p>\n\n",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003cp>California’s latest effort to legalize psychedelic substances for therapeutic purposes has tripped up.\u003c/p>\n\u003cp>A \u003ca href=\"https://leginfo.legislature.ca.gov/faces/billTextClient.xhtml?bill_id=202320240SB803\">bipartisan bill\u003c/a> that would have allowed three counties — San Francisco, San Diego and Santa Cruz — to operate facilities for three years where veterans and former first responders could use psilocybin, or psychedelic mushrooms, under the supervision of a licensed physician died in committee on Tuesday.\u003c/p>\n\u003cp>Sen. John Becker (D-Menlo Park) and Sen. Brian Jones (R-San Diego) recently put Senate Bill 803 forward after a \u003ca href=\"https://www.kqed.org/science/1992363/as-california-seeks-to-legalize-psychedelics-for-therapeutic-use-oregon-provides-key-lessons\">broader bill\u003c/a> aiming to legalize psychedelic substances also \u003ca href=\"https://www.kqed.org/science/1992997/advocates-for-legalized-psychedelics-in-california-plan-a-ballot-measure-push\">died in committee last month\u003c/a>. The authors pulled SB 803, titled the \u003cem>Heal Our Heroes Act\u003c/em>, after it appeared headed for a ‘no’ vote.\u003c/p>\n\u003cp>“While the Heal Our Heroes Act will not advance in the Assembly Health Committee, it has raised awareness of the work-related trauma and troubling mental health issues our veterans and first responders face after honorably serving our state and country,” Becker said in a statement to KQED. “More than 17 veterans die by suicide each week. This is unacceptable. Our heroes deserve the best care possible.”\u003c/p>\n\u003cp>SB 803 was the fourth major effort by state lawmakers in recent years to create legal access to psychedelics for therapeutic use.\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>“The Legislature has again failed veterans, first responders and the 130,000 veteran families that have lost a loved one to suicide,” said Jesse Gould, founder of Heroic Hearts Project, a nonprofit which works to further the acceptance of psychedelic therapies for veterans. “We applaud the legislators that supported SB 803 and its previous iterations, and are undeterred in our fight to find effective solutions to reduce veteran suicide and the veteran mental health crisis.”\u003c/p>\n\u003cp>Assembly Health Committee Chair Mia Bonta vowed to keep the issue top-of-mind.\u003c/p>\n\u003cp>“It may well be that psychedelics have the potential to provide significant mental health benefits for those experiencing Post-Traumatic Stress Disorder. However, it is also crucial to provide a medical and therapeutic pathway with robust and meaningful regulation so California can be a beacon of leadership on this form of care,” Bonta said in a prepared statement. “This issue will undoubtedly remain top of mind for me as I seek to ensure all Californians can access the safest and most effective care possible.”\u003c/p>\n\u003cp>At the local level, cities including Berkeley, Oakland, San Francisco and Santa Cruz have voted to effectively decriminalize psychedelic mushrooms by de-prioritizing law enforcement and penalties for possession and use of the substances.\u003c/p>\n\u003cp>But the push to regulate psychedelics has been an uphill battle in the Golden State, where it is illegal to possess, cultivate and sell psilocybin and psilocin.\u003c/p>\n\u003cp>In 2023, Gov. Gavin Newsom vetoed a broad bill aiming to decriminalize psychedelic substances. In his veto, the governor asked lawmakers to come back with a bill \u003ca href=\"https://www.kqed.org/science/1992363/as-california-seeks-to-legalize-psychedelics-for-therapeutic-use-oregon-provides-key-lessons\">similar to a model already used in Oregon\u003c/a>, the first state in the U.S. to pass a regulatory framework for the use of psychedelic mushrooms.\u003c/p>\n\u003cp>The bill lawmakers came back with, authored by Sen. Scott Wiener (D-San Francisco), would have approved service centers where people could use magic mushrooms, MDMA and mescaline for therapeutic purposes. That bill died in committee in May.\u003c/p>\n\u003cp>Advocates for therapeutic uses of psychedelics said they are seeking to put the issue in voters’ hands in 2026.\u003c/p>\n\u003cp>\u003ca href=\"https://www.kqed.org/news/11990945/uc-berkeley-launches-landmark-study-how-exactly-do-magic-mushrooms-alter-the-brain\">A small but growing body of research\u003c/a> shows that using magic mushrooms can help with certain mental health challenges like \u003ca href=\"https://pubmed.ncbi.nlm.nih.gov/37844352/\">anxiety and depression\u003c/a>. However, studies have also shown a small portion of people have negative experiences using psychedelics, including anxiety and suicidal thoughts, particularly with recreational use outside of a controlled setting.\u003c/p>\n\u003cp>\u003c/p>\n\u003cp>\u003cem>This story has been updated.\u003c/em>\u003c/p>\n\n\u003c/div>\u003c/p>",
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"slug": "uc-berkeley-launches-landmark-study-how-exactly-do-magic-mushrooms-alter-the-brain",
"title": "UC Berkeley Launches Landmark Study: How Exactly Do Magic Mushrooms Alter the Brain?",
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"content": "\u003cp>\u003cem>Updated 3 p.m. Tuesday\u003c/em>\u003c/p>\n\u003cp>Amid mounting efforts to legalize psychedelic drugs, UC Berkeley researchers will use neuroimaging to observe how psilocybin alters the brain — the university’s first human study involving a Schedule 1 substance.\u003c/p>\n\u003cp>While previous research has predominantly focused on the drug’s influence on clinical symptoms or human behavior, this study aims to uncover how the brain constructs reality under the influence of psilocybin, the psychoactive compound in magic mushrooms.\u003c/p>\n\u003cp>Healthy participants will ingest psilocybin and then perform simple perceptual tasks while activity in the part of the brain that processes visual information is recorded using functional magnetic resonance imaging, or fMRI.\u003c/p>\n\u003cp>[ad fullwidth]\u003c/p>\n\u003cp>“We have this incredible opportunity to characterize the psychedelic experience in real-time — while it’s happening — using modern neuroimaging methods,” Michael Silver, the director of the UC Berkeley Center for the Science of Psychedelics and the study’s lead investigator, said in a recent university \u003ca href=\"https://news.berkeley.edu/2024/06/11/psychedelics-change-how-we-see-the-world-a-uc-berkeley-study-aims-to-find-out-why/\">press release\u003c/a>. “Understanding the actions of psychedelics at a neuroscientific level will generate insights into how they’re working as medicines and will hopefully help us develop more effective treatments for mental health disorders.”\u003c/p>\n\u003cp>A growing \u003ca href=\"https://pubmed.ncbi.nlm.nih.gov/37844352/\">body of research\u003c/a> suggests psilocybin, when administered in controlled conditions with supportive therapy, is \u003ca href=\"https://www.kqed.org/science/1992997/advocates-for-legalized-psychedelics-in-california-plan-a-ballot-measure-push\">a promising treatment for psychiatric disorders\u003c/a> such as addiction and anxiety. Individuals suffering from long-term, debilitating depression have reported significant relief after a single session of psychedelic-assisted therapy.\u003c/p>\n\u003cp>Still, several recent attempts to reintroduce banned drugs into medical practice have hit roadblocks. Earlier this year, \u003ca href=\"https://leginfo.legislature.ca.gov/faces/billTextClient.xhtml?bill_id=202320240SB1012&search_keywords=mushrooms\">SB 1012\u003c/a>, a bill championed by Sen. Scott Wiener (D-San Francisco) to legalize psychedelic-assisted therapy, failed to advance to a full Senate vote. The \u003ca href=\"https://leginfo.legislature.ca.gov/faces/billAnalysisClient.xhtml?bill_id=202320240SB1012\">Senate analysis\u003c/a> indicated “unknown significant ongoing costs, likely ranging in the low millions of dollars,” a daunting prospect given the state’s \u003ca href=\"https://www.kqed.org/news/11986700/california-budget-deficit-forces-lawmakers-to-shelve-bills-on-psychedelic-therapy-reparations\">projected $56 billion budget deficit\u003c/a>.[aside postID=science_1992363 hero='https://cdn.kqed.org/wp-content/uploads/sites/35/2024/04/GettyImages-1449327777-1020x680.jpg']Last year, Gov. Gavin Newsom vetoed a bill to decriminalize the possession and personal use of hallucinogenic drugs, citing the need for more rigorous guidelines to ensure safe use. Similarly, this spring, federal health advisors decisively rejected \u003ca href=\"https://www.kqed.org/forum/2010101893344/the-history-controversy-and-promise-of-mdma\">MDMA-aided therapy\u003c/a> for post-traumatic stress disorder in a 10-1 vote, citing flawed study data, questionable research practices and significant drug risks, including potential heart complications.\u003c/p>\n\u003cp>Despite these setbacks, advocates remain undeterred, pushing for more targeted initiatives. State Senate Minority Leader Brian Jones (R-San Diego) and Sen. Josh Becker (D-Menlo Park) have introduced \u003ca href=\"https://leginfo.legislature.ca.gov/faces/billNavClient.xhtml?bill_id=202320240SB803\">legislation\u003c/a> for a three-year psychedelic therapy pilot program in San Francisco, Santa Cruz, and San Diego counties, focusing on veterans and first responders.\u003c/p>\n\u003cp>“To be clear, I’m not calling for the widespread legalization of psychedelic drugs. Rather, I’m championing a targeted medical treatment aimed specifically at aiding veterans and first responders in their recovery,” Jones said in a \u003ca href=\"https://sr40.senate.ca.gov/content/leader-jones-and-senator-becker-introduce-legislation-authorizing-psychedelic-medical\">statement\u003c/a>.\u003c/p>\n\u003cp>Psilocybin, belonging to the same class of psychedelics as LSD and mescaline, activates serotonin receptors, particularly in the prefrontal cortex. Its effects can include euphoria and hallucinations, spiritual experiences, panic and feelings of detachment.\u003c/p>\n\u003cp>“Psychedelics have always seemed like an interesting, extreme case of how the brain can create really fantastical and amazing visual representations,” said Sean Noah, a UC Berkeley postdoctoral researcher. “I think there’s a lot of unexplored potential in using psychedelics as tools to understand how the brain constructs our visual representation of the world and how the brain is related to consciousness in general.”\u003c/p>\n\u003cp>As researchers in the UC Berkeley study enroll volunteers and begin screening participants, they hope their efforts will solidify the scientific credibility of psilocybin. The recent policy setbacks indicate legislators are not convinced by current evidence, but further clinical trials can help pave the way for more informed policy decisions as advocates continue to push for legalization.\u003c/p>\n\u003cp>“The knowledge we gain from this foundational research will be essential for harnessing the therapeutic potential of psychedelics and improving mental health outcomes for countless individuals in need,” Silver, the study’s lead investigator, said in an email.\u003c/p>\n\u003cp>\u003c/p>\n",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003cp>\u003cem>Updated 3 p.m. Tuesday\u003c/em>\u003c/p>\n\u003cp>Amid mounting efforts to legalize psychedelic drugs, UC Berkeley researchers will use neuroimaging to observe how psilocybin alters the brain — the university’s first human study involving a Schedule 1 substance.\u003c/p>\n\u003cp>While previous research has predominantly focused on the drug’s influence on clinical symptoms or human behavior, this study aims to uncover how the brain constructs reality under the influence of psilocybin, the psychoactive compound in magic mushrooms.\u003c/p>\n\u003cp>Healthy participants will ingest psilocybin and then perform simple perceptual tasks while activity in the part of the brain that processes visual information is recorded using functional magnetic resonance imaging, or fMRI.\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>“We have this incredible opportunity to characterize the psychedelic experience in real-time — while it’s happening — using modern neuroimaging methods,” Michael Silver, the director of the UC Berkeley Center for the Science of Psychedelics and the study’s lead investigator, said in a recent university \u003ca href=\"https://news.berkeley.edu/2024/06/11/psychedelics-change-how-we-see-the-world-a-uc-berkeley-study-aims-to-find-out-why/\">press release\u003c/a>. “Understanding the actions of psychedelics at a neuroscientific level will generate insights into how they’re working as medicines and will hopefully help us develop more effective treatments for mental health disorders.”\u003c/p>\n\u003cp>A growing \u003ca href=\"https://pubmed.ncbi.nlm.nih.gov/37844352/\">body of research\u003c/a> suggests psilocybin, when administered in controlled conditions with supportive therapy, is \u003ca href=\"https://www.kqed.org/science/1992997/advocates-for-legalized-psychedelics-in-california-plan-a-ballot-measure-push\">a promising treatment for psychiatric disorders\u003c/a> such as addiction and anxiety. Individuals suffering from long-term, debilitating depression have reported significant relief after a single session of psychedelic-assisted therapy.\u003c/p>\n\u003cp>Still, several recent attempts to reintroduce banned drugs into medical practice have hit roadblocks. Earlier this year, \u003ca href=\"https://leginfo.legislature.ca.gov/faces/billTextClient.xhtml?bill_id=202320240SB1012&search_keywords=mushrooms\">SB 1012\u003c/a>, a bill championed by Sen. Scott Wiener (D-San Francisco) to legalize psychedelic-assisted therapy, failed to advance to a full Senate vote. The \u003ca href=\"https://leginfo.legislature.ca.gov/faces/billAnalysisClient.xhtml?bill_id=202320240SB1012\">Senate analysis\u003c/a> indicated “unknown significant ongoing costs, likely ranging in the low millions of dollars,” a daunting prospect given the state’s \u003ca href=\"https://www.kqed.org/news/11986700/california-budget-deficit-forces-lawmakers-to-shelve-bills-on-psychedelic-therapy-reparations\">projected $56 billion budget deficit\u003c/a>.\u003c/p>\u003c/div>",
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"content": "\u003cdiv class=\"post-body\">\u003cp>Last year, Gov. Gavin Newsom vetoed a bill to decriminalize the possession and personal use of hallucinogenic drugs, citing the need for more rigorous guidelines to ensure safe use. Similarly, this spring, federal health advisors decisively rejected \u003ca href=\"https://www.kqed.org/forum/2010101893344/the-history-controversy-and-promise-of-mdma\">MDMA-aided therapy\u003c/a> for post-traumatic stress disorder in a 10-1 vote, citing flawed study data, questionable research practices and significant drug risks, including potential heart complications.\u003c/p>\n\u003cp>Despite these setbacks, advocates remain undeterred, pushing for more targeted initiatives. State Senate Minority Leader Brian Jones (R-San Diego) and Sen. Josh Becker (D-Menlo Park) have introduced \u003ca href=\"https://leginfo.legislature.ca.gov/faces/billNavClient.xhtml?bill_id=202320240SB803\">legislation\u003c/a> for a three-year psychedelic therapy pilot program in San Francisco, Santa Cruz, and San Diego counties, focusing on veterans and first responders.\u003c/p>\n\u003cp>“To be clear, I’m not calling for the widespread legalization of psychedelic drugs. Rather, I’m championing a targeted medical treatment aimed specifically at aiding veterans and first responders in their recovery,” Jones said in a \u003ca href=\"https://sr40.senate.ca.gov/content/leader-jones-and-senator-becker-introduce-legislation-authorizing-psychedelic-medical\">statement\u003c/a>.\u003c/p>\n\u003cp>Psilocybin, belonging to the same class of psychedelics as LSD and mescaline, activates serotonin receptors, particularly in the prefrontal cortex. Its effects can include euphoria and hallucinations, spiritual experiences, panic and feelings of detachment.\u003c/p>\n\u003cp>“Psychedelics have always seemed like an interesting, extreme case of how the brain can create really fantastical and amazing visual representations,” said Sean Noah, a UC Berkeley postdoctoral researcher. “I think there’s a lot of unexplored potential in using psychedelics as tools to understand how the brain constructs our visual representation of the world and how the brain is related to consciousness in general.”\u003c/p>\n\u003cp>As researchers in the UC Berkeley study enroll volunteers and begin screening participants, they hope their efforts will solidify the scientific credibility of psilocybin. The recent policy setbacks indicate legislators are not convinced by current evidence, but further clinical trials can help pave the way for more informed policy decisions as advocates continue to push for legalization.\u003c/p>\n\u003cp>“The knowledge we gain from this foundational research will be essential for harnessing the therapeutic potential of psychedelics and improving mental health outcomes for countless individuals in need,” Silver, the study’s lead investigator, said in an email.\u003c/p>\n\u003cp>\u003c/p>\n\u003c/div>\u003c/p>",
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"content": "\u003cp>I went to Ruth Whippman’s Berkeley home for tea in early May because it was time for my anxiety check.\u003c/p>\n\u003cp>When I arrived, I realized that my appointments with Whippman, a \u003ca href=\"https://www.nytimes.com/2024/06/05/opinion/boys-parenting-loneliness.html\">British author and cultural critic\u003c/a>, were aligned with presidential election cycles. I find Whippman’s candor refreshing and rational. She doesn’t sugarcoat but adds sugar to the tea that she serves.\u003c/p>\n\u003cp>Whippman’s husband, Neil Levine, was working downstairs and Zephy, 10, was at band practice. Solly, 13, breezed through the kitchen on his way out the door to play Dungeons & Dragons at Games of Berkeley. As he held the toy leaf blower he was delivering to his 6-year-old brother, Abe, we briefly talked about game strategy. He flinched when Whippman lifted her light blue mug, which was the same color as her phone case.\u003c/p>\n\u003cp>[ad fullwidth]\u003c/p>\n\u003cp>Last week, Whippman published \u003cem>BoyMom: Reimagining Boyhood in the Age of Impossible Masculinity\u003c/em>, a treatise on the difficult challenge of raising decent men in an era when masculinity is weaponized.\u003c/p>\n\u003cp>\u003cem>BoyMom\u003c/em> is a memoir of a six-year stretch that included the election of a rapacious, misogynistic and xenophobic president, the #MeToo movement, the rise of the masculinity influencer and the isolation of the pandemic. Whippman, a mother of three boys, was concerned about raising her sons alongside a generation of boys that insecure tough guys are exploiting.\u003c/p>\n\u003cp>Using reporting and analysis, she interrogated the toxic patterns in boys and men. In the book, you’ll meet insecure teenage boys. You’ll meet hopeless incels — the portmanteau of “involuntary celibate” — who are susceptible to the agitators who play on the fears of white male emasculation for likes. You’ll also meet fathers, mothers and therapists who are battling the invisible ways we separate boys from their humanity.\u003c/p>\n\u003cp>Wait a minute, how did we get here?\u003c/p>\n\u003cp>Let’s go back to 2017, when women began using a hashtag to shine awareness on sexual abuse, sexual harassment and rape.\u003c/p>\n\u003cfigure id=\"attachment_11987769\" class=\"wp-caption aligncenter\" style=\"max-width: 1920px\">\u003cimg loading=\"lazy\" decoding=\"async\" class=\"size-full wp-image-11987769\" src=\"https://cdn.kqed.org/wp-content/uploads/sites/10/2024/05/240522-BoyMom-10-BL_qut.jpg\" alt=\"\" width=\"1920\" height=\"1280\" srcset=\"https://cdn.kqed.org/wp-content/uploads/sites/10/2024/05/240522-BoyMom-10-BL_qut.jpg 1920w, https://cdn.kqed.org/wp-content/uploads/sites/10/2024/05/240522-BoyMom-10-BL_qut-800x533.jpg 800w, https://cdn.kqed.org/wp-content/uploads/sites/10/2024/05/240522-BoyMom-10-BL_qut-1020x680.jpg 1020w, https://cdn.kqed.org/wp-content/uploads/sites/10/2024/05/240522-BoyMom-10-BL_qut-160x107.jpg 160w, https://cdn.kqed.org/wp-content/uploads/sites/10/2024/05/240522-BoyMom-10-BL_qut-1536x1024.jpg 1536w\" sizes=\"(max-width: 1920px) 100vw, 1920px\">\u003cfigcaption class=\"wp-caption-text\">Ruth Whippman poses for a photo at her home in Berkeley on May 22. \u003ccite>(Beth LaBerge/KQED)\u003c/cite>\u003c/figcaption>\u003c/figure>\n\u003cp>“As much as it was a revelation of substance, #MeToo was a revolution of storytelling,” Whippman writes in \u003cem>BoyMom\u003c/em>. “Perhaps the ultimate power available to any human being is to have control of the narrative.”\u003c/p>\n\u003cp>#MeToo exposed men who used privilege, power and wealth to assault women and dodge consequences. The left branded masculinity as toxic, while the right, if you will, leaned in and packaged toxic masculinity, as Whippman writes, “the answer to all our problems, both politicians and online influencers peddling a new brand of wounded, furious manhood, drawn from a combination of superhero fantasies and defensive rage.”\u003c/p>\n\u003cp>Oh boy, we are in trouble.\u003c/p>\n\u003cp>According to Whippman’s reporting, boys mature more slowly than girls socially, cognitively and physically, and are about 10 times more likely than girls to develop into antisocial adolescents. But what is less well known is that boys are more vulnerable emotionally.\u003c/p>\n\u003cp>“The sad irony is that while masculinity norms push boys to be tough — to squash their feelings and hide their weaknesses, right from birth and throughout childhood — young boys are actually more sensitive and emotionally fragile than young girls,” Whippman writes.\u003c/p>\n\u003cp>Because society expects rigid stoicism from men, mental health for boys often goes undetected, Whippman posits. Instead of emotional support, boys are getting infected by men who project an impossible standard of masculinity. To some, men are supposed to be without flaws, feelings or vulnerabilities.\u003c/p>\n\u003cp>Just last month, Jerry Seinfeld said he \u003ca href=\"https://www.nbcnews.com/pop-culture/pop-culture-news/-real-man-jerry-seinfeld-says-misses-dominant-masculinity-rcna154708\">missed dominant masculinity\u003c/a>. Andrew Tate spews toxic, misogynistic commentary that is parroted by YouTubers, podcasters and social media influencers who get rich by preaching about alpha male achievements. They want you to believe that masculinity is under attack and only a strongman — you know, the kind anointed to sell Bibles for 60 bucks — is capable of making manhood great again.\u003c/p>\n\u003cfigure id=\"attachment_11987768\" class=\"wp-caption aligncenter\" style=\"max-width: 1920px\">\u003cimg loading=\"lazy\" decoding=\"async\" class=\"size-full wp-image-11987768\" src=\"https://cdn.kqed.org/wp-content/uploads/sites/10/2024/05/240522-BoyMom-12-BL_qut.jpg\" alt=\"\" width=\"1920\" height=\"1280\" srcset=\"https://cdn.kqed.org/wp-content/uploads/sites/10/2024/05/240522-BoyMom-12-BL_qut.jpg 1920w, https://cdn.kqed.org/wp-content/uploads/sites/10/2024/05/240522-BoyMom-12-BL_qut-800x533.jpg 800w, https://cdn.kqed.org/wp-content/uploads/sites/10/2024/05/240522-BoyMom-12-BL_qut-1020x680.jpg 1020w, https://cdn.kqed.org/wp-content/uploads/sites/10/2024/05/240522-BoyMom-12-BL_qut-160x107.jpg 160w, https://cdn.kqed.org/wp-content/uploads/sites/10/2024/05/240522-BoyMom-12-BL_qut-1536x1024.jpg 1536w\" sizes=\"(max-width: 1920px) 100vw, 1920px\">\u003cfigcaption class=\"wp-caption-text\">Ruth Whippman writes notes in her office at her home in Berkeley on May 22. \u003ccite>(Beth LaBerge/KQED)\u003c/cite>\u003c/figcaption>\u003c/figure>\n\u003cp>“For something that is supposed to be so innate, masculinity sure seems to take a lot of hard work,” Whippman quips in the book.\u003c/p>\n\u003cp>To understand the “scripts of masculinity,” Whippman went to Iron Gate, a therapeutic center for adolescent boys and young men in southern Utah. When I first met Whippman in 2016, the pursuit of happiness had prompted her to visit happy Mormons in Utah to report for \u003cem>America the Anxious: How Our Pursuit of Happiness Is Creating a Nation of Nervous Wrecks\u003c/em>, her book about how our cultural obsession with happiness made us crazy. I was then a columnist at the \u003cem>San Francisco Chronicle\u003c/em> and, over tea, we talked about the multibillion-dollar self-improvement industry that sold everything but happiness.\u003c/p>\n\u003cp>My \u003ca href=\"https://www.sfchronicle.com/news/article/Author-finds-happiness-not-misery-loves-company-9961102.php\">column\u003c/a> was published two days after America became familiar with how a certain presidential candidate \u003ca href=\"https://www.washingtonpost.com/politics/trump-recorded-having-extremely-lewd-conversation-about-women-in-2005/2016/10/07/3b9ce776-8cb4-11e6-bf8a-3d26847eeed4_story.html\">talks in locker rooms\u003c/a>.\u003c/p>\n\u003cp>For \u003cem>BoyMom\u003c/em>, Whippman also traveled to New York to an exclusive, all-boys private school that boasts politicians, journalists and banking executives as alumni to sit in on Modern Masculinities, a class that challenges toxic masculinity. In the Los Angeles area, she attended Guys Group, a therapy and social group for teen boys.\u003c/p>\n\u003cp>Boys are at a social disadvantage because we have failed to model more intimate friendships, according to Whippman. “Online life can open up new worlds and perspectives that might otherwise be closed off to them,” she writes.\u003c/p>\n\u003cp>Boys have retreated online to play video games and mingle virtually on communication platforms such as Discord and Telegram, where they are exposed to racism and hate. They socialize less because they don’t have the real-world friendships and relationships they crave. They are isolated. Worse, they are lonely.\u003c/p>\n\u003cp>“It’s just easier to just retreat into a screen when they feel like nobody cares about them,” Whippman told me as we sat at her kitchen table. “Everyone thinks they’re terrible. Everyone thinks they’re predators.”\u003c/p>\n\u003cfigure id=\"attachment_11987771\" class=\"wp-caption aligncenter\" style=\"max-width: 1920px\">\u003cimg loading=\"lazy\" decoding=\"async\" class=\"size-full wp-image-11987771\" src=\"https://cdn.kqed.org/wp-content/uploads/sites/10/2024/05/240522-BoyMom-17-BL_qut.jpg\" alt=\"\" width=\"1920\" height=\"1280\" srcset=\"https://cdn.kqed.org/wp-content/uploads/sites/10/2024/05/240522-BoyMom-17-BL_qut.jpg 1920w, https://cdn.kqed.org/wp-content/uploads/sites/10/2024/05/240522-BoyMom-17-BL_qut-800x533.jpg 800w, https://cdn.kqed.org/wp-content/uploads/sites/10/2024/05/240522-BoyMom-17-BL_qut-1020x680.jpg 1020w, https://cdn.kqed.org/wp-content/uploads/sites/10/2024/05/240522-BoyMom-17-BL_qut-160x107.jpg 160w, https://cdn.kqed.org/wp-content/uploads/sites/10/2024/05/240522-BoyMom-17-BL_qut-1536x1024.jpg 1536w\" sizes=\"(max-width: 1920px) 100vw, 1920px\">\u003cfigcaption class=\"wp-caption-text\">Ruth Whippman sits with her husband, Neil Levine, and sons Abe, 6, Zephy, 10, and Solly, 13, at their home in Berkeley on May 22. \u003ccite>(Beth LaBerge/KQED)\u003c/cite>\u003c/figcaption>\u003c/figure>\n\u003cp>Whippman’s most illuminative reporting is reserved for the back half of the book. She ventured into the online forums where right-leaning and alt-right people congregate on 4chan, 8chan and other violent communities. It’s where the aggrieved find solace among others who share a deep hatred of women. The spaces are where incels, an online subculture of men frustrated with a lack of sexual experiences, are accepted.\u003c/p>\n\u003cp>“There is a notorious overlap between misogyny, white supremacy, homophobia and anti-semiticism in online spaces,” Whippman writes.\u003c/p>\n\u003cp>There aren’t many interviews with incels about their personal perspectives and experiences. Whippman went beneath surface-level reporting to examine the emotional and psychological triggers that were driving boys and young men to such intolerant spaces. In the book, she shares the stories of young men she interviewed.\u003c/p>\n\u003cp>We must understand the path that leads to hatred if we’re going to offer a course correction.\u003c/p>\n\u003cp>“What I wanted to do was to not give them a platform for their opinions. They absolutely don’t need that,” she told me. “And I in no way wanted to promote these toxic opinions, but I wanted to listen to the feelings that were driving them,” \u003ca href=\"https://www.kqed.org/forum/2010101905968/how-to-raise-sons-in-the-age-of-impossible-masculinity\">she said last week in an interview at KQED after appearing on Forum\u003c/a>.\u003c/p>\n\u003cp>“Everybody’s going to feel some sense of inadequacy or shame that they have to make up for in some way,” she continued. “It’s not their masculinity that makes them violent. It’s the shame that they’re not masculine enough, that they’re not meeting the standard. That’s where the violence is. That’s where the toxicity is. It’s those feelings of shame.”\u003c/p>\n\u003cp>Last month, a petulant former president who, I imagine, abhors accountability as much as he does facts, was \u003ca href=\"https://www.npr.org/2024/05/30/g-s1-1848/trump-hush-money-trial-34-counts\">convicted of 34 felony counts of falsified business records\u003c/a>. He still faces indictments for election inference, hoarding national security documents and for attempting to overturn election results. He’s been whining about getting the conviction overturned while obsessively wailing about the election he fairly lost.\u003c/p>\n\u003cp>Someone should tell the walking tough guy meme that boys don’t cry.\u003c/p>\n\u003cp>[ad floatright]\u003c/p>\n",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003cp>I went to Ruth Whippman’s Berkeley home for tea in early May because it was time for my anxiety check.\u003c/p>\n\u003cp>When I arrived, I realized that my appointments with Whippman, a \u003ca href=\"https://www.nytimes.com/2024/06/05/opinion/boys-parenting-loneliness.html\">British author and cultural critic\u003c/a>, were aligned with presidential election cycles. I find Whippman’s candor refreshing and rational. She doesn’t sugarcoat but adds sugar to the tea that she serves.\u003c/p>\n\u003cp>Whippman’s husband, Neil Levine, was working downstairs and Zephy, 10, was at band practice. Solly, 13, breezed through the kitchen on his way out the door to play Dungeons & Dragons at Games of Berkeley. As he held the toy leaf blower he was delivering to his 6-year-old brother, Abe, we briefly talked about game strategy. He flinched when Whippman lifted her light blue mug, which was the same color as her phone case.\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>Last week, Whippman published \u003cem>BoyMom: Reimagining Boyhood in the Age of Impossible Masculinity\u003c/em>, a treatise on the difficult challenge of raising decent men in an era when masculinity is weaponized.\u003c/p>\n\u003cp>\u003cem>BoyMom\u003c/em> is a memoir of a six-year stretch that included the election of a rapacious, misogynistic and xenophobic president, the #MeToo movement, the rise of the masculinity influencer and the isolation of the pandemic. Whippman, a mother of three boys, was concerned about raising her sons alongside a generation of boys that insecure tough guys are exploiting.\u003c/p>\n\u003cp>Using reporting and analysis, she interrogated the toxic patterns in boys and men. In the book, you’ll meet insecure teenage boys. You’ll meet hopeless incels — the portmanteau of “involuntary celibate” — who are susceptible to the agitators who play on the fears of white male emasculation for likes. You’ll also meet fathers, mothers and therapists who are battling the invisible ways we separate boys from their humanity.\u003c/p>\n\u003cp>Wait a minute, how did we get here?\u003c/p>\n\u003cp>Let’s go back to 2017, when women began using a hashtag to shine awareness on sexual abuse, sexual harassment and rape.\u003c/p>\n\u003cfigure id=\"attachment_11987769\" class=\"wp-caption aligncenter\" style=\"max-width: 1920px\">\u003cimg loading=\"lazy\" decoding=\"async\" class=\"size-full wp-image-11987769\" src=\"https://cdn.kqed.org/wp-content/uploads/sites/10/2024/05/240522-BoyMom-10-BL_qut.jpg\" alt=\"\" width=\"1920\" height=\"1280\" srcset=\"https://cdn.kqed.org/wp-content/uploads/sites/10/2024/05/240522-BoyMom-10-BL_qut.jpg 1920w, https://cdn.kqed.org/wp-content/uploads/sites/10/2024/05/240522-BoyMom-10-BL_qut-800x533.jpg 800w, https://cdn.kqed.org/wp-content/uploads/sites/10/2024/05/240522-BoyMom-10-BL_qut-1020x680.jpg 1020w, https://cdn.kqed.org/wp-content/uploads/sites/10/2024/05/240522-BoyMom-10-BL_qut-160x107.jpg 160w, https://cdn.kqed.org/wp-content/uploads/sites/10/2024/05/240522-BoyMom-10-BL_qut-1536x1024.jpg 1536w\" sizes=\"(max-width: 1920px) 100vw, 1920px\">\u003cfigcaption class=\"wp-caption-text\">Ruth Whippman poses for a photo at her home in Berkeley on May 22. \u003ccite>(Beth LaBerge/KQED)\u003c/cite>\u003c/figcaption>\u003c/figure>\n\u003cp>“As much as it was a revelation of substance, #MeToo was a revolution of storytelling,” Whippman writes in \u003cem>BoyMom\u003c/em>. “Perhaps the ultimate power available to any human being is to have control of the narrative.”\u003c/p>\n\u003cp>#MeToo exposed men who used privilege, power and wealth to assault women and dodge consequences. The left branded masculinity as toxic, while the right, if you will, leaned in and packaged toxic masculinity, as Whippman writes, “the answer to all our problems, both politicians and online influencers peddling a new brand of wounded, furious manhood, drawn from a combination of superhero fantasies and defensive rage.”\u003c/p>\n\u003cp>Oh boy, we are in trouble.\u003c/p>\n\u003cp>According to Whippman’s reporting, boys mature more slowly than girls socially, cognitively and physically, and are about 10 times more likely than girls to develop into antisocial adolescents. But what is less well known is that boys are more vulnerable emotionally.\u003c/p>\n\u003cp>“The sad irony is that while masculinity norms push boys to be tough — to squash their feelings and hide their weaknesses, right from birth and throughout childhood — young boys are actually more sensitive and emotionally fragile than young girls,” Whippman writes.\u003c/p>\n\u003cp>Because society expects rigid stoicism from men, mental health for boys often goes undetected, Whippman posits. Instead of emotional support, boys are getting infected by men who project an impossible standard of masculinity. To some, men are supposed to be without flaws, feelings or vulnerabilities.\u003c/p>\n\u003cp>Just last month, Jerry Seinfeld said he \u003ca href=\"https://www.nbcnews.com/pop-culture/pop-culture-news/-real-man-jerry-seinfeld-says-misses-dominant-masculinity-rcna154708\">missed dominant masculinity\u003c/a>. Andrew Tate spews toxic, misogynistic commentary that is parroted by YouTubers, podcasters and social media influencers who get rich by preaching about alpha male achievements. They want you to believe that masculinity is under attack and only a strongman — you know, the kind anointed to sell Bibles for 60 bucks — is capable of making manhood great again.\u003c/p>\n\u003cfigure id=\"attachment_11987768\" class=\"wp-caption aligncenter\" style=\"max-width: 1920px\">\u003cimg loading=\"lazy\" decoding=\"async\" class=\"size-full wp-image-11987768\" src=\"https://cdn.kqed.org/wp-content/uploads/sites/10/2024/05/240522-BoyMom-12-BL_qut.jpg\" alt=\"\" width=\"1920\" height=\"1280\" srcset=\"https://cdn.kqed.org/wp-content/uploads/sites/10/2024/05/240522-BoyMom-12-BL_qut.jpg 1920w, https://cdn.kqed.org/wp-content/uploads/sites/10/2024/05/240522-BoyMom-12-BL_qut-800x533.jpg 800w, https://cdn.kqed.org/wp-content/uploads/sites/10/2024/05/240522-BoyMom-12-BL_qut-1020x680.jpg 1020w, https://cdn.kqed.org/wp-content/uploads/sites/10/2024/05/240522-BoyMom-12-BL_qut-160x107.jpg 160w, https://cdn.kqed.org/wp-content/uploads/sites/10/2024/05/240522-BoyMom-12-BL_qut-1536x1024.jpg 1536w\" sizes=\"(max-width: 1920px) 100vw, 1920px\">\u003cfigcaption class=\"wp-caption-text\">Ruth Whippman writes notes in her office at her home in Berkeley on May 22. \u003ccite>(Beth LaBerge/KQED)\u003c/cite>\u003c/figcaption>\u003c/figure>\n\u003cp>“For something that is supposed to be so innate, masculinity sure seems to take a lot of hard work,” Whippman quips in the book.\u003c/p>\n\u003cp>To understand the “scripts of masculinity,” Whippman went to Iron Gate, a therapeutic center for adolescent boys and young men in southern Utah. When I first met Whippman in 2016, the pursuit of happiness had prompted her to visit happy Mormons in Utah to report for \u003cem>America the Anxious: How Our Pursuit of Happiness Is Creating a Nation of Nervous Wrecks\u003c/em>, her book about how our cultural obsession with happiness made us crazy. I was then a columnist at the \u003cem>San Francisco Chronicle\u003c/em> and, over tea, we talked about the multibillion-dollar self-improvement industry that sold everything but happiness.\u003c/p>\n\u003cp>My \u003ca href=\"https://www.sfchronicle.com/news/article/Author-finds-happiness-not-misery-loves-company-9961102.php\">column\u003c/a> was published two days after America became familiar with how a certain presidential candidate \u003ca href=\"https://www.washingtonpost.com/politics/trump-recorded-having-extremely-lewd-conversation-about-women-in-2005/2016/10/07/3b9ce776-8cb4-11e6-bf8a-3d26847eeed4_story.html\">talks in locker rooms\u003c/a>.\u003c/p>\n\u003cp>For \u003cem>BoyMom\u003c/em>, Whippman also traveled to New York to an exclusive, all-boys private school that boasts politicians, journalists and banking executives as alumni to sit in on Modern Masculinities, a class that challenges toxic masculinity. In the Los Angeles area, she attended Guys Group, a therapy and social group for teen boys.\u003c/p>\n\u003cp>Boys are at a social disadvantage because we have failed to model more intimate friendships, according to Whippman. “Online life can open up new worlds and perspectives that might otherwise be closed off to them,” she writes.\u003c/p>\n\u003cp>Boys have retreated online to play video games and mingle virtually on communication platforms such as Discord and Telegram, where they are exposed to racism and hate. They socialize less because they don’t have the real-world friendships and relationships they crave. They are isolated. Worse, they are lonely.\u003c/p>\n\u003cp>“It’s just easier to just retreat into a screen when they feel like nobody cares about them,” Whippman told me as we sat at her kitchen table. “Everyone thinks they’re terrible. Everyone thinks they’re predators.”\u003c/p>\n\u003cfigure id=\"attachment_11987771\" class=\"wp-caption aligncenter\" style=\"max-width: 1920px\">\u003cimg loading=\"lazy\" decoding=\"async\" class=\"size-full wp-image-11987771\" src=\"https://cdn.kqed.org/wp-content/uploads/sites/10/2024/05/240522-BoyMom-17-BL_qut.jpg\" alt=\"\" width=\"1920\" height=\"1280\" srcset=\"https://cdn.kqed.org/wp-content/uploads/sites/10/2024/05/240522-BoyMom-17-BL_qut.jpg 1920w, https://cdn.kqed.org/wp-content/uploads/sites/10/2024/05/240522-BoyMom-17-BL_qut-800x533.jpg 800w, https://cdn.kqed.org/wp-content/uploads/sites/10/2024/05/240522-BoyMom-17-BL_qut-1020x680.jpg 1020w, https://cdn.kqed.org/wp-content/uploads/sites/10/2024/05/240522-BoyMom-17-BL_qut-160x107.jpg 160w, https://cdn.kqed.org/wp-content/uploads/sites/10/2024/05/240522-BoyMom-17-BL_qut-1536x1024.jpg 1536w\" sizes=\"(max-width: 1920px) 100vw, 1920px\">\u003cfigcaption class=\"wp-caption-text\">Ruth Whippman sits with her husband, Neil Levine, and sons Abe, 6, Zephy, 10, and Solly, 13, at their home in Berkeley on May 22. \u003ccite>(Beth LaBerge/KQED)\u003c/cite>\u003c/figcaption>\u003c/figure>\n\u003cp>Whippman’s most illuminative reporting is reserved for the back half of the book. She ventured into the online forums where right-leaning and alt-right people congregate on 4chan, 8chan and other violent communities. It’s where the aggrieved find solace among others who share a deep hatred of women. The spaces are where incels, an online subculture of men frustrated with a lack of sexual experiences, are accepted.\u003c/p>\n\u003cp>“There is a notorious overlap between misogyny, white supremacy, homophobia and anti-semiticism in online spaces,” Whippman writes.\u003c/p>\n\u003cp>There aren’t many interviews with incels about their personal perspectives and experiences. Whippman went beneath surface-level reporting to examine the emotional and psychological triggers that were driving boys and young men to such intolerant spaces. In the book, she shares the stories of young men she interviewed.\u003c/p>\n\u003cp>We must understand the path that leads to hatred if we’re going to offer a course correction.\u003c/p>\n\u003cp>“What I wanted to do was to not give them a platform for their opinions. They absolutely don’t need that,” she told me. “And I in no way wanted to promote these toxic opinions, but I wanted to listen to the feelings that were driving them,” \u003ca href=\"https://www.kqed.org/forum/2010101905968/how-to-raise-sons-in-the-age-of-impossible-masculinity\">she said last week in an interview at KQED after appearing on Forum\u003c/a>.\u003c/p>\n\u003cp>“Everybody’s going to feel some sense of inadequacy or shame that they have to make up for in some way,” she continued. “It’s not their masculinity that makes them violent. It’s the shame that they’re not masculine enough, that they’re not meeting the standard. That’s where the violence is. That’s where the toxicity is. It’s those feelings of shame.”\u003c/p>\n\u003cp>Last month, a petulant former president who, I imagine, abhors accountability as much as he does facts, was \u003ca href=\"https://www.npr.org/2024/05/30/g-s1-1848/trump-hush-money-trial-34-counts\">convicted of 34 felony counts of falsified business records\u003c/a>. He still faces indictments for election inference, hoarding national security documents and for attempting to overturn election results. He’s been whining about getting the conviction overturned while obsessively wailing about the election he fairly lost.\u003c/p>\n\u003cp>Someone should tell the walking tough guy meme that boys don’t cry.\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"content": "\u003cp>\u003cspan style=\"font-weight: 400\">At elite high schools in Silicon Valley, the pressure to succeed is intense. And according to Sophia Shao, a former student at Los Altos High School, her proximity to California’s tech capital is a big reason why. \u003c/span>\u003c/p>\n\u003cp>\u003cspan style=\"font-weight: 400\">In this special collaboration with \u003c/span>\u003ca href=\"http://kqed.org/youthtakeover\">\u003cspan style=\"font-weight: 400\">KQED’s Youth Takeover\u003c/span>\u003c/a>\u003cspan style=\"font-weight: 400\">, a yearlong project to highlight compelling stories written and produced by local teens, Shao talks with us about going to school in a place where everyone is expected to excel.\u003c/span>\u003c/p>\n\u003cp>\u003c!-- iframe plugin v.4.3 wordpress.org/plugins/iframe/ -->\u003cbr>\n\u003ciframe loading=\"lazy\" frameborder=\"0\" height=\"200\" scrolling=\"no\" src=\"https://playlist.megaphone.fm/?e=KQINC3806424948\" width=\"100%\" class=\"iframe-class\">\u003c/iframe>\u003c/p>\n\u003cp>\u003ci>\u003cspan style=\"font-weight: 400\">This episode first ran on Aug. 15, 2022\u003c/span>\u003c/i>\u003c/p>\n\u003ch2 id=\"episode-transcript\">Episode Transcript\u003c/h2>\n\u003cp>\u003ci>This is a computer-generated transcript. While our team has reviewed it, there may be errors.\u003c/i>\u003c/p>\n\u003cp>[ad fullwidth]\u003c/p>\n\u003cp>\u003cb>Sophia Shao: \u003c/b>\u003cem>[00:03:57] \u003c/em>My name is Sophia. Sophia Shao. I’m from Los Altos, California. I go to Los Altos High School. I’m 17.5. I guess I’m almost 18. For fun, I play tennis. I box a little bit. I swim a little bit. It’s cool. It’s a little bit of everything.\u003c/p>\n\u003cp>\u003cb>Ericka Cruz Guevarra: \u003c/b>\u003cem>[00:04:19] \u003c/em>I feel like boxing is very rare. I never hear. That.\u003c/p>\n\u003cp>\u003cb>Sophia Shao: \u003c/b>\u003cem>[00:04:22] \u003c/em>Yeah, it’s kind of casual, but, like, it’s a good way to stress relief. Yeah.\u003c/p>\n\u003cp>\u003cb>Ericka Cruz Guevarra: \u003c/b>\u003cem>[00:04:28] \u003c/em>Yeah. Can that makes sense? Can you tell me a little bit about your family sophia?\u003c/p>\n\u003cp>\u003cb>Sophia Shao: \u003c/b>\u003cem>[00:04:34] \u003c/em>My parents both immigrated here from China. My dad went to one of the top universities in China, and both of them were able to move to the US. Right now, my grandparents are staying with us, which is pretty nice. My little sister is a rising sophomore in high school, so she’s excited for that.\u003c/p>\n\u003cp>\u003cb>Ericka Cruz Guevarra: \u003c/b>\u003cem>[00:05:00] \u003c/em>I’m curious. Growing up in Milpitas and then also now. I Mean, you’re still growing up in many ways in Los Altos. What are the people you’re growing up around like?\u003c/p>\n\u003cp>\u003cb>Sophia Shao: \u003c/b>\u003cem>[00:05:13] \u003c/em>When I was in elementary school, obviously, I remember there was a really big emphasis on the AMC test. Like, what’s that? It was like a big math competition. Specifically, remember the two kids who got the best scores in our school? And then I got third. And then in eighth grade where we had like an actual graduation with caps and gowns. And we had little ropes that we hung around or not. If you had a 4.0 and a four or a 4.5. We had awards for every grade. I remember I got to very proud of myself. And parents are also very proud of me because you got to stand in front of the stage and have you just say a speech about you. Wow. But it’s kind of those things where you just kind of grow up knowing that you need to be at a certain caliber to compete with everyone else. I just I remember growing up like that and being really upset when I got like a 3.9 or 3.8. I was so obsessed with getting A’s and I think I carried that with me tonight. Great. And it just hit me like a ton of bricks.\u003c/p>\n\u003cp>\u003cb>Ericka Cruz Guevarra: \u003c/b>\u003cem>[00:06:42] \u003c/em>I mean, you also grew up in an immigrant household, which for me has come with, I think, like a certain pressure to succeed, at least in the sense that I felt like I should live a better life than my parents had. Right. I’m curious if that’s similar to your experience at all.\u003c/p>\n\u003cp>\u003cb>Sophia Shao: \u003c/b>\u003cem>[00:07:00] \u003c/em>I think in the beginning it was when I was in elementary school if when I was in middle school, because they took such long sacrifices to get us where we were today. And when I moved to Los Altos, though, and I started high school, that almost faded in a way, mostly because I started piling on like work after work. Like, for example, today I have this obviously in the morning at about 130. I have a physical for my tennis season that’s coming up in a week. And then after that, I’m helping out my coach with something and they’re all things that I kind of signed up for that. And I probably have to do call jobs because tomorrow at 830, I have a college counselor meeting. My goodness. It’s kind of been my summer. So it’s gotten to the point where my parents are just like, you need to cool down, like just takes some things off of your schedule. So at this point, it’s like the parents are there. Like if it’s okay, if you don’t become like a heart surgeon or something.\u003c/p>\n\u003cp>\u003cb>Ericka Cruz Guevarra: \u003c/b>\u003cem>[00:08:11] \u003c/em>It’s interesting because it sounds like the pressure isn’t necessarily coming from your parents, but like, more like yourself. Like a self-imposed pressure?\u003c/p>\n\u003cp>\u003cb>Sophia Shao: \u003c/b>\u003cem>[00:08:21] \u003c/em>Yeah. I mean, I really like being busy. It used to be because of college, and I think a lot of people still do it because of college.\u003c/p>\n\u003cp>\u003cb>Ericka Cruz Guevarra: \u003c/b>\u003cem>[00:08:31] \u003c/em>Yeah. Like, you want to get into the best school.\u003c/p>\n\u003cp>\u003cb>Sophia Shao: \u003c/b>\u003cem>[00:08:34] \u003c/em>Right. But like at this point, I just kind of I’m used to it, so it’s like, I’ll just keep doing it, I guess.\u003c/p>\n\u003cp>\u003cb>Ericka Cruz Guevarra: \u003c/b>\u003cem>[00:08:42] \u003c/em>When you were a freshman, though, what were like how did this stress show up in conversations that you had with your friends? Like where you all just like struggling every day, just like, my God, I hate this math homework right now. Or like, did you have friends who noticed that stress to do that come up in their conversations?\u003c/p>\n\u003cp>\u003cb>Sophia Shao: \u003c/b>\u003cem>[00:09:02] \u003c/em>I remember the first time I had a conversation about college was freshman year, and when I was in freshman year, any two colleges I knew Stanford and Harvard. And I remember sophomore year I asked my appearance for a college counselor because I was still in the mindset of do whatever on your resume. They can get you into college.\u003c/p>\n\u003cp>\u003cb>Ericka Cruz Guevarra: \u003c/b>\u003cem>[00:09:27] \u003c/em>What was the turning point for you then? Did you have a turning point where you were like, This is too much for me?\u003c/p>\n\u003cp>\u003cb>Sophia Shao: \u003c/b>\u003cem>[00:09:35] \u003c/em>Sophomore year, summer, junior year, I kind of had a mental health episode. And that kind of it did kind of shift me into perspective because I went to like a bunch of hospitals and I saw kind of the state that the pandemic and being in Silicon Valley had left me in. And I talked to a lot of the psychiatrist there, and they told me that a lot of the people who come to mental hospitals and asylums, they’re from areas like Super Chino and Los Altos, who are also known for churning out like higher success rates, high graduating rates. Wow. And it kind of just hit me that I would just rather do things that I like doing rather than having to follow some sort of guidebook. You start this thing and you start this thing and you’re the founder of this club. It just you go down the list of what, a college football.\u003c/p>\n\u003cp>\u003cb>Ericka Cruz Guevarra: \u003c/b>\u003cem>[00:11:00] \u003c/em>So you realized that this pressure was eating at your soul, right? It sounds like. Yeah. And that a lot of it comes from just growing up in a place that values success and achievement over all else. Yeah. How do you fight against that?\u003c/p>\n\u003cp>\u003cb>Sophia Shao: \u003c/b>\u003cem>[00:11:18] \u003c/em>As like, bad as it is, if I just put it in like, a phrase I just don’t really care about. I mean, obviously, I want to get into college. Like, I don’t want people to listen to this and be like, Yes, I do want to get into college. It would be nice, but. I don’t want getting into a good college. Kind of take away from me actually living my life and going through each day.\u003c/p>\n\u003cp>\u003cb>Ericka Cruz Guevarra: \u003c/b>\u003cem>[00:11:50] \u003c/em>I mean, what things do you love to do and hope to do?\u003c/p>\n\u003cp>\u003cb>Sophia Shao: \u003c/b>\u003cem>[00:11:54] \u003c/em>I love helping people. I’ve talked to a friend about this who got into you. Chicago. If he hears this, isn’t so happy that you did. But he kind of helped me put it into words where I want to make a measurable impact on helping people, especially people in marginalized communities and kids. Because I worked at it as a head coach at a local sports camp. I love helping kids, especially the people, the kids that are either on the spectrum or have trouble controlling their emotions because I kind of see me a little bit in that and I feel like I don’t know. It just feels amazing to be able to make a difference for those kids. I like volunteering. I love playing tennis. My ball kid. Yesterday I got to meet Naomi Osaka and saw her practicing. I know. And that was awesome. Is that going to help my college resumé? Not that much. Am I ever going to see Naomi Osaka, like, five feet away from me? Probably not. So it’s like a give and take system.\u003c/p>\n\u003cp>\u003cb>Ericka Cruz Guevarra: \u003c/b>\u003cem>[00:13:03] \u003c/em>I mean, it is. So it’s. Speaking of college, it’s college application season. What are your conversations with your friends like now?\u003c/p>\n\u003cp>\u003cb>Sophia Shao: \u003c/b>\u003cem>[00:13:12] \u003c/em>My thing is I had a lot of issues in high school that I got over and a lot of comebacks that I’ve made, but it doesn’t the comebacks don’t show up on my GPA and my score. And I’m much more proud of my comebacks than him. Anything else.\u003c/p>\n\u003cp>\u003cb>Ericka Cruz Guevarra: \u003c/b>\u003cem>[00:13:31] \u003c/em>Like personal comebacks?\u003c/p>\n\u003cp>\u003cb>Sophia Shao: \u003c/b>\u003cem>[00:13:34] \u003c/em>Yeah personal comebacks\u003cem> \u003c/em>\u003c/p>\n\u003cp>\u003cb>Ericka Cruz Guevarra: \u003c/b>\u003cem>[00:13:34] \u003c/em>Not academic comebacks.\u003cem> \u003c/em>\u003c/p>\n\u003cp>\u003cb>Sophia Shao: \u003c/b>\u003cem>[00:13:37] \u003c/em>But so many of my friends. So that’s the reason why I’m not as stressed out. But a lot of my other friends either they suffered in silence or they deal with their issues in another sort of way. But a lot of them, when they’re nearing college application season, they know that their parents and themselves have super high expectations on where they want to go. Last year, I think around eight people got into Stanford, and I know everything. Not personally, but I know every single one of them by name. And more people got into Cornell’s Ivies, a lot of them into you C’s. You can tell because in your insta in their Instagram bio, they didn’t put a college probably means that they’re not going to college that they’re necessarily proud of.\u003c/p>\n\u003cp>\u003cb>Ericka Cruz Guevarra: \u003c/b>\u003cem>[00:14:29] \u003c/em>Wow.\u003c/p>\n\u003cp>\u003cb>Sophia Shao: \u003c/b>\u003cem>[00:14:30] \u003c/em>Or they didn’t reach that high expectation. But if they did put it in their Instagram bio, then they probably did.\u003c/p>\n\u003cp>\u003cb>Ericka Cruz Guevarra: \u003c/b>\u003cem>[00:14:37] \u003c/em>Well, Sophia, I mean, it’s your senior year. It is. That’s very exciting. I’m curious what you’re looking forward to most this year outside of academics.\u003c/p>\n\u003cp>\u003cb>Sophia Shao: \u003c/b>\u003cem>[00:14:50] \u003c/em>I am so excited for Tennis Season like so excited. I don’t know if I’m going to be captain or not yet, but I am going to be one of the oldest, if not the oldest person on the team. And it feels like only it might be because of the pandemic, but it feels like yesterday where I was a freshman on on my tennis team and the seniors were driving me home. I can’t drive, but it’s like it feels like it’s a roundabout now. I again took a lot of apps. I’m taking six, I believe, and I need to make up a lot of classes from sophomore year. I’m taking classes that I think I’ve never done before or at least are like sort of interesting to me, except for physics.\u003c/p>\n\u003cp>\u003cb>Ericka Cruz Guevarra: \u003c/b>\u003cem>[00:15:42] \u003c/em>But which one are you excited about the most?\u003c/p>\n\u003cp>\u003cb>Sophia Shao: \u003c/b>\u003cem>[00:15:45] \u003c/em>I’m really excited to take AP psych. I think it’ll be yeah, I think it’ll be pretty fun. I’m starting to do emergency medical service type things. I’m excited for my journalism class.\u003c/p>\n\u003cp>\u003cb>Ericka Cruz Guevarra: \u003c/b>\u003cem>[00:15:57] \u003c/em>Ooo love that\u003cem> \u003c/em>\u003c/p>\n\u003cp>\u003cb>Sophia Shao: \u003c/b>\u003cem>[00:15:59] \u003c/em>Yeah. I’ll again be one of the oldest. So it’ll be nice to have everyone new coming in. I hope at least my teacher trusts me enough now, so she’ll let me do, like, solo projects. But I guess we’ll see. Yeah. Senior year it should be. It should be pretty fun.\u003c/p>\n\u003cp>\u003cb>Ericka Cruz Guevarra: \u003c/b>\u003cem>[00:16:23] \u003c/em>Well, I hope that it is fun. Sophia. I hope you enjoy your last year of high school. Thank you so much for joining us.\u003c/p>\n\u003cp>[ad floatright]\u003c/p>\n\u003cp>\u003cb>Sophia Shao: \u003c/b>\u003cem>[00:16:30] \u003c/em>Thank you really appreciate it. \u003cem> [\u003c/em> \u003cb>Ericka Cruz Guevarra: \u003c/b>\u003cem>[00:16:41] \u003c/em>That was Sophia Shao, a former student at Los Altos High School. We checked in with Sophia to see what she’s been up to since this episode first aired in August of 2022. I’m happy to report Sophia is doing great and is finishing up her first year at UC Irvine. She plans to major in human biology and hopes to pursue medical school. And she’s still keeping busy outside of school as well with all of her hobbies. She’s a research assistant studying neural circuits in depression, and she volunteers for a few nonprofits working on suicide prevention. And yes, she’s still boxing, and she tells me she can’t imagine being anywhere else but where she is now. Sophia, it’s so awesome to hear you are thriving in Irvine. We wish you the best of luck with finals this week.\u003c/p>\n\n",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003cp>\u003cspan style=\"font-weight: 400\">At elite high schools in Silicon Valley, the pressure to succeed is intense. And according to Sophia Shao, a former student at Los Altos High School, her proximity to California’s tech capital is a big reason why. \u003c/span>\u003c/p>\n\u003cp>\u003cspan style=\"font-weight: 400\">In this special collaboration with \u003c/span>\u003ca href=\"http://kqed.org/youthtakeover\">\u003cspan style=\"font-weight: 400\">KQED’s Youth Takeover\u003c/span>\u003c/a>\u003cspan style=\"font-weight: 400\">, a yearlong project to highlight compelling stories written and produced by local teens, Shao talks with us about going to school in a place where everyone is expected to excel.\u003c/span>\u003c/p>\n\u003cp>\u003c!-- iframe plugin v.4.3 wordpress.org/plugins/iframe/ -->\u003cbr>\n\u003ciframe loading=\"lazy\" frameborder=\"0\" height=\"200\" scrolling=\"no\" src=\"https://playlist.megaphone.fm/?e=KQINC3806424948\" width=\"100%\" class=\"iframe-class\">\u003c/iframe>\u003c/p>\n\u003cp>\u003ci>\u003cspan style=\"font-weight: 400\">This episode first ran on Aug. 15, 2022\u003c/span>\u003c/i>\u003c/div>",
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"content": "\u003cdiv class=\"post-content post-body\">\u003ch2 id=\"episode-transcript\">Episode Transcript\u003c/h2>\n\u003cp>\u003ci>This is a computer-generated transcript. While our team has reviewed it, there may be errors.\u003c/i>\u003c/p>\n\u003cp>\u003c/p>\n\u003cp>\u003cb>Sophia Shao: \u003c/b>\u003cem>[00:03:57] \u003c/em>My name is Sophia. Sophia Shao. I’m from Los Altos, California. I go to Los Altos High School. I’m 17.5. I guess I’m almost 18. For fun, I play tennis. I box a little bit. I swim a little bit. It’s cool. It’s a little bit of everything.\u003c/p>\n\u003cp>\u003cb>Ericka Cruz Guevarra: \u003c/b>\u003cem>[00:04:19] \u003c/em>I feel like boxing is very rare. I never hear. That.\u003c/p>\n\u003cp>\u003cb>Sophia Shao: \u003c/b>\u003cem>[00:04:22] \u003c/em>Yeah, it’s kind of casual, but, like, it’s a good way to stress relief. Yeah.\u003c/p>\n\u003cp>\u003cb>Ericka Cruz Guevarra: \u003c/b>\u003cem>[00:04:28] \u003c/em>Yeah. Can that makes sense? Can you tell me a little bit about your family sophia?\u003c/p>\n\u003cp>\u003cb>Sophia Shao: \u003c/b>\u003cem>[00:04:34] \u003c/em>My parents both immigrated here from China. My dad went to one of the top universities in China, and both of them were able to move to the US. Right now, my grandparents are staying with us, which is pretty nice. My little sister is a rising sophomore in high school, so she’s excited for that.\u003c/p>\n\u003cp>\u003cb>Ericka Cruz Guevarra: \u003c/b>\u003cem>[00:05:00] \u003c/em>I’m curious. Growing up in Milpitas and then also now. I Mean, you’re still growing up in many ways in Los Altos. What are the people you’re growing up around like?\u003c/p>\n\u003cp>\u003cb>Sophia Shao: \u003c/b>\u003cem>[00:05:13] \u003c/em>When I was in elementary school, obviously, I remember there was a really big emphasis on the AMC test. Like, what’s that? It was like a big math competition. Specifically, remember the two kids who got the best scores in our school? And then I got third. And then in eighth grade where we had like an actual graduation with caps and gowns. And we had little ropes that we hung around or not. If you had a 4.0 and a four or a 4.5. We had awards for every grade. I remember I got to very proud of myself. And parents are also very proud of me because you got to stand in front of the stage and have you just say a speech about you. Wow. But it’s kind of those things where you just kind of grow up knowing that you need to be at a certain caliber to compete with everyone else. I just I remember growing up like that and being really upset when I got like a 3.9 or 3.8. I was so obsessed with getting A’s and I think I carried that with me tonight. Great. And it just hit me like a ton of bricks.\u003c/p>\n\u003cp>\u003cb>Ericka Cruz Guevarra: \u003c/b>\u003cem>[00:06:42] \u003c/em>I mean, you also grew up in an immigrant household, which for me has come with, I think, like a certain pressure to succeed, at least in the sense that I felt like I should live a better life than my parents had. Right. I’m curious if that’s similar to your experience at all.\u003c/p>\n\u003cp>\u003cb>Sophia Shao: \u003c/b>\u003cem>[00:07:00] \u003c/em>I think in the beginning it was when I was in elementary school if when I was in middle school, because they took such long sacrifices to get us where we were today. And when I moved to Los Altos, though, and I started high school, that almost faded in a way, mostly because I started piling on like work after work. Like, for example, today I have this obviously in the morning at about 130. I have a physical for my tennis season that’s coming up in a week. And then after that, I’m helping out my coach with something and they’re all things that I kind of signed up for that. And I probably have to do call jobs because tomorrow at 830, I have a college counselor meeting. My goodness. It’s kind of been my summer. So it’s gotten to the point where my parents are just like, you need to cool down, like just takes some things off of your schedule. So at this point, it’s like the parents are there. Like if it’s okay, if you don’t become like a heart surgeon or something.\u003c/p>\n\u003cp>\u003cb>Ericka Cruz Guevarra: \u003c/b>\u003cem>[00:08:11] \u003c/em>It’s interesting because it sounds like the pressure isn’t necessarily coming from your parents, but like, more like yourself. Like a self-imposed pressure?\u003c/p>\n\u003cp>\u003cb>Sophia Shao: \u003c/b>\u003cem>[00:08:21] \u003c/em>Yeah. I mean, I really like being busy. It used to be because of college, and I think a lot of people still do it because of college.\u003c/p>\n\u003cp>\u003cb>Ericka Cruz Guevarra: \u003c/b>\u003cem>[00:08:31] \u003c/em>Yeah. Like, you want to get into the best school.\u003c/p>\n\u003cp>\u003cb>Sophia Shao: \u003c/b>\u003cem>[00:08:34] \u003c/em>Right. But like at this point, I just kind of I’m used to it, so it’s like, I’ll just keep doing it, I guess.\u003c/p>\n\u003cp>\u003cb>Ericka Cruz Guevarra: \u003c/b>\u003cem>[00:08:42] \u003c/em>When you were a freshman, though, what were like how did this stress show up in conversations that you had with your friends? Like where you all just like struggling every day, just like, my God, I hate this math homework right now. Or like, did you have friends who noticed that stress to do that come up in their conversations?\u003c/p>\n\u003cp>\u003cb>Sophia Shao: \u003c/b>\u003cem>[00:09:02] \u003c/em>I remember the first time I had a conversation about college was freshman year, and when I was in freshman year, any two colleges I knew Stanford and Harvard. And I remember sophomore year I asked my appearance for a college counselor because I was still in the mindset of do whatever on your resume. They can get you into college.\u003c/p>\n\u003cp>\u003cb>Ericka Cruz Guevarra: \u003c/b>\u003cem>[00:09:27] \u003c/em>What was the turning point for you then? Did you have a turning point where you were like, This is too much for me?\u003c/p>\n\u003cp>\u003cb>Sophia Shao: \u003c/b>\u003cem>[00:09:35] \u003c/em>Sophomore year, summer, junior year, I kind of had a mental health episode. And that kind of it did kind of shift me into perspective because I went to like a bunch of hospitals and I saw kind of the state that the pandemic and being in Silicon Valley had left me in. And I talked to a lot of the psychiatrist there, and they told me that a lot of the people who come to mental hospitals and asylums, they’re from areas like Super Chino and Los Altos, who are also known for churning out like higher success rates, high graduating rates. Wow. And it kind of just hit me that I would just rather do things that I like doing rather than having to follow some sort of guidebook. You start this thing and you start this thing and you’re the founder of this club. It just you go down the list of what, a college football.\u003c/p>\n\u003cp>\u003cb>Ericka Cruz Guevarra: \u003c/b>\u003cem>[00:11:00] \u003c/em>So you realized that this pressure was eating at your soul, right? It sounds like. Yeah. And that a lot of it comes from just growing up in a place that values success and achievement over all else. Yeah. How do you fight against that?\u003c/p>\n\u003cp>\u003cb>Sophia Shao: \u003c/b>\u003cem>[00:11:18] \u003c/em>As like, bad as it is, if I just put it in like, a phrase I just don’t really care about. I mean, obviously, I want to get into college. Like, I don’t want people to listen to this and be like, Yes, I do want to get into college. It would be nice, but. I don’t want getting into a good college. Kind of take away from me actually living my life and going through each day.\u003c/p>\n\u003cp>\u003cb>Ericka Cruz Guevarra: \u003c/b>\u003cem>[00:11:50] \u003c/em>I mean, what things do you love to do and hope to do?\u003c/p>\n\u003cp>\u003cb>Sophia Shao: \u003c/b>\u003cem>[00:11:54] \u003c/em>I love helping people. I’ve talked to a friend about this who got into you. Chicago. If he hears this, isn’t so happy that you did. But he kind of helped me put it into words where I want to make a measurable impact on helping people, especially people in marginalized communities and kids. Because I worked at it as a head coach at a local sports camp. I love helping kids, especially the people, the kids that are either on the spectrum or have trouble controlling their emotions because I kind of see me a little bit in that and I feel like I don’t know. It just feels amazing to be able to make a difference for those kids. I like volunteering. I love playing tennis. My ball kid. Yesterday I got to meet Naomi Osaka and saw her practicing. I know. And that was awesome. Is that going to help my college resumé? Not that much. Am I ever going to see Naomi Osaka, like, five feet away from me? Probably not. So it’s like a give and take system.\u003c/p>\n\u003cp>\u003cb>Ericka Cruz Guevarra: \u003c/b>\u003cem>[00:13:03] \u003c/em>I mean, it is. So it’s. Speaking of college, it’s college application season. What are your conversations with your friends like now?\u003c/p>\n\u003cp>\u003cb>Sophia Shao: \u003c/b>\u003cem>[00:13:12] \u003c/em>My thing is I had a lot of issues in high school that I got over and a lot of comebacks that I’ve made, but it doesn’t the comebacks don’t show up on my GPA and my score. And I’m much more proud of my comebacks than him. Anything else.\u003c/p>\n\u003cp>\u003cb>Ericka Cruz Guevarra: \u003c/b>\u003cem>[00:13:31] \u003c/em>Like personal comebacks?\u003c/p>\n\u003cp>\u003cb>Sophia Shao: \u003c/b>\u003cem>[00:13:34] \u003c/em>Yeah personal comebacks\u003cem> \u003c/em>\u003c/p>\n\u003cp>\u003cb>Ericka Cruz Guevarra: \u003c/b>\u003cem>[00:13:34] \u003c/em>Not academic comebacks.\u003cem> \u003c/em>\u003c/p>\n\u003cp>\u003cb>Sophia Shao: \u003c/b>\u003cem>[00:13:37] \u003c/em>But so many of my friends. So that’s the reason why I’m not as stressed out. But a lot of my other friends either they suffered in silence or they deal with their issues in another sort of way. But a lot of them, when they’re nearing college application season, they know that their parents and themselves have super high expectations on where they want to go. Last year, I think around eight people got into Stanford, and I know everything. Not personally, but I know every single one of them by name. And more people got into Cornell’s Ivies, a lot of them into you C’s. You can tell because in your insta in their Instagram bio, they didn’t put a college probably means that they’re not going to college that they’re necessarily proud of.\u003c/p>\n\u003cp>\u003cb>Ericka Cruz Guevarra: \u003c/b>\u003cem>[00:14:29] \u003c/em>Wow.\u003c/p>\n\u003cp>\u003cb>Sophia Shao: \u003c/b>\u003cem>[00:14:30] \u003c/em>Or they didn’t reach that high expectation. But if they did put it in their Instagram bio, then they probably did.\u003c/p>\n\u003cp>\u003cb>Ericka Cruz Guevarra: \u003c/b>\u003cem>[00:14:37] \u003c/em>Well, Sophia, I mean, it’s your senior year. It is. That’s very exciting. I’m curious what you’re looking forward to most this year outside of academics.\u003c/p>\n\u003cp>\u003cb>Sophia Shao: \u003c/b>\u003cem>[00:14:50] \u003c/em>I am so excited for Tennis Season like so excited. I don’t know if I’m going to be captain or not yet, but I am going to be one of the oldest, if not the oldest person on the team. And it feels like only it might be because of the pandemic, but it feels like yesterday where I was a freshman on on my tennis team and the seniors were driving me home. I can’t drive, but it’s like it feels like it’s a roundabout now. I again took a lot of apps. I’m taking six, I believe, and I need to make up a lot of classes from sophomore year. I’m taking classes that I think I’ve never done before or at least are like sort of interesting to me, except for physics.\u003c/p>\n\u003cp>\u003cb>Ericka Cruz Guevarra: \u003c/b>\u003cem>[00:15:42] \u003c/em>But which one are you excited about the most?\u003c/p>\n\u003cp>\u003cb>Sophia Shao: \u003c/b>\u003cem>[00:15:45] \u003c/em>I’m really excited to take AP psych. I think it’ll be yeah, I think it’ll be pretty fun. I’m starting to do emergency medical service type things. I’m excited for my journalism class.\u003c/p>\n\u003cp>\u003cb>Ericka Cruz Guevarra: \u003c/b>\u003cem>[00:15:57] \u003c/em>Ooo love that\u003cem> \u003c/em>\u003c/p>\n\u003cp>\u003cb>Sophia Shao: \u003c/b>\u003cem>[00:15:59] \u003c/em>Yeah. I’ll again be one of the oldest. So it’ll be nice to have everyone new coming in. I hope at least my teacher trusts me enough now, so she’ll let me do, like, solo projects. But I guess we’ll see. Yeah. Senior year it should be. It should be pretty fun.\u003c/p>\n\u003cp>\u003cb>Ericka Cruz Guevarra: \u003c/b>\u003cem>[00:16:23] \u003c/em>Well, I hope that it is fun. Sophia. I hope you enjoy your last year of high school. Thank you so much for joining us.\u003c/p>\n\u003cp>\u003c/p>\n\u003cp>\u003cb>Sophia Shao: \u003c/b>\u003cem>[00:16:30] \u003c/em>Thank you really appreciate it. \u003cem> [\u003c/em> \u003cb>Ericka Cruz Guevarra: \u003c/b>\u003cem>[00:16:41] \u003c/em>That was Sophia Shao, a former student at Los Altos High School. We checked in with Sophia to see what she’s been up to since this episode first aired in August of 2022. I’m happy to report Sophia is doing great and is finishing up her first year at UC Irvine. She plans to major in human biology and hopes to pursue medical school. And she’s still keeping busy outside of school as well with all of her hobbies. She’s a research assistant studying neural circuits in depression, and she volunteers for a few nonprofits working on suicide prevention. And yes, she’s still boxing, and she tells me she can’t imagine being anywhere else but where she is now. Sophia, it’s so awesome to hear you are thriving in Irvine. We wish you the best of luck with finals this week.\u003c/p>\n\n\u003c/div>"
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"content": "\u003cp>The family of a teenager who \u003ca href=\"https://www.kqed.org/news/11981317/sunnyvale-police-release-body-cam-footage-of-last-weeks-fatal-shooting\">Sunnyvale police shot and killed in March\u003c/a> has filed a claim against the city, alleging that police failed to de-escalate the situation or use less lethal weapons before using deadly force.\u003c/p>\n\u003cp>Emmanuel Perez Becerra, 19, was in the midst of a mental health crisis on March 23 and called police for help. But when officers arrived, Perez was naked from the waist down and walking around the Plaza Del Rey mobile home park with a knife. The Sunnyvale police department released \u003ca href=\"https://www.youtube.com/watch?si=Hg8OKOppKw-w8s4I&t=316&v=rr82N1ChfB0&feature=youtu.be\">footage from the fatal shooting\u003c/a> during a press conference on March 29 as part of the investigation into the incident. The two officers involved are now back at work after being on administrative leave.\u003c/p>\n\u003cp>[aside postID=\"news_11981317\" label=\"Related Story\"]The claim filed Friday against the city of Sunnyvale said that an officer began yelling commands at Perez before shooting him. Following the shooting, the Sunnyvale Department of Public Safety \u003ca href=\"https://www.sunnyvale.ca.gov/home/showpublisheddocument/5135/638469718419030000\">issued a news release\u003c/a>, saying, “The officers gave the subject commands to stay where he was and to place the knife on the ground. The subject ignored the officers’ repeated commands and advanced on one of the officers.”\u003c/p>\n\u003cp>The claim filed on behalf of the Perez family said available video footage, including police body camera, shows Perez “did not verbally threaten any officers nor point the knife at any officer” before Sunnyvale Officer Kevin Lemos shot and killed him. The claim also states Lemos “prohibited” a second unnamed officer “from providing any assistance or non-lethal measures to de-escalate the situation or apprehend Emmanuel.”\u003c/p>\n\u003cfigure id=\"attachment_11981319\" class=\"wp-caption aligncenter\" style=\"max-width: 563px\">\u003ca href=\"https://cdn.kqed.org/wp-content/uploads/sites/10/2024/03/PHOTO-2024-03-27-19-56-12.jpg\">\u003cimg loading=\"lazy\" decoding=\"async\" class=\"size-full wp-image-11981319\" src=\"https://cdn.kqed.org/wp-content/uploads/sites/10/2024/03/PHOTO-2024-03-27-19-56-12.jpg\" alt=\"a teenager wearing glasses and a baseball hat\" width=\"563\" height=\"1218\" srcset=\"https://cdn.kqed.org/wp-content/uploads/sites/10/2024/03/PHOTO-2024-03-27-19-56-12.jpg 563w, https://cdn.kqed.org/wp-content/uploads/sites/10/2024/03/PHOTO-2024-03-27-19-56-12-160x346.jpg 160w\" sizes=\"(max-width: 563px) 100vw, 563px\">\u003c/a>\u003cfigcaption class=\"wp-caption-text\">Emmanuel Perez Becerra, 19, was shot and killed by Sunnyvale police officers on March 23, 2024. \u003ccite>(Courtesy of Jonathan Perez)\u003c/cite>\u003c/figcaption>\u003c/figure>\n\u003cp>Adante Pointer — the attorney who filed the claim ahead of a planned federal civil rights lawsuit — said the officers did not follow their training by de-escalating the situation and putting distance between themselves and someone armed with a knife.\u003c/p>\n\u003cp>[ad fullwidth]\u003c/p>\n\u003cp>“You don’t yell threats to the person who’s in a mental health crisis because it ratchets up the tension, the anxiety, and turns it into a more unpredictable situation. And that’s exactly what the officer did,” he said.\u003c/p>\n\u003cp>Pointer said Perez’s mental health problems started when he was in high school, where he had been a good student with good grades. But, as his mental health issues progressed, he had several contacts with law enforcement.\u003c/p>\n\u003cp>“Sunnyvale police had come out to his home on previous occasions because of his mental health issues, so they were familiar with him,” Pointer said. “They were familiar with what he was suffering from and understood that he had not ever harmed anyone.”\u003c/p>\n\u003cp>Pointer said that had police followed their training, Perez would have been able to celebrate his 20th birthday on Saturday.\u003c/p>\n\u003cp>“He called the police for help. Instead of receiving the help he deserved, and frankly, is required, he was met with bullets and ultimately death,” Pointer said.\u003c/p>\n\u003cp>Jennifer Garnett, a city spokesperson, said the city doesn’t have a record of the claim being filed as of Sunday, but they typically don’t comment on pending litigation.\u003c/p>\n\u003cp>The city said SDPS is investigating the shooting and the Santa Clara County District Attorney’s Office, per county protocol.\u003c/p>\n\u003cp>\u003c/p>\n\u003cp>\u003cem>KQED’s Brian Krans contributed reporting to this story.\u003c/em>\u003c/p>\n\n",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003cp>The family of a teenager who \u003ca href=\"https://www.kqed.org/news/11981317/sunnyvale-police-release-body-cam-footage-of-last-weeks-fatal-shooting\">Sunnyvale police shot and killed in March\u003c/a> has filed a claim against the city, alleging that police failed to de-escalate the situation or use less lethal weapons before using deadly force.\u003c/p>\n\u003cp>Emmanuel Perez Becerra, 19, was in the midst of a mental health crisis on March 23 and called police for help. But when officers arrived, Perez was naked from the waist down and walking around the Plaza Del Rey mobile home park with a knife. The Sunnyvale police department released \u003ca href=\"https://www.youtube.com/watch?si=Hg8OKOppKw-w8s4I&t=316&v=rr82N1ChfB0&feature=youtu.be\">footage from the fatal shooting\u003c/a> during a press conference on March 29 as part of the investigation into the incident. The two officers involved are now back at work after being on administrative leave.\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"content": "\u003cdiv class=\"post-body\">\u003cp>The claim filed Friday against the city of Sunnyvale said that an officer began yelling commands at Perez before shooting him. Following the shooting, the Sunnyvale Department of Public Safety \u003ca href=\"https://www.sunnyvale.ca.gov/home/showpublisheddocument/5135/638469718419030000\">issued a news release\u003c/a>, saying, “The officers gave the subject commands to stay where he was and to place the knife on the ground. The subject ignored the officers’ repeated commands and advanced on one of the officers.”\u003c/p>\n\u003cp>The claim filed on behalf of the Perez family said available video footage, including police body camera, shows Perez “did not verbally threaten any officers nor point the knife at any officer” before Sunnyvale Officer Kevin Lemos shot and killed him. The claim also states Lemos “prohibited” a second unnamed officer “from providing any assistance or non-lethal measures to de-escalate the situation or apprehend Emmanuel.”\u003c/p>\n\u003cfigure id=\"attachment_11981319\" class=\"wp-caption aligncenter\" style=\"max-width: 563px\">\u003ca href=\"https://cdn.kqed.org/wp-content/uploads/sites/10/2024/03/PHOTO-2024-03-27-19-56-12.jpg\">\u003cimg loading=\"lazy\" decoding=\"async\" class=\"size-full wp-image-11981319\" src=\"https://cdn.kqed.org/wp-content/uploads/sites/10/2024/03/PHOTO-2024-03-27-19-56-12.jpg\" alt=\"a teenager wearing glasses and a baseball hat\" width=\"563\" height=\"1218\" srcset=\"https://cdn.kqed.org/wp-content/uploads/sites/10/2024/03/PHOTO-2024-03-27-19-56-12.jpg 563w, https://cdn.kqed.org/wp-content/uploads/sites/10/2024/03/PHOTO-2024-03-27-19-56-12-160x346.jpg 160w\" sizes=\"(max-width: 563px) 100vw, 563px\">\u003c/a>\u003cfigcaption class=\"wp-caption-text\">Emmanuel Perez Becerra, 19, was shot and killed by Sunnyvale police officers on March 23, 2024. \u003ccite>(Courtesy of Jonathan Perez)\u003c/cite>\u003c/figcaption>\u003c/figure>\n\u003cp>Adante Pointer — the attorney who filed the claim ahead of a planned federal civil rights lawsuit — said the officers did not follow their training by de-escalating the situation and putting distance between themselves and someone armed with a knife.\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>“You don’t yell threats to the person who’s in a mental health crisis because it ratchets up the tension, the anxiety, and turns it into a more unpredictable situation. And that’s exactly what the officer did,” he said.\u003c/p>\n\u003cp>Pointer said Perez’s mental health problems started when he was in high school, where he had been a good student with good grades. But, as his mental health issues progressed, he had several contacts with law enforcement.\u003c/p>\n\u003cp>“Sunnyvale police had come out to his home on previous occasions because of his mental health issues, so they were familiar with him,” Pointer said. “They were familiar with what he was suffering from and understood that he had not ever harmed anyone.”\u003c/p>\n\u003cp>Pointer said that had police followed their training, Perez would have been able to celebrate his 20th birthday on Saturday.\u003c/p>\n\u003cp>“He called the police for help. Instead of receiving the help he deserved, and frankly, is required, he was met with bullets and ultimately death,” Pointer said.\u003c/p>\n\u003cp>Jennifer Garnett, a city spokesperson, said the city doesn’t have a record of the claim being filed as of Sunday, but they typically don’t comment on pending litigation.\u003c/p>\n\u003cp>The city said SDPS is investigating the shooting and the Santa Clara County District Attorney’s Office, per county protocol.\u003c/p>\n\u003cp>\u003c/p>\n\u003cp>\u003cem>KQED’s Brian Krans contributed reporting to this story.\u003c/em>\u003c/p>\n\n\u003c/div>\u003c/p>",
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"content": "\u003cp>As Dr. Rishi Patel’s street medicine van bounces over dirt roads and empty fields in rural Kern County, he’s looking for a particular patient he knows is overdue for her shot.\u003c/p>\n\u003cp>The woman, who has schizophrenia and has been living outside for five years, has several goals for herself: Start thinking more clearly, stop using meth and get an ID so she can visit her son in jail. Patel hopes the shot — a long-acting antipsychotic — will help her meet all of them.\u003c/p>\n\u003cp>Patel, medical director of Akido Street Medicine, is one of many street doctors throughout California using these injections as an increasingly common tool to help combat the state’s intertwined homelessness and mental health crises. Typically administered into a patient’s shoulder muscle, the medication slowly releases into the bloodstream over time, providing relief from symptoms of psychosis for a month or longer. The shots replace a patient’s oral medication — no more taking a pill every day. For people who are homeless and routinely have their pills stolen, can’t make it to a pharmacy for a refill or simply forget to take them, the shots can mean the difference between staying on their medication, or not.\u003c/p>\n\u003cp>“They’ve been an absolute game-changer,” Patel said.\u003c/p>\n\u003cp>Street medicine teams bring the shots directly to their patients wherever they are — whether it’s in a tent along Skid Row in Los Angeles, in a dugout in the middle of a field in the Central Valley, or along the bank of a stream in Shasta County. Doctors can diagnose someone, prescribe the medication, get their consent and give the shot within a matter of days — or sometimes even more quickly — and with minimal paperwork and red tape. They don’t need a psychiatrist’s sign-off.\u003c/p>\n\u003cp>[ad fullwidth]\u003c/p>\n\u003cp>It’s estimated that California is home to more than 180,000 homeless residents. \u003ca href=\"https://calmatters.org/housing/2023/08/care-court-california-start/\">How to help\u003c/a> the sickest of them — people with severe, untreated psychosis who might wander into traffic or otherwise put themselves in danger — has become a \u003ca href=\"https://calmatters.org/health/mental-health/2023/12/mental-health-conservatorship-newsom/\">hot-button issue\u003c/a>, with Gov. Gavin Newsom and state lawmakers creating new and sometimes controversial ways to get people into treatment. In a recent \u003ca href=\"https://homelessness.ucsf.edu/sites/default/files/2023-06/CASPEH_Report_62023.pdf\">UCSF survey (PDF)\u003c/a> of homeless Californians, 12% reported experiencing hallucinations in the past 30 days, and more than a quarter said they’d ever been hospitalized for a mental health condition.\u003c/p>\n\u003cp>Doctors say the goal of giving an antipsychotic shot to someone living in an encampment is to get them thinking clearly, so that they can start engaging with social workers, sign up for benefits and get on housing waitlists. While Newsom’s new CARE Court allows judges to order people into mental health treatment, and other recent legislation makes it easier to put people with a serious mental illness into conservatorships, doctors administering street injections take a different approach. The treatment is voluntary, and people can get help where they are, instead of in a locked facility.[aside label=\"Related Stories\" tag=\"homelessness\"]Some success stories are dramatic. Doctors talk about patients who one day are babbling incoherently, and a week after a shot, are having conversations.\u003c/p>\n\u003cp>“It’s been pretty common that that’s the initiation of, ‘We’re going indoors,’” said Dr. Coley King, director of homeless health care for the Venice Family Clinic in Los Angeles. He said he’s seen dozens of patients get off the street after taking these shots.\u003c/p>\n\u003cp>As with any medication, the shots can have side effects. And while a patient can stop taking a pill and generally put a stop to a negative reaction, once they’ve been given a shot, they have no choice but to wait a month for the drug to wear off.\u003c/p>\n\u003cp>Despite some street doctors’ rave reviews, injectable antipsychotics still aren’t reaching everyone who experts say they could help. Street medicine teams report having just a handful of patients on these medications at any one time (King’s team in Los Angeles has about two dozen). Some patients don’t want the shots, balking at the idea of having a drug in their system for an entire month, especially if they have feelings of paranoia related to health care.\u003c/p>\n\u003cp>And street doctors complain that hospitals still seem to prefer discharging patients from temporary psychiatric holds with a bottle of pills they may or may not take — instead of giving them a long-acting shot.\u003c/p>\n\u003ch2 id=\"h-losing-track-of-patients\" class=\"wp-block-heading\">Losing track of patients\u003c/h2>\n\u003cp>One of the biggest challenges street doctors face in administering these shots is following up with patients.\u003c/p>\n\u003cp>In Kern County, Patel hasn’t seen the woman he’s looking for since his team gave her first antipsychotic shot almost two months ago. Now she’s past due for another dose.\u003c/p>\n\u003cp>It’s worrying, Patel said, “because I don’t know how she did on it.”\u003c/p>\n\u003cp>The last place they saw her was at an encampment known as “The Sump” in the Central Valley farming community of Lamont, where she lived in a plywood shack along a muddy ditch behind a farm. But code enforcement recently cleared everyone out of that area, and Patel’s team doesn’t have a phone number or any other way to contact her.\u003c/p>\n\u003cfigure id=\"attachment_11989533\" class=\"wp-caption aligncenter\" style=\"max-width: 1568px\">\u003cimg loading=\"lazy\" decoding=\"async\" class=\"size-full wp-image-11989533\" src=\"https://cdn.kqed.org/wp-content/uploads/sites/10/2024/06/053124-Bakersfield-Injectable-LV_15-ezgif.com-webp-to-jpg-converter.jpg\" alt=\"\" width=\"1568\" height=\"1045\" srcset=\"https://cdn.kqed.org/wp-content/uploads/sites/10/2024/06/053124-Bakersfield-Injectable-LV_15-ezgif.com-webp-to-jpg-converter.jpg 1568w, https://cdn.kqed.org/wp-content/uploads/sites/10/2024/06/053124-Bakersfield-Injectable-LV_15-ezgif.com-webp-to-jpg-converter-800x533.jpg 800w, https://cdn.kqed.org/wp-content/uploads/sites/10/2024/06/053124-Bakersfield-Injectable-LV_15-ezgif.com-webp-to-jpg-converter-1020x680.jpg 1020w, https://cdn.kqed.org/wp-content/uploads/sites/10/2024/06/053124-Bakersfield-Injectable-LV_15-ezgif.com-webp-to-jpg-converter-160x107.jpg 160w, https://cdn.kqed.org/wp-content/uploads/sites/10/2024/06/053124-Bakersfield-Injectable-LV_15-ezgif.com-webp-to-jpg-converter-1536x1024.jpg 1536w\" sizes=\"auto, (max-width: 1568px) 100vw, 1568px\">\u003cfigcaption class=\"wp-caption-text\">Dr. Rishi Patel from the Akido street medicine team checks on several unhoused people on May 28, 2024. Street medicine teams throughout California are increasingly using long-acting injectable antipsychotic medication to stabilize the mental health of people living in homeless encampments. \u003ccite>(Larry Valenzuela/CalMatters/CatchLight Local)\u003c/cite>\u003c/figcaption>\u003c/figure>\n\u003cp>The first place they look is another encampment known as “the Shrine,” because it once held a shrine to Santa Muerte, a Mexican saint of death often prayed to by drug dealers. The team drives the van through an empty field of dead, yellow grass. Several people are living in room-sized pits they’ve dug into the dirt and covered with tarps and sheets of metal. Next to the vacant land is a vineyard, with rows of vines dotted with small, green grapes.\u003c/p>\n\u003cp>She’s not there, so the team hands out sack lunches and bottles of water, then gets back in the van and leaves.\u003c/p>\n\u003cp>“We’ve seen results,” said Kirk McGowan, a street medicine nurse with Akido. “But we’ve seen more failures than successes. That’s just kind of the nature of the situation.”\u003c/p>\n\u003ch2>Who should prescribe antipsychotic injections?\u003c/h2>\n\u003cp>In most cases, the people prescribing and administering antipsychotic shots in homeless encampments are general practice doctors — not specially trained psychiatrists. That’s because despite the growing prevalence of street medicine, street psychiatrists are still rare, according to a recent \u003ca href=\"https://www.chcf.org/wp-content/uploads/2023/03/CAStreetMedLandscapeSurveyReport.pdf\">USC report (PDF)\u003c/a>.\u003c/p>\n\u003cp>“You look over your shoulder and there’s not a psychiatrist there helping you out,” King said. “And we want to meet the need. We want to take care of these patients. They’re really, really ill, they’re really disorganized, and suffering and dying on the streets.”\u003c/p>\n\u003cp>There are no legal restrictions preventing a general practice doctor from administering these injections. But some practitioners think the responsibility should be reserved for psychiatric providers.\u003c/p>\n\u003cfigure id=\"attachment_11989539\" class=\"wp-caption aligncenter\" style=\"max-width: 2000px\">\u003cimg loading=\"lazy\" decoding=\"async\" class=\"size-full wp-image-11989539\" src=\"https://cdn.kqed.org/wp-content/uploads/sites/10/2024/06/053124-Bakersfield-Injectable-LV_11-ezgif.com-webp-to-jpg-converter.jpg\" alt=\"\" width=\"2000\" height=\"1333\" srcset=\"https://cdn.kqed.org/wp-content/uploads/sites/10/2024/06/053124-Bakersfield-Injectable-LV_11-ezgif.com-webp-to-jpg-converter.jpg 2000w, https://cdn.kqed.org/wp-content/uploads/sites/10/2024/06/053124-Bakersfield-Injectable-LV_11-ezgif.com-webp-to-jpg-converter-800x533.jpg 800w, https://cdn.kqed.org/wp-content/uploads/sites/10/2024/06/053124-Bakersfield-Injectable-LV_11-ezgif.com-webp-to-jpg-converter-1020x680.jpg 1020w, https://cdn.kqed.org/wp-content/uploads/sites/10/2024/06/053124-Bakersfield-Injectable-LV_11-ezgif.com-webp-to-jpg-converter-160x107.jpg 160w, https://cdn.kqed.org/wp-content/uploads/sites/10/2024/06/053124-Bakersfield-Injectable-LV_11-ezgif.com-webp-to-jpg-converter-1536x1024.jpg 1536w, https://cdn.kqed.org/wp-content/uploads/sites/10/2024/06/053124-Bakersfield-Injectable-LV_11-ezgif.com-webp-to-jpg-converter-1920x1280.jpg 1920w\" sizes=\"auto, (max-width: 2000px) 100vw, 2000px\">\u003cfigcaption class=\"wp-caption-text\">Dr. Rishi Patel from the Akido street medicine team checks on an unhoused man living in a vineyard in Arvin on May 28, 2024. Street medicine teams throughout California are increasingly using long-acting injectable antipsychotic medication to stabilize the mental health of people living in homeless encampments. \u003ccite>(Larry Valenzuela/CalMatters/CatchLight Local)\u003c/cite>\u003c/figcaption>\u003c/figure>\n\u003cp>“These medications are in there for an extended period of time,” said Keri Weinstock, a psychiatric nurse practitioner who practices street medicine in Shasta County. “They do come with risks. There are specialty things that come along with some of these specialty meds, and it’s a lot to learn when you have to know everything else, too.”\u003c/p>\n\u003cp>Some street doctors who give these shots seek out additional psychiatric training, while others learn on the job — often with a psychiatrist on speed dial, just in case.\u003c/p>\n\u003cp>“I don’t think it’s rocket science to diagnose schizophrenia, as long as we’ve done it with some thoughtfulness,” King said.\u003c/p>\n\u003cp>In-the-field diagnoses aren’t always clear-cut, Patel said. Sometimes, people do such a good job of hiding their symptoms that it’s hard to tell they’re dealing with psychosis. Or, instead of experiencing obvious hallucinations or other symptoms commonly associated with schizophrenia, patients experience “negative symptoms,” such as extreme social withdrawal.\u003c/p>\n\u003cp>When those types of cases arise, Patel calls a psychologist for a second opinion.\u003c/p>\n\u003cp>While these drugs are generally considered safe, they do come with a risk of side effects that can include dizziness, sedation, stiffness and decreased mobility. Those symptoms might be no big deal for someone living in a house, but for someone on the street, could be catastrophic, said Dr. Shayan Rab, a street psychiatrist with Los Angeles County’s Homeless Outreach and Mobile Engagement team. It could make someone more vulnerable to being attacked or robbed, or prevent them from accessing food or shelter.\u003c/p>\n\u003cp>“It’s a very serious kind of action that’s being taken and a lot of time needs to be spent before you say, ‘Hey, this individual is safe for a long-acting injection,’” he said.\u003c/p>\n\u003cp>To make sure a patient doesn’t have an adverse reaction, doctors typically give them an oral dose of the same medication for a few days before administering the shot.\u003c/p>\n\u003cfigure id=\"attachment_11989540\" class=\"wp-caption aligncenter\" style=\"max-width: 1568px\">\u003cimg loading=\"lazy\" decoding=\"async\" class=\"size-full wp-image-11989540\" src=\"https://cdn.kqed.org/wp-content/uploads/sites/10/2024/06/053124-Bakersfield-Injectable-LV_20-ezgif.com-webp-to-jpg-converter.jpg\" alt=\"\" width=\"1568\" height=\"1045\" srcset=\"https://cdn.kqed.org/wp-content/uploads/sites/10/2024/06/053124-Bakersfield-Injectable-LV_20-ezgif.com-webp-to-jpg-converter.jpg 1568w, https://cdn.kqed.org/wp-content/uploads/sites/10/2024/06/053124-Bakersfield-Injectable-LV_20-ezgif.com-webp-to-jpg-converter-800x533.jpg 800w, https://cdn.kqed.org/wp-content/uploads/sites/10/2024/06/053124-Bakersfield-Injectable-LV_20-ezgif.com-webp-to-jpg-converter-1020x680.jpg 1020w, https://cdn.kqed.org/wp-content/uploads/sites/10/2024/06/053124-Bakersfield-Injectable-LV_20-ezgif.com-webp-to-jpg-converter-160x107.jpg 160w, https://cdn.kqed.org/wp-content/uploads/sites/10/2024/06/053124-Bakersfield-Injectable-LV_20-ezgif.com-webp-to-jpg-converter-1536x1024.jpg 1536w\" sizes=\"auto, (max-width: 1568px) 100vw, 1568px\">\u003cfigcaption class=\"wp-caption-text\">An Abilify Maintena shot being prepared by the Akido street medicine team at their main office in Bakersfield on May 28, 2024. Street medicine teams throughout California are increasingly using long-acting injectable antipsychotic medication to stabilize the mental health of people living in homeless encampments. \u003ccite>(Larry Valenzuela/CalMatters/CatchLight Local)\u003c/cite>\u003c/figcaption>\u003c/figure>\n\u003cp>There’s also a risk that after a street doctor gives someone a shot, that patient could later get sent to the hospital on a temporary psychiatric hold. Doctors there might not know the patient already has a long-acting dose of antipsychotic medication in their body, and might give them another dose.\u003c/p>\n\u003cp>Before giving someone a shot, Dr. Aislinn Bird wants to be 100% sure their symptoms are actually caused by psychotic disorder, such as schizophrenia, and not complex PTSD, major depressive disorder, methamphetamine use, or something else. Overdiagnosis of psychotic disorders is rampant, especially in the African American community, Bird said.\u003c/p>\n\u003cp>“You have to be sure you really know the correct diagnosis,” said Bird, who serves as director of Integrated Care at Health Care for the Homeless in Alameda County.\u003c/p>\n\u003cp>But Dr. Susan Partovi, who practices street medicine on Skid Row in Los Angeles, said that’s an “antiquated way of thinking.” When someone is experiencing psychosis, it’s an emergency that needs to be treated as soon as possible, no matter the cause, she said. Her preference is to treat the symptoms first, and then see if the patient wants to work on other issues, such as substance use.\u003c/p>\n\u003cp>Antipsychotic injectables, such as Abilify and Invega, tend to be most prevalent in street medicine practices. But street doctors also administer long-acting injectable HIV medication, as well as medication for addiction such as Vivitrol — an injectable, long-acting medication that can help reduce cravings for opioids and alcohol, and protect against overdose.\u003c/p>\n\u003ch2 id=\"h-silencing-the-voices-in-his-head\" class=\"wp-block-heading\">Silencing the voices in his head\u003c/h2>\n\u003cp>Ricardo Fonseca Jr., who goes by “Ricky,” has been homeless for two years, living in a tent behind a Dollar Tree, then in a park in rural Kern County. The 31-year-old said he was working as a welder until he had a sudden mental breakdown and started hearing voices.\u003c/p>\n\u003cp>The voices said horrible things to him. Sometimes they yelled, and he yelled back, scaring those around him. He used methamphetamine to cope.\u003c/p>\n\u003cp>“It was getting to the point where I just felt like killing myself,” Fonseca said.\u003c/p>\n\u003cp>Two months ago, Fonseca started taking a monthly shot of the antipsychotic drug Abilify. Since then, “everything’s changed,” he said.\u003c/p>\n\u003cp>Now, Fonseca is staying at a friend’s house and considering going to school. He says he’s stopped using meth.\u003c/p>\n\u003cp>[ad floatright]\u003c/p>\n\u003cp>“I can finally hear the birds and the crickets,” he said. “I couldn’t hear them before.”\u003c/p>\n\n",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003cp>As Dr. Rishi Patel’s street medicine van bounces over dirt roads and empty fields in rural Kern County, he’s looking for a particular patient he knows is overdue for her shot.\u003c/p>\n\u003cp>The woman, who has schizophrenia and has been living outside for five years, has several goals for herself: Start thinking more clearly, stop using meth and get an ID so she can visit her son in jail. Patel hopes the shot — a long-acting antipsychotic — will help her meet all of them.\u003c/p>\n\u003cp>Patel, medical director of Akido Street Medicine, is one of many street doctors throughout California using these injections as an increasingly common tool to help combat the state’s intertwined homelessness and mental health crises. Typically administered into a patient’s shoulder muscle, the medication slowly releases into the bloodstream over time, providing relief from symptoms of psychosis for a month or longer. The shots replace a patient’s oral medication — no more taking a pill every day. For people who are homeless and routinely have their pills stolen, can’t make it to a pharmacy for a refill or simply forget to take them, the shots can mean the difference between staying on their medication, or not.\u003c/p>\n\u003cp>“They’ve been an absolute game-changer,” Patel said.\u003c/p>\n\u003cp>Street medicine teams bring the shots directly to their patients wherever they are — whether it’s in a tent along Skid Row in Los Angeles, in a dugout in the middle of a field in the Central Valley, or along the bank of a stream in Shasta County. Doctors can diagnose someone, prescribe the medication, get their consent and give the shot within a matter of days — or sometimes even more quickly — and with minimal paperwork and red tape. They don’t need a psychiatrist’s sign-off.\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>It’s estimated that California is home to more than 180,000 homeless residents. \u003ca href=\"https://calmatters.org/housing/2023/08/care-court-california-start/\">How to help\u003c/a> the sickest of them — people with severe, untreated psychosis who might wander into traffic or otherwise put themselves in danger — has become a \u003ca href=\"https://calmatters.org/health/mental-health/2023/12/mental-health-conservatorship-newsom/\">hot-button issue\u003c/a>, with Gov. Gavin Newsom and state lawmakers creating new and sometimes controversial ways to get people into treatment. In a recent \u003ca href=\"https://homelessness.ucsf.edu/sites/default/files/2023-06/CASPEH_Report_62023.pdf\">UCSF survey (PDF)\u003c/a> of homeless Californians, 12% reported experiencing hallucinations in the past 30 days, and more than a quarter said they’d ever been hospitalized for a mental health condition.\u003c/p>\n\u003cp>Doctors say the goal of giving an antipsychotic shot to someone living in an encampment is to get them thinking clearly, so that they can start engaging with social workers, sign up for benefits and get on housing waitlists. While Newsom’s new CARE Court allows judges to order people into mental health treatment, and other recent legislation makes it easier to put people with a serious mental illness into conservatorships, doctors administering street injections take a different approach. The treatment is voluntary, and people can get help where they are, instead of in a locked facility.\u003c/p>\u003c/div>",
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"content": "\u003cdiv class=\"post-body\">\u003cp>Some success stories are dramatic. Doctors talk about patients who one day are babbling incoherently, and a week after a shot, are having conversations.\u003c/p>\n\u003cp>“It’s been pretty common that that’s the initiation of, ‘We’re going indoors,’” said Dr. Coley King, director of homeless health care for the Venice Family Clinic in Los Angeles. He said he’s seen dozens of patients get off the street after taking these shots.\u003c/p>\n\u003cp>As with any medication, the shots can have side effects. And while a patient can stop taking a pill and generally put a stop to a negative reaction, once they’ve been given a shot, they have no choice but to wait a month for the drug to wear off.\u003c/p>\n\u003cp>Despite some street doctors’ rave reviews, injectable antipsychotics still aren’t reaching everyone who experts say they could help. Street medicine teams report having just a handful of patients on these medications at any one time (King’s team in Los Angeles has about two dozen). Some patients don’t want the shots, balking at the idea of having a drug in their system for an entire month, especially if they have feelings of paranoia related to health care.\u003c/p>\n\u003cp>And street doctors complain that hospitals still seem to prefer discharging patients from temporary psychiatric holds with a bottle of pills they may or may not take — instead of giving them a long-acting shot.\u003c/p>\n\u003ch2 id=\"h-losing-track-of-patients\" class=\"wp-block-heading\">Losing track of patients\u003c/h2>\n\u003cp>One of the biggest challenges street doctors face in administering these shots is following up with patients.\u003c/p>\n\u003cp>In Kern County, Patel hasn’t seen the woman he’s looking for since his team gave her first antipsychotic shot almost two months ago. Now she’s past due for another dose.\u003c/p>\n\u003cp>It’s worrying, Patel said, “because I don’t know how she did on it.”\u003c/p>\n\u003cp>The last place they saw her was at an encampment known as “The Sump” in the Central Valley farming community of Lamont, where she lived in a plywood shack along a muddy ditch behind a farm. But code enforcement recently cleared everyone out of that area, and Patel’s team doesn’t have a phone number or any other way to contact her.\u003c/p>\n\u003cfigure id=\"attachment_11989533\" class=\"wp-caption aligncenter\" style=\"max-width: 1568px\">\u003cimg loading=\"lazy\" decoding=\"async\" class=\"size-full wp-image-11989533\" src=\"https://cdn.kqed.org/wp-content/uploads/sites/10/2024/06/053124-Bakersfield-Injectable-LV_15-ezgif.com-webp-to-jpg-converter.jpg\" alt=\"\" width=\"1568\" height=\"1045\" srcset=\"https://cdn.kqed.org/wp-content/uploads/sites/10/2024/06/053124-Bakersfield-Injectable-LV_15-ezgif.com-webp-to-jpg-converter.jpg 1568w, https://cdn.kqed.org/wp-content/uploads/sites/10/2024/06/053124-Bakersfield-Injectable-LV_15-ezgif.com-webp-to-jpg-converter-800x533.jpg 800w, https://cdn.kqed.org/wp-content/uploads/sites/10/2024/06/053124-Bakersfield-Injectable-LV_15-ezgif.com-webp-to-jpg-converter-1020x680.jpg 1020w, https://cdn.kqed.org/wp-content/uploads/sites/10/2024/06/053124-Bakersfield-Injectable-LV_15-ezgif.com-webp-to-jpg-converter-160x107.jpg 160w, https://cdn.kqed.org/wp-content/uploads/sites/10/2024/06/053124-Bakersfield-Injectable-LV_15-ezgif.com-webp-to-jpg-converter-1536x1024.jpg 1536w\" sizes=\"auto, (max-width: 1568px) 100vw, 1568px\">\u003cfigcaption class=\"wp-caption-text\">Dr. Rishi Patel from the Akido street medicine team checks on several unhoused people on May 28, 2024. Street medicine teams throughout California are increasingly using long-acting injectable antipsychotic medication to stabilize the mental health of people living in homeless encampments. \u003ccite>(Larry Valenzuela/CalMatters/CatchLight Local)\u003c/cite>\u003c/figcaption>\u003c/figure>\n\u003cp>The first place they look is another encampment known as “the Shrine,” because it once held a shrine to Santa Muerte, a Mexican saint of death often prayed to by drug dealers. The team drives the van through an empty field of dead, yellow grass. Several people are living in room-sized pits they’ve dug into the dirt and covered with tarps and sheets of metal. Next to the vacant land is a vineyard, with rows of vines dotted with small, green grapes.\u003c/p>\n\u003cp>She’s not there, so the team hands out sack lunches and bottles of water, then gets back in the van and leaves.\u003c/p>\n\u003cp>“We’ve seen results,” said Kirk McGowan, a street medicine nurse with Akido. “But we’ve seen more failures than successes. That’s just kind of the nature of the situation.”\u003c/p>\n\u003ch2>Who should prescribe antipsychotic injections?\u003c/h2>\n\u003cp>In most cases, the people prescribing and administering antipsychotic shots in homeless encampments are general practice doctors — not specially trained psychiatrists. That’s because despite the growing prevalence of street medicine, street psychiatrists are still rare, according to a recent \u003ca href=\"https://www.chcf.org/wp-content/uploads/2023/03/CAStreetMedLandscapeSurveyReport.pdf\">USC report (PDF)\u003c/a>.\u003c/p>\n\u003cp>“You look over your shoulder and there’s not a psychiatrist there helping you out,” King said. “And we want to meet the need. We want to take care of these patients. They’re really, really ill, they’re really disorganized, and suffering and dying on the streets.”\u003c/p>\n\u003cp>There are no legal restrictions preventing a general practice doctor from administering these injections. But some practitioners think the responsibility should be reserved for psychiatric providers.\u003c/p>\n\u003cfigure id=\"attachment_11989539\" class=\"wp-caption aligncenter\" style=\"max-width: 2000px\">\u003cimg loading=\"lazy\" decoding=\"async\" class=\"size-full wp-image-11989539\" src=\"https://cdn.kqed.org/wp-content/uploads/sites/10/2024/06/053124-Bakersfield-Injectable-LV_11-ezgif.com-webp-to-jpg-converter.jpg\" alt=\"\" width=\"2000\" height=\"1333\" srcset=\"https://cdn.kqed.org/wp-content/uploads/sites/10/2024/06/053124-Bakersfield-Injectable-LV_11-ezgif.com-webp-to-jpg-converter.jpg 2000w, https://cdn.kqed.org/wp-content/uploads/sites/10/2024/06/053124-Bakersfield-Injectable-LV_11-ezgif.com-webp-to-jpg-converter-800x533.jpg 800w, https://cdn.kqed.org/wp-content/uploads/sites/10/2024/06/053124-Bakersfield-Injectable-LV_11-ezgif.com-webp-to-jpg-converter-1020x680.jpg 1020w, https://cdn.kqed.org/wp-content/uploads/sites/10/2024/06/053124-Bakersfield-Injectable-LV_11-ezgif.com-webp-to-jpg-converter-160x107.jpg 160w, https://cdn.kqed.org/wp-content/uploads/sites/10/2024/06/053124-Bakersfield-Injectable-LV_11-ezgif.com-webp-to-jpg-converter-1536x1024.jpg 1536w, https://cdn.kqed.org/wp-content/uploads/sites/10/2024/06/053124-Bakersfield-Injectable-LV_11-ezgif.com-webp-to-jpg-converter-1920x1280.jpg 1920w\" sizes=\"auto, (max-width: 2000px) 100vw, 2000px\">\u003cfigcaption class=\"wp-caption-text\">Dr. Rishi Patel from the Akido street medicine team checks on an unhoused man living in a vineyard in Arvin on May 28, 2024. Street medicine teams throughout California are increasingly using long-acting injectable antipsychotic medication to stabilize the mental health of people living in homeless encampments. \u003ccite>(Larry Valenzuela/CalMatters/CatchLight Local)\u003c/cite>\u003c/figcaption>\u003c/figure>\n\u003cp>“These medications are in there for an extended period of time,” said Keri Weinstock, a psychiatric nurse practitioner who practices street medicine in Shasta County. “They do come with risks. There are specialty things that come along with some of these specialty meds, and it’s a lot to learn when you have to know everything else, too.”\u003c/p>\n\u003cp>Some street doctors who give these shots seek out additional psychiatric training, while others learn on the job — often with a psychiatrist on speed dial, just in case.\u003c/p>\n\u003cp>“I don’t think it’s rocket science to diagnose schizophrenia, as long as we’ve done it with some thoughtfulness,” King said.\u003c/p>\n\u003cp>In-the-field diagnoses aren’t always clear-cut, Patel said. Sometimes, people do such a good job of hiding their symptoms that it’s hard to tell they’re dealing with psychosis. Or, instead of experiencing obvious hallucinations or other symptoms commonly associated with schizophrenia, patients experience “negative symptoms,” such as extreme social withdrawal.\u003c/p>\n\u003cp>When those types of cases arise, Patel calls a psychologist for a second opinion.\u003c/p>\n\u003cp>While these drugs are generally considered safe, they do come with a risk of side effects that can include dizziness, sedation, stiffness and decreased mobility. Those symptoms might be no big deal for someone living in a house, but for someone on the street, could be catastrophic, said Dr. Shayan Rab, a street psychiatrist with Los Angeles County’s Homeless Outreach and Mobile Engagement team. It could make someone more vulnerable to being attacked or robbed, or prevent them from accessing food or shelter.\u003c/p>\n\u003cp>“It’s a very serious kind of action that’s being taken and a lot of time needs to be spent before you say, ‘Hey, this individual is safe for a long-acting injection,’” he said.\u003c/p>\n\u003cp>To make sure a patient doesn’t have an adverse reaction, doctors typically give them an oral dose of the same medication for a few days before administering the shot.\u003c/p>\n\u003cfigure id=\"attachment_11989540\" class=\"wp-caption aligncenter\" style=\"max-width: 1568px\">\u003cimg loading=\"lazy\" decoding=\"async\" class=\"size-full wp-image-11989540\" src=\"https://cdn.kqed.org/wp-content/uploads/sites/10/2024/06/053124-Bakersfield-Injectable-LV_20-ezgif.com-webp-to-jpg-converter.jpg\" alt=\"\" width=\"1568\" height=\"1045\" srcset=\"https://cdn.kqed.org/wp-content/uploads/sites/10/2024/06/053124-Bakersfield-Injectable-LV_20-ezgif.com-webp-to-jpg-converter.jpg 1568w, https://cdn.kqed.org/wp-content/uploads/sites/10/2024/06/053124-Bakersfield-Injectable-LV_20-ezgif.com-webp-to-jpg-converter-800x533.jpg 800w, https://cdn.kqed.org/wp-content/uploads/sites/10/2024/06/053124-Bakersfield-Injectable-LV_20-ezgif.com-webp-to-jpg-converter-1020x680.jpg 1020w, https://cdn.kqed.org/wp-content/uploads/sites/10/2024/06/053124-Bakersfield-Injectable-LV_20-ezgif.com-webp-to-jpg-converter-160x107.jpg 160w, https://cdn.kqed.org/wp-content/uploads/sites/10/2024/06/053124-Bakersfield-Injectable-LV_20-ezgif.com-webp-to-jpg-converter-1536x1024.jpg 1536w\" sizes=\"auto, (max-width: 1568px) 100vw, 1568px\">\u003cfigcaption class=\"wp-caption-text\">An Abilify Maintena shot being prepared by the Akido street medicine team at their main office in Bakersfield on May 28, 2024. Street medicine teams throughout California are increasingly using long-acting injectable antipsychotic medication to stabilize the mental health of people living in homeless encampments. \u003ccite>(Larry Valenzuela/CalMatters/CatchLight Local)\u003c/cite>\u003c/figcaption>\u003c/figure>\n\u003cp>There’s also a risk that after a street doctor gives someone a shot, that patient could later get sent to the hospital on a temporary psychiatric hold. Doctors there might not know the patient already has a long-acting dose of antipsychotic medication in their body, and might give them another dose.\u003c/p>\n\u003cp>Before giving someone a shot, Dr. Aislinn Bird wants to be 100% sure their symptoms are actually caused by psychotic disorder, such as schizophrenia, and not complex PTSD, major depressive disorder, methamphetamine use, or something else. Overdiagnosis of psychotic disorders is rampant, especially in the African American community, Bird said.\u003c/p>\n\u003cp>“You have to be sure you really know the correct diagnosis,” said Bird, who serves as director of Integrated Care at Health Care for the Homeless in Alameda County.\u003c/p>\n\u003cp>But Dr. Susan Partovi, who practices street medicine on Skid Row in Los Angeles, said that’s an “antiquated way of thinking.” When someone is experiencing psychosis, it’s an emergency that needs to be treated as soon as possible, no matter the cause, she said. Her preference is to treat the symptoms first, and then see if the patient wants to work on other issues, such as substance use.\u003c/p>\n\u003cp>Antipsychotic injectables, such as Abilify and Invega, tend to be most prevalent in street medicine practices. But street doctors also administer long-acting injectable HIV medication, as well as medication for addiction such as Vivitrol — an injectable, long-acting medication that can help reduce cravings for opioids and alcohol, and protect against overdose.\u003c/p>\n\u003ch2 id=\"h-silencing-the-voices-in-his-head\" class=\"wp-block-heading\">Silencing the voices in his head\u003c/h2>\n\u003cp>Ricardo Fonseca Jr., who goes by “Ricky,” has been homeless for two years, living in a tent behind a Dollar Tree, then in a park in rural Kern County. The 31-year-old said he was working as a welder until he had a sudden mental breakdown and started hearing voices.\u003c/p>\n\u003cp>The voices said horrible things to him. Sometimes they yelled, and he yelled back, scaring those around him. He used methamphetamine to cope.\u003c/p>\n\u003cp>“It was getting to the point where I just felt like killing myself,” Fonseca said.\u003c/p>\n\u003cp>Two months ago, Fonseca started taking a monthly shot of the antipsychotic drug Abilify. Since then, “everything’s changed,” he said.\u003c/p>\n\u003cp>Now, Fonseca is staying at a friend’s house and considering going to school. He says he’s stopped using meth.\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>“I can finally hear the birds and the crickets,” he said. “I couldn’t hear them before.”\u003c/p>\n\n\u003c/div>\u003c/p>",
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"content": "\u003cp>Gov. Gavin Newsom celebrated the passage of Proposition 1 on Thursday after his ambitious proposal to reshape care for Californians grappling with behavioral health issues and homelessness won narrow approval from voters following more than two weeks of vote counting.\u003c/p>\n\u003cp>“Change has its enemies, change is tough, change is hard,” Newsom said at a press conference in Los Angeles. “These have been a few long weeks, sleepless weeks.”\u003c/p>\n\u003cp>The measure authorizes the state to borrow nearly $6.4 billion to build residential treatment facilities and affordable apartments while also earmarking a greater share of future mental health dollars for housing.\u003c/p>\n\u003cp>[pullquote align=\"right\" size=\"medium\" citation=\"California Gov. Gavin Newsom\"]‘Change has its enemies, change is tough, change is hard. These have been a few long weeks, sleepless weeks.’[/pullquote]After breathing a sigh of relief that Proposition 1 was able to survive an unfriendly primary electorate, Newsom aimed much of his remarks at the county governments who will be tasked with implementing many of the measure’s provisions. The governor acknowledged his legacy would hinge in part on the rollout of the measure and related programs at the intersection of behavioral health and homelessness.\u003c/p>\n\u003cp>“I’ve got three more years here, roughly, to prove that we can make a dent in this,” Newsom said.\u003c/p>\n\u003cp>The \u003cem>Associated Press\u003c/em> called Proposition 1’s victory late Wednesday. The measure currently leads by just under 30,000 votes — out of more than 7 million ballots cast.\u003c/p>\n\u003cp>A broad bipartisan coalition backed Proposition 1, and supporters vastly outspent a mostly volunteer group of opponents. However, the low turnout in the primary resulted in an electorate that skewed conservative. These voters may have looked askance at the billions in borrowing that the measure proposed, political strategist Marva Diaz said.\u003c/p>\n\u003cp>[ad fullwidth]\u003c/p>\n\u003cp>“They had an uphill climb here with — there’s a budget deficit, prices are pretty high right now for families and we’re asking them to then say yes on a bond,” said Diaz, the owner and publisher of the California Target Book. “That perfect storm just made it very, very difficult but they ended up pulling it off and it passed.”\u003c/p>\n\u003cp>Diaz also pointed to the measure’s complexity: In addition to the bond, Proposition 1 will rework the Mental Health Services Act, in part by expanding services to Californians with substance use challenges and setting aside 30% of the act’s revenue for housing.\u003c/p>\n\u003cp>[aside label=\"Related Stories\" postID=\"news_11980236,news_11979822,news_11977998\"]“It’s always easier to run a ballot measure that is extremely simple and clear to voters,” she said. “The more they have to research, the more they have to unpack, the more they have to figure out themselves, the harder it is to get them to vote yes.”\u003c/p>\n\u003cp>On Thursday, Newsom said voters may have been skeptical that the housing promised by Proposition 1 would be built quickly, citing the slow rollout of previous state bonds. But the governor pointed to language in the measure that will allow projects to skip environmental review.\u003c/p>\n\u003cp>“We’re going to start putting out notices for funding availability in just a matter of months, the first ones come out in October,” Newsom said. “That’s unprecedented in California history.”\u003c/p>\n\u003cp>With funding secured, Newsom turned his attention to California’s county governments, who will largely be tasked with implementing the new behavioral health law.\u003c/p>\n\u003cp>“We’ve done our job, now the cities and counties need to step up,” Newsom said.\u003c/p>\n\u003cp>Many of those same counties opposed Proposition 1, fearing that the new focus on housing would reduce funding for the counseling, screening and preventative programs that counties currently bankroll.\u003c/p>\n\u003cp>Michelle Doty Cabrera, executive director of the County Behavioral Health Directors Association, applauded the new investments in housing but said, “Such a massive shift in our behavioral health care system will take time.”\u003c/p>\n\u003cp>[pullquote align=\"right\" size=\"medium\" citation=\"Paul Simmons, 'no' campaign leader and former executive director, Depression and Bipolar Support Alliance California\"]‘We’re going to try to hold [the Newsom administration’s] feet to the fire to make sure that things aren’t cut or that they have to own up to the cuts that are made.’[/pullquote]“Adding new focus and requirements to fund housing placements and substance use disorder services from a source of funding previously dedicated to mental health services will require counties to work in partnership with the state and local communities to identify solutions for the legacy mental health programs currently funded through the MHSA,” Cabrera said in a statement.\u003c/p>\n\u003cp>Leaders of the campaign against Proposition 1 said they were now bracing for cuts to existing mental health programs, particularly support networks led by Californians with lived experience with behavioral health challenges.\u003c/p>\n\u003cp>“Anything that says ‘peer’ next to it is endangered,” said Paul Simmons, a leader of the no campaign and former executive director of Depression and Bipolar Support Alliance California.\u003c/p>\n\u003cp>“We’re going to try to hold [the Newsom administration’s] feet to the fire to make sure that things aren’t cut or that they have to own up to the cuts that are made,” Simmons said.\u003c/p>\n\u003cp>\u003c/p>\n",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003cp>Gov. Gavin Newsom celebrated the passage of Proposition 1 on Thursday after his ambitious proposal to reshape care for Californians grappling with behavioral health issues and homelessness won narrow approval from voters following more than two weeks of vote counting.\u003c/p>\n\u003cp>“Change has its enemies, change is tough, change is hard,” Newsom said at a press conference in Los Angeles. “These have been a few long weeks, sleepless weeks.”\u003c/p>\n\u003cp>The measure authorizes the state to borrow nearly $6.4 billion to build residential treatment facilities and affordable apartments while also earmarking a greater share of future mental health dollars for housing.\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"content": "‘Change has its enemies, change is tough, change is hard. These have been a few long weeks, sleepless weeks.’",
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"content": "\u003cdiv class=\"post-body\">\u003cp>After breathing a sigh of relief that Proposition 1 was able to survive an unfriendly primary electorate, Newsom aimed much of his remarks at the county governments who will be tasked with implementing many of the measure’s provisions. The governor acknowledged his legacy would hinge in part on the rollout of the measure and related programs at the intersection of behavioral health and homelessness.\u003c/p>\n\u003cp>“I’ve got three more years here, roughly, to prove that we can make a dent in this,” Newsom said.\u003c/p>\n\u003cp>The \u003cem>Associated Press\u003c/em> called Proposition 1’s victory late Wednesday. The measure currently leads by just under 30,000 votes — out of more than 7 million ballots cast.\u003c/p>\n\u003cp>A broad bipartisan coalition backed Proposition 1, and supporters vastly outspent a mostly volunteer group of opponents. However, the low turnout in the primary resulted in an electorate that skewed conservative. These voters may have looked askance at the billions in borrowing that the measure proposed, political strategist Marva Diaz said.\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>“They had an uphill climb here with — there’s a budget deficit, prices are pretty high right now for families and we’re asking them to then say yes on a bond,” said Diaz, the owner and publisher of the California Target Book. “That perfect storm just made it very, very difficult but they ended up pulling it off and it passed.”\u003c/p>\n\u003cp>Diaz also pointed to the measure’s complexity: In addition to the bond, Proposition 1 will rework the Mental Health Services Act, in part by expanding services to Californians with substance use challenges and setting aside 30% of the act’s revenue for housing.\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"content": "\u003cdiv class=\"post-body\">\u003cp>“It’s always easier to run a ballot measure that is extremely simple and clear to voters,” she said. “The more they have to research, the more they have to unpack, the more they have to figure out themselves, the harder it is to get them to vote yes.”\u003c/p>\n\u003cp>On Thursday, Newsom said voters may have been skeptical that the housing promised by Proposition 1 would be built quickly, citing the slow rollout of previous state bonds. But the governor pointed to language in the measure that will allow projects to skip environmental review.\u003c/p>\n\u003cp>“We’re going to start putting out notices for funding availability in just a matter of months, the first ones come out in October,” Newsom said. “That’s unprecedented in California history.”\u003c/p>\n\u003cp>With funding secured, Newsom turned his attention to California’s county governments, who will largely be tasked with implementing the new behavioral health law.\u003c/p>\n\u003cp>“We’ve done our job, now the cities and counties need to step up,” Newsom said.\u003c/p>\n\u003cp>Many of those same counties opposed Proposition 1, fearing that the new focus on housing would reduce funding for the counseling, screening and preventative programs that counties currently bankroll.\u003c/p>\n\u003cp>Michelle Doty Cabrera, executive director of the County Behavioral Health Directors Association, applauded the new investments in housing but said, “Such a massive shift in our behavioral health care system will take time.”\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"content": "‘We’re going to try to hold [the Newsom administration’s] feet to the fire to make sure that things aren’t cut or that they have to own up to the cuts that are made.’",
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"content": "\u003cdiv class=\"post-body\">\u003cp>“Adding new focus and requirements to fund housing placements and substance use disorder services from a source of funding previously dedicated to mental health services will require counties to work in partnership with the state and local communities to identify solutions for the legacy mental health programs currently funded through the MHSA,” Cabrera said in a statement.\u003c/p>\n\u003cp>Leaders of the campaign against Proposition 1 said they were now bracing for cuts to existing mental health programs, particularly support networks led by Californians with lived experience with behavioral health challenges.\u003c/p>\n\u003cp>“Anything that says ‘peer’ next to it is endangered,” said Paul Simmons, a leader of the no campaign and former executive director of Depression and Bipolar Support Alliance California.\u003c/p>\n\u003cp>“We’re going to try to hold [the Newsom administration’s] feet to the fire to make sure that things aren’t cut or that they have to own up to the cuts that are made,” Simmons said.\u003c/p>\n\u003cp>\u003c/p>\n\u003c/div>\u003c/p>",
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"title": "Proposition 1 Update: Gavin Newsom’s Mental Health Plan Maintains Slim Lead",
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"headTitle": "Proposition 1 Update: Gavin Newsom’s Mental Health Plan Maintains Slim Lead | KQED",
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"content": "\u003cp>California voters, by a thin margin, are favoring Gov. Gavin Newsom’s $6.4 billion plan to build mental health treatment beds and housing through a ballot measure that he characterizes as critical to addressing the state’s homelessness crisis.\u003c/p>\n\u003cp>\u003ca href=\"https://calmatters.org/health/mental-health/2023/09/gavin-newsom-mental-health-2024-election/\" target=\"_blank\" rel=\"noreferrer noopener\">Proposition 1 is a two-part ballot initiative\u003c/a>. It includes a bond to build treatment facilities and \u003ca href=\"https://calmatters.org/health/mental-health/2023/09/gavin-newsom-mental-health-2024-election/\" target=\"_blank\" rel=\"noreferrer noopener\">permanent supportive housing for people with mental health\u003c/a> and addiction challenges. It also proposes changes to a longstanding tax on personal incomes over $1 million, known as the Mental Health Services Act, by requiring counties to spend 30% of that revenue on housing instead of other services.\u003c/p>\n\u003cp>\u003ca href=\"https://cdn.kqed.org/wp-content/uploads/sites/10/2024/03/Screenshot-2024-03-11-at-12.59.16-PM.png\">\u003cimg loading=\"lazy\" decoding=\"async\" class=\"aligncenter size-full wp-image-11978927\" src=\"https://cdn.kqed.org/wp-content/uploads/sites/10/2024/03/Screenshot-2024-03-11-at-12.59.16-PM.png\" alt=\"\" width=\"1576\" height=\"382\" srcset=\"https://cdn.kqed.org/wp-content/uploads/sites/10/2024/03/Screenshot-2024-03-11-at-12.59.16-PM.png 1576w, https://cdn.kqed.org/wp-content/uploads/sites/10/2024/03/Screenshot-2024-03-11-at-12.59.16-PM-800x194.png 800w, https://cdn.kqed.org/wp-content/uploads/sites/10/2024/03/Screenshot-2024-03-11-at-12.59.16-PM-1020x247.png 1020w, https://cdn.kqed.org/wp-content/uploads/sites/10/2024/03/Screenshot-2024-03-11-at-12.59.16-PM-160x39.png 160w, https://cdn.kqed.org/wp-content/uploads/sites/10/2024/03/Screenshot-2024-03-11-at-12.59.16-PM-1536x372.png 1536w\" sizes=\"(max-width: 1576px) 100vw, 1576px\">\u003c/a>\u003cbr>\nAs of 9:15 a.m., Monday, with about 5.4 million votes counted, the measure is leading by 50.3% to 49.7%.\u003c/p>\n\u003cp>Newsom has previously said Proposition 1 will help California fulfill a decadeslong promise to get “people off the streets, out of tents and into treatment.”\u003c/p>\n\u003cp>\u003ca href=\"https://calmatters.org/health/mental-health/2024/03/proposition-1-gavin-newsom/\" target=\"_blank\" rel=\"noreferrer noopener\">The Yes on Proposition 1 campaign\u003c/a> amassed a nearly $21 million war chest for the ballot measure, drawing support from law enforcement groups, major health care organizations and the mental health advocacy group NAMI California.\u003c/p>\n\u003cp>[ad fullwidth]\u003c/p>\n\u003cp>[aside postID=\"news_11977998,news_11975170\" label=\"Related Stories\"]“This is exactly where we thought we’d be,” Anthony York, a spokesman for the Yes on Proposition 1 campaign, said on Wednesday. “There are 2 to 3 million ballots outstanding. I’d say we’re cautiously optimistic.”\u003c/p>\n\u003cp>In contrast, the opposition campaign raised very little money. Opponents are led by clients of mental health services and some small mental health agencies who worry their programs could lose funding if the measure passes. Others, including the Howard Jarvis Taxpayers Association, opposed the measure because of its cost.\u003c/p>\n\u003cp>Paul Simmons, executive director of the opposition campaign, struck a hopeful tone as early votes started rolling in Tuesday night.\u003c/p>\n\u003cp>“We expected to be further behind in the early voting,” Simmons said. “This being at 51% or 50% is very encouraging to me.”\u003c/p>\n\u003cp>Recent polling casts uncertainty over what many initially considered an easy win for the governor. Fifty percent of likely voters supported the measure a week ago, according to the latest poll by \u003ca href=\"https://escholarship.org/content/qt9qm0g9w3/qt9qm0g9w3.pdf?t=s9mlwp\" target=\"_blank\" rel=\"noreferrer noopener\">UC Berkeley’s Institute of Governmental Studies\u003c/a>. The poll tallied opposition at 34% and undecided at 16%.\u003c/p>\n\u003cp>Proposition 1 needs a simple majority of the vote to pass.\u003c/p>\n\u003cp>Jon Coupal, executive director of the Howard Jarvis Taxpayer Association, said the results so far show that Californians are concerned about government spending.\u003c/p>\n\u003cp>“This has two strikes. No. 1, it was a bond measure. People are sensitive right now to government debt. A lot of people had the reaction of, ‘I’m all for helping the homeless, but do we really need a bond to do this?’\u003c/p>\n\u003cp>“Then secondly, I think people are well aware of the billions of dollars we have thrown at \u003ca href=\"https://calmatters.org/housing/2023/02/california-homelessness-spending-report/\" target=\"_blank\" rel=\"noreferrer noopener\">homelessness and mental health\u003c/a> and the problem just seems to get worse, so I think people may look at that and say, you’re asking for more money, and you’re not demonstrating any results,” he said.\u003c/p>\n\u003cp>Here’s a look at what the measure would do.\u003c/p>\n\u003ch2>What does Proposition 1 promise?\u003c/h2>\n\u003cp>The dual bond measure and change to California’s so-called “millionaire’s tax” are Newsom’s attempt to increase the state’s mental health and addiction treatment capacity and get people living in encampments into stable housing.\u003c/p>\n\u003cp>The number of unhoused Californians had ballooned to 181,000 people in 2022 during the most recent point-in-time count, a 60% increase over the past decade. \u003ca href=\"https://calmatters.org/housing/2023/06/california-homeless-growth-report/\" target=\"_blank\" rel=\"noreferrer noopener\">New research from UCSF\u003c/a> estimated that more than 21,000 homeless people currently experience hallucinations. Meanwhile, the number of \u003ca href=\"https://calmatters.org/wp-content/uploads/2019/04/CHA-Psych-Bed-Data-Report-Sept.-2018.pdf\" target=\"_blank\" rel=\"noreferrer noopener\">acute care mental health hospital beds\u003c/a> decreased by at least 30% between 1995 and 2016, according to the California Hospital Association.\u003c/p>\n\u003cp>The bond measure is supposed to build a combined 11,150 treatment beds and housing units, with some set aside for veterans.\u003c/p>\n\u003ch2>Where will the money go?\u003c/h2>\n\u003cp>Money raised by the bond would be funneled into two existing state programs: the Behavioral Health Continuum Infrastructure Program and Project Homekey.\u003c/p>\n\u003cp>The behavioral health program would get a $4.4 billion infusion to build 6,800 in-patient mental health and substance use disorder treatment beds. The Department of Health Care Services will award grants to counties and local organizations to construct, acquire and expand treatment capacity. To date, the department has awarded more than $1.6 billion to a variety of programs, including \u003ca href=\"https://www.infrastructure.buildingcalhhs.com/\" target=\"_blank\" rel=\"noreferrer noopener\">crisis care and children’s facilities,\u003c/a> as part of a pre-existing budget investment.\u003c/p>\n\u003cp>Project Homekey would get $2 billion to build 4,350 units of supportive housing for people with mental health and addiction challenges. A little more than half of the units will be reserved for homeless veterans. Project Homekey is an \u003ca href=\"https://calmatters.org/housing/2020/11/newsom-pandemic-beat-homelessness/\" target=\"_blank\" rel=\"noreferrer noopener\">extension of Newsom’s pandemic-era efforts to house people\u003c/a> living in encampments during the height of the COVID-19 pandemic. The state budget previously gave the Department of Housing and Community Services $736 million to convert hotels, motels and other buildings into housing.\u003c/p>\n\u003ch2>How much will it cost?\u003c/h2>\n\u003cp>Bonds allow government agencies to borrow money and repay debt over time. Proposition 1 is estimated to cost $310 million annually over 30 years, totaling $9.3 billion, according to the nonpartisan \u003ca href=\"https://lao.ca.gov/BallotAnalysis/Proposition?number=1&year=2024\">Legislative Analyst’s Office\u003c/a>. Payments would be made from the state general fund.\u003c/p>\n\u003cp>\u003ca href=\"https://calmatters.org/politics/capitol/2024/02/california-budget-deficit-balloons/\">California faces state budget cuts\u003c/a> for the second consecutive year, with some estimates projecting a $73 billion shortfall.\u003c/p>\n\u003ch2>What other changes have happened recently?\u003c/h2>\n\u003cp>Newsom has made mental health a signature issue. If Proposition 1 passes, it would represent another milestone in his \u003ca href=\"https://calmatters.org/health/mental-health/2024/02/california-mental-health-history/\" target=\"_blank\" rel=\"noreferrer noopener\">overhaul of California’s behavioral health system\u003c/a>.\u003c/p>\n\u003cp>Last year, Newsom signed a law easing restrictions on California’s decades-old conservatorship law, which limits who can be placed in \u003ca href=\"https://calmatters.org/health/2023/10/california-mental-health-involuntary-treatment-law/\" target=\"_blank\" rel=\"noreferrer noopener\">involuntary treatment programs\u003c/a>.\u003c/p>\n\u003cp>In 2022, his signature mental health push established a special \u003ca href=\"https://calmatters.org/housing/2023/08/care-court-california-start/\" target=\"_blank\" rel=\"noreferrer noopener\">court system to compel people with untreated mental health\u003c/a> and addiction challenges into treatment programs.\u003c/p>\n\u003cp>And in 2021, Newsom poured more than $4 billion in one-time funds into children’s programs to address \u003ca href=\"https://calmatters.org/health/2022/03/california-children-mental-health-crisis/\" target=\"_blank\" rel=\"noreferrer noopener\">rising suicide rates and overdoses among youth\u003c/a>.\u003c/p>\n\u003ch2>Who opposed it and why?\u003c/h2>\n\u003cp>[ad floatright]\u003c/p>\n\u003cp>A coalition of small mental health organizations, disability advocates and current clients of county mental health programs opposed Proposition 1. They argued that the measure would increase the amount of involuntary treatment and divert money from local organizations that serve hard-to-reach populations, such as LGBTQ people and communities of color.\u003c/p>\n\n",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003cp>California voters, by a thin margin, are favoring Gov. Gavin Newsom’s $6.4 billion plan to build mental health treatment beds and housing through a ballot measure that he characterizes as critical to addressing the state’s homelessness crisis.\u003c/p>\n\u003cp>\u003ca href=\"https://calmatters.org/health/mental-health/2023/09/gavin-newsom-mental-health-2024-election/\" target=\"_blank\" rel=\"noreferrer noopener\">Proposition 1 is a two-part ballot initiative\u003c/a>. It includes a bond to build treatment facilities and \u003ca href=\"https://calmatters.org/health/mental-health/2023/09/gavin-newsom-mental-health-2024-election/\" target=\"_blank\" rel=\"noreferrer noopener\">permanent supportive housing for people with mental health\u003c/a> and addiction challenges. It also proposes changes to a longstanding tax on personal incomes over $1 million, known as the Mental Health Services Act, by requiring counties to spend 30% of that revenue on housing instead of other services.\u003c/p>\n\u003cp>\u003ca href=\"https://cdn.kqed.org/wp-content/uploads/sites/10/2024/03/Screenshot-2024-03-11-at-12.59.16-PM.png\">\u003cimg loading=\"lazy\" decoding=\"async\" class=\"aligncenter size-full wp-image-11978927\" src=\"https://cdn.kqed.org/wp-content/uploads/sites/10/2024/03/Screenshot-2024-03-11-at-12.59.16-PM.png\" alt=\"\" width=\"1576\" height=\"382\" srcset=\"https://cdn.kqed.org/wp-content/uploads/sites/10/2024/03/Screenshot-2024-03-11-at-12.59.16-PM.png 1576w, https://cdn.kqed.org/wp-content/uploads/sites/10/2024/03/Screenshot-2024-03-11-at-12.59.16-PM-800x194.png 800w, https://cdn.kqed.org/wp-content/uploads/sites/10/2024/03/Screenshot-2024-03-11-at-12.59.16-PM-1020x247.png 1020w, https://cdn.kqed.org/wp-content/uploads/sites/10/2024/03/Screenshot-2024-03-11-at-12.59.16-PM-160x39.png 160w, https://cdn.kqed.org/wp-content/uploads/sites/10/2024/03/Screenshot-2024-03-11-at-12.59.16-PM-1536x372.png 1536w\" sizes=\"(max-width: 1576px) 100vw, 1576px\">\u003c/a>\u003cbr>\nAs of 9:15 a.m., Monday, with about 5.4 million votes counted, the measure is leading by 50.3% to 49.7%.\u003c/p>\n\u003cp>Newsom has previously said Proposition 1 will help California fulfill a decadeslong promise to get “people off the streets, out of tents and into treatment.”\u003c/p>\n\u003cp>\u003ca href=\"https://calmatters.org/health/mental-health/2024/03/proposition-1-gavin-newsom/\" target=\"_blank\" rel=\"noreferrer noopener\">The Yes on Proposition 1 campaign\u003c/a> amassed a nearly $21 million war chest for the ballot measure, drawing support from law enforcement groups, major health care organizations and the mental health advocacy group NAMI California.\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"content": "\u003cdiv class=\"post-body\">\u003cp>“This is exactly where we thought we’d be,” Anthony York, a spokesman for the Yes on Proposition 1 campaign, said on Wednesday. “There are 2 to 3 million ballots outstanding. I’d say we’re cautiously optimistic.”\u003c/p>\n\u003cp>In contrast, the opposition campaign raised very little money. Opponents are led by clients of mental health services and some small mental health agencies who worry their programs could lose funding if the measure passes. Others, including the Howard Jarvis Taxpayers Association, opposed the measure because of its cost.\u003c/p>\n\u003cp>Paul Simmons, executive director of the opposition campaign, struck a hopeful tone as early votes started rolling in Tuesday night.\u003c/p>\n\u003cp>“We expected to be further behind in the early voting,” Simmons said. “This being at 51% or 50% is very encouraging to me.”\u003c/p>\n\u003cp>Recent polling casts uncertainty over what many initially considered an easy win for the governor. Fifty percent of likely voters supported the measure a week ago, according to the latest poll by \u003ca href=\"https://escholarship.org/content/qt9qm0g9w3/qt9qm0g9w3.pdf?t=s9mlwp\" target=\"_blank\" rel=\"noreferrer noopener\">UC Berkeley’s Institute of Governmental Studies\u003c/a>. The poll tallied opposition at 34% and undecided at 16%.\u003c/p>\n\u003cp>Proposition 1 needs a simple majority of the vote to pass.\u003c/p>\n\u003cp>Jon Coupal, executive director of the Howard Jarvis Taxpayer Association, said the results so far show that Californians are concerned about government spending.\u003c/p>\n\u003cp>“This has two strikes. No. 1, it was a bond measure. People are sensitive right now to government debt. A lot of people had the reaction of, ‘I’m all for helping the homeless, but do we really need a bond to do this?’\u003c/p>\n\u003cp>“Then secondly, I think people are well aware of the billions of dollars we have thrown at \u003ca href=\"https://calmatters.org/housing/2023/02/california-homelessness-spending-report/\" target=\"_blank\" rel=\"noreferrer noopener\">homelessness and mental health\u003c/a> and the problem just seems to get worse, so I think people may look at that and say, you’re asking for more money, and you’re not demonstrating any results,” he said.\u003c/p>\n\u003cp>Here’s a look at what the measure would do.\u003c/p>\n\u003ch2>What does Proposition 1 promise?\u003c/h2>\n\u003cp>The dual bond measure and change to California’s so-called “millionaire’s tax” are Newsom’s attempt to increase the state’s mental health and addiction treatment capacity and get people living in encampments into stable housing.\u003c/p>\n\u003cp>The number of unhoused Californians had ballooned to 181,000 people in 2022 during the most recent point-in-time count, a 60% increase over the past decade. \u003ca href=\"https://calmatters.org/housing/2023/06/california-homeless-growth-report/\" target=\"_blank\" rel=\"noreferrer noopener\">New research from UCSF\u003c/a> estimated that more than 21,000 homeless people currently experience hallucinations. Meanwhile, the number of \u003ca href=\"https://calmatters.org/wp-content/uploads/2019/04/CHA-Psych-Bed-Data-Report-Sept.-2018.pdf\" target=\"_blank\" rel=\"noreferrer noopener\">acute care mental health hospital beds\u003c/a> decreased by at least 30% between 1995 and 2016, according to the California Hospital Association.\u003c/p>\n\u003cp>The bond measure is supposed to build a combined 11,150 treatment beds and housing units, with some set aside for veterans.\u003c/p>\n\u003ch2>Where will the money go?\u003c/h2>\n\u003cp>Money raised by the bond would be funneled into two existing state programs: the Behavioral Health Continuum Infrastructure Program and Project Homekey.\u003c/p>\n\u003cp>The behavioral health program would get a $4.4 billion infusion to build 6,800 in-patient mental health and substance use disorder treatment beds. The Department of Health Care Services will award grants to counties and local organizations to construct, acquire and expand treatment capacity. To date, the department has awarded more than $1.6 billion to a variety of programs, including \u003ca href=\"https://www.infrastructure.buildingcalhhs.com/\" target=\"_blank\" rel=\"noreferrer noopener\">crisis care and children’s facilities,\u003c/a> as part of a pre-existing budget investment.\u003c/p>\n\u003cp>Project Homekey would get $2 billion to build 4,350 units of supportive housing for people with mental health and addiction challenges. A little more than half of the units will be reserved for homeless veterans. Project Homekey is an \u003ca href=\"https://calmatters.org/housing/2020/11/newsom-pandemic-beat-homelessness/\" target=\"_blank\" rel=\"noreferrer noopener\">extension of Newsom’s pandemic-era efforts to house people\u003c/a> living in encampments during the height of the COVID-19 pandemic. The state budget previously gave the Department of Housing and Community Services $736 million to convert hotels, motels and other buildings into housing.\u003c/p>\n\u003ch2>How much will it cost?\u003c/h2>\n\u003cp>Bonds allow government agencies to borrow money and repay debt over time. Proposition 1 is estimated to cost $310 million annually over 30 years, totaling $9.3 billion, according to the nonpartisan \u003ca href=\"https://lao.ca.gov/BallotAnalysis/Proposition?number=1&year=2024\">Legislative Analyst’s Office\u003c/a>. Payments would be made from the state general fund.\u003c/p>\n\u003cp>\u003ca href=\"https://calmatters.org/politics/capitol/2024/02/california-budget-deficit-balloons/\">California faces state budget cuts\u003c/a> for the second consecutive year, with some estimates projecting a $73 billion shortfall.\u003c/p>\n\u003ch2>What other changes have happened recently?\u003c/h2>\n\u003cp>Newsom has made mental health a signature issue. If Proposition 1 passes, it would represent another milestone in his \u003ca href=\"https://calmatters.org/health/mental-health/2024/02/california-mental-health-history/\" target=\"_blank\" rel=\"noreferrer noopener\">overhaul of California’s behavioral health system\u003c/a>.\u003c/p>\n\u003cp>Last year, Newsom signed a law easing restrictions on California’s decades-old conservatorship law, which limits who can be placed in \u003ca href=\"https://calmatters.org/health/2023/10/california-mental-health-involuntary-treatment-law/\" target=\"_blank\" rel=\"noreferrer noopener\">involuntary treatment programs\u003c/a>.\u003c/p>\n\u003cp>In 2022, his signature mental health push established a special \u003ca href=\"https://calmatters.org/housing/2023/08/care-court-california-start/\" target=\"_blank\" rel=\"noreferrer noopener\">court system to compel people with untreated mental health\u003c/a> and addiction challenges into treatment programs.\u003c/p>\n\u003cp>And in 2021, Newsom poured more than $4 billion in one-time funds into children’s programs to address \u003ca href=\"https://calmatters.org/health/2022/03/california-children-mental-health-crisis/\" target=\"_blank\" rel=\"noreferrer noopener\">rising suicide rates and overdoses among youth\u003c/a>.\u003c/p>\n\u003ch2>Who opposed it and why?\u003c/h2>\n\u003cp>\u003c/p>\u003c/div>",
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"tagline": "Where conversation and cultura meet",
"info": "What kind of no sabo word is Hyphenación? For us, it’s about living within a hyphenation. Like being a third-gen Mexican-American from the Texas border now living that Bay Area Chicano life. Like Xorje! Each week we bring together a couple of hyphenated Latinos to talk all about personal life choices: family, careers, relationships, belonging … everything is on the table. ",
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"info": "The Political Mind of Jerry Brown brings listeners the wisdom of the former Governor, Mayor, and presidential candidate. Scott Shafer interviewed Brown for more than 40 hours, covering the former governor's life and half-century in the political game – and Brown has some lessons he'd like to share. ",
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"marketplace": {
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"info": "Our flagship program, helmed by Kai Ryssdal, examines what the day in money delivered, through stories, conversations, newsworthy numbers and more. Updated Monday through Friday at about 3:30 p.m. PT.",
"airtime": "MON-FRI 4pm-4:30pm, MON-WED 6:30pm-7pm",
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"info": "The MindShift podcast explores the innovations in education that are shaping how kids learn. Hosts Ki Sung and Katrina Schwartz introduce listeners to educators, researchers, parents and students who are developing effective ways to improve how kids learn. We cover topics like how fed-up administrators are developing surprising tactics to deal with classroom disruptions; how listening to podcasts are helping kids develop reading skills; the consequences of overparenting; and why interdisciplinary learning can engage students on all ends of the traditional achievement spectrum. This podcast is part of the MindShift education site, a division of KQED News. KQED is an NPR/PBS member station based in San Francisco. You can also visit the MindShift website for episodes and supplemental blog posts or tweet us \u003ca href=\"https://twitter.com/MindShiftKQED\">@MindShiftKQED\u003c/a> or visit us at \u003ca href=\"/mindshift\">MindShift.KQED.org\u003c/a>",
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"info": "For decades, the process for how police police themselves has been inconsistent – if not opaque. In some states, like California, these proceedings were completely hidden. After a new police transparency law unsealed scores of internal affairs files, our reporters set out to examine these cases and the shadow world of police discipline. On Our Watch brings listeners into the rooms where officers are questioned and witnesses are interrogated to find out who this system is really protecting. Is it the officers, or the public they've sworn to serve?",
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"info": "Our weekly podcast explores how the media 'sausage' is made, casts an incisive eye on fluctuations in the marketplace of ideas, and examines threats to the freedom of information and expression in America and abroad. For one hour a week, the show tries to lift the veil from the process of \"making media,\" especially news media, because it's through that lens that we see the world and the world sees us",
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"info": "The economy explained. Imagine you could call up a friend and say, Meet me at the bar and tell me what's going on with the economy. Now imagine that's actually a fun evening.",
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"politicalbreakdown": {
"id": "politicalbreakdown",
"title": "Political Breakdown",
"tagline": "Politics from a personal perspective",
"info": "Political Breakdown is a new series that explores the political intersection of California and the nation. Each week hosts Scott Shafer and Marisa Lagos are joined with a new special guest to unpack politics -- with personality — and offer an insider’s glimpse at how politics happens.",
"airtime": "THU 6:30pm-7pm",
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"possible": {
"id": "possible",
"title": "Possible",
"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.",
"airtime": "SUN 2pm",
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"pri-the-world": {
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"title": "PRI's The World: Latest Edition",
"info": "Each weekday, host Marco Werman and his team of producers bring you the world's most interesting stories in an hour of radio that reminds us just how small our planet really is.",
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"imageSrc": "https://cdn.kqed.org/wp-content/uploads/2024/04/The-World-Podcast-Tile-360x360-1.jpg",
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},
"radiolab": {
"id": "radiolab",
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"info": "A two-time Peabody Award-winner, Radiolab is an investigation told through sounds and stories, and centered around one big idea. In the Radiolab world, information sounds like music and science and culture collide. Hosted by Jad Abumrad and Robert Krulwich, the show is designed for listeners who demand skepticism, but appreciate wonder. WNYC Studios is the producer of other leading podcasts including Freakonomics Radio, Death, Sex & Money, On the Media and many more.",
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"reveal": {
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"info": "Created by The Center for Investigative Reporting and PRX, Reveal is public radios first one-hour weekly radio show and podcast dedicated to investigative reporting. Credible, fact based and without a partisan agenda, Reveal combines the power and artistry of driveway moment storytelling with data-rich reporting on critically important issues. The result is stories that inform and inspire, arming our listeners with information to right injustices, hold the powerful accountable and improve lives.Reveal is hosted by Al Letson and showcases the award-winning work of CIR and newsrooms large and small across the nation. In a radio and podcast market crowded with choices, Reveal focuses on important and often surprising stories that illuminate the world for our listeners.",
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},
"rightnowish": {
"id": "rightnowish",
"title": "Rightnowish",
"tagline": "Art is where you find it",
"info": "Rightnowish digs into life in the Bay Area right now… ish. Journalist Pendarvis Harshaw takes us to galleries painted on the sides of liquor stores in West Oakland. We'll dance in warehouses in the Bayview, make smoothies with kids in South Berkeley, and listen to classical music in a 1984 Cutlass Supreme in Richmond. Every week, Pen talks to movers and shakers about how the Bay Area shapes what they create, and how they shape the place we call home.",
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},
"science-friday": {
"id": "science-friday",
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"info": "Science Friday is a weekly science talk show, broadcast live over public radio stations nationwide. Each week, the show focuses on science topics that are in the news and tries to bring an educated, balanced discussion to bear on the scientific issues at hand. Panels of expert guests join host Ira Flatow, a veteran science journalist, to discuss science and to take questions from listeners during the call-in portion of the program.",
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"snap-judgment": {
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"title": "Snap Judgment",
"tagline": "Real stories with killer beats",
"info": "The Snap Judgment radio show and podcast mixes real stories with killer beats to produce cinematic, dramatic radio. Snap's musical brand of storytelling dares listeners to see the world through the eyes of another. This is storytelling... with a BEAT!! Snap first aired on public radio stations nationwide in July 2010. Today, Snap Judgment airs on over 450 public radio stations and is brought to the airwaves by KQED & PRX.",
"airtime": "SAT 1pm-2pm, 9pm-10pm",
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},
"soldout": {
"id": "soldout",
"title": "SOLD OUT: Rethinking Housing in America",
"tagline": "A new future for housing",
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