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"slug": "california-needs-more-latinx-therapists-but-the-mental-health-field-is-still-full-of-barriers-to-entry",
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"content": "\u003cp>Growing up in Daly City, Eric Valladares remembers hearing how his parents and extended family fled El Salvador during the country’s 12-year civil war that ended in 1992.\u003c/p>\n\u003cp>After settling in California, some members struggled financially, finding it hard to adjust to a country where they didn’t speak the language and felt like outsiders.\u003c/p>\n\u003cp>[aside label=\"Related Stories\" postID=\"news_11929333,news_11926978,news_11912753\"]His family never discussed how they coped with those traumas or mentioned mental health. He remembers adults masking emotions with alcohol, something he later imitated. He didn’t realize he had a problem until he was in graduate school, learning how to help others with \u003ci>their\u003c/i> problems.\u003c/p>\n\u003cp>Valladares decided to become a therapist while an undergraduate student at San Francisco State University. He made the career choice believing he just wanted to help the Latinx community, but his decision was deeper than that.\u003c/p>\n\u003cp>“There was pain and there were experiences from my life and my family’s life that in subtle ways put me on this path,” he said. “I wanted to help others heal and help myself heal, but it didn’t occur to me until later. I thought of it as, ‘Isn’t it nice that I want to help people?’ But no, it was really, ‘I have unresolved issues and I want to work them out.’”\u003c/p>\n\u003cp>Valladares, now 37, spent years providing therapy to mostly immigrant, Spanish-speaking people. He’s now the executive director of Family Connections, a Palo Alto nonprofit that provides educational and mental health services to families with young children.\u003c/p>\n\u003cfigure id=\"attachment_11929791\" class=\"wp-caption aligncenter\" style=\"max-width: 800px\">\u003ca href=\"https://ww2.kqed.org/app/uploads/sites/10/2022/10/RS58551_010_KQED_EricValladaresFamilyConnections_09062022-qut.jpg\">\u003cimg loading=\"lazy\" decoding=\"async\" class=\"size-medium wp-image-11929791\" src=\"https://ww2.kqed.org/app/uploads/sites/10/2022/10/RS58551_010_KQED_EricValladaresFamilyConnections_09062022-qut-800x533.jpg\" alt=\"a Latino man in a blue and white checked shirt poses for a portrait in front of a colorful tree decoration in an office\" width=\"800\" height=\"533\" srcset=\"https://cdn.kqed.org/wp-content/uploads/sites/10/2022/10/RS58551_010_KQED_EricValladaresFamilyConnections_09062022-qut-800x533.jpg 800w, https://cdn.kqed.org/wp-content/uploads/sites/10/2022/10/RS58551_010_KQED_EricValladaresFamilyConnections_09062022-qut-1020x680.jpg 1020w, https://cdn.kqed.org/wp-content/uploads/sites/10/2022/10/RS58551_010_KQED_EricValladaresFamilyConnections_09062022-qut-160x107.jpg 160w, https://cdn.kqed.org/wp-content/uploads/sites/10/2022/10/RS58551_010_KQED_EricValladaresFamilyConnections_09062022-qut-1536x1024.jpg 1536w, https://cdn.kqed.org/wp-content/uploads/sites/10/2022/10/RS58551_010_KQED_EricValladaresFamilyConnections_09062022-qut.jpg 1920w\" sizes=\"auto, (max-width: 800px) 100vw, 800px\">\u003c/a>\u003cfigcaption class=\"wp-caption-text\">Executive Director Eric Valladares at the Redwood City location of his mental health nonprofit, Family Connections. \u003ccite>(Beth LaBerge/KQED)\u003c/cite>\u003c/figcaption>\u003c/figure>\n\u003cp>In many ways, Valladares exemplifies what experts and policymakers say California needs more of: He’s a multilingual Latino who brings cultural competency to mental health services. But his journey into the profession demonstrates the difficulties mental health care providers face, such as addressing their own traumas and figuring out how to navigate the professional mental health field — from earning enough money to dealing with insurance companies resistant to paying for patient care.\u003c/p>\n\u003ch2>‘Folks need to be served by people who look like them’\u003c/h2>\n\u003cp>Despite growing demand for mental health services for children struggling with depression, anxiety and suicidal ideation, the mental health field has failed at recruiting enough professionals — of any background. California has less than a quarter of the therapists it needs to care for the state’s population, and the majority specialize in treating adults, according to the Kaiser Family Foundation.\u003c/p>\n\u003cp>And the existing mental health workforce doesn’t mirror the state’s demographics. About 40% of Californians identify as Hispanic or Latino, according to research provided to KQED by the Healthforce Center at UCSF. But only 9% of clinical psychologists, 21% of marriage and family therapists and 27% of mental health counselors identified as Hispanic or Latino from 2015 to 2019, the research shows.\u003c/p>\n\u003cp>“Part of what makes any kind of therapeutic intervention work is the relationship between the provider and the person getting the service,” said Chris Stoner-Mertz, CEO of the California Alliance of Child and Family Services, a coalition of about 150 nonprofits and organizations that serve the state’s children and families. “Folks need to be served by people who look like them and who maybe had some of their life experiences.”\u003c/p>\n\u003cp>[pullquote align=\"right\" size=\"medium\" citation=\"Chris Stoner-Mertz, CEO, California Alliance of Child and Family Services\"]‘Part of what makes any kind of therapeutic intervention work is the relationship between the provider and the person getting the service. Folks need to be served by people who … maybe had some of their life experiences.’[/pullquote]The two biggest barriers to accessing mental health care are the cost and lack of providers. Insurers make it difficult for therapists to get paid by requiring a lot of paperwork, limiting mental health services they will cover and covering only patients with specific diagnoses or those who meet “medical necessity.”\u003c/p>\n\u003cp>Mental health professionals tend to fall into two camps: those who work in the public or nonprofit side and those in private practice. To avoid the hassle of dealing with insurance companies, many therapists go into private practice and accept only cash payments, which inherently means they end up serving patients who can afford to pay $100 to $250 per session.\u003c/p>\n\u003cp>The public or nonprofit side is typically supported by tax or philanthropic funding, and serves people with lower incomes or who aren’t covered by insurance. The government covers the biggest share of mental health care spending in the U.S. In 2019, \u003ca href=\"https://openminds.com/press/u-s-mental-health-spending-reached-225-1-billion-in-2019-open-minds-releases-new-analysis-on-market-spending/\">taxpayers covered 63% of all mental health care costs\u003c/a> — about $150 billion — including therapy and prescriptions, according to Open Minds, a health care market research firm.\u003c/p>\n\u003cp>When Valladares began his career 12 years ago, he wanted to treat underserved Latinx clients who had lower incomes or were immigrants, so he focused on working for nonprofit organizations. At his first job after completing a master’s degree in 2010, he earned $22 per hour or about $46,000 per year.\u003c/p>\n\u003cp>“I lived at home with my parents,” he said, to make it work financially.\u003c/p>\n\u003cp>Valladares estimates that a therapist entering a nonprofit or publicly funded agency now can expect to earn $55,000 to $70,000 per year.\u003c/p>\n\u003cp>“We’re losing a lot of therapists to private practice, and that’s OK,” Valladares said. “I don’t fault them. They don’t want yachts. They just want to be able to live.”\u003c/p>\n\u003cp>Haggling insurance companies to get paid for their services “creates a disillusionment with our mental health system,” Valladares said. “Providers like to say, ‘I don’t want to be a part of a system that just perpetuates this cycle of putting Band-Aids on much deeper issues,’ and then it pushes people into private practice. But again, if you go into private practice, who’s not getting served?”\u003c/p>\n\u003cfigure id=\"attachment_11929795\" class=\"wp-caption aligncenter\" style=\"max-width: 800px\">\u003ca href=\"https://ww2.kqed.org/app/uploads/sites/10/2022/10/RS58566_024_KQED_EricValladaresFamilyConnections_09062022-qut.jpg\">\u003cimg loading=\"lazy\" decoding=\"async\" class=\"size-medium wp-image-11929795\" src=\"https://ww2.kqed.org/app/uploads/sites/10/2022/10/RS58566_024_KQED_EricValladaresFamilyConnections_09062022-qut-800x533.jpg\" alt=\"a Latino man in a blue checked shirt with a mask shows an orange wall of musical instruments\" width=\"800\" height=\"533\" srcset=\"https://cdn.kqed.org/wp-content/uploads/sites/10/2022/10/RS58566_024_KQED_EricValladaresFamilyConnections_09062022-qut-800x533.jpg 800w, https://cdn.kqed.org/wp-content/uploads/sites/10/2022/10/RS58566_024_KQED_EricValladaresFamilyConnections_09062022-qut-1020x680.jpg 1020w, https://cdn.kqed.org/wp-content/uploads/sites/10/2022/10/RS58566_024_KQED_EricValladaresFamilyConnections_09062022-qut-160x107.jpg 160w, https://cdn.kqed.org/wp-content/uploads/sites/10/2022/10/RS58566_024_KQED_EricValladaresFamilyConnections_09062022-qut-1536x1024.jpg 1536w, https://cdn.kqed.org/wp-content/uploads/sites/10/2022/10/RS58566_024_KQED_EricValladaresFamilyConnections_09062022-qut.jpg 1920w\" sizes=\"auto, (max-width: 800px) 100vw, 800px\">\u003c/a>\u003cfigcaption class=\"wp-caption-text\">Executive Director Eric Valladares displays musical instruments in the play area at the Redwood City location of Family Connections. \u003ccite>(Beth LaBerge/KQED)\u003c/cite>\u003c/figcaption>\u003c/figure>\n\u003cp>Valladares’ focus on the Latinx community is tied to his upbringing. He recalled how some of the relatives who fled El Salvador were later hospitalized or placed on psychiatric holds because of mental health crises. One of his uncles had an alcohol addiction.\u003c/p>\n\u003cp>“I saw in my own family how they were impacted by immigration, trauma, the war that they had witnessed in their country and losing a piece of their identity through that,” he said.\u003c/p>\n\u003cp>The way he saw his relatives cope was by not talking about their issues and drinking in excess, habits he also picked up — which later led to his own alcohol addiction.\u003c/p>\n\u003cp>“In college, it’s normal to have a drink when you’re stressed out,” he said. “You don’t really look at it as a pattern or something you inherited from your family.”\u003c/p>\n\u003cp>[pullquote align=\"right\" size=\"medium\" citation=\"Eric Valladares, executive director, Family Connections\"]‘I don’t think that there’s enough of us out there. But I do have a lot of faith that there are people out there who still want to help.’[/pullquote]No one questioned Valladares about his drinking until he entered a psychology master’s program at SF State when he was 23. The program encouraged students to see a therapist. When his therapist asked him why he drank frequently, he became defensive and ignored her concerns.\u003c/p>\n\u003cp>He went from only drinking with friends on weekends to frequently drinking at home on weeknights. Then he started canceling plans because he was too hungover. As he was nearing 30, he realized he needed to change.\u003c/p>\n\u003cp>“I was able to dismiss (my alcohol addiction) for years,” he said. “I started getting older and I realized that my patterns hadn’t only changed, they had gotten worse. The biggest part was meeting my wife. She was not OK with my lifestyle.”\u003c/p>\n\u003cp>When he decided to seek help, his insurance company denied him coverage for therapy and suggested he try a support group. He paid out of pocket for a therapist for about two years and has been in recovery for seven years.\u003c/p>\n\u003cp>His graduate program opened his eyes to the undiagnosed mental health conditions he had observed in his family, and how they lacked the understanding and vocabulary to talk about their issues. His mother never described herself as having anxiety, but would often say, “I just worry a lot.”\u003c/p>\n\u003cp>“My mom was an anxious person and I was an anxious child and we bonded over that,” he recalled. “Years later, alcohol helped me calm down.”\u003c/p>\n\u003cfigure id=\"attachment_11929800\" class=\"wp-caption aligncenter\" style=\"max-width: 800px\">\u003ca href=\"https://ww2.kqed.org/app/uploads/sites/10/2022/10/RS58556_016_KQED_EricValladaresFamilyConnections_09062022-qut.jpg\">\u003cimg loading=\"lazy\" decoding=\"async\" class=\"size-medium wp-image-11929800\" src=\"https://ww2.kqed.org/app/uploads/sites/10/2022/10/RS58556_016_KQED_EricValladaresFamilyConnections_09062022-qut-800x533.jpg\" alt=\"two people in masks speak in a children's therapy office\" width=\"800\" height=\"533\" srcset=\"https://cdn.kqed.org/wp-content/uploads/sites/10/2022/10/RS58556_016_KQED_EricValladaresFamilyConnections_09062022-qut-800x533.jpg 800w, https://cdn.kqed.org/wp-content/uploads/sites/10/2022/10/RS58556_016_KQED_EricValladaresFamilyConnections_09062022-qut-1020x680.jpg 1020w, https://cdn.kqed.org/wp-content/uploads/sites/10/2022/10/RS58556_016_KQED_EricValladaresFamilyConnections_09062022-qut-160x107.jpg 160w, https://cdn.kqed.org/wp-content/uploads/sites/10/2022/10/RS58556_016_KQED_EricValladaresFamilyConnections_09062022-qut-1536x1024.jpg 1536w, https://cdn.kqed.org/wp-content/uploads/sites/10/2022/10/RS58556_016_KQED_EricValladaresFamilyConnections_09062022-qut.jpg 1920w\" sizes=\"auto, (max-width: 800px) 100vw, 800px\">\u003c/a>\u003cfigcaption class=\"wp-caption-text\">Eric Valladares speaks with Carolina Calderón Balladares at the Redwood City location of Family Connections. \u003ccite>(Beth LaBerge/KQED)\u003c/cite>\u003c/figcaption>\u003c/figure>\n\u003cp>His experience overcoming substance use disorder taught him that even for someone working in mental health, getting access to care is still a challenge. It also illustrated how valuable therapy can be.\u003c/p>\n\u003cp>“If I had not gotten into the mental health field, I would have just assumed and assimilated that that’s part of who I am,” he said. “It does make me a believer in what we do. I don’t think that there’s enough of us out there. But I do have a lot of faith that there are people out there who still want to help.”\u003c/p>\n\u003ch2>A lack of parity\u003c/h2>\n\u003cp>Elected officials in California also recognize that the state needs to expand its mental health workforce. One strategy is to hire more counselors and behavioral coaches — roles that require less education than psychiatrists and psychologists.\u003c/p>\n\u003cp>On August 18, Gov. Gavin Newsom announced a plan to add 40,000 mental health care professionals across the state. At least half of those positions will mostly be housed in schools. Newsom said the missing component to helping kids is “people willing to do this work.” Others say the system isn’t working as it should.\u003c/p>\n\u003cp>The federal Mental Health Parity Act, passed in 1996, ruled that insurers’ dollar limits on mental health benefits couldn’t be lower than their equivalents for physical health. But “that has not been in effect for most insurance companies across the country,” said Naomi Allen, CEO and co-founder of Brightline, a Palo Alto-based behavioral health start-up that provides virtual therapy to kids.\u003c/p>\n\u003cp>She was so frustrated by the experience of trying to find therapists for her three children using commercial insurance that she co-founded Brightline in 2019.\u003c/p>\n\u003cp>“What we have is a situation where year over year, more and more therapists are not available through insurance. They’re going out of network. They’re in private practice,” Allen said. “And so we have this scenario that existed pre-COVID, where care was essentially unaffordable to the vast majority of families.”\u003c/p>\n\u003cfigure id=\"attachment_11929797\" class=\"wp-caption aligncenter\" style=\"max-width: 800px\">\u003ca href=\"https://ww2.kqed.org/app/uploads/sites/10/2022/10/RS58544_001_KQED_EricValladaresFamilyConnections_09062022-qut.jpg\">\u003cimg loading=\"lazy\" decoding=\"async\" class=\"size-medium wp-image-11929797\" src=\"https://ww2.kqed.org/app/uploads/sites/10/2022/10/RS58544_001_KQED_EricValladaresFamilyConnections_09062022-qut-800x533.jpg\" alt=\"kids' art on a bulletin board in a therapist's office\" width=\"800\" height=\"533\" srcset=\"https://cdn.kqed.org/wp-content/uploads/sites/10/2022/10/RS58544_001_KQED_EricValladaresFamilyConnections_09062022-qut-800x533.jpg 800w, https://cdn.kqed.org/wp-content/uploads/sites/10/2022/10/RS58544_001_KQED_EricValladaresFamilyConnections_09062022-qut-1020x680.jpg 1020w, https://cdn.kqed.org/wp-content/uploads/sites/10/2022/10/RS58544_001_KQED_EricValladaresFamilyConnections_09062022-qut-160x107.jpg 160w, https://cdn.kqed.org/wp-content/uploads/sites/10/2022/10/RS58544_001_KQED_EricValladaresFamilyConnections_09062022-qut-1536x1024.jpg 1536w, https://cdn.kqed.org/wp-content/uploads/sites/10/2022/10/RS58544_001_KQED_EricValladaresFamilyConnections_09062022-qut.jpg 1920w\" sizes=\"auto, (max-width: 800px) 100vw, 800px\">\u003c/a>\u003cfigcaption class=\"wp-caption-text\">Art hangs in the therapy room at the Redwood City location of Family Connections. \u003ccite>(Beth LaBerge/KQED)\u003c/cite>\u003c/figcaption>\u003c/figure>\n\u003cp>Patricia Alvarado is one of those practitioners. She founded her online-only practice, Alvarado Therapy, about five years ago, and now employs a team of mostly bilingual therapists serving Latinx clients.\u003c/p>\n\u003cp>“We’re a private pay organization,” she said. “Sometimes it can be really hard to obtain payment (from insurance companies). It could take many months. There’s a lot of restrictions … like you could only work with a client for X amount of sessions and that’s it, and the client may need more.”\u003c/p>\n\u003cp>Some patients who have insurance end up paying out of pocket just to speed up the process of getting care.\u003c/p>\n\u003cp>“A lot of time passes by, and that can take away the motivation of wanting to seek services,” Alvarado said. “It shouldn’t be as hard as it is. ”\u003c/p>\n\u003cp>Valladares provided therapy until he burned out. Then he made the switch to running programs for nonprofits like Family Connections, which works with families who don’t qualify for lower-income programs and can’t afford to pay out of pocket.\u003c/p>\n\u003cp>“As long as the families expressed an interest in mental health services, we’re able to provide them with those services, which has been really great,” he said.\u003c/p>\n\u003cp>The shift to administrative work helped Valladares stay in the field, make more money and have time to spend with his wife and two kids, ages 5 and 1.\u003c/p>\n\u003cp>“I still want to be in a position where I can affect change and support families in a different way,” he said. “I make it a point to go out there and make a connection with the people my organization is serving and definitely not lose sight of why I do what I do.”\u003c/p>\n\u003cp>\u003cem>Blanca Torres reported this story while participating in the \u003ca href=\"https://centerforhealthjournalism.org/about-us\">USC Annenberg Center for Health Journalism’s 2022 California Fellowship\u003c/a>.\u003c/em> \u003cem>Subscribe to her monthly newsletter focused on the Bay Area’s Latinx community, K Onda KQED. \u003ca href=\"https://www.kqed.org/newsletters/k-onda\">Click here to subscribe\u003c/a>.\u003c/em>\u003c/p>\n\u003cp>[ad fullwidth]\u003c/p>\n\u003cp>[ad floatright]\u003c/p>\n",
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"excerpt": "Despite growing demand for children's mental health services, California has less than a quarter of the therapists it needs — and due to low pay, burnout and other barriers, culturally competent care from Latinx therapists and other therapists of color is even harder to find.",
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"title": "California Needs More Latinx Therapists — but the Mental Health Field Is Still Full of Barriers to Entry | KQED",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003cp>Growing up in Daly City, Eric Valladares remembers hearing how his parents and extended family fled El Salvador during the country’s 12-year civil war that ended in 1992.\u003c/p>\n\u003cp>After settling in California, some members struggled financially, finding it hard to adjust to a country where they didn’t speak the language and felt like outsiders.\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"content": "\u003cdiv class=\"post-body\">\u003cp>His family never discussed how they coped with those traumas or mentioned mental health. He remembers adults masking emotions with alcohol, something he later imitated. He didn’t realize he had a problem until he was in graduate school, learning how to help others with \u003ci>their\u003c/i> problems.\u003c/p>\n\u003cp>Valladares decided to become a therapist while an undergraduate student at San Francisco State University. He made the career choice believing he just wanted to help the Latinx community, but his decision was deeper than that.\u003c/p>\n\u003cp>“There was pain and there were experiences from my life and my family’s life that in subtle ways put me on this path,” he said. “I wanted to help others heal and help myself heal, but it didn’t occur to me until later. I thought of it as, ‘Isn’t it nice that I want to help people?’ But no, it was really, ‘I have unresolved issues and I want to work them out.’”\u003c/p>\n\u003cp>Valladares, now 37, spent years providing therapy to mostly immigrant, Spanish-speaking people. He’s now the executive director of Family Connections, a Palo Alto nonprofit that provides educational and mental health services to families with young children.\u003c/p>\n\u003cfigure id=\"attachment_11929791\" class=\"wp-caption aligncenter\" style=\"max-width: 800px\">\u003ca href=\"https://ww2.kqed.org/app/uploads/sites/10/2022/10/RS58551_010_KQED_EricValladaresFamilyConnections_09062022-qut.jpg\">\u003cimg loading=\"lazy\" decoding=\"async\" class=\"size-medium wp-image-11929791\" src=\"https://ww2.kqed.org/app/uploads/sites/10/2022/10/RS58551_010_KQED_EricValladaresFamilyConnections_09062022-qut-800x533.jpg\" alt=\"a Latino man in a blue and white checked shirt poses for a portrait in front of a colorful tree decoration in an office\" width=\"800\" height=\"533\" srcset=\"https://cdn.kqed.org/wp-content/uploads/sites/10/2022/10/RS58551_010_KQED_EricValladaresFamilyConnections_09062022-qut-800x533.jpg 800w, https://cdn.kqed.org/wp-content/uploads/sites/10/2022/10/RS58551_010_KQED_EricValladaresFamilyConnections_09062022-qut-1020x680.jpg 1020w, https://cdn.kqed.org/wp-content/uploads/sites/10/2022/10/RS58551_010_KQED_EricValladaresFamilyConnections_09062022-qut-160x107.jpg 160w, https://cdn.kqed.org/wp-content/uploads/sites/10/2022/10/RS58551_010_KQED_EricValladaresFamilyConnections_09062022-qut-1536x1024.jpg 1536w, https://cdn.kqed.org/wp-content/uploads/sites/10/2022/10/RS58551_010_KQED_EricValladaresFamilyConnections_09062022-qut.jpg 1920w\" sizes=\"auto, (max-width: 800px) 100vw, 800px\">\u003c/a>\u003cfigcaption class=\"wp-caption-text\">Executive Director Eric Valladares at the Redwood City location of his mental health nonprofit, Family Connections. \u003ccite>(Beth LaBerge/KQED)\u003c/cite>\u003c/figcaption>\u003c/figure>\n\u003cp>In many ways, Valladares exemplifies what experts and policymakers say California needs more of: He’s a multilingual Latino who brings cultural competency to mental health services. But his journey into the profession demonstrates the difficulties mental health care providers face, such as addressing their own traumas and figuring out how to navigate the professional mental health field — from earning enough money to dealing with insurance companies resistant to paying for patient care.\u003c/p>\n\u003ch2>‘Folks need to be served by people who look like them’\u003c/h2>\n\u003cp>Despite growing demand for mental health services for children struggling with depression, anxiety and suicidal ideation, the mental health field has failed at recruiting enough professionals — of any background. California has less than a quarter of the therapists it needs to care for the state’s population, and the majority specialize in treating adults, according to the Kaiser Family Foundation.\u003c/p>\n\u003cp>And the existing mental health workforce doesn’t mirror the state’s demographics. About 40% of Californians identify as Hispanic or Latino, according to research provided to KQED by the Healthforce Center at UCSF. But only 9% of clinical psychologists, 21% of marriage and family therapists and 27% of mental health counselors identified as Hispanic or Latino from 2015 to 2019, the research shows.\u003c/p>\n\u003cp>“Part of what makes any kind of therapeutic intervention work is the relationship between the provider and the person getting the service,” said Chris Stoner-Mertz, CEO of the California Alliance of Child and Family Services, a coalition of about 150 nonprofits and organizations that serve the state’s children and families. “Folks need to be served by people who look like them and who maybe had some of their life experiences.”\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"content": "\u003cdiv class=\"post-body\">\u003cp>The two biggest barriers to accessing mental health care are the cost and lack of providers. Insurers make it difficult for therapists to get paid by requiring a lot of paperwork, limiting mental health services they will cover and covering only patients with specific diagnoses or those who meet “medical necessity.”\u003c/p>\n\u003cp>Mental health professionals tend to fall into two camps: those who work in the public or nonprofit side and those in private practice. To avoid the hassle of dealing with insurance companies, many therapists go into private practice and accept only cash payments, which inherently means they end up serving patients who can afford to pay $100 to $250 per session.\u003c/p>\n\u003cp>The public or nonprofit side is typically supported by tax or philanthropic funding, and serves people with lower incomes or who aren’t covered by insurance. The government covers the biggest share of mental health care spending in the U.S. In 2019, \u003ca href=\"https://openminds.com/press/u-s-mental-health-spending-reached-225-1-billion-in-2019-open-minds-releases-new-analysis-on-market-spending/\">taxpayers covered 63% of all mental health care costs\u003c/a> — about $150 billion — including therapy and prescriptions, according to Open Minds, a health care market research firm.\u003c/p>\n\u003cp>When Valladares began his career 12 years ago, he wanted to treat underserved Latinx clients who had lower incomes or were immigrants, so he focused on working for nonprofit organizations. At his first job after completing a master’s degree in 2010, he earned $22 per hour or about $46,000 per year.\u003c/p>\n\u003cp>“I lived at home with my parents,” he said, to make it work financially.\u003c/p>\n\u003cp>Valladares estimates that a therapist entering a nonprofit or publicly funded agency now can expect to earn $55,000 to $70,000 per year.\u003c/p>\n\u003cp>“We’re losing a lot of therapists to private practice, and that’s OK,” Valladares said. “I don’t fault them. They don’t want yachts. They just want to be able to live.”\u003c/p>\n\u003cp>Haggling insurance companies to get paid for their services “creates a disillusionment with our mental health system,” Valladares said. “Providers like to say, ‘I don’t want to be a part of a system that just perpetuates this cycle of putting Band-Aids on much deeper issues,’ and then it pushes people into private practice. But again, if you go into private practice, who’s not getting served?”\u003c/p>\n\u003cfigure id=\"attachment_11929795\" class=\"wp-caption aligncenter\" style=\"max-width: 800px\">\u003ca href=\"https://ww2.kqed.org/app/uploads/sites/10/2022/10/RS58566_024_KQED_EricValladaresFamilyConnections_09062022-qut.jpg\">\u003cimg loading=\"lazy\" decoding=\"async\" class=\"size-medium wp-image-11929795\" src=\"https://ww2.kqed.org/app/uploads/sites/10/2022/10/RS58566_024_KQED_EricValladaresFamilyConnections_09062022-qut-800x533.jpg\" alt=\"a Latino man in a blue checked shirt with a mask shows an orange wall of musical instruments\" width=\"800\" height=\"533\" srcset=\"https://cdn.kqed.org/wp-content/uploads/sites/10/2022/10/RS58566_024_KQED_EricValladaresFamilyConnections_09062022-qut-800x533.jpg 800w, https://cdn.kqed.org/wp-content/uploads/sites/10/2022/10/RS58566_024_KQED_EricValladaresFamilyConnections_09062022-qut-1020x680.jpg 1020w, https://cdn.kqed.org/wp-content/uploads/sites/10/2022/10/RS58566_024_KQED_EricValladaresFamilyConnections_09062022-qut-160x107.jpg 160w, https://cdn.kqed.org/wp-content/uploads/sites/10/2022/10/RS58566_024_KQED_EricValladaresFamilyConnections_09062022-qut-1536x1024.jpg 1536w, https://cdn.kqed.org/wp-content/uploads/sites/10/2022/10/RS58566_024_KQED_EricValladaresFamilyConnections_09062022-qut.jpg 1920w\" sizes=\"auto, (max-width: 800px) 100vw, 800px\">\u003c/a>\u003cfigcaption class=\"wp-caption-text\">Executive Director Eric Valladares displays musical instruments in the play area at the Redwood City location of Family Connections. \u003ccite>(Beth LaBerge/KQED)\u003c/cite>\u003c/figcaption>\u003c/figure>\n\u003cp>Valladares’ focus on the Latinx community is tied to his upbringing. He recalled how some of the relatives who fled El Salvador were later hospitalized or placed on psychiatric holds because of mental health crises. One of his uncles had an alcohol addiction.\u003c/p>\n\u003cp>“I saw in my own family how they were impacted by immigration, trauma, the war that they had witnessed in their country and losing a piece of their identity through that,” he said.\u003c/p>\n\u003cp>The way he saw his relatives cope was by not talking about their issues and drinking in excess, habits he also picked up — which later led to his own alcohol addiction.\u003c/p>\n\u003cp>“In college, it’s normal to have a drink when you’re stressed out,” he said. “You don’t really look at it as a pattern or something you inherited from your family.”\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"content": "‘I don’t think that there’s enough of us out there. But I do have a lot of faith that there are people out there who still want to help.’",
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"content": "\u003cdiv class=\"post-body\">\u003cp>No one questioned Valladares about his drinking until he entered a psychology master’s program at SF State when he was 23. The program encouraged students to see a therapist. When his therapist asked him why he drank frequently, he became defensive and ignored her concerns.\u003c/p>\n\u003cp>He went from only drinking with friends on weekends to frequently drinking at home on weeknights. Then he started canceling plans because he was too hungover. As he was nearing 30, he realized he needed to change.\u003c/p>\n\u003cp>“I was able to dismiss (my alcohol addiction) for years,” he said. “I started getting older and I realized that my patterns hadn’t only changed, they had gotten worse. The biggest part was meeting my wife. She was not OK with my lifestyle.”\u003c/p>\n\u003cp>When he decided to seek help, his insurance company denied him coverage for therapy and suggested he try a support group. He paid out of pocket for a therapist for about two years and has been in recovery for seven years.\u003c/p>\n\u003cp>His graduate program opened his eyes to the undiagnosed mental health conditions he had observed in his family, and how they lacked the understanding and vocabulary to talk about their issues. His mother never described herself as having anxiety, but would often say, “I just worry a lot.”\u003c/p>\n\u003cp>“My mom was an anxious person and I was an anxious child and we bonded over that,” he recalled. “Years later, alcohol helped me calm down.”\u003c/p>\n\u003cfigure id=\"attachment_11929800\" class=\"wp-caption aligncenter\" style=\"max-width: 800px\">\u003ca href=\"https://ww2.kqed.org/app/uploads/sites/10/2022/10/RS58556_016_KQED_EricValladaresFamilyConnections_09062022-qut.jpg\">\u003cimg loading=\"lazy\" decoding=\"async\" class=\"size-medium wp-image-11929800\" src=\"https://ww2.kqed.org/app/uploads/sites/10/2022/10/RS58556_016_KQED_EricValladaresFamilyConnections_09062022-qut-800x533.jpg\" alt=\"two people in masks speak in a children's therapy office\" width=\"800\" height=\"533\" srcset=\"https://cdn.kqed.org/wp-content/uploads/sites/10/2022/10/RS58556_016_KQED_EricValladaresFamilyConnections_09062022-qut-800x533.jpg 800w, https://cdn.kqed.org/wp-content/uploads/sites/10/2022/10/RS58556_016_KQED_EricValladaresFamilyConnections_09062022-qut-1020x680.jpg 1020w, https://cdn.kqed.org/wp-content/uploads/sites/10/2022/10/RS58556_016_KQED_EricValladaresFamilyConnections_09062022-qut-160x107.jpg 160w, https://cdn.kqed.org/wp-content/uploads/sites/10/2022/10/RS58556_016_KQED_EricValladaresFamilyConnections_09062022-qut-1536x1024.jpg 1536w, https://cdn.kqed.org/wp-content/uploads/sites/10/2022/10/RS58556_016_KQED_EricValladaresFamilyConnections_09062022-qut.jpg 1920w\" sizes=\"auto, (max-width: 800px) 100vw, 800px\">\u003c/a>\u003cfigcaption class=\"wp-caption-text\">Eric Valladares speaks with Carolina Calderón Balladares at the Redwood City location of Family Connections. \u003ccite>(Beth LaBerge/KQED)\u003c/cite>\u003c/figcaption>\u003c/figure>\n\u003cp>His experience overcoming substance use disorder taught him that even for someone working in mental health, getting access to care is still a challenge. It also illustrated how valuable therapy can be.\u003c/p>\n\u003cp>“If I had not gotten into the mental health field, I would have just assumed and assimilated that that’s part of who I am,” he said. “It does make me a believer in what we do. I don’t think that there’s enough of us out there. But I do have a lot of faith that there are people out there who still want to help.”\u003c/p>\n\u003ch2>A lack of parity\u003c/h2>\n\u003cp>Elected officials in California also recognize that the state needs to expand its mental health workforce. One strategy is to hire more counselors and behavioral coaches — roles that require less education than psychiatrists and psychologists.\u003c/p>\n\u003cp>On August 18, Gov. Gavin Newsom announced a plan to add 40,000 mental health care professionals across the state. At least half of those positions will mostly be housed in schools. Newsom said the missing component to helping kids is “people willing to do this work.” Others say the system isn’t working as it should.\u003c/p>\n\u003cp>The federal Mental Health Parity Act, passed in 1996, ruled that insurers’ dollar limits on mental health benefits couldn’t be lower than their equivalents for physical health. But “that has not been in effect for most insurance companies across the country,” said Naomi Allen, CEO and co-founder of Brightline, a Palo Alto-based behavioral health start-up that provides virtual therapy to kids.\u003c/p>\n\u003cp>She was so frustrated by the experience of trying to find therapists for her three children using commercial insurance that she co-founded Brightline in 2019.\u003c/p>\n\u003cp>“What we have is a situation where year over year, more and more therapists are not available through insurance. They’re going out of network. They’re in private practice,” Allen said. “And so we have this scenario that existed pre-COVID, where care was essentially unaffordable to the vast majority of families.”\u003c/p>\n\u003cfigure id=\"attachment_11929797\" class=\"wp-caption aligncenter\" style=\"max-width: 800px\">\u003ca href=\"https://ww2.kqed.org/app/uploads/sites/10/2022/10/RS58544_001_KQED_EricValladaresFamilyConnections_09062022-qut.jpg\">\u003cimg loading=\"lazy\" decoding=\"async\" class=\"size-medium wp-image-11929797\" src=\"https://ww2.kqed.org/app/uploads/sites/10/2022/10/RS58544_001_KQED_EricValladaresFamilyConnections_09062022-qut-800x533.jpg\" alt=\"kids' art on a bulletin board in a therapist's office\" width=\"800\" height=\"533\" srcset=\"https://cdn.kqed.org/wp-content/uploads/sites/10/2022/10/RS58544_001_KQED_EricValladaresFamilyConnections_09062022-qut-800x533.jpg 800w, https://cdn.kqed.org/wp-content/uploads/sites/10/2022/10/RS58544_001_KQED_EricValladaresFamilyConnections_09062022-qut-1020x680.jpg 1020w, https://cdn.kqed.org/wp-content/uploads/sites/10/2022/10/RS58544_001_KQED_EricValladaresFamilyConnections_09062022-qut-160x107.jpg 160w, https://cdn.kqed.org/wp-content/uploads/sites/10/2022/10/RS58544_001_KQED_EricValladaresFamilyConnections_09062022-qut-1536x1024.jpg 1536w, https://cdn.kqed.org/wp-content/uploads/sites/10/2022/10/RS58544_001_KQED_EricValladaresFamilyConnections_09062022-qut.jpg 1920w\" sizes=\"auto, (max-width: 800px) 100vw, 800px\">\u003c/a>\u003cfigcaption class=\"wp-caption-text\">Art hangs in the therapy room at the Redwood City location of Family Connections. \u003ccite>(Beth LaBerge/KQED)\u003c/cite>\u003c/figcaption>\u003c/figure>\n\u003cp>Patricia Alvarado is one of those practitioners. She founded her online-only practice, Alvarado Therapy, about five years ago, and now employs a team of mostly bilingual therapists serving Latinx clients.\u003c/p>\n\u003cp>“We’re a private pay organization,” she said. “Sometimes it can be really hard to obtain payment (from insurance companies). It could take many months. There’s a lot of restrictions … like you could only work with a client for X amount of sessions and that’s it, and the client may need more.”\u003c/p>\n\u003cp>Some patients who have insurance end up paying out of pocket just to speed up the process of getting care.\u003c/p>\n\u003cp>“A lot of time passes by, and that can take away the motivation of wanting to seek services,” Alvarado said. “It shouldn’t be as hard as it is. ”\u003c/p>\n\u003cp>Valladares provided therapy until he burned out. Then he made the switch to running programs for nonprofits like Family Connections, which works with families who don’t qualify for lower-income programs and can’t afford to pay out of pocket.\u003c/p>\n\u003cp>“As long as the families expressed an interest in mental health services, we’re able to provide them with those services, which has been really great,” he said.\u003c/p>\n\u003cp>The shift to administrative work helped Valladares stay in the field, make more money and have time to spend with his wife and two kids, ages 5 and 1.\u003c/p>\n\u003cp>“I still want to be in a position where I can affect change and support families in a different way,” he said. “I make it a point to go out there and make a connection with the people my organization is serving and definitely not lose sight of why I do what I do.”\u003c/p>\n\u003cp>\u003cem>Blanca Torres reported this story while participating in the \u003ca href=\"https://centerforhealthjournalism.org/about-us\">USC Annenberg Center for Health Journalism’s 2022 California Fellowship\u003c/a>.\u003c/em> \u003cem>Subscribe to her monthly newsletter focused on the Bay Area’s Latinx community, K Onda KQED. \u003ca href=\"https://www.kqed.org/newsletters/k-onda\">Click here to subscribe\u003c/a>.\u003c/em>\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"content": "\u003cp>Some 2,000 Kaiser Permanente mental health care employees in Northern California are returning to work after voting almost unanimously to ratify a new contract on Thursday, ending a grueling 10-week standoff over staffing shortages, wages and patient care.\u003c/p>\n\u003cp>The four-year contract gives therapists nearly two hours of additional time per week to respond to patient emails, contact social service agencies and perform other administrative tasks. The deal also includes a commitment from Kaiser to hire more therapists, improve access to treatment for patients and increase initial consultation times for children.\u003c/p>\n\u003cp>“It took much longer than it should have to reach this agreement, but, in the end, we succeeded in securing important improvements in patient care that Kaiser negotiators told us across the bargaining table that they’d never agree to,” Jennifer Browning, a Kaiser social worker who served on the bargaining committee, said in a statement.[aside label=\"related coverage\" tag=\"kaiser-strike\"]The hard-fought deal between the Oakland-based health care giant and the National Union of Healthcare Workers — the union representing Kaiser therapists, social workers, chemical dependency counselors and other mental health staffers in the Bay Area and Central Valley — \u003ca href=\"https://about.kaiserpermanente.org/who-we-are/labor-relations/tentative-agreement-reached-with-nuhw-to-end-strike\">was reached earlier this week\u003c/a> after Sacramento Mayor Darrell Steinberg stepped in to mediate. Thursday’s official approval of the agreement ends the longest strike among mental health care workers in U.S. history, according to the union.\u003c/p>\n\u003cp>In a statement, Kaiser officials said they were “very pleased at the outcome” of the vote. \u003c/p>\n\u003cp>“We appreciate our therapists’ confidence in this agreement, which addresses the concerns they expressed, while upholding Kaiser Permanente’s commitment that any agreement must protect and enhance access to mental health for our members,” the statement said. “We are glad to have all our employees back, caring for their patients.”\u003c/p>\n\u003cp>\u003ca href=\"https://www.kqed.org/news/11922524/kaiser-mental-health-workers-in-northern-california-begin-open-ended-strike-over-staffing-shortages\">Workers first walked out on August 15\u003c/a>, amid accounts of widespread burnout, retention issues and unsafe therapist-to-client ratios — sometimes resulting in patients having to wait as long as three months to see a therapist, workers said. \u003c/p>\n\u003cp>Early on in the strike, Ilana Marcucci-Morris, a licensed clinical social worker in Kaiser’s psychiatry department in Oakland, said burnout and poor working conditions were contributing to dismal retention rates among employees, and making it difficult for the company to recruit new ones.\u003c/p>\n\u003cp>“There isn’t a shortage of clinicians. There’s only a shortage of clinicians that want to work for Kaiser,” Marcucci-Morris \u003ca href=\"https://www.kqed.org/news/11923034/were-drowning-why-kaiser-mental-health-workers-are-striking\">told KQED’s Forum in August\u003c/a>. “We get into this field to help people, and it’s hard to recruit therapists when Kaiser’s reputation is known to make people wait so long for therapy sessions. It’s really, really not ethical.”\u003c/p>\n\u003cp>Pressure mounted on Kaiser to resolve the impasse, as striking workers garnered support from notable state lawmakers, including Lt. Governor Eleni Kounalakis, state Senate President Pro Tempore Toni Atkins, state Sen. Scott Wiener (D-San Francisco), and Assembly Speaker Anthony Rendon.\u003c/p>\n\u003cp>“The day is going to come where the people of this country … truly have access to behavioral health care and mental health care that they need, that they deserve,” NUHW President Sal Rosselli told striking workers last Friday, speaking from the steps of Kaiser’s downtown Oakland offices, after announcing that Steinberg had agreed to mediate. “And when that day comes, historians are going to point to this strike, this union strike, as the catalyst that made it happen.”\u003c/p>\n\u003cp>Natalie Rogers, a Kaiser therapist in Santa Rosa, was among scores of employees who breathed a collective sigh of relief on Thursday, after not receiving any compensation for 10 weeks.\u003c/p>\n\u003cp>“I think we are all happy that we are going back to work. As you could imagine, it was definitely a financial strain, and an emotional strain,” Rogers said. “But I think that we have formed a unity like no other. I think that we now know … what we are capable of doing if we stick together.”\u003c/p>\n\u003cp>And because of that, she added, morale will be higher. “We will have the support from one another that we need to help push Kaiser to where we feel our patients will get the best care,” she said.\u003c/p>\n\u003cp>\u003ci>This story includes reporting from KQED’s Lesley McClurg.\u003c/i>\u003cbr>\n[ad fullwidth]\u003c/p>\n\u003cp>\u003c/p>\n",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003cp>Some 2,000 Kaiser Permanente mental health care employees in Northern California are returning to work after voting almost unanimously to ratify a new contract on Thursday, ending a grueling 10-week standoff over staffing shortages, wages and patient care.\u003c/p>\n\u003cp>The four-year contract gives therapists nearly two hours of additional time per week to respond to patient emails, contact social service agencies and perform other administrative tasks. The deal also includes a commitment from Kaiser to hire more therapists, improve access to treatment for patients and increase initial consultation times for children.\u003c/p>\n\u003cp>“It took much longer than it should have to reach this agreement, but, in the end, we succeeded in securing important improvements in patient care that Kaiser negotiators told us across the bargaining table that they’d never agree to,” Jennifer Browning, a Kaiser social worker who served on the bargaining committee, said in a statement.\u003c/p>\u003c/div>",
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"content": "\u003cdiv class=\"post-body\">\u003cp>The hard-fought deal between the Oakland-based health care giant and the National Union of Healthcare Workers — the union representing Kaiser therapists, social workers, chemical dependency counselors and other mental health staffers in the Bay Area and Central Valley — \u003ca href=\"https://about.kaiserpermanente.org/who-we-are/labor-relations/tentative-agreement-reached-with-nuhw-to-end-strike\">was reached earlier this week\u003c/a> after Sacramento Mayor Darrell Steinberg stepped in to mediate. Thursday’s official approval of the agreement ends the longest strike among mental health care workers in U.S. history, according to the union.\u003c/p>\n\u003cp>In a statement, Kaiser officials said they were “very pleased at the outcome” of the vote. \u003c/p>\n\u003cp>“We appreciate our therapists’ confidence in this agreement, which addresses the concerns they expressed, while upholding Kaiser Permanente’s commitment that any agreement must protect and enhance access to mental health for our members,” the statement said. “We are glad to have all our employees back, caring for their patients.”\u003c/p>\n\u003cp>\u003ca href=\"https://www.kqed.org/news/11922524/kaiser-mental-health-workers-in-northern-california-begin-open-ended-strike-over-staffing-shortages\">Workers first walked out on August 15\u003c/a>, amid accounts of widespread burnout, retention issues and unsafe therapist-to-client ratios — sometimes resulting in patients having to wait as long as three months to see a therapist, workers said. \u003c/p>\n\u003cp>Early on in the strike, Ilana Marcucci-Morris, a licensed clinical social worker in Kaiser’s psychiatry department in Oakland, said burnout and poor working conditions were contributing to dismal retention rates among employees, and making it difficult for the company to recruit new ones.\u003c/p>\n\u003cp>“There isn’t a shortage of clinicians. There’s only a shortage of clinicians that want to work for Kaiser,” Marcucci-Morris \u003ca href=\"https://www.kqed.org/news/11923034/were-drowning-why-kaiser-mental-health-workers-are-striking\">told KQED’s Forum in August\u003c/a>. “We get into this field to help people, and it’s hard to recruit therapists when Kaiser’s reputation is known to make people wait so long for therapy sessions. It’s really, really not ethical.”\u003c/p>\n\u003cp>Pressure mounted on Kaiser to resolve the impasse, as striking workers garnered support from notable state lawmakers, including Lt. Governor Eleni Kounalakis, state Senate President Pro Tempore Toni Atkins, state Sen. Scott Wiener (D-San Francisco), and Assembly Speaker Anthony Rendon.\u003c/p>\n\u003cp>“The day is going to come where the people of this country … truly have access to behavioral health care and mental health care that they need, that they deserve,” NUHW President Sal Rosselli told striking workers last Friday, speaking from the steps of Kaiser’s downtown Oakland offices, after announcing that Steinberg had agreed to mediate. “And when that day comes, historians are going to point to this strike, this union strike, as the catalyst that made it happen.”\u003c/p>\n\u003cp>Natalie Rogers, a Kaiser therapist in Santa Rosa, was among scores of employees who breathed a collective sigh of relief on Thursday, after not receiving any compensation for 10 weeks.\u003c/p>\n\u003cp>“I think we are all happy that we are going back to work. As you could imagine, it was definitely a financial strain, and an emotional strain,” Rogers said. “But I think that we have formed a unity like no other. I think that we now know … what we are capable of doing if we stick together.”\u003c/p>\n\u003cp>And because of that, she added, morale will be higher. “We will have the support from one another that we need to help push Kaiser to where we feel our patients will get the best care,” she said.\u003c/p>\n\u003cp>\u003ci>This story includes reporting from KQED’s Lesley McClurg.\u003c/i>\u003cbr>\n\u003c/p>\u003c/div>",
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"content": "\u003cp>The union representing Kaiser Permanente mental health care workers in Northern California on Tuesday reached a tentative four-year agreement with the health care giant, potentially ending a two-month strike among thousands of workers.\u003c/p>\n\u003cp>[aside label=\"related coverage\" tag=\"kaiser-strike\"]The tentative agreement would benefit patients and “drive collaborative efforts aimed at improving access to mental health care, while at the same time recognizing and better supporting mental health therapists” in their work, according to a \u003ca href=\"https://twitter.com/NUHW/status/1582454798242050053\">joint statement by Kaiser and the National Union of Healthcare Workers (NUHW)\u003c/a>.\u003c/p>\n\u003cp>“The day is going to come where the people of this country … truly have access to behavioral health care and mental health care that they need, that they deserve,” NUHW President Sal Rosselli told striking workers on Friday, speaking from the steps of Kaiser’s downtown Oakland offices, where he announced that Sacramento Mayor Darrell Steinberg had agreed to mediate negotiations. “And when that day comes, historians are going to point to this strike, this union strike, as the catalyst that made it happen.”\u003c/p>\n\u003cp>“The day is going to come where the term ‘mental health care’ no longer exists — it’s simply ‘health care,’ because of your sacrifice,” Rosselli added.\u003c/p>\n\u003cp>https://twitter.com/HeterodoxThis/status/1582471048334671872\u003c/p>\n\u003cp>Some 2,000 Kaiser Bay Area and Central Valley mental health workers — including therapists, social workers and chemical dependency counselors — \u003ca href=\"https://www.kqed.org/news/11922524/kaiser-mental-health-workers-in-northern-california-begin-open-ended-strike-over-staffing-shortages\">began their open-ended strike on August 15\u003c/a>, to ask for increased staffing, a wage hike and better health care access for patients. Striking employees described widespread burnout, retention issues and unsafe therapist-to-client ratios that meant patients sometimes had to wait as long as three months to see a therapist.\u003c/p>\n\u003cp>Early on in the strike, Ilana Marcucci-Morris, a licensed clinical social worker in Kaiser’s psychiatry department in Oakland, \u003ca href=\"https://www.kqed.org/news/11923034/were-drowning-why-kaiser-mental-health-workers-are-striking\">told KQED’s Forum\u003c/a> that there were 2,600 patients for every mental health worker in the Northern California Kaiser system. She said burnout and poor working conditions were contributing to dismal retention rates among employees, and making it difficult for the company to recruit new ones.\u003c/p>\n\u003cp>“There isn’t a shortage of clinicians. There’s only a shortage of clinicians that want to work for Kaiser,” Marcucci-Morris said. “We get into this field to help people, and it’s hard to recruit therapists when Kaiser’s reputation is known to make people wait so long for therapy sessions. It’s really, really not ethical.”\u003c/p>\n\u003cp>Union leaders \u003ca href=\"https://www.kqed.org/news/11925882/one-month-into-grinding-strike-negotiations-break-down-between-kaiser-permanente-and-mental-health-workers\">rejected a previous contract\u003c/a> offer from Kaiser last month that included wage increases, but did not meet the union’s demands for increased staffing and more time allotted for administrative work.\u003c/p>\n\u003cp>The striking workers garnered support over the last two months from notable state lawmakers including Lt. Governor Eleni Kounalakis, state Senate President Pro Tempore Toni Atkins, state Sen. Scott Wiener (D-San Francisco), and Assembly Speaker Anthony Rendon.\u003c/p>\n\u003cp>More details on the tentative agreement are expected to be available after a two-day ratification vote among workers later this week.\u003c/p>\n\u003cp>\u003ci>This story includes reporting from KQED’s Emma Silvers and Matthew Green, and Bay City News.\u003c/i>\u003c/p>\n\u003cp>[ad fullwidth]\u003c/p>\n\u003cp>\u003c/p>\n",
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"content": "\u003cdiv class=\"post-body\">\u003cp>The tentative agreement would benefit patients and “drive collaborative efforts aimed at improving access to mental health care, while at the same time recognizing and better supporting mental health therapists” in their work, according to a \u003ca href=\"https://twitter.com/NUHW/status/1582454798242050053\">joint statement by Kaiser and the National Union of Healthcare Workers (NUHW)\u003c/a>.\u003c/p>\n\u003cp>“The day is going to come where the people of this country … truly have access to behavioral health care and mental health care that they need, that they deserve,” NUHW President Sal Rosselli told striking workers on Friday, speaking from the steps of Kaiser’s downtown Oakland offices, where he announced that Sacramento Mayor Darrell Steinberg had agreed to mediate negotiations. “And when that day comes, historians are going to point to this strike, this union strike, as the catalyst that made it happen.”\u003c/p>\n\u003cp>“The day is going to come where the term ‘mental health care’ no longer exists — it’s simply ‘health care,’ because of your sacrifice,” Rosselli added.\u003c/p>\u003c/p>\u003c/div>",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\n\u003cp>Some 2,000 Kaiser Bay Area and Central Valley mental health workers — including therapists, social workers and chemical dependency counselors — \u003ca href=\"https://www.kqed.org/news/11922524/kaiser-mental-health-workers-in-northern-california-begin-open-ended-strike-over-staffing-shortages\">began their open-ended strike on August 15\u003c/a>, to ask for increased staffing, a wage hike and better health care access for patients. Striking employees described widespread burnout, retention issues and unsafe therapist-to-client ratios that meant patients sometimes had to wait as long as three months to see a therapist.\u003c/p>\n\u003cp>Early on in the strike, Ilana Marcucci-Morris, a licensed clinical social worker in Kaiser’s psychiatry department in Oakland, \u003ca href=\"https://www.kqed.org/news/11923034/were-drowning-why-kaiser-mental-health-workers-are-striking\">told KQED’s Forum\u003c/a> that there were 2,600 patients for every mental health worker in the Northern California Kaiser system. She said burnout and poor working conditions were contributing to dismal retention rates among employees, and making it difficult for the company to recruit new ones.\u003c/p>\n\u003cp>“There isn’t a shortage of clinicians. There’s only a shortage of clinicians that want to work for Kaiser,” Marcucci-Morris said. “We get into this field to help people, and it’s hard to recruit therapists when Kaiser’s reputation is known to make people wait so long for therapy sessions. It’s really, really not ethical.”\u003c/p>\n\u003cp>Union leaders \u003ca href=\"https://www.kqed.org/news/11925882/one-month-into-grinding-strike-negotiations-break-down-between-kaiser-permanente-and-mental-health-workers\">rejected a previous contract\u003c/a> offer from Kaiser last month that included wage increases, but did not meet the union’s demands for increased staffing and more time allotted for administrative work.\u003c/p>\n\u003cp>The striking workers garnered support over the last two months from notable state lawmakers including Lt. Governor Eleni Kounalakis, state Senate President Pro Tempore Toni Atkins, state Sen. Scott Wiener (D-San Francisco), and Assembly Speaker Anthony Rendon.\u003c/p>\n\u003cp>More details on the tentative agreement are expected to be available after a two-day ratification vote among workers later this week.\u003c/p>\n\u003cp>\u003ci>This story includes reporting from KQED’s Emma Silvers and Matthew Green, and Bay City News.\u003c/i>\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"content": "\u003cp>When Mariana Pimentel thinks about her childhood in a small town in Mexico, she remembers being surrounded by anger and desperation.\u003c/p>\n\u003cp>Her parents worked long hours to support Pimentel and her brothers and sisters, so they were often absent. When they \u003cem>were\u003c/em> home, her parents communicated by yelling.\u003c/p>\n\u003cp>“I want my kids to grow up in a different environment from how I grew up and not repeat the same mistakes,” said Pimentel, a 41-year-old mother of three.\u003c/p>\n\u003cp>[aside label=\"Related Stories\" postID=\"news_11926978,news_11924343,news_11924980\"]Shifting away from the parenting style she grew up with took time and lots of work. Nine years ago, Pimentel, who lives in Salinas, began attending free classes on topics such as positive parenting and discipline at GoKids Inc., a nonprofit that provides early childhood education to lower-income families.\u003c/p>\n\u003cp>“I’ve noticed that if I am stressed or anxious, I will end up transmitting that to my kids. There is a connection,” Pimentel said. “The more I attend classes, the more I learn, the better I can help my children and the better off they will be.”\u003c/p>\n\u003cp>In addition to taking classes, Pimentel, her husband and two of her children received individual therapy through GoKids to deal with depression and anxiety. The family’s experience demonstrates the importance of addressing mental health not just for one person, but the family as a whole.\u003c/p>\n\u003ch2>Pandemic ‘forced us to look at the shadows’\u003c/h2>\n\u003cp>During the first year of the pandemic, \u003ca href=\"https://www.cdc.gov/mmwr/volumes/70/wr/mm7024a3.htm#:~:text=Among%202%2C391%20parents%2Dcaregivers%2C%20approximately,past%2Dmonth%20serious%20suicidal%20ideation.\">nearly two-thirds of caregivers, including parents, reported adverse mental or behavioral health symptoms\u003c/a>, according to a Centers for Disease Control and Prevention survey. The survey also found that 27% of parents of children under 18 reported that their mental health worsened during the pandemic.\u003c/p>\n\u003cp>The need to come to terms with how parental mental health influences the mental health of children has come into sharper focus as the United States grapples with a crisis of children experiencing higher rates of anxiety, depression and thoughts of suicide.\u003c/p>\n\u003cp>In 2020, California saw a 70% increase in kids being diagnosed with anxiety or depression. That’s 1 in 8, up from 1 in 14 in 2016, \u003ca href=\"https://assets.aecf.org/m/resourcedoc/aecf-2022kidscountdatabook-2022.pdf\">according to The Annie E. Casey Foundation (PDF)\u003c/a>.\u003c/p>\n\u003cfigure id=\"attachment_11929357\" class=\"wp-caption aligncenter\" style=\"max-width: 800px\">\u003ca href=\"https://ww2.kqed.org/app/uploads/sites/10/2022/10/RS58811_image000000-1-2-qut.jpg\">\u003cimg loading=\"lazy\" decoding=\"async\" class=\"size-medium wp-image-11929357\" src=\"https://ww2.kqed.org/app/uploads/sites/10/2022/10/RS58811_image000000-1-2-qut-800x640.jpg\" alt=\"a young Latinx couple, a man and a woman, in white shirts, smiling in front of a blue sky\" width=\"800\" height=\"640\" srcset=\"https://cdn.kqed.org/wp-content/uploads/sites/10/2022/10/RS58811_image000000-1-2-qut-800x640.jpg 800w, https://cdn.kqed.org/wp-content/uploads/sites/10/2022/10/RS58811_image000000-1-2-qut-1020x816.jpg 1020w, https://cdn.kqed.org/wp-content/uploads/sites/10/2022/10/RS58811_image000000-1-2-qut-160x128.jpg 160w, https://cdn.kqed.org/wp-content/uploads/sites/10/2022/10/RS58811_image000000-1-2-qut-1536x1229.jpg 1536w, https://cdn.kqed.org/wp-content/uploads/sites/10/2022/10/RS58811_image000000-1-2-qut.jpg 1920w\" sizes=\"(max-width: 800px) 100vw, 800px\">\u003c/a>\u003cfigcaption class=\"wp-caption-text\">Jose Angel Morales and Mariana Pimentel learned to manage their own stress and anxiety with therapy, and are working to pass the tools they’ve learned on to their children. \u003ccite>(Courtesy of Mariana Pimentel)\u003c/cite>\u003c/figcaption>\u003c/figure>\n\u003cp>Children of color suffer the most, say experts, because services remain inaccessible to them for a variety of reasons.\u003c/p>\n\u003cp>“One thing the pandemic did is that it forced us to look at the shadows, the darker things, both within ourselves and within our communities that need attention,” said Tlazoltiani Jessica Zamarripa, who co-founded the Institute of Chicana/o/x Psychology with her husband, Manuel X. Zamarripa.\u003c/p>\n\u003cp>Based in Austin, Texas, the organization provides training for mental health providers and individuals with an emphasis on ancestral knowledge and practices from Indigenous cultures of Mexico. The Zamarripas founded the Institute of Chicana/o/x Psychology as a way to combat what they call the “mental health industrial complex” that has largely left kids from nonwhite communities underserved.\u003c/p>\n\u003cp>“Our children have never been immune to the stresses, the anxieties, the intergenerational ancestral, familial, interpersonal and racial traumas, and the harms and violence we have experienced and experience now,” Zamarripa said.\u003c/p>\n\u003cp>[pullquote align=\"right\" size=\"medium\" citation=\"Tlazoltiani Jessica Zamarripa, co-founder, Institute of Chicana/o/x Psychology\"]‘Our children have never been immune to the stresses, the anxieties, the intergenerational ancestral, familial, interpersonal and racial traumas, and the harms and violence we have experienced.’[/pullquote]Often, when a child is struggling, the focus is solely on what they are doing wrong and correcting those behaviors, while not taking into account the stressors in their environment, including some caused by stressed parents. Parents need to recognize when their children need help, but also need to understand their own behavior, mental health and patterns of generational trauma, Zamarripa said.\u003c/p>\n\u003cp>In 2019, close to 1 in 5 white children received some form of mental health treatment. For \u003ca href=\"https://www.cdc.gov/nchs/products/databriefs/db381.htm\">Latino and Black children the rate was about 1 in 11\u003c/a>, according to the CDC.\u003c/p>\n\u003cp>“It’s a deep pain to know that our children are struggling and suffering,” Zamarripa said. “We just want to believe that they’re happy and playful.”\u003c/p>\n\u003cp>But children don’t have the same coping mechanisms and understanding that adults have. When a child is acting out, Zamarripa’s advice is to avoid reacting, punishing or judging the behavior.\u003c/p>\n\u003cp>“Kids act out in all kinds of ways, and for generations and generations and generations that has been misinterpreted as bad behavior when, in fact, all behavior is communication,” she said.\u003c/p>\n\u003cfigure id=\"attachment_11929393\" class=\"wp-caption aligncenter\" style=\"max-width: 709px\">\u003ca href=\"https://ww2.kqed.org/app/uploads/sites/10/2022/10/RS58816_2_5_2022-12_52_44-AM.jpg\">\u003cimg loading=\"lazy\" decoding=\"async\" class=\"size-full wp-image-11929393\" src=\"https://ww2.kqed.org/app/uploads/sites/10/2022/10/RS58816_2_5_2022-12_52_44-AM.jpg\" alt=\"a man and a woman in traditional Chicana/o/x dress talk in a room\" width=\"709\" height=\"399\" srcset=\"https://cdn.kqed.org/wp-content/uploads/sites/10/2022/10/RS58816_2_5_2022-12_52_44-AM.jpg 709w, https://cdn.kqed.org/wp-content/uploads/sites/10/2022/10/RS58816_2_5_2022-12_52_44-AM-160x90.jpg 160w\" sizes=\"(max-width: 709px) 100vw, 709px\">\u003c/a>\u003cfigcaption class=\"wp-caption-text\">Manuel X. Zamarippa (left) and Tlazoltiani Jessica Zamarripa, co-founders of the Institute of Chicana/o/x Psychology. \u003ccite>(Courtesy of the Institute of Chicana/o/x Psychology)\u003c/cite>\u003c/figcaption>\u003c/figure>\n\u003cp>Some parents, particularly the parents of children of color, often don’t know how to manage the stigma attached to seeking therapy for themselves or their children.\u003c/p>\n\u003cp>“Sometimes the difficulty with gaining access [to mental health care] is even getting buy-in” from parents, said Patricia Alvarado of Alvarado Therapy, a Los Angeles-based practice made up of Latinx and Spanish-speaking therapists. “If we’re talking about a young person, like a kid or a teenager, it can be quite difficult to say, ‘Yes, I need help.’ And also for the parent, depending on their socioeconomic status, their background, their education, they may not even know what that means.”\u003c/p>\n\u003cp>Not treating mental illness in kids can cause long-term harm. CDC researchers estimate that \u003ca href=\"https://www.cdc.gov/childrensmentalhealth/features/kf-childrens-mental-health-report.html\">13% to 20% of children are affected by an emotional or mental health disorder before the age of 17\u003c/a>.\u003c/p>\n\u003cp>“We still don’t know the long-term impact of the pandemic on children,” said Dr. Sandra Pisano, director of behavioral health for AltaMed, a community health provider in Southern California that serves lower-income people and mostly Latinx patients. “By normalizing wellness and self-care, this is where there’s a great opportunity for us to provide services to develop a healthy future generation after the pandemic.”\u003c/p>\n\u003cp>[pullquote align=\"right\" size=\"medium\" citation=\"Dr. Sandra Pisano, director of behavioral health, AltaMed\"]‘By normalizing wellness and self-care, this is where there’s a great opportunity for us to provide services to develop a healthy future generation after the pandemic.’[/pullquote]According to Pisano, many parents don’t know how to talk to their children about self-care, which can be as simple as good sleep, eating well, taking deep breaths and doing something that brings joy or relaxation.\u003c/p>\n\u003cp>“It’s important for them as they grow older … that they still have the practice of self-care, because this is creating a healthy child who will eventually be a healthy adult,” Pisano said.\u003c/p>\n\u003ch2>The transformative power of therapy\u003c/h2>\n\u003cp>When she was 24 years old, Pimentel left her home in Hidalgo, a state in central Mexico, to join her brother and sister in Salinas. There she met her husband, Jose Angel Morales, and started a family. Their three children are ages 9, 6 and 7 months.\u003c/p>\n\u003cp>“I looked for parenting resources when my eldest daughter was born, and connected with GoKids,” she said. “We started with classes and workshops and then wellness visits for my daughter and then, eventually, I found out they offered therapy.”\u003c/p>\n\u003cp>In 2020, Pimentel sank into depression after going through a miscarriage and went to therapy for the first time to deal with her grief.\u003c/p>\n\u003cp>In early 2021, she noticed her son biting his nails, a habit that went from occasional to excessive. His personality shifted from mostly happy and outgoing to somber and anxious, she said. He came home from school with bruises because classmates were bullying him.\u003c/p>\n\u003cfigure id=\"attachment_11929362\" class=\"wp-caption aligncenter\" style=\"max-width: 800px\">\u003ca href=\"https://ww2.kqed.org/app/uploads/sites/10/2022/10/RS58810_IMG-20220915-WA0009-qut.jpg\">\u003cimg loading=\"lazy\" decoding=\"async\" class=\"size-medium wp-image-11929362\" src=\"https://ww2.kqed.org/app/uploads/sites/10/2022/10/RS58810_IMG-20220915-WA0009-qut-800x600.jpg\" alt=\"a Latinx family posing in a park, with a dad, mom and three young kids\" width=\"800\" height=\"600\" srcset=\"https://cdn.kqed.org/wp-content/uploads/sites/10/2022/10/RS58810_IMG-20220915-WA0009-qut-800x600.jpg 800w, https://cdn.kqed.org/wp-content/uploads/sites/10/2022/10/RS58810_IMG-20220915-WA0009-qut-1020x765.jpg 1020w, https://cdn.kqed.org/wp-content/uploads/sites/10/2022/10/RS58810_IMG-20220915-WA0009-qut-160x120.jpg 160w, https://cdn.kqed.org/wp-content/uploads/sites/10/2022/10/RS58810_IMG-20220915-WA0009-qut-1536x1153.jpg 1536w, https://cdn.kqed.org/wp-content/uploads/sites/10/2022/10/RS58810_IMG-20220915-WA0009-qut.jpg 1599w\" sizes=\"(max-width: 800px) 100vw, 800px\">\u003c/a>\u003cfigcaption class=\"wp-caption-text\">Jose Angel Morales, Mariana Pimentel and their children. \u003ccite>(Courtesy of Mariana Pimentel)\u003c/cite>\u003c/figcaption>\u003c/figure>\n\u003cp>At the same time, Pimentel’s 9-year-old was also showing signs of anxiety. When she had to take a test or do something new, she would freeze with fear and struggle to complete her work. The stress of going from remote to in-person school also put a strain on her. Her children attended therapy sessions for about a year, until December of 2021.\u003c/p>\n\u003cp>Pimentel’s husband went to therapy last year to cope with stress from the pandemic — like losing his job at a car wash and family members contracting the virus, including Pimentel.\u003c/p>\n\u003cp>According to Pimentel, her husband’s therapist helped him realize that he had put too much emphasis on working extra hours or taking on additional tasks, all because he was afraid of being fired. He eventually found a new job at a different car wash and is far less stressed about work.\u003c/p>\n\u003cp>For families like Pimentel’s, having timely access to affordable mental health services was transformative, along with creating a culture of mental wellness at home.\u003c/p>\n\u003cp>Her son is more relaxed and joyful, she said, and many of his anxious behaviors, such as the nail biting, have decreased. He’s also developed the tools and confidence to stand up to bullies.\u003c/p>\n\u003cp>Her daughter has learned to calm her anxiety with techniques such as taking deep breaths, a sip of water or a short walk. She is bringing home higher grades.\u003c/p>\n\u003cp>“I didn’t know that I had depression or that I had a lot of anxiety,” Pimentel said, referring to the time before she entered therapy. “I have discovered many things, how to understand these issues and how I can work on them. And also how to help my children.”\u003c/p>\n\u003cp>\u003cem>Blanca Torres reported this story while participating in the \u003ca href=\"https://centerforhealthjournalism.org/about-us\">USC Annenberg Center for Health Journalism’s 2022 California Fellowship\u003c/a>.\u003c/em>\u003c/p>\n\u003cp>[ad fullwidth]\u003c/p>\n\u003cp>[ad floatright]\u003c/p>\n",
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"content": "\u003cdiv class=\"post-body\">\u003cp>Shifting away from the parenting style she grew up with took time and lots of work. Nine years ago, Pimentel, who lives in Salinas, began attending free classes on topics such as positive parenting and discipline at GoKids Inc., a nonprofit that provides early childhood education to lower-income families.\u003c/p>\n\u003cp>“I’ve noticed that if I am stressed or anxious, I will end up transmitting that to my kids. There is a connection,” Pimentel said. “The more I attend classes, the more I learn, the better I can help my children and the better off they will be.”\u003c/p>\n\u003cp>In addition to taking classes, Pimentel, her husband and two of her children received individual therapy through GoKids to deal with depression and anxiety. The family’s experience demonstrates the importance of addressing mental health not just for one person, but the family as a whole.\u003c/p>\n\u003ch2>Pandemic ‘forced us to look at the shadows’\u003c/h2>\n\u003cp>During the first year of the pandemic, \u003ca href=\"https://www.cdc.gov/mmwr/volumes/70/wr/mm7024a3.htm#:~:text=Among%202%2C391%20parents%2Dcaregivers%2C%20approximately,past%2Dmonth%20serious%20suicidal%20ideation.\">nearly two-thirds of caregivers, including parents, reported adverse mental or behavioral health symptoms\u003c/a>, according to a Centers for Disease Control and Prevention survey. The survey also found that 27% of parents of children under 18 reported that their mental health worsened during the pandemic.\u003c/p>\n\u003cp>The need to come to terms with how parental mental health influences the mental health of children has come into sharper focus as the United States grapples with a crisis of children experiencing higher rates of anxiety, depression and thoughts of suicide.\u003c/p>\n\u003cp>In 2020, California saw a 70% increase in kids being diagnosed with anxiety or depression. That’s 1 in 8, up from 1 in 14 in 2016, \u003ca href=\"https://assets.aecf.org/m/resourcedoc/aecf-2022kidscountdatabook-2022.pdf\">according to The Annie E. Casey Foundation (PDF)\u003c/a>.\u003c/p>\n\u003cfigure id=\"attachment_11929357\" class=\"wp-caption aligncenter\" style=\"max-width: 800px\">\u003ca href=\"https://ww2.kqed.org/app/uploads/sites/10/2022/10/RS58811_image000000-1-2-qut.jpg\">\u003cimg loading=\"lazy\" decoding=\"async\" class=\"size-medium wp-image-11929357\" src=\"https://ww2.kqed.org/app/uploads/sites/10/2022/10/RS58811_image000000-1-2-qut-800x640.jpg\" alt=\"a young Latinx couple, a man and a woman, in white shirts, smiling in front of a blue sky\" width=\"800\" height=\"640\" srcset=\"https://cdn.kqed.org/wp-content/uploads/sites/10/2022/10/RS58811_image000000-1-2-qut-800x640.jpg 800w, https://cdn.kqed.org/wp-content/uploads/sites/10/2022/10/RS58811_image000000-1-2-qut-1020x816.jpg 1020w, https://cdn.kqed.org/wp-content/uploads/sites/10/2022/10/RS58811_image000000-1-2-qut-160x128.jpg 160w, https://cdn.kqed.org/wp-content/uploads/sites/10/2022/10/RS58811_image000000-1-2-qut-1536x1229.jpg 1536w, https://cdn.kqed.org/wp-content/uploads/sites/10/2022/10/RS58811_image000000-1-2-qut.jpg 1920w\" sizes=\"(max-width: 800px) 100vw, 800px\">\u003c/a>\u003cfigcaption class=\"wp-caption-text\">Jose Angel Morales and Mariana Pimentel learned to manage their own stress and anxiety with therapy, and are working to pass the tools they’ve learned on to their children. \u003ccite>(Courtesy of Mariana Pimentel)\u003c/cite>\u003c/figcaption>\u003c/figure>\n\u003cp>Children of color suffer the most, say experts, because services remain inaccessible to them for a variety of reasons.\u003c/p>\n\u003cp>“One thing the pandemic did is that it forced us to look at the shadows, the darker things, both within ourselves and within our communities that need attention,” said Tlazoltiani Jessica Zamarripa, who co-founded the Institute of Chicana/o/x Psychology with her husband, Manuel X. Zamarripa.\u003c/p>\n\u003cp>Based in Austin, Texas, the organization provides training for mental health providers and individuals with an emphasis on ancestral knowledge and practices from Indigenous cultures of Mexico. The Zamarripas founded the Institute of Chicana/o/x Psychology as a way to combat what they call the “mental health industrial complex” that has largely left kids from nonwhite communities underserved.\u003c/p>\n\u003cp>“Our children have never been immune to the stresses, the anxieties, the intergenerational ancestral, familial, interpersonal and racial traumas, and the harms and violence we have experienced and experience now,” Zamarripa said.\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"content": "‘Our children have never been immune to the stresses, the anxieties, the intergenerational ancestral, familial, interpersonal and racial traumas, and the harms and violence we have experienced.’",
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"content": "\u003cdiv class=\"post-body\">\u003cp>Often, when a child is struggling, the focus is solely on what they are doing wrong and correcting those behaviors, while not taking into account the stressors in their environment, including some caused by stressed parents. Parents need to recognize when their children need help, but also need to understand their own behavior, mental health and patterns of generational trauma, Zamarripa said.\u003c/p>\n\u003cp>In 2019, close to 1 in 5 white children received some form of mental health treatment. For \u003ca href=\"https://www.cdc.gov/nchs/products/databriefs/db381.htm\">Latino and Black children the rate was about 1 in 11\u003c/a>, according to the CDC.\u003c/p>\n\u003cp>“It’s a deep pain to know that our children are struggling and suffering,” Zamarripa said. “We just want to believe that they’re happy and playful.”\u003c/p>\n\u003cp>But children don’t have the same coping mechanisms and understanding that adults have. When a child is acting out, Zamarripa’s advice is to avoid reacting, punishing or judging the behavior.\u003c/p>\n\u003cp>“Kids act out in all kinds of ways, and for generations and generations and generations that has been misinterpreted as bad behavior when, in fact, all behavior is communication,” she said.\u003c/p>\n\u003cfigure id=\"attachment_11929393\" class=\"wp-caption aligncenter\" style=\"max-width: 709px\">\u003ca href=\"https://ww2.kqed.org/app/uploads/sites/10/2022/10/RS58816_2_5_2022-12_52_44-AM.jpg\">\u003cimg loading=\"lazy\" decoding=\"async\" class=\"size-full wp-image-11929393\" src=\"https://ww2.kqed.org/app/uploads/sites/10/2022/10/RS58816_2_5_2022-12_52_44-AM.jpg\" alt=\"a man and a woman in traditional Chicana/o/x dress talk in a room\" width=\"709\" height=\"399\" srcset=\"https://cdn.kqed.org/wp-content/uploads/sites/10/2022/10/RS58816_2_5_2022-12_52_44-AM.jpg 709w, https://cdn.kqed.org/wp-content/uploads/sites/10/2022/10/RS58816_2_5_2022-12_52_44-AM-160x90.jpg 160w\" sizes=\"(max-width: 709px) 100vw, 709px\">\u003c/a>\u003cfigcaption class=\"wp-caption-text\">Manuel X. Zamarippa (left) and Tlazoltiani Jessica Zamarripa, co-founders of the Institute of Chicana/o/x Psychology. \u003ccite>(Courtesy of the Institute of Chicana/o/x Psychology)\u003c/cite>\u003c/figcaption>\u003c/figure>\n\u003cp>Some parents, particularly the parents of children of color, often don’t know how to manage the stigma attached to seeking therapy for themselves or their children.\u003c/p>\n\u003cp>“Sometimes the difficulty with gaining access [to mental health care] is even getting buy-in” from parents, said Patricia Alvarado of Alvarado Therapy, a Los Angeles-based practice made up of Latinx and Spanish-speaking therapists. “If we’re talking about a young person, like a kid or a teenager, it can be quite difficult to say, ‘Yes, I need help.’ And also for the parent, depending on their socioeconomic status, their background, their education, they may not even know what that means.”\u003c/p>\n\u003cp>Not treating mental illness in kids can cause long-term harm. CDC researchers estimate that \u003ca href=\"https://www.cdc.gov/childrensmentalhealth/features/kf-childrens-mental-health-report.html\">13% to 20% of children are affected by an emotional or mental health disorder before the age of 17\u003c/a>.\u003c/p>\n\u003cp>“We still don’t know the long-term impact of the pandemic on children,” said Dr. Sandra Pisano, director of behavioral health for AltaMed, a community health provider in Southern California that serves lower-income people and mostly Latinx patients. “By normalizing wellness and self-care, this is where there’s a great opportunity for us to provide services to develop a healthy future generation after the pandemic.”\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"content": "\u003cdiv class=\"post-body\">\u003cp>According to Pisano, many parents don’t know how to talk to their children about self-care, which can be as simple as good sleep, eating well, taking deep breaths and doing something that brings joy or relaxation.\u003c/p>\n\u003cp>“It’s important for them as they grow older … that they still have the practice of self-care, because this is creating a healthy child who will eventually be a healthy adult,” Pisano said.\u003c/p>\n\u003ch2>The transformative power of therapy\u003c/h2>\n\u003cp>When she was 24 years old, Pimentel left her home in Hidalgo, a state in central Mexico, to join her brother and sister in Salinas. There she met her husband, Jose Angel Morales, and started a family. Their three children are ages 9, 6 and 7 months.\u003c/p>\n\u003cp>“I looked for parenting resources when my eldest daughter was born, and connected with GoKids,” she said. “We started with classes and workshops and then wellness visits for my daughter and then, eventually, I found out they offered therapy.”\u003c/p>\n\u003cp>In 2020, Pimentel sank into depression after going through a miscarriage and went to therapy for the first time to deal with her grief.\u003c/p>\n\u003cp>In early 2021, she noticed her son biting his nails, a habit that went from occasional to excessive. His personality shifted from mostly happy and outgoing to somber and anxious, she said. He came home from school with bruises because classmates were bullying him.\u003c/p>\n\u003cfigure id=\"attachment_11929362\" class=\"wp-caption aligncenter\" style=\"max-width: 800px\">\u003ca href=\"https://ww2.kqed.org/app/uploads/sites/10/2022/10/RS58810_IMG-20220915-WA0009-qut.jpg\">\u003cimg loading=\"lazy\" decoding=\"async\" class=\"size-medium wp-image-11929362\" src=\"https://ww2.kqed.org/app/uploads/sites/10/2022/10/RS58810_IMG-20220915-WA0009-qut-800x600.jpg\" alt=\"a Latinx family posing in a park, with a dad, mom and three young kids\" width=\"800\" height=\"600\" srcset=\"https://cdn.kqed.org/wp-content/uploads/sites/10/2022/10/RS58810_IMG-20220915-WA0009-qut-800x600.jpg 800w, https://cdn.kqed.org/wp-content/uploads/sites/10/2022/10/RS58810_IMG-20220915-WA0009-qut-1020x765.jpg 1020w, https://cdn.kqed.org/wp-content/uploads/sites/10/2022/10/RS58810_IMG-20220915-WA0009-qut-160x120.jpg 160w, https://cdn.kqed.org/wp-content/uploads/sites/10/2022/10/RS58810_IMG-20220915-WA0009-qut-1536x1153.jpg 1536w, https://cdn.kqed.org/wp-content/uploads/sites/10/2022/10/RS58810_IMG-20220915-WA0009-qut.jpg 1599w\" sizes=\"(max-width: 800px) 100vw, 800px\">\u003c/a>\u003cfigcaption class=\"wp-caption-text\">Jose Angel Morales, Mariana Pimentel and their children. \u003ccite>(Courtesy of Mariana Pimentel)\u003c/cite>\u003c/figcaption>\u003c/figure>\n\u003cp>At the same time, Pimentel’s 9-year-old was also showing signs of anxiety. When she had to take a test or do something new, she would freeze with fear and struggle to complete her work. The stress of going from remote to in-person school also put a strain on her. Her children attended therapy sessions for about a year, until December of 2021.\u003c/p>\n\u003cp>Pimentel’s husband went to therapy last year to cope with stress from the pandemic — like losing his job at a car wash and family members contracting the virus, including Pimentel.\u003c/p>\n\u003cp>According to Pimentel, her husband’s therapist helped him realize that he had put too much emphasis on working extra hours or taking on additional tasks, all because he was afraid of being fired. He eventually found a new job at a different car wash and is far less stressed about work.\u003c/p>\n\u003cp>For families like Pimentel’s, having timely access to affordable mental health services was transformative, along with creating a culture of mental wellness at home.\u003c/p>\n\u003cp>Her son is more relaxed and joyful, she said, and many of his anxious behaviors, such as the nail biting, have decreased. He’s also developed the tools and confidence to stand up to bullies.\u003c/p>\n\u003cp>Her daughter has learned to calm her anxiety with techniques such as taking deep breaths, a sip of water or a short walk. She is bringing home higher grades.\u003c/p>\n\u003cp>“I didn’t know that I had depression or that I had a lot of anxiety,” Pimentel said, referring to the time before she entered therapy. “I have discovered many things, how to understand these issues and how I can work on them. And also how to help my children.”\u003c/p>\n\u003cp>\u003cem>Blanca Torres reported this story while participating in the \u003ca href=\"https://centerforhealthjournalism.org/about-us\">USC Annenberg Center for Health Journalism’s 2022 California Fellowship\u003c/a>.\u003c/em>\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"title": "Many California Families Can't Access Mental Health Care for Kids. This East Palo Alto Mom Found a Way",
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"headTitle": "Many California Families Can’t Access Mental Health Care for Kids. This East Palo Alto Mom Found a Way | KQED",
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"content": "\u003cp>Jasmine Cuevas stood at her kitchen stove preparing migas, stirring a pan of eggs and tortillas before calling her four children to dinner.\u003c/p>\n\u003cp>She spooned servings onto plates while asking each about their day.\u003c/p>\n\u003cp>“I get out of work, get them from school and then we come straight home,” she said. “And, it’s a wreck: dinner, homework, reading, bath and then bedtime by 7:30 at the latest.”\u003c/p>\n\u003cp>Cuevas, who lives in East Palo Alto, does her best to manage her parental duties from the mundane to the challenging. Before her two oldest children, now ages 7 and 9, started kindergarten, they showed signs of anxiety, stress and frustration.\u003c/p>\n\u003cp>One child had violent outbursts regularly, hitting and biting siblings — or anyone around. Sometimes, according to Cuevas, the child cried inconsolably. She said the other child began exhibiting signs of anxiety in preschool.\u003c/p>\n\u003cp>[ad fullwidth]\u003c/p>\n\u003cp>Three years ago, Cuevas, who has been a single mother for stretches of her kids’ lives, decided to seek therapy for her children. She remembers telling them, “You need to talk to someone, let’s talk to someone.”\u003c/p>\n\u003cfigure id=\"attachment_11927013\" class=\"wp-caption alignnone\" style=\"max-width: 800px\">\u003ca href=\"https://ww2.kqed.org/app/uploads/sites/10/2022/09/RS54936_007_KQED_JasmineCuevasFamily_03302022-qut.jpg\">\u003cimg loading=\"lazy\" decoding=\"async\" class=\"size-medium wp-image-11927013\" src=\"https://ww2.kqed.org/app/uploads/sites/10/2022/09/RS54936_007_KQED_JasmineCuevasFamily_03302022-qut-800x533.jpg\" alt=\"A woman wearing all black clothing and red lipstick stands in a well-lit kitchen spooning eggs from a pan to a plate.\" width=\"800\" height=\"533\" srcset=\"https://cdn.kqed.org/wp-content/uploads/sites/10/2022/09/RS54936_007_KQED_JasmineCuevasFamily_03302022-qut-800x533.jpg 800w, https://cdn.kqed.org/wp-content/uploads/sites/10/2022/09/RS54936_007_KQED_JasmineCuevasFamily_03302022-qut-1020x680.jpg 1020w, https://cdn.kqed.org/wp-content/uploads/sites/10/2022/09/RS54936_007_KQED_JasmineCuevasFamily_03302022-qut-160x107.jpg 160w, https://cdn.kqed.org/wp-content/uploads/sites/10/2022/09/RS54936_007_KQED_JasmineCuevasFamily_03302022-qut-1536x1024.jpg 1536w, https://cdn.kqed.org/wp-content/uploads/sites/10/2022/09/RS54936_007_KQED_JasmineCuevasFamily_03302022-qut.jpg 1920w\" sizes=\"(max-width: 800px) 100vw, 800px\">\u003c/a>\u003cfigcaption class=\"wp-caption-text\">Jasmine Cuevas cooks dinner for her four children at their home in East Palo Alto on March 30, 2022. \u003ccite>(Beth LaBerge/KQED)\u003c/cite>\u003c/figcaption>\u003c/figure>\n\u003cp>Cuevas is among millions of parents whose children are struggling with their emotional and mental health. KQED decided to not include the names and genders of Cuevas’ children in this story to protect their privacy after consulting a gender educator.\u003c/p>\n\u003cp>In California, \u003ca href=\"https://assets.aecf.org/m/resourcedoc/aecf-2022kidscountdatabook-2022.pdf\">1 in 8 children was diagnosed with anxiety or depression in 2020\u003c/a>, a 70% increase from 2016 when 1 in 14 received a similar diagnosis, according to a 2022 report from The Annie E. Casey Foundation.\u003c/p>\n\u003cp>Demand for mental health services for children has swelled as expressions of anxiety, depression and suicidal thoughts have increased alarmingly — a situation experts have labeled a crisis. But while parents are told to “get help” for their children, they often run into one or two main obstacles: the high cost of care, and the lack of therapists.[pullquote align=\"right\" size=\"medium\" citation=\"Alex Briscoe, principal, California Children's Trust\"]‘What will we do as a culture when we come into consciousness about the fact that twice as many of our kids are trying to kill themselves?’[/pullquote]Many therapists who run private practices don’t accept insurance. Without insurance, therapy is unaffordable for most families, as sessions can cost anywhere from $100 to $250 or more, according to health care providers interviewed for this story.\u003c/p>\n\u003cp>The result is that \u003ca href=\"https://www.cdc.gov/nchs/products/databriefs/db381.htm\">Black and Latinx children receive mental health care at about half the rate of white children\u003c/a>, according to the Centers for Disease Control and Prevention.\u003c/p>\n\u003cp>Advising the parents of non-white children to “get help” is like telling them to open a door to an empty room, said Eric Valladares, executive director of Family Connections, a Palo Alto-based nonprofit that provides educational and mental health services to families with young children.\u003c/p>\n\u003cfigure id=\"attachment_11927054\" class=\"wp-caption alignnone\" style=\"max-width: 800px\">\u003cimg loading=\"lazy\" decoding=\"async\" class=\"size-medium wp-image-11927054\" src=\"https://ww2.kqed.org/app/uploads/sites/10/2022/09/RS58557_015_KQED_EricValladaresFamilyConnections_09062022-qut-800x533.jpg\" alt=\"A man in a a blue plaid shirt and blue surgical mask holds his hands together in front of him as he seemingly talks with a person standing out of focus with their back to the camera. \" width=\"800\" height=\"533\" srcset=\"https://cdn.kqed.org/wp-content/uploads/sites/10/2022/09/RS58557_015_KQED_EricValladaresFamilyConnections_09062022-qut-800x533.jpg 800w, https://cdn.kqed.org/wp-content/uploads/sites/10/2022/09/RS58557_015_KQED_EricValladaresFamilyConnections_09062022-qut-1020x680.jpg 1020w, https://cdn.kqed.org/wp-content/uploads/sites/10/2022/09/RS58557_015_KQED_EricValladaresFamilyConnections_09062022-qut-160x107.jpg 160w, https://cdn.kqed.org/wp-content/uploads/sites/10/2022/09/RS58557_015_KQED_EricValladaresFamilyConnections_09062022-qut-1536x1024.jpg 1536w, https://cdn.kqed.org/wp-content/uploads/sites/10/2022/09/RS58557_015_KQED_EricValladaresFamilyConnections_09062022-qut.jpg 1920w\" sizes=\"(max-width: 800px) 100vw, 800px\">\u003cfigcaption class=\"wp-caption-text\">Executive Director Eric Valladares speaks with Carolina Calderón Balladares at Family Connections in Redwood City on Sept. 6, 2022. \u003ccite>(Beth LaBerge/KQED)\u003c/cite>\u003c/figcaption>\u003c/figure>\n\u003cp>“There’s not much furniture in there,” he continued. “That’s where there is a gap for our families. They tell us, ‘I want to talk about these things, but where do I go? Who do I grab on to?’”\u003c/p>\n\u003cp>According to the CDC, \u003ca href=\"https://www.cdc.gov/mmwr/volumes/71/su/su7102a1.htm?s_cid=su7102a1_w#results\">1 in 5 children and adolescents age 12 to 17 reported experiencing a major depressive episode\u003c/a> from 2013 to 2019. The CDC also reported that in 2019, \u003ca href=\"https://www.cdc.gov/nchhstp/dear_colleague/2020/dcl-102320-YRBS-2009-2019-report.html\">37% of high school students expressed feeling sad or hopeless\u003c/a>, up from 26% in 2009.\u003c/p>\n\u003cp>“Over the last 10 to 15 years, we’ve seen a doubling of inpatient admissions for self-injury, and suicide leapfrogging cancer and car wrecks as a cause of death” for young people, said Alex Briscoe, principal at the California Children’s Trust, a nonprofit organization focused on reimagining California’s approach to children’s mental health.\u003c/p>\n\u003cp>“So the broader question for us is, what will we do as a culture when we come into consciousness about the fact that twice as many of our kids are trying to kill themselves?”\u003c/p>\n\u003cp>Health insurers often won’t cover preventive services and instead provide coverage only when a patient’s condition is severe or fits a particular diagnosis. A 2018 study by the California Health Care Foundation found that close to \u003ca href=\"https://www.chcf.org/wp-content/uploads/2018/12/MentalHealthCA2018.pdf\">two-thirds of adolescents with major depressive episodes in California do not receive treatment\u003c/a>.\u003c/p>\n\u003cp>Nationwide, spending on mental health, from therapy to prescriptions, more than doubled to \u003ca href=\"https://openminds.com/press/u-s-mental-health-spending-reached-225-1-billion-in-2019-open-minds-releases-new-analysis-on-market-spending/\">$225 billion from 2009 to 2019\u003c/a>, according to a report from Open Minds, a health care market research firm. That represents only about 5.5% of all health care spending, the report says.\u003c/p>\n\u003cp>California is rolling out the Child and Youth Behavioral Health Initiative, a $4.7 billion, five-year plan to overhaul the way the state prevents, treats and responds to mental illness and disorders in children.\u003c/p>\n\u003cp>“What we hear particularly from youth is the importance of prevention and nonclinical support,” Melissa Stafford Jones, the program’s director, told KQED. “They’ve said to us, ‘Don’t wait until we’re in a crisis to support us.’”\u003c/p>\n\u003cp>The funding was approved in 2021, but state leaders and agencies are still deciding how to dole out the money. The plan’s goals include making services more accessible to underserved children and expanding the workforce of therapists and service providers.\u003c/p>\n\u003cp>The initiative could bring about substantial change, but that will probably take four to five years, according to Chris Stoner-Mertz, CEO of California Alliance of Child and Family Services, a coalition of about 150 nonprofits and organizations that serve the state’s children and families.\u003c/p>\n\u003cp>When asked whether the money is specifically helping kids in crisis now, Stoner-Mertz replied, “To be frank, no.”\u003c/p>\n\u003cp>“It really is primarily infrastructure, and capacity building,” she continued. “But none of it is like, ‘Here’s money to provide a service today.’”[pullquote align=\"right\" size=\"medium\" citation=\"Melissa Stafford Jones, program director, Child and Youth Behavioral Health Initiative\"]‘What we hear particularly from youth is the importance of prevention and nonclinical support. They’ve said to us, ‘Don’t wait until we’re in a crisis to support us.”[/pullquote]Medi-Cal, the state-funded insurance program for people with lower incomes, covers mental health care services including therapy, but of the 5.3 million children and youth enrolled in the program, only 5% have received a mental health care service, according to the California Children’s Trust.\u003c/p>\n\u003cp>Cuevas’ family is part of that small fraction who has benefitted. And unlike some parents who are afraid or distrustful of seeking help, she was eager for her kids to go to therapy. That’s because she knew how much it helped her.\u003c/p>\n\u003cp>Cuevas, 29, said she was raised in a home she considered emotionally and physically abusive. She remembers briefly seeing a therapist when she was 8 or 9 years old.\u003c/p>\n\u003cp>“I loved it, loved it, loved it. (The therapist) was so nice. She was so understanding,” Cuevas said. “I never used to express myself at all. Nobody ever listened to me. And when they did listen to me, they said, ‘Oh, you’re lying.’”\u003c/p>\n\u003cp>After a few sessions, her mother abruptly stopped taking her to appointments, Cuevas said. She never found out why.\u003c/p>\n\u003cp>“It was really hard,” she recalled. “I was like, ‘Great, I’m back to my little bubble in my corner of darkness and not knowing what to do.’”\u003c/p>\n\u003cp>Cuevas became a mom at 20. She was in a marriage that she described as emotionally abusive. It ended soon after her first child was born. Cuevas remarried and had three more children. Her second husband was also abusive, she said. She briefly lived in her car after the relationship fell apart.\u003c/p>\n\u003cp>She connected with Gabriela Buendia, a therapist who worked at her kids’ preschool as a mental health consultant. Cuevas met with Buendia almost weekly to talk about her children’s behaviors. She said she learned to try to understand why her kids were acting out instead of just correcting or reacting to them.\u003c/p>\n\u003cp>Preschool-age children show their emotions through their behaviors, according to Buendia.\u003c/p>\n\u003cp>“A lot of kids are dealing with chronic stress, chronic trauma, significant challenges at home,” said Buendia, who offered assessments to Cuevas but didn’t treat her children. “Many of them don’t have the language to express how they are feeling, so they will show us through their behaviors.”\u003c/p>\n\u003cfigure id=\"attachment_11927056\" class=\"wp-caption alignnone\" style=\"max-width: 800px\">\u003cimg loading=\"lazy\" decoding=\"async\" class=\"wp-image-11927056 size-medium\" src=\"https://ww2.kqed.org/app/uploads/sites/10/2022/09/RS58566_024_KQED_EricValladaresFamilyConnections_09062022-qut-800x533.jpg\" alt=\"A man in a blue plaid shirt and surgical mask, with grey pants stands in a yard and gestures toward a bright orange wall adorned with varies items nailed or fixed in place such as pots, pans, a colander and a xylophone. Above them all on the wall is the word musical. \" width=\"800\" height=\"533\" srcset=\"https://cdn.kqed.org/wp-content/uploads/sites/10/2022/09/RS58566_024_KQED_EricValladaresFamilyConnections_09062022-qut-800x533.jpg 800w, https://cdn.kqed.org/wp-content/uploads/sites/10/2022/09/RS58566_024_KQED_EricValladaresFamilyConnections_09062022-qut-1020x680.jpg 1020w, https://cdn.kqed.org/wp-content/uploads/sites/10/2022/09/RS58566_024_KQED_EricValladaresFamilyConnections_09062022-qut-160x107.jpg 160w, https://cdn.kqed.org/wp-content/uploads/sites/10/2022/09/RS58566_024_KQED_EricValladaresFamilyConnections_09062022-qut-1536x1024.jpg 1536w, https://cdn.kqed.org/wp-content/uploads/sites/10/2022/09/RS58566_024_KQED_EricValladaresFamilyConnections_09062022-qut.jpg 1920w\" sizes=\"(max-width: 800px) 100vw, 800px\">\u003cfigcaption class=\"wp-caption-text\">Executive Director Eric Valladares in the play area at Family Connections in Redwood City on Sept. 6, 2022. \u003ccite>(Beth LaBerge/KQED)\u003c/cite>\u003c/figcaption>\u003c/figure>\n\u003cp>After a few years of building trust, Cuevas started going to Buendia for therapy for herself. She never forgot the feeling of having someone in her life she could trust who listened.\u003c/p>\n\u003cp>“I’m more open-minded,” she said. “I’ve been able to express my feelings more.”\u003c/p>\n\u003cp>Finding help for her two oldest children was relatively simple, Cuevas said. She went to a San Mateo County health office to request appointments.\u003c/p>\n\u003cp>“I went through four therapists before we found the right match,” she said. “I didn’t give up.”\u003c/p>\n\u003cp>Starting in 2019, her two oldest children saw a therapist once a week over Zoom. Their sessions often involved games and activities.\u003c/p>\n\u003cp>Buendia said a couple of factors made a difference for Cuevas’ family. One is that her kids’ preschool looked for signs of mental health challenges and had a consultant on staff.\u003c/p>\n\u003cp>Another is that Cuevas learned how to advocate for her children, and had access to insurance that covered therapy. Many parents, Buendia said, either don’t have access to the system or don’t know how to navigate it.\u003c/p>\n\u003cp>“I admire this mom so much. She’s like the epitome of someone who has struggled so much, overcome so much,” Buendia said. “She’s overcome so many obstacles and trauma and yet is still so connected to her feelings and is vulnerable and is so connected to her children. She’s incredible.”\u003c/p>\n\u003cp>In February, Cuevas moved her family into a townhome in East Palo Alto, providing a more stable situation. She had to stop working at the start of the pandemic to care for her kids, but is back to work full-time in food service at Stanford University. In August, she married again.\u003c/p>\n\u003cp>“I’m finally in this great relationship with a person who loves my kids, who loves me, and treats me the way I need to be treated. My kids are happier than ever,” Cuevas said. “I’m not going to lie, I have a lot of anxiety. I have a lot of panic attacks. So, I’m working on it.”\u003c/p>\n\u003cp>Cuevas said therapy improved the way she communicates with her children. In the past, she said she worried more about cleaning her home than taking the time to connect with her children. Now she makes sure they eat meals together and talk before bedtime. She wants her children to have a different experience than she had growing up.\u003c/p>\n\u003cp>She wants them to feel free to express their needs and emotions.\u003c/p>\n\u003cp>“I know that after finding the therapist for them and finding one myself, I noticed a change where they could confide in me and tell me what’s going on and express themselves,” Cuevas said. “It’s amazing how much trauma and how much hurt we have in our family. But there’s hope.\u003c/p>\n\u003cp>“With therapy you have that hope.”\u003c/p>\n\u003cp>\u003cem>Blanca Torres reported this story while participating in the \u003ca href=\"https://centerforhealthjournalism.org/about-us\">USC Annenberg Center for Health Journalism’s 2022 California Fellowship\u003c/a>\u003c/em>.\u003c/p>\n\u003cp>[ad floatright]\u003c/p>\n\u003cp> \u003c/p>\n\n",
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"excerpt": "Demand for mental health services for children has swelled amid a striking increase in signs of anxiety, depression and suicidal thoughts — a situation some mental health experts have labeled a crisis.",
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"title": "Many California Families Can't Access Mental Health Care for Kids. This East Palo Alto Mom Found a Way | KQED",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003cp>Jasmine Cuevas stood at her kitchen stove preparing migas, stirring a pan of eggs and tortillas before calling her four children to dinner.\u003c/p>\n\u003cp>She spooned servings onto plates while asking each about their day.\u003c/p>\n\u003cp>“I get out of work, get them from school and then we come straight home,” she said. “And, it’s a wreck: dinner, homework, reading, bath and then bedtime by 7:30 at the latest.”\u003c/p>\n\u003cp>Cuevas, who lives in East Palo Alto, does her best to manage her parental duties from the mundane to the challenging. Before her two oldest children, now ages 7 and 9, started kindergarten, they showed signs of anxiety, stress and frustration.\u003c/p>\n\u003cp>One child had violent outbursts regularly, hitting and biting siblings — or anyone around. Sometimes, according to Cuevas, the child cried inconsolably. She said the other child began exhibiting signs of anxiety in preschool.\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>Three years ago, Cuevas, who has been a single mother for stretches of her kids’ lives, decided to seek therapy for her children. She remembers telling them, “You need to talk to someone, let’s talk to someone.”\u003c/p>\n\u003cfigure id=\"attachment_11927013\" class=\"wp-caption alignnone\" style=\"max-width: 800px\">\u003ca href=\"https://ww2.kqed.org/app/uploads/sites/10/2022/09/RS54936_007_KQED_JasmineCuevasFamily_03302022-qut.jpg\">\u003cimg loading=\"lazy\" decoding=\"async\" class=\"size-medium wp-image-11927013\" src=\"https://ww2.kqed.org/app/uploads/sites/10/2022/09/RS54936_007_KQED_JasmineCuevasFamily_03302022-qut-800x533.jpg\" alt=\"A woman wearing all black clothing and red lipstick stands in a well-lit kitchen spooning eggs from a pan to a plate.\" width=\"800\" height=\"533\" srcset=\"https://cdn.kqed.org/wp-content/uploads/sites/10/2022/09/RS54936_007_KQED_JasmineCuevasFamily_03302022-qut-800x533.jpg 800w, https://cdn.kqed.org/wp-content/uploads/sites/10/2022/09/RS54936_007_KQED_JasmineCuevasFamily_03302022-qut-1020x680.jpg 1020w, https://cdn.kqed.org/wp-content/uploads/sites/10/2022/09/RS54936_007_KQED_JasmineCuevasFamily_03302022-qut-160x107.jpg 160w, https://cdn.kqed.org/wp-content/uploads/sites/10/2022/09/RS54936_007_KQED_JasmineCuevasFamily_03302022-qut-1536x1024.jpg 1536w, https://cdn.kqed.org/wp-content/uploads/sites/10/2022/09/RS54936_007_KQED_JasmineCuevasFamily_03302022-qut.jpg 1920w\" sizes=\"(max-width: 800px) 100vw, 800px\">\u003c/a>\u003cfigcaption class=\"wp-caption-text\">Jasmine Cuevas cooks dinner for her four children at their home in East Palo Alto on March 30, 2022. \u003ccite>(Beth LaBerge/KQED)\u003c/cite>\u003c/figcaption>\u003c/figure>\n\u003cp>Cuevas is among millions of parents whose children are struggling with their emotional and mental health. KQED decided to not include the names and genders of Cuevas’ children in this story to protect their privacy after consulting a gender educator.\u003c/p>\n\u003cp>In California, \u003ca href=\"https://assets.aecf.org/m/resourcedoc/aecf-2022kidscountdatabook-2022.pdf\">1 in 8 children was diagnosed with anxiety or depression in 2020\u003c/a>, a 70% increase from 2016 when 1 in 14 received a similar diagnosis, according to a 2022 report from The Annie E. Casey Foundation.\u003c/p>\n\u003cp>Demand for mental health services for children has swelled as expressions of anxiety, depression and suicidal thoughts have increased alarmingly — a situation experts have labeled a crisis. But while parents are told to “get help” for their children, they often run into one or two main obstacles: the high cost of care, and the lack of therapists.\u003c/p>\u003c/div>",
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"content": "‘What will we do as a culture when we come into consciousness about the fact that twice as many of our kids are trying to kill themselves?’",
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"content": "\u003cdiv class=\"post-body\">\u003cp>Many therapists who run private practices don’t accept insurance. Without insurance, therapy is unaffordable for most families, as sessions can cost anywhere from $100 to $250 or more, according to health care providers interviewed for this story.\u003c/p>\n\u003cp>The result is that \u003ca href=\"https://www.cdc.gov/nchs/products/databriefs/db381.htm\">Black and Latinx children receive mental health care at about half the rate of white children\u003c/a>, according to the Centers for Disease Control and Prevention.\u003c/p>\n\u003cp>Advising the parents of non-white children to “get help” is like telling them to open a door to an empty room, said Eric Valladares, executive director of Family Connections, a Palo Alto-based nonprofit that provides educational and mental health services to families with young children.\u003c/p>\n\u003cfigure id=\"attachment_11927054\" class=\"wp-caption alignnone\" style=\"max-width: 800px\">\u003cimg loading=\"lazy\" decoding=\"async\" class=\"size-medium wp-image-11927054\" src=\"https://ww2.kqed.org/app/uploads/sites/10/2022/09/RS58557_015_KQED_EricValladaresFamilyConnections_09062022-qut-800x533.jpg\" alt=\"A man in a a blue plaid shirt and blue surgical mask holds his hands together in front of him as he seemingly talks with a person standing out of focus with their back to the camera. \" width=\"800\" height=\"533\" srcset=\"https://cdn.kqed.org/wp-content/uploads/sites/10/2022/09/RS58557_015_KQED_EricValladaresFamilyConnections_09062022-qut-800x533.jpg 800w, https://cdn.kqed.org/wp-content/uploads/sites/10/2022/09/RS58557_015_KQED_EricValladaresFamilyConnections_09062022-qut-1020x680.jpg 1020w, https://cdn.kqed.org/wp-content/uploads/sites/10/2022/09/RS58557_015_KQED_EricValladaresFamilyConnections_09062022-qut-160x107.jpg 160w, https://cdn.kqed.org/wp-content/uploads/sites/10/2022/09/RS58557_015_KQED_EricValladaresFamilyConnections_09062022-qut-1536x1024.jpg 1536w, https://cdn.kqed.org/wp-content/uploads/sites/10/2022/09/RS58557_015_KQED_EricValladaresFamilyConnections_09062022-qut.jpg 1920w\" sizes=\"(max-width: 800px) 100vw, 800px\">\u003cfigcaption class=\"wp-caption-text\">Executive Director Eric Valladares speaks with Carolina Calderón Balladares at Family Connections in Redwood City on Sept. 6, 2022. \u003ccite>(Beth LaBerge/KQED)\u003c/cite>\u003c/figcaption>\u003c/figure>\n\u003cp>“There’s not much furniture in there,” he continued. “That’s where there is a gap for our families. They tell us, ‘I want to talk about these things, but where do I go? Who do I grab on to?’”\u003c/p>\n\u003cp>According to the CDC, \u003ca href=\"https://www.cdc.gov/mmwr/volumes/71/su/su7102a1.htm?s_cid=su7102a1_w#results\">1 in 5 children and adolescents age 12 to 17 reported experiencing a major depressive episode\u003c/a> from 2013 to 2019. The CDC also reported that in 2019, \u003ca href=\"https://www.cdc.gov/nchhstp/dear_colleague/2020/dcl-102320-YRBS-2009-2019-report.html\">37% of high school students expressed feeling sad or hopeless\u003c/a>, up from 26% in 2009.\u003c/p>\n\u003cp>“Over the last 10 to 15 years, we’ve seen a doubling of inpatient admissions for self-injury, and suicide leapfrogging cancer and car wrecks as a cause of death” for young people, said Alex Briscoe, principal at the California Children’s Trust, a nonprofit organization focused on reimagining California’s approach to children’s mental health.\u003c/p>\n\u003cp>“So the broader question for us is, what will we do as a culture when we come into consciousness about the fact that twice as many of our kids are trying to kill themselves?”\u003c/p>\n\u003cp>Health insurers often won’t cover preventive services and instead provide coverage only when a patient’s condition is severe or fits a particular diagnosis. A 2018 study by the California Health Care Foundation found that close to \u003ca href=\"https://www.chcf.org/wp-content/uploads/2018/12/MentalHealthCA2018.pdf\">two-thirds of adolescents with major depressive episodes in California do not receive treatment\u003c/a>.\u003c/p>\n\u003cp>Nationwide, spending on mental health, from therapy to prescriptions, more than doubled to \u003ca href=\"https://openminds.com/press/u-s-mental-health-spending-reached-225-1-billion-in-2019-open-minds-releases-new-analysis-on-market-spending/\">$225 billion from 2009 to 2019\u003c/a>, according to a report from Open Minds, a health care market research firm. That represents only about 5.5% of all health care spending, the report says.\u003c/p>\n\u003cp>California is rolling out the Child and Youth Behavioral Health Initiative, a $4.7 billion, five-year plan to overhaul the way the state prevents, treats and responds to mental illness and disorders in children.\u003c/p>\n\u003cp>“What we hear particularly from youth is the importance of prevention and nonclinical support,” Melissa Stafford Jones, the program’s director, told KQED. “They’ve said to us, ‘Don’t wait until we’re in a crisis to support us.’”\u003c/p>\n\u003cp>The funding was approved in 2021, but state leaders and agencies are still deciding how to dole out the money. The plan’s goals include making services more accessible to underserved children and expanding the workforce of therapists and service providers.\u003c/p>\n\u003cp>The initiative could bring about substantial change, but that will probably take four to five years, according to Chris Stoner-Mertz, CEO of California Alliance of Child and Family Services, a coalition of about 150 nonprofits and organizations that serve the state’s children and families.\u003c/p>\n\u003cp>When asked whether the money is specifically helping kids in crisis now, Stoner-Mertz replied, “To be frank, no.”\u003c/p>\n\u003cp>“It really is primarily infrastructure, and capacity building,” she continued. “But none of it is like, ‘Here’s money to provide a service today.’”\u003c/p>\u003c/div>",
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"content": "\u003cdiv class=\"post-body\">\u003cp>Medi-Cal, the state-funded insurance program for people with lower incomes, covers mental health care services including therapy, but of the 5.3 million children and youth enrolled in the program, only 5% have received a mental health care service, according to the California Children’s Trust.\u003c/p>\n\u003cp>Cuevas’ family is part of that small fraction who has benefitted. And unlike some parents who are afraid or distrustful of seeking help, she was eager for her kids to go to therapy. That’s because she knew how much it helped her.\u003c/p>\n\u003cp>Cuevas, 29, said she was raised in a home she considered emotionally and physically abusive. She remembers briefly seeing a therapist when she was 8 or 9 years old.\u003c/p>\n\u003cp>“I loved it, loved it, loved it. (The therapist) was so nice. She was so understanding,” Cuevas said. “I never used to express myself at all. Nobody ever listened to me. And when they did listen to me, they said, ‘Oh, you’re lying.’”\u003c/p>\n\u003cp>After a few sessions, her mother abruptly stopped taking her to appointments, Cuevas said. She never found out why.\u003c/p>\n\u003cp>“It was really hard,” she recalled. “I was like, ‘Great, I’m back to my little bubble in my corner of darkness and not knowing what to do.’”\u003c/p>\n\u003cp>Cuevas became a mom at 20. She was in a marriage that she described as emotionally abusive. It ended soon after her first child was born. Cuevas remarried and had three more children. Her second husband was also abusive, she said. She briefly lived in her car after the relationship fell apart.\u003c/p>\n\u003cp>She connected with Gabriela Buendia, a therapist who worked at her kids’ preschool as a mental health consultant. Cuevas met with Buendia almost weekly to talk about her children’s behaviors. She said she learned to try to understand why her kids were acting out instead of just correcting or reacting to them.\u003c/p>\n\u003cp>Preschool-age children show their emotions through their behaviors, according to Buendia.\u003c/p>\n\u003cp>“A lot of kids are dealing with chronic stress, chronic trauma, significant challenges at home,” said Buendia, who offered assessments to Cuevas but didn’t treat her children. “Many of them don’t have the language to express how they are feeling, so they will show us through their behaviors.”\u003c/p>\n\u003cfigure id=\"attachment_11927056\" class=\"wp-caption alignnone\" style=\"max-width: 800px\">\u003cimg loading=\"lazy\" decoding=\"async\" class=\"wp-image-11927056 size-medium\" src=\"https://ww2.kqed.org/app/uploads/sites/10/2022/09/RS58566_024_KQED_EricValladaresFamilyConnections_09062022-qut-800x533.jpg\" alt=\"A man in a blue plaid shirt and surgical mask, with grey pants stands in a yard and gestures toward a bright orange wall adorned with varies items nailed or fixed in place such as pots, pans, a colander and a xylophone. Above them all on the wall is the word musical. \" width=\"800\" height=\"533\" srcset=\"https://cdn.kqed.org/wp-content/uploads/sites/10/2022/09/RS58566_024_KQED_EricValladaresFamilyConnections_09062022-qut-800x533.jpg 800w, https://cdn.kqed.org/wp-content/uploads/sites/10/2022/09/RS58566_024_KQED_EricValladaresFamilyConnections_09062022-qut-1020x680.jpg 1020w, https://cdn.kqed.org/wp-content/uploads/sites/10/2022/09/RS58566_024_KQED_EricValladaresFamilyConnections_09062022-qut-160x107.jpg 160w, https://cdn.kqed.org/wp-content/uploads/sites/10/2022/09/RS58566_024_KQED_EricValladaresFamilyConnections_09062022-qut-1536x1024.jpg 1536w, https://cdn.kqed.org/wp-content/uploads/sites/10/2022/09/RS58566_024_KQED_EricValladaresFamilyConnections_09062022-qut.jpg 1920w\" sizes=\"(max-width: 800px) 100vw, 800px\">\u003cfigcaption class=\"wp-caption-text\">Executive Director Eric Valladares in the play area at Family Connections in Redwood City on Sept. 6, 2022. \u003ccite>(Beth LaBerge/KQED)\u003c/cite>\u003c/figcaption>\u003c/figure>\n\u003cp>After a few years of building trust, Cuevas started going to Buendia for therapy for herself. She never forgot the feeling of having someone in her life she could trust who listened.\u003c/p>\n\u003cp>“I’m more open-minded,” she said. “I’ve been able to express my feelings more.”\u003c/p>\n\u003cp>Finding help for her two oldest children was relatively simple, Cuevas said. She went to a San Mateo County health office to request appointments.\u003c/p>\n\u003cp>“I went through four therapists before we found the right match,” she said. “I didn’t give up.”\u003c/p>\n\u003cp>Starting in 2019, her two oldest children saw a therapist once a week over Zoom. Their sessions often involved games and activities.\u003c/p>\n\u003cp>Buendia said a couple of factors made a difference for Cuevas’ family. One is that her kids’ preschool looked for signs of mental health challenges and had a consultant on staff.\u003c/p>\n\u003cp>Another is that Cuevas learned how to advocate for her children, and had access to insurance that covered therapy. Many parents, Buendia said, either don’t have access to the system or don’t know how to navigate it.\u003c/p>\n\u003cp>“I admire this mom so much. She’s like the epitome of someone who has struggled so much, overcome so much,” Buendia said. “She’s overcome so many obstacles and trauma and yet is still so connected to her feelings and is vulnerable and is so connected to her children. She’s incredible.”\u003c/p>\n\u003cp>In February, Cuevas moved her family into a townhome in East Palo Alto, providing a more stable situation. She had to stop working at the start of the pandemic to care for her kids, but is back to work full-time in food service at Stanford University. In August, she married again.\u003c/p>\n\u003cp>“I’m finally in this great relationship with a person who loves my kids, who loves me, and treats me the way I need to be treated. My kids are happier than ever,” Cuevas said. “I’m not going to lie, I have a lot of anxiety. I have a lot of panic attacks. So, I’m working on it.”\u003c/p>\n\u003cp>Cuevas said therapy improved the way she communicates with her children. In the past, she said she worried more about cleaning her home than taking the time to connect with her children. Now she makes sure they eat meals together and talk before bedtime. She wants her children to have a different experience than she had growing up.\u003c/p>\n\u003cp>She wants them to feel free to express their needs and emotions.\u003c/p>\n\u003cp>“I know that after finding the therapist for them and finding one myself, I noticed a change where they could confide in me and tell me what’s going on and express themselves,” Cuevas said. “It’s amazing how much trauma and how much hurt we have in our family. But there’s hope.\u003c/p>\n\u003cp>“With therapy you have that hope.”\u003c/p>\n\u003cp>\u003cem>Blanca Torres reported this story while participating in the \u003ca href=\"https://centerforhealthjournalism.org/about-us\">USC Annenberg Center for Health Journalism’s 2022 California Fellowship\u003c/a>\u003c/em>.\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"title": "Why California Is Facing a Mental Health Care Worker Shortage",
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"content": "\u003cp>The need for therapists, social workers, psychologists and psychiatrists is greater than ever. Under relentless pressure from the pandemic and inflation, wildfires, gun violence, racism and war, Californians are crying out for help.\u003c/p>\n\u003cp>But that doesn’t mean they can get it.\u003c/p>\n\u003cp>In every corner of mental health right now, a similar story is being told: There simply aren’t enough providers.\u003c/p>\n\u003cp>Patients receive lists of names from their insurers, only to learn none of the therapists on these so-called “ghost lists” will see them. Clinicians who do offer a spot often only accept cash.\u003c/p>\n\u003cp>Nonprofit mental health care providers report needing to have an offer letter ready at a job interview, fearing applicants will take another position if they wait.\u003c/p>\n\u003cp>[ad fullwidth]\u003c/p>\n\u003cp>Kaiser mental health care clinicians have been \u003ca href=\"https://www.kqed.org/news/11923034/were-drowning-why-kaiser-mental-health-workers-are-striking\">out on strike for weeks\u003c/a> now in Northern California, describing exhausting working conditions and long delays in care for their patients. Kaiser, for its part, points a finger at a familiar culprit: the mental health care provider shortage.\u003c/p>\n\u003cp>CalMatters spoke with more than two dozen mental health experts, public officials and providers around California to ask about the impacts of the mental health care provider shortage, and what can be done about it. Their responses ranged from desperate to hopeful.\u003c/p>\n\u003cp>All agree we are at a pivotal movement.\u003c/p>\n\u003cp>In part, that’s because Gov. Gavin Newsom’s administration is investing heavily in overhauling the state’s mental health care system. At the same time, the state recently enacted laws requiring insurers to provide timely access to mental health care. Some worry a lack of providers could jeopardize these bold new initiatives. Others see this as an opportunity to reimagine how mental health care in the state is delivered.\u003c/p>\n\u003cp>Here’s what the experts had to say:\u003c/p>\n\u003ch2>How big is the provider shortage problem?\u003c/h2>\n\u003cp>It depends on what part of the elephant you’re looking at, said Catherine Teare, associate director of the California Health Care Foundation’s People-Centered Care team. County mental health departments are struggling to hire. So are commercial health plans. So are nonprofits.\u003c/p>\n\u003cp>At the same time, she said, “the level of mental distress is increased.”\u003c/p>\n\u003cp>“For children or adults who need a lot, or need it urgently, it’s a scary time,” she said.\u003c/p>\n\u003cp>Dr. Mark Ghaly, secretary of the California Health and Human Services Agency, told CalMatters that the number of licensed behavioral health care providers in the state increased by 20% between 2016 and 2020. But, that’s been offset by an increase in demand he calls “really unprecedented.”\u003c/p>\n\u003cp>For patients, how bad the shortage is depends, in part, on where you live, your insurance, your income, your age, the care you need and whether you want a clinician of color or one who speaks a language other than English.\u003c/p>\n\u003cp>\u003ca href=\"https://www.chcf.org/publication/californias-current-future-behavioral-health-workforce/\">A report\u003c/a> published by the University of California, San Francisco in 2018 — even before the \u003ca href=\"https://www.healthmanagement.com/wp-content/uploads/HMA-NCMW-Issue-Brief-10-27-21.pdf\">pandemic sent need skyrocketing\u003c/a> — predicted that by 2028, demand for psychologists and other therapists would be 40% more than supply. For kids, the shortage is especially dire: Close to a third of California’s 58 counties have \u003ca href=\"https://www.aacap.org/aacap/Advocacy/Federal_and_State_Initiatives/Workforce_Maps/Home.aspx\">no child and adolescent psychiatrists at all\u003c/a>, according to the American Academy of Child and Adolescent Psychiatry.[aside label=\"Related Stories\" postID=\"news_11924343,news_11924117,news_11923034\"]\u003ca href=\"https://www.chcf.org/wp-content/uploads/2022/07/MentalHealthAlmanac2022.pdf\">A new report\u003c/a> from the California Health Care Foundation shows that the Bay Area has 19 licensed psychiatrists and 73 licensed psychologists per 100,000 people — significantly more than the state averages of 12 and 44. At the other end of the spectrum, the San Joaquin Valley has six psychiatrists and 16 psychologists for the equivalent number of people.\u003c/p>\n\u003cp>Jessica Dominguez, a licensed marriage and family therapist at Kaiser Richmond who is currently on strike, said the Bay Area has plenty of providers.\u003c/p>\n\u003cp>“Throw a rock, you’re going to hit a therapist,” said Dominguez, who said she plans to leave the organization.\u003c/p>\n\u003cp>But others who work in the region, including Matthew Madaus, executive director of the Behavioral Health Collaborative of Alameda County, said “100% absolutely” there’s a shortage even in the Bay Area.\u003c/p>\n\u003cp>If you search for a behavioral health clinician on Indeed.com, Madaus said, it comes up with thousands of open positions within a 25-mile radius.\u003c/p>\n\u003cp>“It’s extraordinary the level of demand,” he said.\u003c/p>\n\u003cp>One problem: It’s difficult to capture how many clinicians don’t accept any insurance at all, and thus aren’t accessible to the vast majority of patients who can’t pay out of pocket.\u003c/p>\n\u003cp>What we do know: We need more and better data. For instance, some experts say the increase described by Ghaly does not reflect how many licensed providers are actually seeing patients, nor does it capture how many are seeing people who are uninsured or on Medi-Cal.\u003c/p>\n\u003cp>Democratic state Sen. Scott Wiener of San Francisco authored\u003ca href=\"https://leginfo.legislature.ca.gov/faces/billTextClient.xhtml?bill_id=202120220SB964\"> a bill\u003c/a> this year that would require the Department of Health Care Access and Information to prepare a report for the Legislature by Jan. 1, 2024, describing the state of California’s behavioral health workforce, and how best to address the shortage. Senate Bill 964 is on the governor’s desk.\u003c/p>\n\u003cp>\u003ca href=\"https://workforce.org/wp-content/uploads/2022/08/San-Diego-Behavioral-Health-Workforce-Report-.pdf\">San Diego County has already researched the shortage.\u003c/a> Officials there estimate they currently have 17,000 behavioral health care workers and need an additional 8,100 to meet current demand. In the next five years, they anticipate needing another 10,000 workers, in part because so many will be retiring.\u003c/p>\n\u003ch2>What’s causing the shortage?\u003c/h2>\n\u003cp>Mental health care leaders will tell you the shortage itself is nothing new. But the pandemic has aggravated the problems. More providers have left their jobs, citing burnout. Or they’ve left the state, citing cost of living. New telehealth start-ups specializing in mental health treatment offer good pay and flexible hours; many experts said they have added to the demand by siphoning off providers from the public sector.[pullquote align=\"right\" size=\"medium\" citation=\"Catherine Teare, associate director of People-Centered Care, California Health Care Foundation\"]‘For children or adults who need a lot, or need it urgently, it’s a scary time.’[/pullquote]In a 2018 report on the \u003ca href=\"https://healthforce.ucsf.edu/publications/california-s-current-and-future-behavioral-health-workforce\">behavioral health workforce shortage\u003c/a>, Janet Coffman of UCSF also raised the concern that 45% of psychiatrists and 37% of psychologists would likely be retiring within a decade. The pandemic has accelerated this trend, she said.\u003c/p>\n\u003cp>Many clinicians say they’re simply exhausted. It’s not just that more people need help, but that many of them are coming in sicker, with mental health issues that have gone untreated.\u003c/p>\n\u003cp>“Our patient population has become so much more difficult to work with than it used to be a decade ago,” said Randall Hagar, legislative advocate and policy consultant for the Psychiatric Physicians Alliance of California.\u003c/p>\n\u003cp>As openings go unfilled, those who remain are left to carry more of the weight, he said.\u003c/p>\n\u003cp>Another problem Hagar and others mention: paperwork. Doctors spend some 40% of their time on paperwork, he said.\u003c/p>\n\u003cp>Many clinicians, especially providers of color, also say they are simply not getting enough emotional support from their employers. Dominguez, the Kaiser therapist, said she founded La Clinica, a nationally recognized pilot program to serve Spanish-speaking clients, in 2016. When tragedies happen in the community, she said, they affect clinicians, too. But, “you’re just expected to plug along and keep going,” she said.\u003c/p>\n\u003cp>Continually witnessing trauma can be exhausting, said Jeff Capps, a social worker with Pacific Clinics in Los Angeles. He emphasizes the need to make the work more sustainable for clinicians. That includes better pay.\u003c/p>\n\u003cp>“Sometimes in our field, the assumption is that since you get value out of your work, you don’t need to be as compensated,” he said.\u003c/p>\n\u003cp>A 2019 report by the health care consulting firm Milliman found that commercial plans in California, when setting rates, \u003ca href=\"https://www.milliman.com/en/insight/addiction-and-mental-health-vs-physical-health-widening-disparities-in-network-use-and-p\">pay primary care providers an average 15% more\u003c/a> than they pay behavioral health care providers.\u003c/p>\n\u003cp>Luke Bergmann, San Diego County’s director of behavioral health, said his county’s report on the provider shortage showed that, in some cases, people chose to work at Panda Express instead of substance use disorder clinics “because they simply cannot make as much.”\u003c/p>\n\u003cp>“People talk about loving the work,” he said. “For people to leave this work is an incredible emotional sacrifice.”\u003c/p>\n\u003cp>Candy Curiel, clinical director of Pacific Clinics for the Inland Empire, said inflation is making the situation even worse.\u003c/p>\n\u003cp>“Everything is so costly at this point, people feel they need to seek more money,” she said.\u003c/p>\n\u003ch2>Everyone is competing with everyone else. Is this a zero-sum game?\u003c/h2>\n\u003cp>Michelle Cabrera, executive director of the County Behavioral Health Directors Association of California, said the state’s mental health care system is so overwhelmed, everyone is poaching from each other.\u003c/p>\n\u003cp>“Let me be clear: It is a zero-sum game,” she said. “There’s only so many licensed or competent professionals in the state of California to do these jobs.”\u003c/p>\n\u003cp>In August, state Superintendent of Public Instruction Tony Thurmond announced that he had secured funding to \u003ca href=\"https://www.cde.ca.gov/nr/ne/yr22/yr22rel39.asp\">hire 10,000 additional mental health clinicians\u003c/a> to serve the state’s students. That effort is key to the Department of Education’s push to increase mental health care provided in schools.\u003c/p>\n\u003cp>Adrienne Shilton, senior policy advocate for the California Alliance of Child and Family Services, called the $200 million to establish a new scholarship program for master’s-level clinicians “a big win.”\u003c/p>\n\u003cp>But for Cabrera, the announcement “just puts fear at the heart of county behavioral health.”\u003c/p>\n\u003cp>She wonders how counties can possibly compete.\u003c/p>\n\u003cp>“I don’t know that we’ve really had a reckoning yet on the degree to which demand so far exceeds the available supply of providers in our state,” she said.[pullquote align=\"right\" size=\"medium\" citation=\"Karen Larsen, CEO, Steinberg Institute\"]‘We finally have all of this money and transformation coming. All these amazing things … and it couldn’t come at a worse time in terms of our workforce.’[/pullquote]This is the vicious circle for workers who are salaried. Nonprofit providers often pay less than schools and counties. Schools and counties, in turn, pay less than Kaiser and some of the new telehealth start-ups.\u003c/p>\n\u003cp>Nonprofit jobs that used to attract 40 or 50 applicants might only get two or three now, said Madaus, of the Behavioral Health Collaborative of Alameda County. Some nonprofits are looking at the possibility of providing free housing as an incentive, he said.\u003c/p>\n\u003cp>Even as it contributes to burnout, the increasing demand has, in some ways, opened new doors for clinicians.\u003c/p>\n\u003cp>Michael Torres, child and family clinical psychologist for Kaiser in San Leandro who is currently on strike, said that of 15 people on his team, six have left in the past year. Some are leaving to do telehealth, or to work in the private sector. Those positions can offer better work-life balance and more flexibility, he said. They also allow clinicians to see patients weekly or biweekly, he said, instead of every four to six weeks as often happens at Kaiser.\u003c/p>\n\u003cfigure id=\"attachment_11923074\" class=\"wp-caption alignnone\" style=\"max-width: 800px\">\u003cimg loading=\"lazy\" decoding=\"async\" class=\"size-medium wp-image-11923074\" src=\"https://ww2.kqed.org/app/uploads/sites/10/2022/08/RS57894_032_KQED_KaiserStrikeOakland_08192022-qut-800x533.jpg\" alt='people in red shirts carrying signs that read \"patients over profits\"' width=\"800\" height=\"533\" srcset=\"https://cdn.kqed.org/wp-content/uploads/sites/10/2022/08/RS57894_032_KQED_KaiserStrikeOakland_08192022-qut-800x533.jpg 800w, https://cdn.kqed.org/wp-content/uploads/sites/10/2022/08/RS57894_032_KQED_KaiserStrikeOakland_08192022-qut-1020x680.jpg 1020w, https://cdn.kqed.org/wp-content/uploads/sites/10/2022/08/RS57894_032_KQED_KaiserStrikeOakland_08192022-qut-160x107.jpg 160w, https://cdn.kqed.org/wp-content/uploads/sites/10/2022/08/RS57894_032_KQED_KaiserStrikeOakland_08192022-qut-1536x1024.jpg 1536w, https://cdn.kqed.org/wp-content/uploads/sites/10/2022/08/RS57894_032_KQED_KaiserStrikeOakland_08192022-qut.jpg 1920w\" sizes=\"(max-width: 800px) 100vw, 800px\">\u003cfigcaption class=\"wp-caption-text\">Kaiser mental health care workers and supporters march from Oakland Kaiser Medical Center to Kaiser’s corporate headquarters on Friday, Aug. 19, 2022, the fifth day of an open-ended strike. \u003ccite>(Beth LaBerge/KQED)\u003c/cite>\u003c/figcaption>\u003c/figure>\n\u003ch2>How will the provider shortage affect the Newsom administration’s big mental health care initiatives?\u003c/h2>\n\u003cp>Coming into office, Newsom made clear that he wanted to prioritize mental health. Over the past few years, his administration has championed a number of bold new initiatives. These include:\u003c/p>\n\u003cul>\n\u003cli>The \u003ca href=\"https://www.chhs.ca.gov/wp-content/uploads/2021/12/Children-and-Youth-Behavioral-Health-Initiative-Brief.pdf\">Children and Youth Behavioral Health Initiative\u003c/a>, a \u003ca href=\"https://www.gov.ca.gov/wp-content/uploads/2022/08/KidsMentalHealthMasterPlan_8.18.22.pdf?emrc=6d3847\">$4.7 billion investment\u003c/a> meant to transform the children’s mental health care system.\u003c/li>\n\u003cli>CalAIM, a major transformation of the state’s Medi-Cal system.\u003c/li>\n\u003cli>\u003ca href=\"https://www.kqed.org/news/11924117/governors-care-court-plan-passes-assembly-clearing-way-to-become-law\">CARE Court\u003c/a>, a controversial proposal to compel people with serious mental illness into care and housing.\u003c/li>\n\u003c/ul>\n\u003cp>Lawmakers in recent years strengthened requirements that private insurers adhere to federal and state mental health parity laws — which require equal treatment of mental and physical health concerns.\u003c/p>\n\u003cp>But many of those tasked with implementing these efforts say they are worried.\u003c/p>\n\u003cp>“We have that conversation all the time,” said Madaus, of the Behavioral Health Collaborative of Alameda County. As new funding sources come online, he said, nonprofit executives consistently tell him: “I can’t take any more funding because I can’t hire more staff.”\u003c/p>\n\u003cp>Karen Larsen, chief executive officer of the Steinberg Institute, a nonprofit that advocates on mental health care policy, is also concerned. Prior to assuming her current role, Larsen spent two decades as head of Yolo County’s behavioral health department.\u003c/p>\n\u003cp>“We finally have all of this money and transformation coming,” she said. “All these amazing things … and it couldn’t come at a worse time in terms of our workforce.”\u003c/p>\n\u003cp>Ghaly says he shares that concern. But he adds that “incredible investments have been made,” not just in innovative programs, but in addressing the workforce shortage head-on.\u003c/p>\n\u003ch2>How do we increase the number of providers?\u003c/h2>\n\u003cp>Earlier this year, Josh Leonard, executive director of the East Bay Agency for Children, was struggling to fill openings for mental health clinicians. Over several months, the nonprofit — anticipating a bump in its contract with Alameda County — raised all clinicians’ salaries by at least 15%.\u003c/p>\n\u003cp>It worked. At least for now.\u003c/p>\n\u003cp>While Leonard’s not considering the workforce crisis over, he knows that decision was important.\u003c/p>\n\u003cp>Jessica Hernandez, a clinician there, agrees.\u003c/p>\n\u003cp>“For me it has helped out tremendously,” she said. “Now I want to stay longer.”[pullquote align=\"right\" size=\"medium\" citation=\"Janet Coffman, University of California San Francisco\"]‘We’re making much bigger investments in the behavioral health workforce than we have since I started engaging in this field in the ’90s.’[/pullquote]To make the work more appealing and sustainable, providers say a lot needs to change. Besides pay, other factors are also critical, including reducing paperwork, offering more flexibility and providing more support to therapists.\u003c/p>\n\u003cp>That last one has been key for Hernandez.\u003c/p>\n\u003cp>“They’re acknowledging that it’s really, really tough,” she said.\u003c/p>\n\u003cp>To meet growing need, new providers also must be brought in. Scholarships and loan repayment programs are helpful, but universities need more spots to train new clinicians.\u003c/p>\n\u003cp>Coffman, of UCSF, calls herself “cautiously optimistic.”\u003c/p>\n\u003cp>“We’re making much bigger investments in the behavioral health workforce than we have since I started engaging in this field in the ’90s,” she said.\u003c/p>\n\u003cp>This year’s budget allocates more than $360 million for the state to spend over the next three years on everything from recruiting high schoolers into behavioral health to expanding social work slots at public universities and helping psychiatry students with loan repayment.\u003c/p>\n\u003cp>Gov. Newsom also emphasized workforce development in his recent \u003ca href=\"https://www.gov.ca.gov/wp-content/uploads/2022/08/KidsMentalHealthMasterPlan_8.18.22.pdf?emrc=6d3847\">master plan for kids’ mental health\u003c/a>. Some of the $4.7 billion will go toward bringing in 40,000 new mental health care workers, he said.\u003c/p>\n\u003ch2>Can we reimagine how mental health care is provided?\u003c/h2>\n\u003cp>Ultimately, getting mental health care to everyone who needs it is going to require both expanding our idea of who should provide that care — and how they should do it.\u003c/p>\n\u003cp>“If you only see the system in the context of what it currently is, yeah, we’re stuck by the provider shortage,” said Alex Briscoe, head of California Children’s Trust, an initiative to change the state’s mental health care system for children.\u003c/p>\n\u003cp>“But I would say that we can’t let that stop us, and I actually think it represents an opportunity,” Briscoe said.\u003c/p>\n\u003cp>For Briscoe, this includes team-based models — already used by some nonprofits — involving a therapist, a case worker, a parenting coach or housing or employment specialist, and a peer provider who has lived with mental illness and is uniquely positioned to support others in crisis.\u003c/p>\n\u003cp>It includes more people with shared life experiences and those who live in the local community, he said.\u003c/p>\n\u003cp>Mental health care workers are often middle-class white women, while many of the people they serve — especially on Medi-Cal — are lower-income people of color, said Dr. Rhea Boyd, a pediatrician and public health advocate who works with Briscoe at the California Children’s Trust. She wonders: What if we expanded the provider class so that it included the people who cut or braid your hair? What if the people who offered you mental health care lived on your block?\u003c/p>\n\u003cp>A lot of these things already exist informally, she said. What’s needed is a way to pay for them.\u003c/p>\n\u003cp>That’s starting to emerge.\u003c/p>\n\u003cp>Two years ago, the state finally authorized a pathway to \u003ca href=\"https://calmatters.org/health/2020/09/california-peer-mental-health/\">certify peer providers\u003c/a>, allowing organizations that employ them to bill Medi-Cal. California was the 49th state to do so.\u003c/p>\n\u003cp>Other new categories of workers are also being proposed. CalAIM created a job description called “community health workers,” trusted residents who do outreach in their own communities. And the state’s Children and Youth Behavioral Health Initiative is developing the role of behavioral health coaches, who work with young people on school campuses. Both would work in team-based models under the supervision of licensed providers.\u003c/p>\n\u003cp>Coffman and others say it’s also important to invest in career ladders, so people who enter the field as peer providers have the option to earn more advanced degrees.\u003c/p>\n\u003cp>[ad floatright]\u003c/p>\n\u003cp>“This is the opportunity California has in front of it,” said Ghaly, secretary of the California Health and Human Services Agency. “And it’s going to start by how transformative, innovative and successful we are in creating not just the workforce that we know but the workforce that we’ve yet to discover.”\u003c/p>\n\n",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003cp>The need for therapists, social workers, psychologists and psychiatrists is greater than ever. Under relentless pressure from the pandemic and inflation, wildfires, gun violence, racism and war, Californians are crying out for help.\u003c/p>\n\u003cp>But that doesn’t mean they can get it.\u003c/p>\n\u003cp>In every corner of mental health right now, a similar story is being told: There simply aren’t enough providers.\u003c/p>\n\u003cp>Patients receive lists of names from their insurers, only to learn none of the therapists on these so-called “ghost lists” will see them. Clinicians who do offer a spot often only accept cash.\u003c/p>\n\u003cp>Nonprofit mental health care providers report needing to have an offer letter ready at a job interview, fearing applicants will take another position if they wait.\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>Kaiser mental health care clinicians have been \u003ca href=\"https://www.kqed.org/news/11923034/were-drowning-why-kaiser-mental-health-workers-are-striking\">out on strike for weeks\u003c/a> now in Northern California, describing exhausting working conditions and long delays in care for their patients. Kaiser, for its part, points a finger at a familiar culprit: the mental health care provider shortage.\u003c/p>\n\u003cp>CalMatters spoke with more than two dozen mental health experts, public officials and providers around California to ask about the impacts of the mental health care provider shortage, and what can be done about it. Their responses ranged from desperate to hopeful.\u003c/p>\n\u003cp>All agree we are at a pivotal movement.\u003c/p>\n\u003cp>In part, that’s because Gov. Gavin Newsom’s administration is investing heavily in overhauling the state’s mental health care system. At the same time, the state recently enacted laws requiring insurers to provide timely access to mental health care. Some worry a lack of providers could jeopardize these bold new initiatives. Others see this as an opportunity to reimagine how mental health care in the state is delivered.\u003c/p>\n\u003cp>Here’s what the experts had to say:\u003c/p>\n\u003ch2>How big is the provider shortage problem?\u003c/h2>\n\u003cp>It depends on what part of the elephant you’re looking at, said Catherine Teare, associate director of the California Health Care Foundation’s People-Centered Care team. County mental health departments are struggling to hire. So are commercial health plans. So are nonprofits.\u003c/p>\n\u003cp>At the same time, she said, “the level of mental distress is increased.”\u003c/p>\n\u003cp>“For children or adults who need a lot, or need it urgently, it’s a scary time,” she said.\u003c/p>\n\u003cp>Dr. Mark Ghaly, secretary of the California Health and Human Services Agency, told CalMatters that the number of licensed behavioral health care providers in the state increased by 20% between 2016 and 2020. But, that’s been offset by an increase in demand he calls “really unprecedented.”\u003c/p>\n\u003cp>For patients, how bad the shortage is depends, in part, on where you live, your insurance, your income, your age, the care you need and whether you want a clinician of color or one who speaks a language other than English.\u003c/p>\n\u003cp>\u003ca href=\"https://www.chcf.org/publication/californias-current-future-behavioral-health-workforce/\">A report\u003c/a> published by the University of California, San Francisco in 2018 — even before the \u003ca href=\"https://www.healthmanagement.com/wp-content/uploads/HMA-NCMW-Issue-Brief-10-27-21.pdf\">pandemic sent need skyrocketing\u003c/a> — predicted that by 2028, demand for psychologists and other therapists would be 40% more than supply. For kids, the shortage is especially dire: Close to a third of California’s 58 counties have \u003ca href=\"https://www.aacap.org/aacap/Advocacy/Federal_and_State_Initiatives/Workforce_Maps/Home.aspx\">no child and adolescent psychiatrists at all\u003c/a>, according to the American Academy of Child and Adolescent Psychiatry.\u003c/p>\u003c/div>",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003ca href=\"https://www.chcf.org/wp-content/uploads/2022/07/MentalHealthAlmanac2022.pdf\">A new report\u003c/a> from the California Health Care Foundation shows that the Bay Area has 19 licensed psychiatrists and 73 licensed psychologists per 100,000 people — significantly more than the state averages of 12 and 44. At the other end of the spectrum, the San Joaquin Valley has six psychiatrists and 16 psychologists for the equivalent number of people.\u003c/p>\n\u003cp>Jessica Dominguez, a licensed marriage and family therapist at Kaiser Richmond who is currently on strike, said the Bay Area has plenty of providers.\u003c/p>\n\u003cp>“Throw a rock, you’re going to hit a therapist,” said Dominguez, who said she plans to leave the organization.\u003c/p>\n\u003cp>But others who work in the region, including Matthew Madaus, executive director of the Behavioral Health Collaborative of Alameda County, said “100% absolutely” there’s a shortage even in the Bay Area.\u003c/p>\n\u003cp>If you search for a behavioral health clinician on Indeed.com, Madaus said, it comes up with thousands of open positions within a 25-mile radius.\u003c/p>\n\u003cp>“It’s extraordinary the level of demand,” he said.\u003c/p>\n\u003cp>One problem: It’s difficult to capture how many clinicians don’t accept any insurance at all, and thus aren’t accessible to the vast majority of patients who can’t pay out of pocket.\u003c/p>\n\u003cp>What we do know: We need more and better data. For instance, some experts say the increase described by Ghaly does not reflect how many licensed providers are actually seeing patients, nor does it capture how many are seeing people who are uninsured or on Medi-Cal.\u003c/p>\n\u003cp>Democratic state Sen. Scott Wiener of San Francisco authored\u003ca href=\"https://leginfo.legislature.ca.gov/faces/billTextClient.xhtml?bill_id=202120220SB964\"> a bill\u003c/a> this year that would require the Department of Health Care Access and Information to prepare a report for the Legislature by Jan. 1, 2024, describing the state of California’s behavioral health workforce, and how best to address the shortage. Senate Bill 964 is on the governor’s desk.\u003c/p>\n\u003cp>\u003ca href=\"https://workforce.org/wp-content/uploads/2022/08/San-Diego-Behavioral-Health-Workforce-Report-.pdf\">San Diego County has already researched the shortage.\u003c/a> Officials there estimate they currently have 17,000 behavioral health care workers and need an additional 8,100 to meet current demand. In the next five years, they anticipate needing another 10,000 workers, in part because so many will be retiring.\u003c/p>\n\u003ch2>What’s causing the shortage?\u003c/h2>\n\u003cp>Mental health care leaders will tell you the shortage itself is nothing new. But the pandemic has aggravated the problems. More providers have left their jobs, citing burnout. Or they’ve left the state, citing cost of living. New telehealth start-ups specializing in mental health treatment offer good pay and flexible hours; many experts said they have added to the demand by siphoning off providers from the public sector.\u003c/p>\u003c/div>",
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"content": "\u003cdiv class=\"post-body\">\u003cp>In a 2018 report on the \u003ca href=\"https://healthforce.ucsf.edu/publications/california-s-current-and-future-behavioral-health-workforce\">behavioral health workforce shortage\u003c/a>, Janet Coffman of UCSF also raised the concern that 45% of psychiatrists and 37% of psychologists would likely be retiring within a decade. The pandemic has accelerated this trend, she said.\u003c/p>\n\u003cp>Many clinicians say they’re simply exhausted. It’s not just that more people need help, but that many of them are coming in sicker, with mental health issues that have gone untreated.\u003c/p>\n\u003cp>“Our patient population has become so much more difficult to work with than it used to be a decade ago,” said Randall Hagar, legislative advocate and policy consultant for the Psychiatric Physicians Alliance of California.\u003c/p>\n\u003cp>As openings go unfilled, those who remain are left to carry more of the weight, he said.\u003c/p>\n\u003cp>Another problem Hagar and others mention: paperwork. Doctors spend some 40% of their time on paperwork, he said.\u003c/p>\n\u003cp>Many clinicians, especially providers of color, also say they are simply not getting enough emotional support from their employers. Dominguez, the Kaiser therapist, said she founded La Clinica, a nationally recognized pilot program to serve Spanish-speaking clients, in 2016. When tragedies happen in the community, she said, they affect clinicians, too. But, “you’re just expected to plug along and keep going,” she said.\u003c/p>\n\u003cp>Continually witnessing trauma can be exhausting, said Jeff Capps, a social worker with Pacific Clinics in Los Angeles. He emphasizes the need to make the work more sustainable for clinicians. That includes better pay.\u003c/p>\n\u003cp>“Sometimes in our field, the assumption is that since you get value out of your work, you don’t need to be as compensated,” he said.\u003c/p>\n\u003cp>A 2019 report by the health care consulting firm Milliman found that commercial plans in California, when setting rates, \u003ca href=\"https://www.milliman.com/en/insight/addiction-and-mental-health-vs-physical-health-widening-disparities-in-network-use-and-p\">pay primary care providers an average 15% more\u003c/a> than they pay behavioral health care providers.\u003c/p>\n\u003cp>Luke Bergmann, San Diego County’s director of behavioral health, said his county’s report on the provider shortage showed that, in some cases, people chose to work at Panda Express instead of substance use disorder clinics “because they simply cannot make as much.”\u003c/p>\n\u003cp>“People talk about loving the work,” he said. “For people to leave this work is an incredible emotional sacrifice.”\u003c/p>\n\u003cp>Candy Curiel, clinical director of Pacific Clinics for the Inland Empire, said inflation is making the situation even worse.\u003c/p>\n\u003cp>“Everything is so costly at this point, people feel they need to seek more money,” she said.\u003c/p>\n\u003ch2>Everyone is competing with everyone else. Is this a zero-sum game?\u003c/h2>\n\u003cp>Michelle Cabrera, executive director of the County Behavioral Health Directors Association of California, said the state’s mental health care system is so overwhelmed, everyone is poaching from each other.\u003c/p>\n\u003cp>“Let me be clear: It is a zero-sum game,” she said. “There’s only so many licensed or competent professionals in the state of California to do these jobs.”\u003c/p>\n\u003cp>In August, state Superintendent of Public Instruction Tony Thurmond announced that he had secured funding to \u003ca href=\"https://www.cde.ca.gov/nr/ne/yr22/yr22rel39.asp\">hire 10,000 additional mental health clinicians\u003c/a> to serve the state’s students. That effort is key to the Department of Education’s push to increase mental health care provided in schools.\u003c/p>\n\u003cp>Adrienne Shilton, senior policy advocate for the California Alliance of Child and Family Services, called the $200 million to establish a new scholarship program for master’s-level clinicians “a big win.”\u003c/p>\n\u003cp>But for Cabrera, the announcement “just puts fear at the heart of county behavioral health.”\u003c/p>\n\u003cp>She wonders how counties can possibly compete.\u003c/p>\n\u003cp>“I don’t know that we’ve really had a reckoning yet on the degree to which demand so far exceeds the available supply of providers in our state,” she said.\u003c/p>\u003c/div>",
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"content": "\u003cdiv class=\"post-body\">\u003cp>This is the vicious circle for workers who are salaried. Nonprofit providers often pay less than schools and counties. Schools and counties, in turn, pay less than Kaiser and some of the new telehealth start-ups.\u003c/p>\n\u003cp>Nonprofit jobs that used to attract 40 or 50 applicants might only get two or three now, said Madaus, of the Behavioral Health Collaborative of Alameda County. Some nonprofits are looking at the possibility of providing free housing as an incentive, he said.\u003c/p>\n\u003cp>Even as it contributes to burnout, the increasing demand has, in some ways, opened new doors for clinicians.\u003c/p>\n\u003cp>Michael Torres, child and family clinical psychologist for Kaiser in San Leandro who is currently on strike, said that of 15 people on his team, six have left in the past year. Some are leaving to do telehealth, or to work in the private sector. Those positions can offer better work-life balance and more flexibility, he said. They also allow clinicians to see patients weekly or biweekly, he said, instead of every four to six weeks as often happens at Kaiser.\u003c/p>\n\u003cfigure id=\"attachment_11923074\" class=\"wp-caption alignnone\" style=\"max-width: 800px\">\u003cimg loading=\"lazy\" decoding=\"async\" class=\"size-medium wp-image-11923074\" src=\"https://ww2.kqed.org/app/uploads/sites/10/2022/08/RS57894_032_KQED_KaiserStrikeOakland_08192022-qut-800x533.jpg\" alt='people in red shirts carrying signs that read \"patients over profits\"' width=\"800\" height=\"533\" srcset=\"https://cdn.kqed.org/wp-content/uploads/sites/10/2022/08/RS57894_032_KQED_KaiserStrikeOakland_08192022-qut-800x533.jpg 800w, https://cdn.kqed.org/wp-content/uploads/sites/10/2022/08/RS57894_032_KQED_KaiserStrikeOakland_08192022-qut-1020x680.jpg 1020w, https://cdn.kqed.org/wp-content/uploads/sites/10/2022/08/RS57894_032_KQED_KaiserStrikeOakland_08192022-qut-160x107.jpg 160w, https://cdn.kqed.org/wp-content/uploads/sites/10/2022/08/RS57894_032_KQED_KaiserStrikeOakland_08192022-qut-1536x1024.jpg 1536w, https://cdn.kqed.org/wp-content/uploads/sites/10/2022/08/RS57894_032_KQED_KaiserStrikeOakland_08192022-qut.jpg 1920w\" sizes=\"(max-width: 800px) 100vw, 800px\">\u003cfigcaption class=\"wp-caption-text\">Kaiser mental health care workers and supporters march from Oakland Kaiser Medical Center to Kaiser’s corporate headquarters on Friday, Aug. 19, 2022, the fifth day of an open-ended strike. \u003ccite>(Beth LaBerge/KQED)\u003c/cite>\u003c/figcaption>\u003c/figure>\n\u003ch2>How will the provider shortage affect the Newsom administration’s big mental health care initiatives?\u003c/h2>\n\u003cp>Coming into office, Newsom made clear that he wanted to prioritize mental health. Over the past few years, his administration has championed a number of bold new initiatives. These include:\u003c/p>\n\u003cul>\n\u003cli>The \u003ca href=\"https://www.chhs.ca.gov/wp-content/uploads/2021/12/Children-and-Youth-Behavioral-Health-Initiative-Brief.pdf\">Children and Youth Behavioral Health Initiative\u003c/a>, a \u003ca href=\"https://www.gov.ca.gov/wp-content/uploads/2022/08/KidsMentalHealthMasterPlan_8.18.22.pdf?emrc=6d3847\">$4.7 billion investment\u003c/a> meant to transform the children’s mental health care system.\u003c/li>\n\u003cli>CalAIM, a major transformation of the state’s Medi-Cal system.\u003c/li>\n\u003cli>\u003ca href=\"https://www.kqed.org/news/11924117/governors-care-court-plan-passes-assembly-clearing-way-to-become-law\">CARE Court\u003c/a>, a controversial proposal to compel people with serious mental illness into care and housing.\u003c/li>\n\u003c/ul>\n\u003cp>Lawmakers in recent years strengthened requirements that private insurers adhere to federal and state mental health parity laws — which require equal treatment of mental and physical health concerns.\u003c/p>\n\u003cp>But many of those tasked with implementing these efforts say they are worried.\u003c/p>\n\u003cp>“We have that conversation all the time,” said Madaus, of the Behavioral Health Collaborative of Alameda County. As new funding sources come online, he said, nonprofit executives consistently tell him: “I can’t take any more funding because I can’t hire more staff.”\u003c/p>\n\u003cp>Karen Larsen, chief executive officer of the Steinberg Institute, a nonprofit that advocates on mental health care policy, is also concerned. Prior to assuming her current role, Larsen spent two decades as head of Yolo County’s behavioral health department.\u003c/p>\n\u003cp>“We finally have all of this money and transformation coming,” she said. “All these amazing things … and it couldn’t come at a worse time in terms of our workforce.”\u003c/p>\n\u003cp>Ghaly says he shares that concern. But he adds that “incredible investments have been made,” not just in innovative programs, but in addressing the workforce shortage head-on.\u003c/p>\n\u003ch2>How do we increase the number of providers?\u003c/h2>\n\u003cp>Earlier this year, Josh Leonard, executive director of the East Bay Agency for Children, was struggling to fill openings for mental health clinicians. Over several months, the nonprofit — anticipating a bump in its contract with Alameda County — raised all clinicians’ salaries by at least 15%.\u003c/p>\n\u003cp>It worked. At least for now.\u003c/p>\n\u003cp>While Leonard’s not considering the workforce crisis over, he knows that decision was important.\u003c/p>\n\u003cp>Jessica Hernandez, a clinician there, agrees.\u003c/p>\n\u003cp>“For me it has helped out tremendously,” she said. “Now I want to stay longer.”\u003c/p>\u003c/div>",
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"content": "\u003cdiv class=\"post-body\">\u003cp>To make the work more appealing and sustainable, providers say a lot needs to change. Besides pay, other factors are also critical, including reducing paperwork, offering more flexibility and providing more support to therapists.\u003c/p>\n\u003cp>That last one has been key for Hernandez.\u003c/p>\n\u003cp>“They’re acknowledging that it’s really, really tough,” she said.\u003c/p>\n\u003cp>To meet growing need, new providers also must be brought in. Scholarships and loan repayment programs are helpful, but universities need more spots to train new clinicians.\u003c/p>\n\u003cp>Coffman, of UCSF, calls herself “cautiously optimistic.”\u003c/p>\n\u003cp>“We’re making much bigger investments in the behavioral health workforce than we have since I started engaging in this field in the ’90s,” she said.\u003c/p>\n\u003cp>This year’s budget allocates more than $360 million for the state to spend over the next three years on everything from recruiting high schoolers into behavioral health to expanding social work slots at public universities and helping psychiatry students with loan repayment.\u003c/p>\n\u003cp>Gov. Newsom also emphasized workforce development in his recent \u003ca href=\"https://www.gov.ca.gov/wp-content/uploads/2022/08/KidsMentalHealthMasterPlan_8.18.22.pdf?emrc=6d3847\">master plan for kids’ mental health\u003c/a>. Some of the $4.7 billion will go toward bringing in 40,000 new mental health care workers, he said.\u003c/p>\n\u003ch2>Can we reimagine how mental health care is provided?\u003c/h2>\n\u003cp>Ultimately, getting mental health care to everyone who needs it is going to require both expanding our idea of who should provide that care — and how they should do it.\u003c/p>\n\u003cp>“If you only see the system in the context of what it currently is, yeah, we’re stuck by the provider shortage,” said Alex Briscoe, head of California Children’s Trust, an initiative to change the state’s mental health care system for children.\u003c/p>\n\u003cp>“But I would say that we can’t let that stop us, and I actually think it represents an opportunity,” Briscoe said.\u003c/p>\n\u003cp>For Briscoe, this includes team-based models — already used by some nonprofits — involving a therapist, a case worker, a parenting coach or housing or employment specialist, and a peer provider who has lived with mental illness and is uniquely positioned to support others in crisis.\u003c/p>\n\u003cp>It includes more people with shared life experiences and those who live in the local community, he said.\u003c/p>\n\u003cp>Mental health care workers are often middle-class white women, while many of the people they serve — especially on Medi-Cal — are lower-income people of color, said Dr. Rhea Boyd, a pediatrician and public health advocate who works with Briscoe at the California Children’s Trust. She wonders: What if we expanded the provider class so that it included the people who cut or braid your hair? What if the people who offered you mental health care lived on your block?\u003c/p>\n\u003cp>A lot of these things already exist informally, she said. What’s needed is a way to pay for them.\u003c/p>\n\u003cp>That’s starting to emerge.\u003c/p>\n\u003cp>Two years ago, the state finally authorized a pathway to \u003ca href=\"https://calmatters.org/health/2020/09/california-peer-mental-health/\">certify peer providers\u003c/a>, allowing organizations that employ them to bill Medi-Cal. California was the 49th state to do so.\u003c/p>\n\u003cp>Other new categories of workers are also being proposed. CalAIM created a job description called “community health workers,” trusted residents who do outreach in their own communities. And the state’s Children and Youth Behavioral Health Initiative is developing the role of behavioral health coaches, who work with young people on school campuses. Both would work in team-based models under the supervision of licensed providers.\u003c/p>\n\u003cp>Coffman and others say it’s also important to invest in career ladders, so people who enter the field as peer providers have the option to earn more advanced degrees.\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>“This is the opportunity California has in front of it,” said Ghaly, secretary of the California Health and Human Services Agency. “And it’s going to start by how transformative, innovative and successful we are in creating not just the workforce that we know but the workforce that we’ve yet to discover.”\u003c/p>\n\n\u003c/div>\u003c/p>",
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"disqusTitle": "How One Oakland School Is Using California's Billion-Dollar Investment in Student Mental Health",
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"content": "\u003cp>\u003ca href=\"https://www.eltimpano.org/\">\u003cem>This story was produced in partnership with the local civic media organization El Tímpano.\u003c/em>\u003c/a>\u003c/p>\n\u003cp>Yesabel Inga works at Bridges Academy at Melrose in East Oakland, where she is the only therapist for some 400 students, a quarter of them newcomers. The majority are from Guatemala and speak Mam, a Mayan language spoken by some half a million people in that country and Mexico.\u003c/p>\n\u003cp>“A lot of them, when they first came in, only spoke Mam, they didn't speak Spanish or English,” said Inga. “And so they were just kind of lost, you know?”\u003c/p>\n\u003cp>As these children and others return to school this month across the Bay Area, one constant is their mental health needs: Reports of increased depression, anxiety, suicidal ideation and emergency hospital visits exacerbated by the pandemic are considered a crisis, according to reports from the \u003ca href=\"https://www.cdc.gov/media/releases/2022/p0331-youth-mental-health-covid-19.html\">CDC\u003c/a>, \u003ca href=\"https://www.aecf.org/blog/national-state-by-state-data-show-depth-of-youth-mental-health-pandemic\">The Annie E. Casey Foundation \u003c/a>and \u003ca href=\"https://mhanational.org/issues/2022/mental-health-america-youth-data#:~:text=Youth%20with%20Severe%20Major%20Depressive%20Episode%202022&text=10.6%25%20of%20youth%20(or%20over,197%2C000%20from%20last%20year's%20dataset.\">Mental Health America\u003c/a>.\u003c/p>\n\u003cp>To meet these needs, California is investing billions of new dollars, on top of state and federal pandemic relief funds. Bridges Academy at Melrose, which is a public school, found a way to leverage the money to maximize impact, pivoting from crisis management to prevention.\u003c/p>\n\u003cp>The principal at Bridges at the time, Anita Comelo, was having to make tough decisions about which kids would get to see the therapist and which would not.[pullquote size=\"medium\" align=\"right\" citation=\"Vivian Yen, fourth grade teacher, Bridges Academy at Melrose\"]'I do think the murder of George Floyd did kind of push us to adjust our curriculum and make it a little bit more social justice-oriented and more ethnic studies-oriented.'[/pullquote]\u003c/p>\n\u003cp>“So we always have to pick which trauma is the bigger trauma, you know?” said Comelo. “We often end up giving the services to what we call ‘externalizers,’ the kids who end up disrupting class.”\u003c/p>\n\u003cp>Those students are typically the boys, Comelo said, adding that means other students who tend to internalize the trauma of their anxiety and depression don’t get the help they need.\u003c/p>\n\u003cp>Because the school therapist, Inga, should only carry a maximum caseload of 15 students at any time, scores of other kids at Bridges who could have used help were not getting it, and the result was a lot of disruption in class and on the playground, says community schools project manager Rosana Covarrubias.\u003c/p>\n\u003cp>“There was a lot of cyberbullying and so we were seeing it erupt here at school because of what was happening online,” said Covarrubias. “They were needing mental health support for that. We were having some students with suicidal ideation.”[aside postID=\"mindshift_59753,mindshift_59361\" label=\"Related Posts\"]However, when Covarrubias tried to refer students out to other community agencies they partner with, she says every one of them had a waitlist.\u003c/p>\n\u003cp>“They’ll say, ‘OK, thank you for the referral, we'll get back to you.’ And sometimes it's months before they get matched to an individual who can support them and be their therapist,” Covarrubias said.\u003c/p>\n\u003cp>And these were the acute cases.\u003c/p>\n\u003cp>Bridges therapist Inga says what makes matters worse is the lack of health care coverage for preventive care. Currently, Medi-Cal managed-care plans and commercial providers such as Kaiser don’t reimburse counties’ behavioral health departments for children without a clinical diagnosis.\u003c/p>\n\u003cp>That could change with legislation, namely \u003ca href=\"https://legiscan.com/CA/text/AB552/id/2494655\">AB 552\u003c/a>, which is now on the governor’s desk. It would nudge private health care plans to work with counties to reimburse community providers such as Seneca, Lincoln Families and East Bay Agency for Children in Alameda County for providing treatment for students with more moderate needs.\u003c/p>\n\u003cp>“If we were to set up kids with therapy support like preventative, you know, we wouldn't have fifth graders that have suicidal ideation,” said Inga, who works for Seneca.\u003c/p>\n\u003ch2>An investment in mental health\u003c/h2>\n\u003cp>California has begun an unprecedented investment toward meeting the mental health needs of K-12 students.\u003c/p>\n\u003cp>There is $4.4 billion for a\u003ca href=\"https://www.chhs.ca.gov/wp-content/uploads/2021/12/Children-and-Youth-Behavioral-Health-Initiative-Brief.pdf\"> youth and adolescent mental health initiative\u003c/a> to reduce structural barriers to kids getting care inside schools; another $4.1 billion for\u003ca href=\"https://edsource.org/2022/california-ready-to-launch-3-billion-multi-year-transition-to-community-schools/666571\"> community schools\u003c/a>, which includes money aimed at mental health needs; plus billions more in federal and state pandemic relief dollars, some of which is also aimed at helping students recover from depression and anxiety brought on during the pandemic and subsequent school closures.\u003c/p>\n\u003cp>In the third round of federal pandemic funding to schools, Oakland Unified got over $100 million dollars. According to records filed with the state in May this year, the district only shows spending about $650,000 of that money. And of that, the district reports nearly half went toward mental health.\u003c/p>\n\u003cp>But by the time the COVID relief money trickled down to Bridges, the school ended up with just $20,000 prioritized for mental health. The money was not enough for even one full-time therapist with benefits, which costs about $160,000.\u003c/p>\n\u003cp>The district says it hasn’t spent all the resources yet, and is spacing out the investment. It says school sites last year requested the investments they wanted based on their site needs, and that they had flexibility in how to spend the dollars.\u003c/p>\n\u003cp>Comelo and staff decided to use their $20,000 to hire a part-time clinical therapist for two hours each week. Inga and the part-time clinician decided to start a six-week, group therapy session with eight to nine students, nearly all of whom were native Mam speakers.\u003c/p>\n\u003cp>“In the beginning, everybody was really quiet and shy,” Inga said. Inga had previously worked with youth in detention camps along the border, and she could relate as an immigrant herself. “My parents brought me here when I was 15, and not having that support … my experiences led me here to this group,” she said.\u003c/p>\n\u003cp>Among the students joining in the first newly formed preventive therapy group was 10-year-old Heymer Domingo Godinez.\u003c/p>\n\u003cfigure id=\"attachment_11924358\" class=\"wp-caption aligncenter\" style=\"max-width: 800px\">\u003ca href=\"https://ww2.kqed.org/app/uploads/sites/10/2022/08/RS58258_019_BridgesAcademyMamStudents_08302022-qut.jpg\">\u003cimg class=\"size-medium wp-image-11924358\" src=\"https://ww2.kqed.org/app/uploads/sites/10/2022/08/RS58258_019_BridgesAcademyMamStudents_08302022-qut-800x533.jpg\" alt=\"Two young girls wearing red decorative shirts and long black skirts prepare food with one holding a vegetable and cutting board and the other holding the handle of a pan with food.\" width=\"800\" height=\"533\" srcset=\"https://ww2.kqed.org/app/uploads/sites/10/2022/08/RS58258_019_BridgesAcademyMamStudents_08302022-qut-800x533.jpg 800w, https://ww2.kqed.org/app/uploads/sites/10/2022/08/RS58258_019_BridgesAcademyMamStudents_08302022-qut-1020x680.jpg 1020w, https://ww2.kqed.org/app/uploads/sites/10/2022/08/RS58258_019_BridgesAcademyMamStudents_08302022-qut-160x107.jpg 160w, https://ww2.kqed.org/app/uploads/sites/10/2022/08/RS58258_019_BridgesAcademyMamStudents_08302022-qut-1536x1024.jpg 1536w, https://ww2.kqed.org/app/uploads/sites/10/2022/08/RS58258_019_BridgesAcademyMamStudents_08302022-qut.jpg 1920w\" sizes=\"(max-width: 800px) 100vw, 800px\">\u003c/a>\u003cfigcaption class=\"wp-caption-text\">Sisters Heymer Johana (left) and Katy Noeli Domingo Godinez cook eggs at their home in Oakland after school on Aug. 30, 2022. \u003ccite>(Beth LaBerge/KQED)\u003c/cite>\u003c/figcaption>\u003c/figure>\n\u003cp>“When I first got here to Bridges Academy, I was afraid. I was crying, because I was scared of the students,” Heymer said in Spanish.\u003c/p>\n\u003cp>Heymer had arrived from Guatemala with her dad in first grade, screaming, kicking and crying when dropped off at school. She was scared to come to school because back in Guatemala she had been too young to go.\u003c/p>\n\u003cp>Heymer and her teachers describe having to hold Heymer to calm her and get her to stay in classes. By fourth grade, Heymer says she had just one friend. Inga says kids like Heymer were confused about where they fit in at the school.\u003c/p>\n\u003cp>“They were not really feeling like they could trust other people,” Inga explained. “Like once they came here, there was no space to really talk about themselves and their culture.” On top of that, the pandemic hit families like Heymer’s living in East Oakland especially hard; her parents lost work and nearly lost their housing, before the school stepped in to help raise money for them.\u003c/p>\n\u003cp>When Heymer and the other students gathered in the small group therapy session, Inga asked each of them to bring something that represented them. Inga said it was Heymer who asked if she could wear her woven huipil and corte, the traditional Mayan Mam clothing she wore at home.\u003c/p>\n\u003cfigure id=\"attachment_11924357\" class=\"wp-caption aligncenter\" style=\"max-width: 800px\">\u003ca href=\"https://ww2.kqed.org/app/uploads/sites/10/2022/08/RS58255_017_BridgesAcademyMamStudents_08302022-qut.jpg\">\u003cimg class=\"size-medium wp-image-11924357\" src=\"https://ww2.kqed.org/app/uploads/sites/10/2022/08/RS58255_017_BridgesAcademyMamStudents_08302022-qut-800x533.jpg\" alt=\"Two young girls wearing red decorative shirts and long black skirts face the kitchen counter.\" width=\"800\" height=\"533\" srcset=\"https://ww2.kqed.org/app/uploads/sites/10/2022/08/RS58255_017_BridgesAcademyMamStudents_08302022-qut-800x533.jpg 800w, https://ww2.kqed.org/app/uploads/sites/10/2022/08/RS58255_017_BridgesAcademyMamStudents_08302022-qut-1020x680.jpg 1020w, https://ww2.kqed.org/app/uploads/sites/10/2022/08/RS58255_017_BridgesAcademyMamStudents_08302022-qut-160x107.jpg 160w, https://ww2.kqed.org/app/uploads/sites/10/2022/08/RS58255_017_BridgesAcademyMamStudents_08302022-qut-1536x1024.jpg 1536w, https://ww2.kqed.org/app/uploads/sites/10/2022/08/RS58255_017_BridgesAcademyMamStudents_08302022-qut.jpg 1920w\" sizes=\"(max-width: 800px) 100vw, 800px\">\u003c/a>\u003cfigcaption class=\"wp-caption-text\">Sisters Heymer Johana (left) and Katy Noeli Domingo Godinez prepare food at their home in Oakland after school on Aug. 30, 2022. \u003ccite>(Beth LaBerge/KQED)\u003c/cite>\u003c/figcaption>\u003c/figure>\n\u003cp>Heymer was nervous, and a bit afraid of being under the microscope. “Because some people are looking at us and some people are thinking, ‘Why is some girl wearing some corte like that?’” she said.\u003c/p>\n\u003cp>Inga told her students they could expect to get some attention from their peers, but that they should see it as an opportunity rather than something they’d rather avoid.\u003c/p>\n\u003cp>\"Listen, some other kids might look at you weird, but it's because they haven't been exposed to other cultures,\" Inga said she told them. \"And if they ask you or say something mean, it's like, you know, 'Let me just, let me tell you about my culture, let me tell you what this means.'\"\u003c/p>\n\u003cp>As the group therapy sessions were taking place, other efforts on the part of teachers throughout the school were also unfolding, aimed at creating\u003ca href=\"https://news.ncsu.edu/2022/08/belonging-helps-black-latino-students-feel-engaged/\"> a greater sense of belonging\u003c/a> for the Mam students.\u003c/p>\n\u003cp>“I know that during parent-teacher conferences, I — and I'm pretty sure other teachers did this as well — explicitly told students in front of their families, ‘Please keep practicing your Mam. We do not want you to lose this language,’” said fourth grade teacher Vivian Yen.\u003c/p>\n\u003cp>Yen said some teachers began taking Mam language lessons, while others were critically rethinking their curricula.\u003c/p>\n\u003cp>“I know that my grade-level team, and the fifth grade and third grade, both did this. We were looking at our ELA [English language arts] curriculum because all of the texts are very white-centered,” Yen said.\u003c/p>\n\u003cp>“I do think the murder of George Floyd did kind of push us to adjust our curriculum and make it a little bit more social justice-oriented and more ethnic studies-oriented. This is so that students would also have time to think about their own identities, thinking about how they fit in and can counter these racist narratives that we're given all the time,” Yen said.\u003c/p>\n\u003cfigure id=\"attachment_11924356\" class=\"wp-caption aligncenter\" style=\"max-width: 800px\">\u003ca href=\"https://ww2.kqed.org/app/uploads/sites/10/2022/08/RS58249_014_BridgesAcademyMamStudents_08302022-qut.jpg\">\u003cimg class=\"size-medium wp-image-11924356\" src=\"https://ww2.kqed.org/app/uploads/sites/10/2022/08/RS58249_014_BridgesAcademyMamStudents_08302022-qut-800x533.jpg\" alt=\"Two young girls wearing red decorative shirts and long black skirts sit on the grass outside a building.\" width=\"800\" height=\"533\" srcset=\"https://ww2.kqed.org/app/uploads/sites/10/2022/08/RS58249_014_BridgesAcademyMamStudents_08302022-qut-800x533.jpg 800w, https://ww2.kqed.org/app/uploads/sites/10/2022/08/RS58249_014_BridgesAcademyMamStudents_08302022-qut-1020x680.jpg 1020w, https://ww2.kqed.org/app/uploads/sites/10/2022/08/RS58249_014_BridgesAcademyMamStudents_08302022-qut-160x107.jpg 160w, https://ww2.kqed.org/app/uploads/sites/10/2022/08/RS58249_014_BridgesAcademyMamStudents_08302022-qut-1536x1024.jpg 1536w, https://ww2.kqed.org/app/uploads/sites/10/2022/08/RS58249_014_BridgesAcademyMamStudents_08302022-qut.jpg 1920w\" sizes=\"(max-width: 800px) 100vw, 800px\">\u003c/a>\u003cfigcaption class=\"wp-caption-text\">Sisters Heymer Johana (left) and Katy Noeli Domingo Godinez sit in the grass outside their new school, Elmhurst United Middle School, in Oakland on Aug. 30, 2022. \u003ccite>(Beth LaBerge/KQED)\u003c/cite>\u003c/figcaption>\u003c/figure>\n\u003cp>The joy Heymer and the other students felt in wearing their cortes spread — more Mam-speaking students began wearing their traditional cortes on Fridays.\u003c/p>\n\u003cp>“Even the boys!” Inga said. “It was just beautiful.”\u003c/p>\n\u003cp>When fifth grade graduation arrived, it was Heymer who welcomed parents to the event in Mam and led the performance. And for the first time, all students who presented recited poems in English, Spanish and Mam.\u003c/p>\n\u003cp>Teachers point to this as a culmination, and a defining moment, of the culture change they had worked so hard to achieve.\u003c/p>\n\u003cp>“Honestly I think it was just the buildup of a bunch of tiny little things that led to this movement,” Yen said.\u003c/p>\n\u003cp>This year, Heymer started sixth grade at Elmhurst United in East Oakland. As she walks the eight blocks to her new school, she likes to sing songs from her church, Iglesia de Dios Evangelio Sana Doctrina in Oakland. She says it makes her happy and calms her.\u003c/p>\n\u003cp>Heymer scouted the school out before classes began, scrutinizing staff photos on the bulletin board outside the school office, looking for faces and names of teachers she thought might speak Spanish.\u003c/p>\n\u003cp>She says while she is worried about going to a new school, she is more confident now of who she is and what she can do.\u003c/p>\n\u003cp>“I want to learn. I don’t care what people say about me. I only care about my mind and achieving my dreams,” she said.\u003c/p>\n\u003cp>Heymer says if she has to, she’ll call on her old teachers at Bridges Academy for help.\u003c/p>\n\u003cp>\u003cem>To help a young person who may be struggling with depression or anxiety:\u003c/em>\u003c/p>\n\u003cul>\n\u003cli>\u003cem>Dial 988: The 24/7 National Suicide Prevention Lifeline is now the\u003c/em>\u003cem> \u003ca href=\"https://www.samhsa.gov/find-help/988\">988 Suicide and Crisis Lifeline\u003c/a>\u003c/em>.\u003c/li>\n\u003cli>\u003cem>\u003ca href=\"https://www.dhcs.ca.gov/individuals/Pages/MHPContactList.aspx\">Find your California county’s mental health services phone number.\u003c/a>\u003c/em>\u003c/li>\n\u003cli>\u003cem>Call the Family Paths Parenting Stress Helpline (English, Spanish) at (800) 829-3777, or \u003ca href=\"https://familypaths.org/\">visit its website\u003c/a>.\u003c/em>\u003c/li>\n\u003cli>\u003cem>\u003ca href=\"https://senecacommunityresources.weebly.com/\">Use Seneca community resources for California counties.\u003c/a>\u003c/em>\u003c/li>\n\u003cli>\u003cem>\u003ca href=\"https://www.acbhcs.org/\">Visit the Alameda County Behavioral Health Care Service webpage.\u003c/a>\u003c/em>\u003c/li>\n\u003c/ul>\n\u003cp>[ad fullwidth]\u003c/p>\n\u003cp>[ad floatright]\u003c/p>\n",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003cp>\u003ca href=\"https://www.eltimpano.org/\">\u003cem>This story was produced in partnership with the local civic media organization El Tímpano.\u003c/em>\u003c/a>\u003c/p>\n\u003cp>Yesabel Inga works at Bridges Academy at Melrose in East Oakland, where she is the only therapist for some 400 students, a quarter of them newcomers. The majority are from Guatemala and speak Mam, a Mayan language spoken by some half a million people in that country and Mexico.\u003c/p>\n\u003cp>“A lot of them, when they first came in, only spoke Mam, they didn't speak Spanish or English,” said Inga. “And so they were just kind of lost, you know?”\u003c/p>\n\u003cp>As these children and others return to school this month across the Bay Area, one constant is their mental health needs: Reports of increased depression, anxiety, suicidal ideation and emergency hospital visits exacerbated by the pandemic are considered a crisis, according to reports from the \u003ca href=\"https://www.cdc.gov/media/releases/2022/p0331-youth-mental-health-covid-19.html\">CDC\u003c/a>, \u003ca href=\"https://www.aecf.org/blog/national-state-by-state-data-show-depth-of-youth-mental-health-pandemic\">The Annie E. Casey Foundation \u003c/a>and \u003ca href=\"https://mhanational.org/issues/2022/mental-health-america-youth-data#:~:text=Youth%20with%20Severe%20Major%20Depressive%20Episode%202022&text=10.6%25%20of%20youth%20(or%20over,197%2C000%20from%20last%20year's%20dataset.\">Mental Health America\u003c/a>.\u003c/p>\n\u003cp>To meet these needs, California is investing billions of new dollars, on top of state and federal pandemic relief funds. Bridges Academy at Melrose, which is a public school, found a way to leverage the money to maximize impact, pivoting from crisis management to prevention.\u003c/p>\n\u003cp>The principal at Bridges at the time, Anita Comelo, was having to make tough decisions about which kids would get to see the therapist and which would not.\u003c/p>\u003c/div>",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>“So we always have to pick which trauma is the bigger trauma, you know?” said Comelo. “We often end up giving the services to what we call ‘externalizers,’ the kids who end up disrupting class.”\u003c/p>\n\u003cp>Those students are typically the boys, Comelo said, adding that means other students who tend to internalize the trauma of their anxiety and depression don’t get the help they need.\u003c/p>\n\u003cp>Because the school therapist, Inga, should only carry a maximum caseload of 15 students at any time, scores of other kids at Bridges who could have used help were not getting it, and the result was a lot of disruption in class and on the playground, says community schools project manager Rosana Covarrubias.\u003c/p>\n\u003cp>“There was a lot of cyberbullying and so we were seeing it erupt here at school because of what was happening online,” said Covarrubias. “They were needing mental health support for that. We were having some students with suicidal ideation.”\u003c/p>\u003c/div>",
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"content": "\u003cdiv class=\"post-body\">\u003cp>However, when Covarrubias tried to refer students out to other community agencies they partner with, she says every one of them had a waitlist.\u003c/p>\n\u003cp>“They’ll say, ‘OK, thank you for the referral, we'll get back to you.’ And sometimes it's months before they get matched to an individual who can support them and be their therapist,” Covarrubias said.\u003c/p>\n\u003cp>And these were the acute cases.\u003c/p>\n\u003cp>Bridges therapist Inga says what makes matters worse is the lack of health care coverage for preventive care. Currently, Medi-Cal managed-care plans and commercial providers such as Kaiser don’t reimburse counties’ behavioral health departments for children without a clinical diagnosis.\u003c/p>\n\u003cp>That could change with legislation, namely \u003ca href=\"https://legiscan.com/CA/text/AB552/id/2494655\">AB 552\u003c/a>, which is now on the governor’s desk. It would nudge private health care plans to work with counties to reimburse community providers such as Seneca, Lincoln Families and East Bay Agency for Children in Alameda County for providing treatment for students with more moderate needs.\u003c/p>\n\u003cp>“If we were to set up kids with therapy support like preventative, you know, we wouldn't have fifth graders that have suicidal ideation,” said Inga, who works for Seneca.\u003c/p>\n\u003ch2>An investment in mental health\u003c/h2>\n\u003cp>California has begun an unprecedented investment toward meeting the mental health needs of K-12 students.\u003c/p>\n\u003cp>There is $4.4 billion for a\u003ca href=\"https://www.chhs.ca.gov/wp-content/uploads/2021/12/Children-and-Youth-Behavioral-Health-Initiative-Brief.pdf\"> youth and adolescent mental health initiative\u003c/a> to reduce structural barriers to kids getting care inside schools; another $4.1 billion for\u003ca href=\"https://edsource.org/2022/california-ready-to-launch-3-billion-multi-year-transition-to-community-schools/666571\"> community schools\u003c/a>, which includes money aimed at mental health needs; plus billions more in federal and state pandemic relief dollars, some of which is also aimed at helping students recover from depression and anxiety brought on during the pandemic and subsequent school closures.\u003c/p>\n\u003cp>In the third round of federal pandemic funding to schools, Oakland Unified got over $100 million dollars. According to records filed with the state in May this year, the district only shows spending about $650,000 of that money. And of that, the district reports nearly half went toward mental health.\u003c/p>\n\u003cp>But by the time the COVID relief money trickled down to Bridges, the school ended up with just $20,000 prioritized for mental health. The money was not enough for even one full-time therapist with benefits, which costs about $160,000.\u003c/p>\n\u003cp>The district says it hasn’t spent all the resources yet, and is spacing out the investment. It says school sites last year requested the investments they wanted based on their site needs, and that they had flexibility in how to spend the dollars.\u003c/p>\n\u003cp>Comelo and staff decided to use their $20,000 to hire a part-time clinical therapist for two hours each week. Inga and the part-time clinician decided to start a six-week, group therapy session with eight to nine students, nearly all of whom were native Mam speakers.\u003c/p>\n\u003cp>“In the beginning, everybody was really quiet and shy,” Inga said. Inga had previously worked with youth in detention camps along the border, and she could relate as an immigrant herself. “My parents brought me here when I was 15, and not having that support … my experiences led me here to this group,” she said.\u003c/p>\n\u003cp>Among the students joining in the first newly formed preventive therapy group was 10-year-old Heymer Domingo Godinez.\u003c/p>\n\u003cfigure id=\"attachment_11924358\" class=\"wp-caption aligncenter\" style=\"max-width: 800px\">\u003ca href=\"https://ww2.kqed.org/app/uploads/sites/10/2022/08/RS58258_019_BridgesAcademyMamStudents_08302022-qut.jpg\">\u003cimg class=\"size-medium wp-image-11924358\" src=\"https://ww2.kqed.org/app/uploads/sites/10/2022/08/RS58258_019_BridgesAcademyMamStudents_08302022-qut-800x533.jpg\" alt=\"Two young girls wearing red decorative shirts and long black skirts prepare food with one holding a vegetable and cutting board and the other holding the handle of a pan with food.\" width=\"800\" height=\"533\" srcset=\"https://ww2.kqed.org/app/uploads/sites/10/2022/08/RS58258_019_BridgesAcademyMamStudents_08302022-qut-800x533.jpg 800w, https://ww2.kqed.org/app/uploads/sites/10/2022/08/RS58258_019_BridgesAcademyMamStudents_08302022-qut-1020x680.jpg 1020w, https://ww2.kqed.org/app/uploads/sites/10/2022/08/RS58258_019_BridgesAcademyMamStudents_08302022-qut-160x107.jpg 160w, https://ww2.kqed.org/app/uploads/sites/10/2022/08/RS58258_019_BridgesAcademyMamStudents_08302022-qut-1536x1024.jpg 1536w, https://ww2.kqed.org/app/uploads/sites/10/2022/08/RS58258_019_BridgesAcademyMamStudents_08302022-qut.jpg 1920w\" sizes=\"(max-width: 800px) 100vw, 800px\">\u003c/a>\u003cfigcaption class=\"wp-caption-text\">Sisters Heymer Johana (left) and Katy Noeli Domingo Godinez cook eggs at their home in Oakland after school on Aug. 30, 2022. \u003ccite>(Beth LaBerge/KQED)\u003c/cite>\u003c/figcaption>\u003c/figure>\n\u003cp>“When I first got here to Bridges Academy, I was afraid. I was crying, because I was scared of the students,” Heymer said in Spanish.\u003c/p>\n\u003cp>Heymer had arrived from Guatemala with her dad in first grade, screaming, kicking and crying when dropped off at school. She was scared to come to school because back in Guatemala she had been too young to go.\u003c/p>\n\u003cp>Heymer and her teachers describe having to hold Heymer to calm her and get her to stay in classes. By fourth grade, Heymer says she had just one friend. Inga says kids like Heymer were confused about where they fit in at the school.\u003c/p>\n\u003cp>“They were not really feeling like they could trust other people,” Inga explained. “Like once they came here, there was no space to really talk about themselves and their culture.” On top of that, the pandemic hit families like Heymer’s living in East Oakland especially hard; her parents lost work and nearly lost their housing, before the school stepped in to help raise money for them.\u003c/p>\n\u003cp>When Heymer and the other students gathered in the small group therapy session, Inga asked each of them to bring something that represented them. Inga said it was Heymer who asked if she could wear her woven huipil and corte, the traditional Mayan Mam clothing she wore at home.\u003c/p>\n\u003cfigure id=\"attachment_11924357\" class=\"wp-caption aligncenter\" style=\"max-width: 800px\">\u003ca href=\"https://ww2.kqed.org/app/uploads/sites/10/2022/08/RS58255_017_BridgesAcademyMamStudents_08302022-qut.jpg\">\u003cimg class=\"size-medium wp-image-11924357\" src=\"https://ww2.kqed.org/app/uploads/sites/10/2022/08/RS58255_017_BridgesAcademyMamStudents_08302022-qut-800x533.jpg\" alt=\"Two young girls wearing red decorative shirts and long black skirts face the kitchen counter.\" width=\"800\" height=\"533\" srcset=\"https://ww2.kqed.org/app/uploads/sites/10/2022/08/RS58255_017_BridgesAcademyMamStudents_08302022-qut-800x533.jpg 800w, https://ww2.kqed.org/app/uploads/sites/10/2022/08/RS58255_017_BridgesAcademyMamStudents_08302022-qut-1020x680.jpg 1020w, https://ww2.kqed.org/app/uploads/sites/10/2022/08/RS58255_017_BridgesAcademyMamStudents_08302022-qut-160x107.jpg 160w, https://ww2.kqed.org/app/uploads/sites/10/2022/08/RS58255_017_BridgesAcademyMamStudents_08302022-qut-1536x1024.jpg 1536w, https://ww2.kqed.org/app/uploads/sites/10/2022/08/RS58255_017_BridgesAcademyMamStudents_08302022-qut.jpg 1920w\" sizes=\"(max-width: 800px) 100vw, 800px\">\u003c/a>\u003cfigcaption class=\"wp-caption-text\">Sisters Heymer Johana (left) and Katy Noeli Domingo Godinez prepare food at their home in Oakland after school on Aug. 30, 2022. \u003ccite>(Beth LaBerge/KQED)\u003c/cite>\u003c/figcaption>\u003c/figure>\n\u003cp>Heymer was nervous, and a bit afraid of being under the microscope. “Because some people are looking at us and some people are thinking, ‘Why is some girl wearing some corte like that?’” she said.\u003c/p>\n\u003cp>Inga told her students they could expect to get some attention from their peers, but that they should see it as an opportunity rather than something they’d rather avoid.\u003c/p>\n\u003cp>\"Listen, some other kids might look at you weird, but it's because they haven't been exposed to other cultures,\" Inga said she told them. \"And if they ask you or say something mean, it's like, you know, 'Let me just, let me tell you about my culture, let me tell you what this means.'\"\u003c/p>\n\u003cp>As the group therapy sessions were taking place, other efforts on the part of teachers throughout the school were also unfolding, aimed at creating\u003ca href=\"https://news.ncsu.edu/2022/08/belonging-helps-black-latino-students-feel-engaged/\"> a greater sense of belonging\u003c/a> for the Mam students.\u003c/p>\n\u003cp>“I know that during parent-teacher conferences, I — and I'm pretty sure other teachers did this as well — explicitly told students in front of their families, ‘Please keep practicing your Mam. We do not want you to lose this language,’” said fourth grade teacher Vivian Yen.\u003c/p>\n\u003cp>Yen said some teachers began taking Mam language lessons, while others were critically rethinking their curricula.\u003c/p>\n\u003cp>“I know that my grade-level team, and the fifth grade and third grade, both did this. We were looking at our ELA [English language arts] curriculum because all of the texts are very white-centered,” Yen said.\u003c/p>\n\u003cp>“I do think the murder of George Floyd did kind of push us to adjust our curriculum and make it a little bit more social justice-oriented and more ethnic studies-oriented. This is so that students would also have time to think about their own identities, thinking about how they fit in and can counter these racist narratives that we're given all the time,” Yen said.\u003c/p>\n\u003cfigure id=\"attachment_11924356\" class=\"wp-caption aligncenter\" style=\"max-width: 800px\">\u003ca href=\"https://ww2.kqed.org/app/uploads/sites/10/2022/08/RS58249_014_BridgesAcademyMamStudents_08302022-qut.jpg\">\u003cimg class=\"size-medium wp-image-11924356\" src=\"https://ww2.kqed.org/app/uploads/sites/10/2022/08/RS58249_014_BridgesAcademyMamStudents_08302022-qut-800x533.jpg\" alt=\"Two young girls wearing red decorative shirts and long black skirts sit on the grass outside a building.\" width=\"800\" height=\"533\" srcset=\"https://ww2.kqed.org/app/uploads/sites/10/2022/08/RS58249_014_BridgesAcademyMamStudents_08302022-qut-800x533.jpg 800w, https://ww2.kqed.org/app/uploads/sites/10/2022/08/RS58249_014_BridgesAcademyMamStudents_08302022-qut-1020x680.jpg 1020w, https://ww2.kqed.org/app/uploads/sites/10/2022/08/RS58249_014_BridgesAcademyMamStudents_08302022-qut-160x107.jpg 160w, https://ww2.kqed.org/app/uploads/sites/10/2022/08/RS58249_014_BridgesAcademyMamStudents_08302022-qut-1536x1024.jpg 1536w, https://ww2.kqed.org/app/uploads/sites/10/2022/08/RS58249_014_BridgesAcademyMamStudents_08302022-qut.jpg 1920w\" sizes=\"(max-width: 800px) 100vw, 800px\">\u003c/a>\u003cfigcaption class=\"wp-caption-text\">Sisters Heymer Johana (left) and Katy Noeli Domingo Godinez sit in the grass outside their new school, Elmhurst United Middle School, in Oakland on Aug. 30, 2022. \u003ccite>(Beth LaBerge/KQED)\u003c/cite>\u003c/figcaption>\u003c/figure>\n\u003cp>The joy Heymer and the other students felt in wearing their cortes spread — more Mam-speaking students began wearing their traditional cortes on Fridays.\u003c/p>\n\u003cp>“Even the boys!” Inga said. “It was just beautiful.”\u003c/p>\n\u003cp>When fifth grade graduation arrived, it was Heymer who welcomed parents to the event in Mam and led the performance. And for the first time, all students who presented recited poems in English, Spanish and Mam.\u003c/p>\n\u003cp>Teachers point to this as a culmination, and a defining moment, of the culture change they had worked so hard to achieve.\u003c/p>\n\u003cp>“Honestly I think it was just the buildup of a bunch of tiny little things that led to this movement,” Yen said.\u003c/p>\n\u003cp>This year, Heymer started sixth grade at Elmhurst United in East Oakland. As she walks the eight blocks to her new school, she likes to sing songs from her church, Iglesia de Dios Evangelio Sana Doctrina in Oakland. She says it makes her happy and calms her.\u003c/p>\n\u003cp>Heymer scouted the school out before classes began, scrutinizing staff photos on the bulletin board outside the school office, looking for faces and names of teachers she thought might speak Spanish.\u003c/p>\n\u003cp>She says while she is worried about going to a new school, she is more confident now of who she is and what she can do.\u003c/p>\n\u003cp>“I want to learn. I don’t care what people say about me. I only care about my mind and achieving my dreams,” she said.\u003c/p>\n\u003cp>Heymer says if she has to, she’ll call on her old teachers at Bridges Academy for help.\u003c/p>\n\u003cp>\u003cem>To help a young person who may be struggling with depression or anxiety:\u003c/em>\u003c/p>\n\u003cul>\n\u003cli>\u003cem>Dial 988: The 24/7 National Suicide Prevention Lifeline is now the\u003c/em>\u003cem> \u003ca href=\"https://www.samhsa.gov/find-help/988\">988 Suicide and Crisis Lifeline\u003c/a>\u003c/em>.\u003c/li>\n\u003cli>\u003cem>\u003ca href=\"https://www.dhcs.ca.gov/individuals/Pages/MHPContactList.aspx\">Find your California county’s mental health services phone number.\u003c/a>\u003c/em>\u003c/li>\n\u003cli>\u003cem>Call the Family Paths Parenting Stress Helpline (English, Spanish) at (800) 829-3777, or \u003ca href=\"https://familypaths.org/\">visit its website\u003c/a>.\u003c/em>\u003c/li>\n\u003cli>\u003cem>\u003ca href=\"https://senecacommunityresources.weebly.com/\">Use Seneca community resources for California counties.\u003c/a>\u003c/em>\u003c/li>\n\u003cli>\u003cem>\u003ca href=\"https://www.acbhcs.org/\">Visit the Alameda County Behavioral Health Care Service webpage.\u003c/a>\u003c/em>\u003c/li>\n\u003c/ul>\n\u003cp>\u003c/p>\u003c/div>",
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"title": "'We're Drowning': Why Kaiser Mental Health Workers Are Striking",
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"content": "\u003cp>On Friday, the fifth day of an open-ended strike by Kaiser Permanente mental health workers across Northern California, some 200 employees and supporters marched to the health care giant’s Oakland headquarters, demanding that management increase staffing and resources.\u003c/p>\n\u003cp>They were among the roughly 2,000 Kaiser therapists, social workers and other mental health care staffers across Northern California — represented by the National Union of Healthcare Workers — who formed picket lines outside Kaiser facilities this week, after negotiations with management ended without resolution last weekend. Those striking said employee morale is dangerously low and patient care has become substandard due to long wait times for treatment. [aside label=\"Related Stories\" postID=\"news_11922524,news_11922748,news_11921580\"] Kaiser officials have called the strike unethical to patients and counterproductive, pointing to the shortage of mental health professionals nationwide. A company representative declined to participate in an interview, citing ongoing negotiations.\u003c/p>\n\u003cp class=\"p1\">But in a statement issued Friday, Deb Catsavas, senior vice president of human resources at Kaiser Permanente Northern California, reiterated the company’s stance that the strike and “disruption to patient care” were unnecessary.\u003c/p>\n\u003cp class=\"p1\">“While [the National Union of Healthcare Workers] claims it is fighting for increased access to care, its primary demand is for union members to spend less time seeing patients,” said Catsavas. “Our patients cannot afford a proposal that significantly reduces the time available to care for our patients and their mental health needs.”\u003c/p>\n\u003cp>The strike comes amid what the White House has described as an unprecedented mental health crisis among Americans of all ages.\u003c/p>\n\u003ch2>Why are Kaiser mental health care workers striking?\u003c/h2>\n\u003cp>“We’re striking because it’s demoralizing to work for a company that actively does things to capitalize on burnout,” Naomi Johnson, an associate clinical social worker for Kaiser, told KQED Forum. “We’re really working very hard as clinicians to try to see patients as frequently as we can, and to provide the care that we’re trained [for] and good at providing. And we’re not supported in doing that by the company.”\u003c/p>\n\u003cp>[ad fullwidth]\u003c/p>\n\u003cp>Kaiser tells patients that “if you have any sort of concerns or you want to come to therapy, please reach out,” added Johnson. “And then as providers, we’re told, ‘Only treat people who meet medical necessity.’ So it’s really difficult because we have this huge influx of people trying to seek services, but there aren’t enough of us to actually meet the demand, so we’re just completely overwhelmed. … We’re drowning, as clinicians.”\u003c/p>\n\u003cfigure id=\"attachment_11923078\" class=\"wp-caption aligncenter\" style=\"max-width: 1920px\">\u003ca href=\"https://ww2.kqed.org/app/uploads/sites/10/2022/08/RS57886_021_KQED_KaiserStrikeOakland_08192022-qut.jpg\">\u003cimg loading=\"lazy\" decoding=\"async\" class=\"size-full wp-image-11923078\" src=\"https://ww2.kqed.org/app/uploads/sites/10/2022/08/RS57886_021_KQED_KaiserStrikeOakland_08192022-qut.jpg\" alt=\"a protest\" width=\"1920\" height=\"1280\" srcset=\"https://cdn.kqed.org/wp-content/uploads/sites/10/2022/08/RS57886_021_KQED_KaiserStrikeOakland_08192022-qut.jpg 1920w, https://cdn.kqed.org/wp-content/uploads/sites/10/2022/08/RS57886_021_KQED_KaiserStrikeOakland_08192022-qut-800x533.jpg 800w, https://cdn.kqed.org/wp-content/uploads/sites/10/2022/08/RS57886_021_KQED_KaiserStrikeOakland_08192022-qut-1020x680.jpg 1020w, https://cdn.kqed.org/wp-content/uploads/sites/10/2022/08/RS57886_021_KQED_KaiserStrikeOakland_08192022-qut-160x107.jpg 160w, https://cdn.kqed.org/wp-content/uploads/sites/10/2022/08/RS57886_021_KQED_KaiserStrikeOakland_08192022-qut-1536x1024.jpg 1536w\" sizes=\"auto, (max-width: 1920px) 100vw, 1920px\">\u003c/a>\u003cfigcaption class=\"wp-caption-text\">Kaiser mental health care workers rally before a march from Oakland Kaiser Medical Center to Kaiser’s corporate headquarters on Friday, Aug. 19, 2022, the fifth day of an open-ended strike. \u003ccite>(Beth LaBerge/KQED)\u003c/cite>\u003c/figcaption>\u003c/figure>\n\u003ch2>How does understaffing affect patients seeking treatment?\u003c/h2>\n\u003cp>“There are currently 2,600 Kaiser patients for every mental health worker in (the) Northern California Kaiser system,” Ilana Marcucci-Morris, a licensed clinical social worker in Kaiser’s psychiatry department in Oakland, told Forum. That means the average Kaiser therapist sees between seven and 12 patients per day, while someone in private practice might see between three and six. After a series of initial intake calls, the majority of Kaiser patients calling with a “nonurgent” need wait between two and three months to see a therapist.\u003c/p>\n\u003cp>The National Union of Healthcare Workers points to \u003ca href=\"https://nuhw.org/more-than-2000-kaiser-permanente-mental-health-clinicians-to-start-open-ended-strike-august-15/\">internal Kaiser documents illustrating\u003c/a> that “patients who received an initial mental health assessment on June 13 weren’t scheduled for follow-up appointments for a month in San Francisco, more than two months in Sacramento and three months or more in other parts of Northern California.” That length of time, experts say, does a disservice to those who have already taken the often-difficult first step of seeking support.\u003c/p>\n\u003cp>“The goal is to help people get better and terminate,” said Marcucci-Morris. “But the system within Kaiser does not allow for that. It’s the opposite. People are waiting longer, and deteriorating to where they either give up and pay [for therapy] out of pocket, which sets up a system for folks who have those resources to pay a private practice therapist and get better.” She said people who can’t afford private therapy and insurance premiums aren’t able to get better. “They get worse and they stay in Kaiser and they just stay sick,” she said.\u003c/p>\n\u003cfigure id=\"attachment_11923083\" class=\"wp-caption aligncenter\" style=\"max-width: 1920px\">\u003ca href=\"https://ww2.kqed.org/app/uploads/sites/10/2022/08/RS57866_005_KQED_KaiserStrikeOakland_08192022-qut.jpg\">\u003cimg loading=\"lazy\" decoding=\"async\" class=\"size-full wp-image-11923083\" src=\"https://ww2.kqed.org/app/uploads/sites/10/2022/08/RS57866_005_KQED_KaiserStrikeOakland_08192022-qut.jpg\" alt=\"protestors reflected in a bus window\" width=\"1920\" height=\"1280\" srcset=\"https://cdn.kqed.org/wp-content/uploads/sites/10/2022/08/RS57866_005_KQED_KaiserStrikeOakland_08192022-qut.jpg 1920w, https://cdn.kqed.org/wp-content/uploads/sites/10/2022/08/RS57866_005_KQED_KaiserStrikeOakland_08192022-qut-800x533.jpg 800w, https://cdn.kqed.org/wp-content/uploads/sites/10/2022/08/RS57866_005_KQED_KaiserStrikeOakland_08192022-qut-1020x680.jpg 1020w, https://cdn.kqed.org/wp-content/uploads/sites/10/2022/08/RS57866_005_KQED_KaiserStrikeOakland_08192022-qut-160x107.jpg 160w, https://cdn.kqed.org/wp-content/uploads/sites/10/2022/08/RS57866_005_KQED_KaiserStrikeOakland_08192022-qut-1536x1024.jpg 1536w\" sizes=\"auto, (max-width: 1920px) 100vw, 1920px\">\u003c/a>\u003cfigcaption class=\"wp-caption-text\">Kaiser mental health care workers and supporters hold signs on the picket line outside Oakland Kaiser Medical Center. \u003ccite>(Beth LaBerge/KQED)\u003c/cite>\u003c/figcaption>\u003c/figure>\n\u003ch2>What is causing the understaffing?\u003c/h2>\n\u003cp>Kaiser administrators point to what they describe as a nationwide staffing shortage. “Across the country, there are not enough mental health care professionals to meet the increased demand for care,” said Kaiser’s Catsavas in an Aug. 15 statement. “This has created challenges for Kaiser Permanente and mental health care providers everywhere.”\u003c/p>\n\u003cp>Company administrators say they have worked to combat the shortage by hiring new mental health clinicians, including nearly 200 new clinicians since January 2021; improving mental health care access through virtual care; and launching a $500,000 initiative to recruit new employees.[pullquote align=\"right\" size=\"medium\" citation=\"Ilana Marcucci-Morris, Kaiser psychiatrist\"]‘There isn’t a shortage of clinicians. There’s only a shortage of clinicians that want to work for Kaiser.’[/pullquote]But those on strike said the severity of the shortage is specific to Kaiser, and that burnout and poor working conditions are contributing to low retention of existing employees, and making it difficult for the company to recruit new ones.\u003c/p>\n\u003cp>“There isn’t a shortage of clinicians. There’s only a shortage of clinicians that want to work for Kaiser,” said Marcucci-Morris. “We get into this field to help people, and it’s hard to recruit therapists when Kaiser’s reputation is known to make people wait so long for therapy sessions. It’s really, really not ethical. And I personally have a handful of colleagues and friends who are therapists with time in their schedules who I’ve tried to recruit for Kaiser. But the reputation is just so poor.”\u003c/p>\n\u003cp>It’s more appealing, said those striking, for qualified therapists to work for a private practice. “Workers just don’t want to work for Kaiser anymore, and that’s the real crisis we’re facing,” said Marcucci-Morris.\u003c/p>\n\u003cp>The union said the rate at which mental health clinicians are leaving Kaiser nearly doubled in the past year, with 668 clinicians leaving between June 2021 and May 2022, compared to 335 clinicians the previous year. In a union survey of 200 of those departing clinicians, 85% said they were leaving because their workload was unsustainable or because they felt they did not have enough time to complete the work, and 76% said they were unable to “treat patients in line with standards of care and medical necessity.”\u003c/p>\n\u003cp>“We need to grow the mental health workforce, there’s no doubt about that,” California state Senator Scott Wiener told KQED Forum. “It is also the case that the shortage is not as severe right now as the health plans say … health plans can take steps to expand their workforce, including paying better, providing better reimbursements to private providers, and those are investments that they should be making that they have not made.”\u003c/p>\n\u003cp>“I don’t think it’s the case that they can just throw up their hands and say, we have some challenges with the workforce, and so therefore, we’re going to make people wait three months,” he added. “We have real shortages of physical health care providers, but we don’t tolerate around physical health what we have long tolerated around mental health, which is effectively denying people access to lifesaving care.”\u003c/p>\n\u003cfigure id=\"attachment_11923080\" class=\"wp-caption aligncenter\" style=\"max-width: 1920px\">\u003ca href=\"https://ww2.kqed.org/app/uploads/sites/10/2022/08/RS57907_044_KQED_KaiserStrikeOakland_08192022-qut.jpg\">\u003cimg loading=\"lazy\" decoding=\"async\" class=\"size-full wp-image-11923080\" src=\"https://ww2.kqed.org/app/uploads/sites/10/2022/08/RS57907_044_KQED_KaiserStrikeOakland_08192022-qut.jpg\" alt=\"a baby in a stroller as part of a protest \" width=\"1920\" height=\"1280\" srcset=\"https://cdn.kqed.org/wp-content/uploads/sites/10/2022/08/RS57907_044_KQED_KaiserStrikeOakland_08192022-qut.jpg 1920w, https://cdn.kqed.org/wp-content/uploads/sites/10/2022/08/RS57907_044_KQED_KaiserStrikeOakland_08192022-qut-800x533.jpg 800w, https://cdn.kqed.org/wp-content/uploads/sites/10/2022/08/RS57907_044_KQED_KaiserStrikeOakland_08192022-qut-1020x680.jpg 1020w, https://cdn.kqed.org/wp-content/uploads/sites/10/2022/08/RS57907_044_KQED_KaiserStrikeOakland_08192022-qut-160x107.jpg 160w, https://cdn.kqed.org/wp-content/uploads/sites/10/2022/08/RS57907_044_KQED_KaiserStrikeOakland_08192022-qut-1536x1024.jpg 1536w\" sizes=\"auto, (max-width: 1920px) 100vw, 1920px\">\u003c/a>\u003cfigcaption class=\"wp-caption-text\">Kaiser mental health care workers carry signs on the picket line outside Oakland Kaiser Medical Center on Friday, Aug. 19, 2022, the fifth day of an open-ended strike. \u003ccite>(Beth LaBerge/KQED)\u003c/cite>\u003c/figcaption>\u003c/figure>\n\u003ch2>Has California passed any recent laws to address this shortage?\u003c/h2>\n\u003cp>\u003ca href=\"https://openstates.org/ca/bills/20212022/SB221/\">Senate Bill 221\u003c/a>, which passed in 2021 and went into effect July 1, 2022, said that “health plans, including Kaiser, must provide timely access to mental health and addiction treatment,” Senator Wiener told Forum. “And that means a prompt first visit.”\u003c/p>\n\u003cp>The law codifies existing regulations from the Department of Managed Health Care and the Department of Insurance that require a health care service plan or an insurer to ensure that “for an enrollee requesting a non-urgent appointment with a non-physician mental health care provider … appointments are offered within 10 business days of the request for an appointment.” Follow-up visits have to happen within two weeks, added Wiener.\u003c/p>\n\u003cp>\u003ca href=\"https://leginfo.legislature.ca.gov/faces/billVotesClient.xhtml?bill_id=202120220SB858\" target=\"_blank\" rel=\"noopener noreferrer\">Senate Bill 858\u003c/a>, which recently passed on the California State Assembly floor and will now move to Gov. Gavin Newsom’s desk, would update the way health insurance companies are fined for violations, something that hasn’t been updated or even adjusted for inflation since the 1970s, said Wiener. Currently, the maximum fine possible stands at $2,500 per violation; the bill, if passed, would increase that amount to $25,000.\u003c/p>\n\u003cp>“We think that will create a much larger incentive to actually follow the law and provide people with timely and appropriate access to health care,” he said.\u003c/p>\n\u003ch2>What exactly are the strikers asking for? What’s the current status of negotiations?\u003c/h2>\n\u003cp>In negotiations that led up to the strike, the National Union of Healthcare Workers accepted Kaiser’s wage-increase offer. But the union held fast on its demand that nine hours per week — up from the current six hours — be allotted for administrative work. Kaiser rejected that demand, arguing it would not leave adequate time to see patients. The company’s counteroffer, of an additional 1.2 hours for that work, was flatly rejected.\u003c/p>\n\u003cp>“We wouldn’t be striking right now if money was the primary [issue],” said Marcucci-Morris, pointing to burnout, retention issues and poor morale — as well as what the union describes as the lack of a clear plan for how the company is going to meet the requirements laid out by SB 221.\u003c/p>\n\u003cp>“It’s not going to fix the problems to buy the therapists out and pay us more,” she said. “What good is more pay when you’re drowning and can’t come up for air?”\u003c/p>\n\u003ch2>How is the strike affecting patients in need of care?\u003c/h2>\n\u003cp>Kaiser is legally obligated to continue providing care for its members during a labor strike.\u003c/p>\n\u003cp>[ad floatright]\u003c/p>\n\u003cp>“Beginning this week, our patients will receive care from those mental health clinicians who choose patient needs over the strike, as well as from our psychiatrists, clinical managers, and other licensed professionals,” said Catsavas in a statement on the first day of the strike, while noting that “some nonurgent appointments may need to be rescheduled” and that patients whose appointments might be affected “will be directly contacted prior to the date of the appointment to ensure they receive the care they need.”\u003c/p>\n\n",
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"excerpt": "On the fifth day of an open-ended strike, Kaiser mental health workers gathered in Oakland to protest outside the health care giant's corporate headquarters. Here's what they're marching for.",
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"title": "'We're Drowning': Why Kaiser Mental Health Workers Are Striking | KQED",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003cp>On Friday, the fifth day of an open-ended strike by Kaiser Permanente mental health workers across Northern California, some 200 employees and supporters marched to the health care giant’s Oakland headquarters, demanding that management increase staffing and resources.\u003c/p>\n\u003cp>They were among the roughly 2,000 Kaiser therapists, social workers and other mental health care staffers across Northern California — represented by the National Union of Healthcare Workers — who formed picket lines outside Kaiser facilities this week, after negotiations with management ended without resolution last weekend. Those striking said employee morale is dangerously low and patient care has become substandard due to long wait times for treatment. \u003c/p>\u003c/div>",
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"content": "\u003cdiv class=\"post-body\">\u003cp> Kaiser officials have called the strike unethical to patients and counterproductive, pointing to the shortage of mental health professionals nationwide. A company representative declined to participate in an interview, citing ongoing negotiations.\u003c/p>\n\u003cp class=\"p1\">But in a statement issued Friday, Deb Catsavas, senior vice president of human resources at Kaiser Permanente Northern California, reiterated the company’s stance that the strike and “disruption to patient care” were unnecessary.\u003c/p>\n\u003cp class=\"p1\">“While [the National Union of Healthcare Workers] claims it is fighting for increased access to care, its primary demand is for union members to spend less time seeing patients,” said Catsavas. “Our patients cannot afford a proposal that significantly reduces the time available to care for our patients and their mental health needs.”\u003c/p>\n\u003cp>The strike comes amid what the White House has described as an unprecedented mental health crisis among Americans of all ages.\u003c/p>\n\u003ch2>Why are Kaiser mental health care workers striking?\u003c/h2>\n\u003cp>“We’re striking because it’s demoralizing to work for a company that actively does things to capitalize on burnout,” Naomi Johnson, an associate clinical social worker for Kaiser, told KQED Forum. “We’re really working very hard as clinicians to try to see patients as frequently as we can, and to provide the care that we’re trained [for] and good at providing. And we’re not supported in doing that by the company.”\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>Kaiser tells patients that “if you have any sort of concerns or you want to come to therapy, please reach out,” added Johnson. “And then as providers, we’re told, ‘Only treat people who meet medical necessity.’ So it’s really difficult because we have this huge influx of people trying to seek services, but there aren’t enough of us to actually meet the demand, so we’re just completely overwhelmed. … We’re drowning, as clinicians.”\u003c/p>\n\u003cfigure id=\"attachment_11923078\" class=\"wp-caption aligncenter\" style=\"max-width: 1920px\">\u003ca href=\"https://ww2.kqed.org/app/uploads/sites/10/2022/08/RS57886_021_KQED_KaiserStrikeOakland_08192022-qut.jpg\">\u003cimg loading=\"lazy\" decoding=\"async\" class=\"size-full wp-image-11923078\" src=\"https://ww2.kqed.org/app/uploads/sites/10/2022/08/RS57886_021_KQED_KaiserStrikeOakland_08192022-qut.jpg\" alt=\"a protest\" width=\"1920\" height=\"1280\" srcset=\"https://cdn.kqed.org/wp-content/uploads/sites/10/2022/08/RS57886_021_KQED_KaiserStrikeOakland_08192022-qut.jpg 1920w, https://cdn.kqed.org/wp-content/uploads/sites/10/2022/08/RS57886_021_KQED_KaiserStrikeOakland_08192022-qut-800x533.jpg 800w, https://cdn.kqed.org/wp-content/uploads/sites/10/2022/08/RS57886_021_KQED_KaiserStrikeOakland_08192022-qut-1020x680.jpg 1020w, https://cdn.kqed.org/wp-content/uploads/sites/10/2022/08/RS57886_021_KQED_KaiserStrikeOakland_08192022-qut-160x107.jpg 160w, https://cdn.kqed.org/wp-content/uploads/sites/10/2022/08/RS57886_021_KQED_KaiserStrikeOakland_08192022-qut-1536x1024.jpg 1536w\" sizes=\"auto, (max-width: 1920px) 100vw, 1920px\">\u003c/a>\u003cfigcaption class=\"wp-caption-text\">Kaiser mental health care workers rally before a march from Oakland Kaiser Medical Center to Kaiser’s corporate headquarters on Friday, Aug. 19, 2022, the fifth day of an open-ended strike. \u003ccite>(Beth LaBerge/KQED)\u003c/cite>\u003c/figcaption>\u003c/figure>\n\u003ch2>How does understaffing affect patients seeking treatment?\u003c/h2>\n\u003cp>“There are currently 2,600 Kaiser patients for every mental health worker in (the) Northern California Kaiser system,” Ilana Marcucci-Morris, a licensed clinical social worker in Kaiser’s psychiatry department in Oakland, told Forum. That means the average Kaiser therapist sees between seven and 12 patients per day, while someone in private practice might see between three and six. After a series of initial intake calls, the majority of Kaiser patients calling with a “nonurgent” need wait between two and three months to see a therapist.\u003c/p>\n\u003cp>The National Union of Healthcare Workers points to \u003ca href=\"https://nuhw.org/more-than-2000-kaiser-permanente-mental-health-clinicians-to-start-open-ended-strike-august-15/\">internal Kaiser documents illustrating\u003c/a> that “patients who received an initial mental health assessment on June 13 weren’t scheduled for follow-up appointments for a month in San Francisco, more than two months in Sacramento and three months or more in other parts of Northern California.” That length of time, experts say, does a disservice to those who have already taken the often-difficult first step of seeking support.\u003c/p>\n\u003cp>“The goal is to help people get better and terminate,” said Marcucci-Morris. “But the system within Kaiser does not allow for that. It’s the opposite. People are waiting longer, and deteriorating to where they either give up and pay [for therapy] out of pocket, which sets up a system for folks who have those resources to pay a private practice therapist and get better.” She said people who can’t afford private therapy and insurance premiums aren’t able to get better. “They get worse and they stay in Kaiser and they just stay sick,” she said.\u003c/p>\n\u003cfigure id=\"attachment_11923083\" class=\"wp-caption aligncenter\" style=\"max-width: 1920px\">\u003ca href=\"https://ww2.kqed.org/app/uploads/sites/10/2022/08/RS57866_005_KQED_KaiserStrikeOakland_08192022-qut.jpg\">\u003cimg loading=\"lazy\" decoding=\"async\" class=\"size-full wp-image-11923083\" src=\"https://ww2.kqed.org/app/uploads/sites/10/2022/08/RS57866_005_KQED_KaiserStrikeOakland_08192022-qut.jpg\" alt=\"protestors reflected in a bus window\" width=\"1920\" height=\"1280\" srcset=\"https://cdn.kqed.org/wp-content/uploads/sites/10/2022/08/RS57866_005_KQED_KaiserStrikeOakland_08192022-qut.jpg 1920w, https://cdn.kqed.org/wp-content/uploads/sites/10/2022/08/RS57866_005_KQED_KaiserStrikeOakland_08192022-qut-800x533.jpg 800w, https://cdn.kqed.org/wp-content/uploads/sites/10/2022/08/RS57866_005_KQED_KaiserStrikeOakland_08192022-qut-1020x680.jpg 1020w, https://cdn.kqed.org/wp-content/uploads/sites/10/2022/08/RS57866_005_KQED_KaiserStrikeOakland_08192022-qut-160x107.jpg 160w, https://cdn.kqed.org/wp-content/uploads/sites/10/2022/08/RS57866_005_KQED_KaiserStrikeOakland_08192022-qut-1536x1024.jpg 1536w\" sizes=\"auto, (max-width: 1920px) 100vw, 1920px\">\u003c/a>\u003cfigcaption class=\"wp-caption-text\">Kaiser mental health care workers and supporters hold signs on the picket line outside Oakland Kaiser Medical Center. \u003ccite>(Beth LaBerge/KQED)\u003c/cite>\u003c/figcaption>\u003c/figure>\n\u003ch2>What is causing the understaffing?\u003c/h2>\n\u003cp>Kaiser administrators point to what they describe as a nationwide staffing shortage. “Across the country, there are not enough mental health care professionals to meet the increased demand for care,” said Kaiser’s Catsavas in an Aug. 15 statement. “This has created challenges for Kaiser Permanente and mental health care providers everywhere.”\u003c/p>\n\u003cp>Company administrators say they have worked to combat the shortage by hiring new mental health clinicians, including nearly 200 new clinicians since January 2021; improving mental health care access through virtual care; and launching a $500,000 initiative to recruit new employees.\u003c/p>\u003c/div>",
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"content": "‘There isn’t a shortage of clinicians. There’s only a shortage of clinicians that want to work for Kaiser.’",
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"content": "\u003cdiv class=\"post-body\">\u003cp>But those on strike said the severity of the shortage is specific to Kaiser, and that burnout and poor working conditions are contributing to low retention of existing employees, and making it difficult for the company to recruit new ones.\u003c/p>\n\u003cp>“There isn’t a shortage of clinicians. There’s only a shortage of clinicians that want to work for Kaiser,” said Marcucci-Morris. “We get into this field to help people, and it’s hard to recruit therapists when Kaiser’s reputation is known to make people wait so long for therapy sessions. It’s really, really not ethical. And I personally have a handful of colleagues and friends who are therapists with time in their schedules who I’ve tried to recruit for Kaiser. But the reputation is just so poor.”\u003c/p>\n\u003cp>It’s more appealing, said those striking, for qualified therapists to work for a private practice. “Workers just don’t want to work for Kaiser anymore, and that’s the real crisis we’re facing,” said Marcucci-Morris.\u003c/p>\n\u003cp>The union said the rate at which mental health clinicians are leaving Kaiser nearly doubled in the past year, with 668 clinicians leaving between June 2021 and May 2022, compared to 335 clinicians the previous year. In a union survey of 200 of those departing clinicians, 85% said they were leaving because their workload was unsustainable or because they felt they did not have enough time to complete the work, and 76% said they were unable to “treat patients in line with standards of care and medical necessity.”\u003c/p>\n\u003cp>“We need to grow the mental health workforce, there’s no doubt about that,” California state Senator Scott Wiener told KQED Forum. “It is also the case that the shortage is not as severe right now as the health plans say … health plans can take steps to expand their workforce, including paying better, providing better reimbursements to private providers, and those are investments that they should be making that they have not made.”\u003c/p>\n\u003cp>“I don’t think it’s the case that they can just throw up their hands and say, we have some challenges with the workforce, and so therefore, we’re going to make people wait three months,” he added. “We have real shortages of physical health care providers, but we don’t tolerate around physical health what we have long tolerated around mental health, which is effectively denying people access to lifesaving care.”\u003c/p>\n\u003cfigure id=\"attachment_11923080\" class=\"wp-caption aligncenter\" style=\"max-width: 1920px\">\u003ca href=\"https://ww2.kqed.org/app/uploads/sites/10/2022/08/RS57907_044_KQED_KaiserStrikeOakland_08192022-qut.jpg\">\u003cimg loading=\"lazy\" decoding=\"async\" class=\"size-full wp-image-11923080\" src=\"https://ww2.kqed.org/app/uploads/sites/10/2022/08/RS57907_044_KQED_KaiserStrikeOakland_08192022-qut.jpg\" alt=\"a baby in a stroller as part of a protest \" width=\"1920\" height=\"1280\" srcset=\"https://cdn.kqed.org/wp-content/uploads/sites/10/2022/08/RS57907_044_KQED_KaiserStrikeOakland_08192022-qut.jpg 1920w, https://cdn.kqed.org/wp-content/uploads/sites/10/2022/08/RS57907_044_KQED_KaiserStrikeOakland_08192022-qut-800x533.jpg 800w, https://cdn.kqed.org/wp-content/uploads/sites/10/2022/08/RS57907_044_KQED_KaiserStrikeOakland_08192022-qut-1020x680.jpg 1020w, https://cdn.kqed.org/wp-content/uploads/sites/10/2022/08/RS57907_044_KQED_KaiserStrikeOakland_08192022-qut-160x107.jpg 160w, https://cdn.kqed.org/wp-content/uploads/sites/10/2022/08/RS57907_044_KQED_KaiserStrikeOakland_08192022-qut-1536x1024.jpg 1536w\" sizes=\"auto, (max-width: 1920px) 100vw, 1920px\">\u003c/a>\u003cfigcaption class=\"wp-caption-text\">Kaiser mental health care workers carry signs on the picket line outside Oakland Kaiser Medical Center on Friday, Aug. 19, 2022, the fifth day of an open-ended strike. \u003ccite>(Beth LaBerge/KQED)\u003c/cite>\u003c/figcaption>\u003c/figure>\n\u003ch2>Has California passed any recent laws to address this shortage?\u003c/h2>\n\u003cp>\u003ca href=\"https://openstates.org/ca/bills/20212022/SB221/\">Senate Bill 221\u003c/a>, which passed in 2021 and went into effect July 1, 2022, said that “health plans, including Kaiser, must provide timely access to mental health and addiction treatment,” Senator Wiener told Forum. “And that means a prompt first visit.”\u003c/p>\n\u003cp>The law codifies existing regulations from the Department of Managed Health Care and the Department of Insurance that require a health care service plan or an insurer to ensure that “for an enrollee requesting a non-urgent appointment with a non-physician mental health care provider … appointments are offered within 10 business days of the request for an appointment.” Follow-up visits have to happen within two weeks, added Wiener.\u003c/p>\n\u003cp>\u003ca href=\"https://leginfo.legislature.ca.gov/faces/billVotesClient.xhtml?bill_id=202120220SB858\" target=\"_blank\" rel=\"noopener noreferrer\">Senate Bill 858\u003c/a>, which recently passed on the California State Assembly floor and will now move to Gov. Gavin Newsom’s desk, would update the way health insurance companies are fined for violations, something that hasn’t been updated or even adjusted for inflation since the 1970s, said Wiener. Currently, the maximum fine possible stands at $2,500 per violation; the bill, if passed, would increase that amount to $25,000.\u003c/p>\n\u003cp>“We think that will create a much larger incentive to actually follow the law and provide people with timely and appropriate access to health care,” he said.\u003c/p>\n\u003ch2>What exactly are the strikers asking for? What’s the current status of negotiations?\u003c/h2>\n\u003cp>In negotiations that led up to the strike, the National Union of Healthcare Workers accepted Kaiser’s wage-increase offer. But the union held fast on its demand that nine hours per week — up from the current six hours — be allotted for administrative work. Kaiser rejected that demand, arguing it would not leave adequate time to see patients. The company’s counteroffer, of an additional 1.2 hours for that work, was flatly rejected.\u003c/p>\n\u003cp>“We wouldn’t be striking right now if money was the primary [issue],” said Marcucci-Morris, pointing to burnout, retention issues and poor morale — as well as what the union describes as the lack of a clear plan for how the company is going to meet the requirements laid out by SB 221.\u003c/p>\n\u003cp>“It’s not going to fix the problems to buy the therapists out and pay us more,” she said. “What good is more pay when you’re drowning and can’t come up for air?”\u003c/p>\n\u003ch2>How is the strike affecting patients in need of care?\u003c/h2>\n\u003cp>Kaiser is legally obligated to continue providing care for its members during a labor strike.\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>“Beginning this week, our patients will receive care from those mental health clinicians who choose patient needs over the strike, as well as from our psychiatrists, clinical managers, and other licensed professionals,” said Catsavas in a statement on the first day of the strike, while noting that “some nonurgent appointments may need to be rescheduled” and that patients whose appointments might be affected “will be directly contacted prior to the date of the appointment to ensure they receive the care they need.”\u003c/p>\n\n\u003c/div>\u003c/p>",
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"content": "\u003cp>Thousands of mental health care workers maintained picket lines Wednesday in front of Kaiser Permanente facilities in the Bay Area and Central Valley, the third day of an open-ended strike to demand the health care giant increase mental health staffing and wages.\u003c/p>\n\u003cp>“This strike is a long time coming,” said state Sen. Scott Wiener, D-San Francisco, among a growing number of state legislative leaders backing the workers. “There have been major issues at Kaiser in terms of providing people with timely access or any access to mental health and addiction treatment and the workers have been advocating for years to have more staffing and compliance with the law and that hasn’t happened.”\u003c/p>\n\u003cp>Jason Lechner, a therapist focused on addiction services for youth, was among a throng of protesters outside a Kaiser Oakland facility on Tuesday, where workers chanted, “What do we want? Patient care. When do we want it? Now!”\u003c/p>\n\u003cp>Lechner said Kaiser doesn’t offer him enough time to carry out essential tasks like answering phone calls and emails, or referring patients to other experts, forcing him and his colleagues to regularly work extra hours in order to complete crucial administrative tasks.\u003c/p>\n\u003cp>“If I need to communicate with your primary care physician about what substances you’re abusing, where’s my time to do that?” he said.[aside label=\"Related Stories\" postID=\"news_11922524,forum_2010101884368,stateofhealth_21358\"]The National Union of Healthcare Workers, which represents Kaiser psychologists, therapists, social workers and chemical dependency counselors in Northern California, is in the thick of negotiating a new contract with Kaiser, and demanding the company hire more mental health workers to ease the burden placed on current staff. The union said negotiations with management this weekend ended without resolution, with Kaiser rejecting the union’s “proposals to increase staffing and end dangerously long waits for mental health therapy appointments.”\u003c/p>\n\u003cp>Nicole Riddle, a labor and delivery nurse, said she has experienced the consequences of staffing shortages, not only as a health care worker, but also as a Kaiser member who has tried to access mental health services for herself.\u003c/p>\n\u003cp>“I’ve had my own experiences, both trying to advocate for myself throughout really traumatic birth experiences, postpartum depression, and then for my own child,” she said. “And I feel like Kaiser kind of banks on people being burnt out enough to not keep escalating and advocating for themselves. And then those who are privileged enough to do so pay out of pocket.”\u003c/p>\n\u003cp>“We deserve a better situation,” she added.\u003c/p>\n\u003cp>\u003ca href=\"https://about.kaiserpermanente.org/who-we-are/labor-relations/committed-to-reaching-a-fair-and-equitable-agreement\">In a statement\u003c/a> issued Sunday, after negotiations stalled, Deb Catsavas, Kaiser’s regional senior vice president of human resources, said the Oakland-based company has “the deepest appreciation and gratitude for our mental health professionals and the extraordinary care they provide to our members.” But, she noted, “there are not enough mental health care professionals to meet the increased demand for care,” both locally and nationwide.\u003c/p>\n\u003cp>The company has hired “nearly 200 new clinicians since January 2021” and launched a $500,000 initiative to recruit new mental health practitioners, Catsavas added.\u003c/p>\n\u003cp>“Despite the union’s harmful tactics, we remain committed to bargaining in good faith to reach a fair and equitable agreement that is good for our therapists and our patients,” she said.\u003c/p>\n\u003cp>In negotiations, the union accepted Kaiser’s wage-increase offer, but held fast on its demand that nine hours per week — up from the current six hours — be allotted for administrative work. Kaiser, however, rejected that demand, arguing it would not leave adequate time to see patients. Its counteroffer, of an additional 1.2 hours for that work, was flatly rejected.\u003c/p>\n\u003cp>California law requires health care providers like Kaiser to offer patients timely care even during labor strikes, and state regulators say they are closely monitoring consumer complaints about the company’s compliance. Kaiser has said it will prioritize urgent mental health situations, but may have to reschedule some ongoing appointments.\u003c/p>\n\u003cp>Oakland City Councilmember Dan Kalb, who joined Oakland staffers on the picket line on Tuesday, said mental health care has been undervalued for far too long.\u003c/p>\n\u003cp>“Mental health care is health care. And (it) needs to stop being seen as the stepchild of health care,” Kalb said, pointing to the longstanding demand for services that has only further escalated since the start of the COVID-19 pandemic. “Kaiser should be ashamed of themselves for not staffing up the mental health care clinicians that they need and not paying them a fair wage. It’s inexcusable.”\u003c/p>\n\u003cp>Kalb called for “unanimous support” for mental health workers, not just at Kaiser, but in all health care settings “to make sure that there are enough health care workers everywhere to meet the needs that people have.”\u003c/p>\n\u003cp>\u003cem>KQED’s Matthew Green contributed reporting.\u003c/em> [ad fullwidth]\u003c/p>\n\u003cp>\u003c/p>\n",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003cp>Thousands of mental health care workers maintained picket lines Wednesday in front of Kaiser Permanente facilities in the Bay Area and Central Valley, the third day of an open-ended strike to demand the health care giant increase mental health staffing and wages.\u003c/p>\n\u003cp>“This strike is a long time coming,” said state Sen. Scott Wiener, D-San Francisco, among a growing number of state legislative leaders backing the workers. “There have been major issues at Kaiser in terms of providing people with timely access or any access to mental health and addiction treatment and the workers have been advocating for years to have more staffing and compliance with the law and that hasn’t happened.”\u003c/p>\n\u003cp>Jason Lechner, a therapist focused on addiction services for youth, was among a throng of protesters outside a Kaiser Oakland facility on Tuesday, where workers chanted, “What do we want? Patient care. When do we want it? Now!”\u003c/p>\n\u003cp>Lechner said Kaiser doesn’t offer him enough time to carry out essential tasks like answering phone calls and emails, or referring patients to other experts, forcing him and his colleagues to regularly work extra hours in order to complete crucial administrative tasks.\u003c/p>\n\u003cp>“If I need to communicate with your primary care physician about what substances you’re abusing, where’s my time to do that?” he said.\u003c/p>\u003c/div>",
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"content": "\u003cdiv class=\"post-body\">\u003cp>The National Union of Healthcare Workers, which represents Kaiser psychologists, therapists, social workers and chemical dependency counselors in Northern California, is in the thick of negotiating a new contract with Kaiser, and demanding the company hire more mental health workers to ease the burden placed on current staff. The union said negotiations with management this weekend ended without resolution, with Kaiser rejecting the union’s “proposals to increase staffing and end dangerously long waits for mental health therapy appointments.”\u003c/p>\n\u003cp>Nicole Riddle, a labor and delivery nurse, said she has experienced the consequences of staffing shortages, not only as a health care worker, but also as a Kaiser member who has tried to access mental health services for herself.\u003c/p>\n\u003cp>“I’ve had my own experiences, both trying to advocate for myself throughout really traumatic birth experiences, postpartum depression, and then for my own child,” she said. “And I feel like Kaiser kind of banks on people being burnt out enough to not keep escalating and advocating for themselves. And then those who are privileged enough to do so pay out of pocket.”\u003c/p>\n\u003cp>“We deserve a better situation,” she added.\u003c/p>\n\u003cp>\u003ca href=\"https://about.kaiserpermanente.org/who-we-are/labor-relations/committed-to-reaching-a-fair-and-equitable-agreement\">In a statement\u003c/a> issued Sunday, after negotiations stalled, Deb Catsavas, Kaiser’s regional senior vice president of human resources, said the Oakland-based company has “the deepest appreciation and gratitude for our mental health professionals and the extraordinary care they provide to our members.” But, she noted, “there are not enough mental health care professionals to meet the increased demand for care,” both locally and nationwide.\u003c/p>\n\u003cp>The company has hired “nearly 200 new clinicians since January 2021” and launched a $500,000 initiative to recruit new mental health practitioners, Catsavas added.\u003c/p>\n\u003cp>“Despite the union’s harmful tactics, we remain committed to bargaining in good faith to reach a fair and equitable agreement that is good for our therapists and our patients,” she said.\u003c/p>\n\u003cp>In negotiations, the union accepted Kaiser’s wage-increase offer, but held fast on its demand that nine hours per week — up from the current six hours — be allotted for administrative work. Kaiser, however, rejected that demand, arguing it would not leave adequate time to see patients. Its counteroffer, of an additional 1.2 hours for that work, was flatly rejected.\u003c/p>\n\u003cp>California law requires health care providers like Kaiser to offer patients timely care even during labor strikes, and state regulators say they are closely monitoring consumer complaints about the company’s compliance. Kaiser has said it will prioritize urgent mental health situations, but may have to reschedule some ongoing appointments.\u003c/p>\n\u003cp>Oakland City Councilmember Dan Kalb, who joined Oakland staffers on the picket line on Tuesday, said mental health care has been undervalued for far too long.\u003c/p>\n\u003cp>“Mental health care is health care. And (it) needs to stop being seen as the stepchild of health care,” Kalb said, pointing to the longstanding demand for services that has only further escalated since the start of the COVID-19 pandemic. “Kaiser should be ashamed of themselves for not staffing up the mental health care clinicians that they need and not paying them a fair wage. It’s inexcusable.”\u003c/p>\n\u003cp>Kalb called for “unanimous support” for mental health workers, not just at Kaiser, but in all health care settings “to make sure that there are enough health care workers everywhere to meet the needs that people have.”\u003c/p>\n\u003cp>\u003cem>KQED’s Matthew Green contributed reporting.\u003c/em> \u003c/p>\u003c/div>",
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"content": "\u003cp>Some 2,000 Kaiser Permanente psychologists, therapists, social workers and chemical dependency counselors in Northern California began what they called an “open-ended” strike Monday over staffing shortages that their union said have overwhelmed workers and resulted in patients waiting months to get help. Workers formed picket lines at Kaiser facilities in San Francisco, San José, Fresno and Sacramento.\u003c/p>\n\u003cp>The National Union of Healthcare Workers, which represents the workers, is negotiating a new contract with the Oakland-based health care giant, and demanding the company hire more mental health workers to ease the burden placed on current staff. The union said negotiations with management ended without resolution this weekend.\u003c/p>\n\u003cp>Kaiser rejected “union proposals to increase staffing and end dangerously long waits for mental health therapy appointments,” organizers said in a statement Sunday.\u003c/p>\n\u003cp>“We’ve been telling Kaiser executives since Day One that this isn’t about money,” said Jennifer Browning, a Kaiser social worker in Roseville, and part of the union’s bargaining team, noting that organizers did accept Kaiser’s wage-increase offer. “It’s about our professional integrity and our ability to provide care that will help patients get better.”\u003c/p>\n\u003cp>At a picket line outside a Kaiser center in San Francisco on Monday, employees held signs that read “patients over profits.”\u003c/p>\n\u003cp>[ad fullwidth]\u003c/p>\n\u003cp>Jeffery Chen-Harding, a clinical social worker with Kaiser who was picketing there, said his patients are having to wait longer and longer for care.\u003c/p>\n\u003cp>[aside postID=\"news_11921580\" hero='https://ww2.kqed.org/app/uploads/sites/10/2022/08/RS40555_KAISER-MENTAL-HEALTH-CASES-photo-qut-1020x680.jpg']“We have people waiting six to eight weeks to get an appointment,” he said.\u003c/p>\n\u003cp>Petaluma clinical psychologist Alexis Petrakis, also picketing in San Francisco, echoed Chen-Harding’s comments about the wait times, describing her caseloads as unrelenting.\u003c/p>\n\u003cp>“I meet somebody new, they tell me their story, and maybe they even are honest about trauma that they’ve experienced,” she said. “I try to find a 30-minute phone call just to check in, but it’s not the care that I know that they deserve.”\u003c/p>\n\u003cp>Deb Catsavas, Kaiser’s senior vice president of human resources in Northern California, said in a statement Sunday that \u003ca href=\"https://about.kaiserpermanente.org/who-we-are/labor-relations/committed-to-reaching-a-fair-and-equitable-agreement\">the company has hired hundreds of new mental health workers\u003c/a>, including 200 since January 2021. She also pointed out that the shortage in mental health care professionals is happening nationwide.\u003c/p>\n\u003cp>There are two main issues, Catsavas noted. “One is wage increases and the other is the union’s demand to increase the time therapists spend on tasks other than seeing patients,” she said. “The primary role — and essential need — for our therapists is to provide mental health care and treat our patients.”\u003c/p>\n\u003cp>The union is demanding that nine hours per week be allotted for administrative work, which would leave only 31 hours to see patients, the company said. It said it proposed increasing the time for administrative tasks from 6 to 7.2 hours, leaving 32.8 hours to see patients.\u003c/p>\n\u003cp>“Our patients cannot afford a proposal that significantly reduces the time available to care for them and their mental health needs,” Catsavas said. “In recognition of our therapists’ concerns and priorities, we have proposed an increase in the scheduled time allocated to administrative tasks, but the union is demanding still more administrative time.”\u003c/p>\n\u003cp>But Chen-Harding argued that the time in question is actually important work related to patient care.\u003c/p>\n\u003cp>“What they’re calling administrative time, it’s actually time when I am calling people who are in a crisis. It may be time when I am learning about the patient that I’m about to meet with,” he said.\u003c/p>\n\u003cp>A shortage in mental health clinicians has been a sticking point between the company and the union for years. In December 2019, Kaiser mental health care workers held a five-day strike over staffing shortages.\u003c/p>\n\u003cp>Catsavas said Kaiser recently reached an agreement with the same union in Southern California, representing about 1,900 mental health professionals.\u003c/p>\n\u003cp>Kaiser said some clinicians will remain on the job during the strike. It also has expanded its network of “high-quality community providers and will continue to prioritize urgent and emergency care” through the duration of the strike, it said, adding that some nonurgent appointments may need to be rescheduled and patients whose appointments may be affected will be contacted directly prior to the date of the appointment.\u003c/p>\n\u003cp>The union said state law requires Kaiser to pay for out-of-network services if it’s unable to provide urgent mental health appointments within 48 hours, and nonurgent appointments within 10 business days, unless the therapist determines that a longer wait would not be detrimental to the patient’s health.\u003c/p>\n\u003cp>No date has been set for further negotiations.\u003c/p>\n\u003cp>\u003c/p>\n\u003cp>\u003cem>This story includes reporting from The Associated Press, Bay City News and KQED’s Lesley McClurg.\u003c/em>\u003c/p>\n\n",
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"excerpt": "The National Union of Healthcare Workers, which represents Kaiser mental health employees, is demanding the company hire more personnel to ease the burden on current staff and lessen appointment wait times for patients.",
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"title": "Kaiser Mental Health Workers in Northern California Begin 'Open-Ended' Strike Over Staffing Shortages | KQED",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003cp>Some 2,000 Kaiser Permanente psychologists, therapists, social workers and chemical dependency counselors in Northern California began what they called an “open-ended” strike Monday over staffing shortages that their union said have overwhelmed workers and resulted in patients waiting months to get help. Workers formed picket lines at Kaiser facilities in San Francisco, San José, Fresno and Sacramento.\u003c/p>\n\u003cp>The National Union of Healthcare Workers, which represents the workers, is negotiating a new contract with the Oakland-based health care giant, and demanding the company hire more mental health workers to ease the burden placed on current staff. The union said negotiations with management ended without resolution this weekend.\u003c/p>\n\u003cp>Kaiser rejected “union proposals to increase staffing and end dangerously long waits for mental health therapy appointments,” organizers said in a statement Sunday.\u003c/p>\n\u003cp>“We’ve been telling Kaiser executives since Day One that this isn’t about money,” said Jennifer Browning, a Kaiser social worker in Roseville, and part of the union’s bargaining team, noting that organizers did accept Kaiser’s wage-increase offer. “It’s about our professional integrity and our ability to provide care that will help patients get better.”\u003c/p>\n\u003cp>At a picket line outside a Kaiser center in San Francisco on Monday, employees held signs that read “patients over profits.”\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>Jeffery Chen-Harding, a clinical social worker with Kaiser who was picketing there, said his patients are having to wait longer and longer for care.\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"content": "\u003cdiv class=\"post-body\">\u003cp>“We have people waiting six to eight weeks to get an appointment,” he said.\u003c/p>\n\u003cp>Petaluma clinical psychologist Alexis Petrakis, also picketing in San Francisco, echoed Chen-Harding’s comments about the wait times, describing her caseloads as unrelenting.\u003c/p>\n\u003cp>“I meet somebody new, they tell me their story, and maybe they even are honest about trauma that they’ve experienced,” she said. “I try to find a 30-minute phone call just to check in, but it’s not the care that I know that they deserve.”\u003c/p>\n\u003cp>Deb Catsavas, Kaiser’s senior vice president of human resources in Northern California, said in a statement Sunday that \u003ca href=\"https://about.kaiserpermanente.org/who-we-are/labor-relations/committed-to-reaching-a-fair-and-equitable-agreement\">the company has hired hundreds of new mental health workers\u003c/a>, including 200 since January 2021. She also pointed out that the shortage in mental health care professionals is happening nationwide.\u003c/p>\n\u003cp>There are two main issues, Catsavas noted. “One is wage increases and the other is the union’s demand to increase the time therapists spend on tasks other than seeing patients,” she said. “The primary role — and essential need — for our therapists is to provide mental health care and treat our patients.”\u003c/p>\n\u003cp>The union is demanding that nine hours per week be allotted for administrative work, which would leave only 31 hours to see patients, the company said. It said it proposed increasing the time for administrative tasks from 6 to 7.2 hours, leaving 32.8 hours to see patients.\u003c/p>\n\u003cp>“Our patients cannot afford a proposal that significantly reduces the time available to care for them and their mental health needs,” Catsavas said. “In recognition of our therapists’ concerns and priorities, we have proposed an increase in the scheduled time allocated to administrative tasks, but the union is demanding still more administrative time.”\u003c/p>\n\u003cp>But Chen-Harding argued that the time in question is actually important work related to patient care.\u003c/p>\n\u003cp>“What they’re calling administrative time, it’s actually time when I am calling people who are in a crisis. It may be time when I am learning about the patient that I’m about to meet with,” he said.\u003c/p>\n\u003cp>A shortage in mental health clinicians has been a sticking point between the company and the union for years. In December 2019, Kaiser mental health care workers held a five-day strike over staffing shortages.\u003c/p>\n\u003cp>Catsavas said Kaiser recently reached an agreement with the same union in Southern California, representing about 1,900 mental health professionals.\u003c/p>\n\u003cp>Kaiser said some clinicians will remain on the job during the strike. It also has expanded its network of “high-quality community providers and will continue to prioritize urgent and emergency care” through the duration of the strike, it said, adding that some nonurgent appointments may need to be rescheduled and patients whose appointments may be affected will be contacted directly prior to the date of the appointment.\u003c/p>\n\u003cp>The union said state law requires Kaiser to pay for out-of-network services if it’s unable to provide urgent mental health appointments within 48 hours, and nonurgent appointments within 10 business days, unless the therapist determines that a longer wait would not be detrimental to the patient’s health.\u003c/p>\n\u003cp>No date has been set for further negotiations.\u003c/p>\n\u003cp>\u003c/p>\n\u003cp>\u003cem>This story includes reporting from The Associated Press, Bay City News and KQED’s Lesley McClurg.\u003c/em>\u003c/p>\n\n\u003c/div>\u003c/p>",
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"slug": "county-officials-are-skeptical-over-gov-newsoms-care-court-program",
"title": "County Officials Are Skeptical Over Gov. Newsom's CARE Court Program",
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"headTitle": "County Officials Are Skeptical Over Gov. Newsom’s CARE Court Program | KQED",
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"content": "\u003cp>In early March, Gov. Gavin Newsom unveiled a controversial proposal to compel people with serious mental health issues into care and housing.\u003c/p>\n\u003cp>Mental health advocates, mayors and family members who stood alongside him at the press conference at a San José behavioral health treatment program heralded the plan, known as CARE Court, as a visionary move.\u003c/p>\n\u003cp>But some county officials say they were stunned.\u003c/p>\n\u003cp>“They really sprung it on everybody,” said Farah McDaid Ting, public affairs director at the California State Association of Counties, who said lawmakers didn’t consult with or even give her organization a heads-up.[pullquote size=\"medium\" align=\"right\" citation=\"Margot Kushel, director, Benioff Homelessness and Housing Initiative, Zuckerberg San Francisco General Hospital and Trauma Center\"]‘I worry if it houses some but leaves others out, are we just reshuffling things?’[/pullquote]\u003c/p>\n\u003cp>Four months later, the bill to establish CARE Court has sailed through all of its policy committees in the Legislature, secured unanimous approval from the Senate in May and is widely expected to become law later this summer. CARE Court — short for \u003ca href=\"https://www.gov.ca.gov/2022/03/03/governor-newsom-launches-new-plan-to-help-californians-struggling-with-mental-health-challenges-homelessness/\">Community Assistance, Recovery and Empowerment Court\u003c/a> — has garnered enthusiastic support from leaders of more than 45 cities, many of whom face fiery criticism over their handling of homelessness. Many family members, who for decades have felt stymied by strict eligibility rules for conservatorship, also are celebrating the new plan.\u003c/p>\n\u003cp>But county representatives continue to ring alarm bells about their ability to implement the proposal, especially as an aggressive timeline comes into focus. A handful of counties have registered support for the proposal, including Marin, Contra Costa and San Diego.\u003c/p>\n\u003cp>Many of the counties’ concerns come in the form of questions: Will the necessary housing be available? Where can they find the outreach workers and therapists needed to serve the population, given massive statewide shortages of both? What happens to all the struggling people who want housing and treatment, and already can’t get it?\u003c/p>\n\u003cp>Disability rights advocates are raising fundamental questions about the very premise of CARE Court: Is it effective to compel people into care? Is involuntary treatment a violation of their civil rights?\u003c/p>\n\u003cp>But many of those who support the concept say the more practical questions feel especially pressing right now, as the Legislature continues its deliberations. While many details are still in flux, the gist of the proposal remains the same as initially outlined. Anyone from family members to first responders could petition a civil court to create a court-ordered care plan for people who meet specific criteria.\u003c/p>\n\u003cp>These include a diagnosis of schizophrenia or other psychotic disorders, along with being at risk of harming themselves or others or being unlikely to survive on their own. Participants would receive legal counsel and a range of mental health services, medication and supportive housing. Following a series of check-ins during a yearlong period, the participant could either graduate or be referred to an additional year of treatment. If a person refuses to comply, or “fails out,” they could be considered by the court for \u003ca href=\"https://calmatters.org/justice/2021/07/britney-spears-conservatorship/\">conservatorship\u003c/a>.\u003c/p>\n\u003cp>Conversations about CARE Court have been peppered with frequent references to people living on California’s sidewalks and under its freeway overpasses. But the administration hasn’t been clear about how much of a dent the proposal would make in the state’s massive homelessness crisis. Prior to the pandemic, more than 161,000 people in the state were estimated to be homeless on any given night; that number has likely grown since. The administration says the program will serve 7,000 to 12,000 people with the most acute mental health needs. Homelessness isn’t a prerequisite to participate.[aside postID=\"news_11916040,news_11914873\" label=\"Related Posts\"]The administration also says the proposal represents a crucial step toward addressing one of the state’s great moral and policy failings: the vast ranks of unhoused people languishing with serious mental illness and without care.\u003c/p>\n\u003cp>“What CARE Court is saying is we must create a pathway wherein these individuals that live in the shadows and often die in the shadows become a priority group,” said Dr. Mark Ghaly, secretary of the California Health and Human Services Agency, who has been championing the program on behalf of the Newsom administration.\u003c/p>\n\u003cp>CARE Court’s supporters say no more time can be wasted. Judge Stephen Manley, who started the state’s first mental health court in Santa Clara County nearly 25 years ago, notes the growing percentage of people in local jails and prisons with serious mental illnesses. Only by mandating that counties prioritize this population, he said, will anything change.\u003c/p>\n\u003cp>“People are always telling me it can’t be done,” he said. “To me it is a tragedy that we repeatedly, year after year after year after year, talk about this issue, do nothing, and all these individuals end up in the criminal justice system.”\u003c/p>\n\u003ch2>Is there enough housing or will there be?\u003c/h2>\n\u003cp>Perhaps the most prominent question that has emerged among legislators and advocates is whether there is enough housing available to get the CARE Court program started.\u003c/p>\n\u003cp>Short answer: No.\u003c/p>\n\u003cp>But the state believes that bringing CARE Court participants to the front of the line, along with making unprecedented investments in housing this year, will allow counties to meet the needs of this population. Opponents fear others awaiting voluntary services will be bumped to the back of the line, leaving their needs to intensify.\u003c/p>\n\u003cp>“I worry if it houses some but leaves others out, are we just reshuffling things?” said Margot Kushel, director of the Benioff Homelessness and Housing Initiative at Zuckerberg San Francisco General Hospital and Trauma Center.\u003c/p>\n\u003cp>While the new budget deal includes $65 million this year and $49 million in ongoing annual funding to cover training, court costs and legal representation, counties say the proposal doesn’t include any new funding for housing or services.\u003c/p>\n\u003cp>“There’s a new door being built onto a small house,” Ting said. “There’s no square footage, there’s no nothing, just a new door. That’s what’s kind of frustrating about the premise.”\u003c/p>\n\u003cp>The administration points skeptics to a $14 billion multiyear homelessness budget put together before the proposal’s announcement — which includes about $5 billion to build thousands of mental health treatment beds and homeless housing. This year’s budget includes $1.5 billion for interim treatment beds to hold patients over while permanent units come online. In response to counties’ concerns that even the bridge beds won’t be ready in time, the bill’s authors recently said counties would be phased into the program over two years, starting in July 2023.\u003c/p>\n\u003cp>Sen. Susan Talamantes Eggman, the bill’s co-author and a Stockton Democrat, says she believes counties are unhappy with the proposal because it finally holds them to account. It requires that they provide the care and housing a participant needs and, if they don’t, face court fines of $1,000 per day. The money, collected by the state treasury, would eventually fund local services for the people CARE Court targets.\u003c/p>\n\u003cp>“We’re not just saying the person has the obligation to accept, we’re saying the system has the obligation to treat,” Eggman said during a recent hearing.\u003c/p>\n\u003cp>Counties counter that these penalties will only take away from their already limited resources to treat people.\u003c/p>\n\u003cp>While the bill says a county has to provide services during the program, courts can’t enforce a participant’s post-graduation plans. Advocates worry that without guaranteed housing, people will wind up back on the streets, in emergency rooms and county jails.\u003c/p>\n\u003cp>“We’re going to release them back into the streets but we expect them to continue to adhere to the care plan and continue to be taking medication,” said Shonique Williams, a statewide organizer for Dignity and Power Now, who opposes the proposal. “But they’re going back into survival mode.”\u003c/p>\n\u003cp>The state doesn’t keep any sort of waitlist or even a count of treatment beds and housing that’s available to people exiting homelessness. As a result, it’s impossible to gauge the exact shortage in each county.\u003c/p>\n\u003cp>But a state-commissioned report released in January found that \u003ca href=\"https://www.dhcs.ca.gov/Pages/Assessing-the-Continuum-of-Care-for-Behavioral-Health-Services-in-California.aspx\">more than 80% of counties need more mental health treatment beds and homeless housing\u003c/a>. A 2021 study from the RAND Corporation, a nonprofit think tank\u003cstrong>,\u003c/strong> showed \u003ca href=\"https://www.rand.org/pubs/research_reports/RRA1824-1-v2.html\">the state lacks 5,000 psychiatric hospital beds and another 3,000 beds at residential treatment facilities and board-and-care homes\u003c/a>. The shortage is most pronounced in the San Joaquin Valley and for patients with additional medical needs.\u003c/p>\n\u003cp>Michelle Doty Cabrera, executive director of the California Behavioral Health Directors Association, said one recent survey showed counties had 14,000 unhoused individuals with serious mental illnesses voluntarily participating in full service partnership programs. But they couldn’t find housing for more than half of these individuals, in part because many were screened out for reasons related to their mental health conditions, she said.\u003c/p>\n\u003cp>In Sacramento County, beds are increasingly rare at board-and-care facilities, where residents receive housing, 24-hour care and three daily meals.\u003c/p>\n\u003cp>“It is a needle in a haystack right now,” said Terry Fiscus, a behavioral health worker at Turning Point, which contracts with the county.\u003c/p>\n\u003cp>The less calm and rule-abiding the patient, the less chance they have of getting or keeping a spot, he said. On top of that, \u003ca href=\"https://calmatters.org/projects/board-and-care-homes-closing-in-california-mental-health-crisis/\">facilities have been closing at a rapid clip\u003c/a> as housing prices soar and government-set reimbursement rates remain stagnant.\u003c/p>\n\u003cp>“There are a lot of people that want to come in all the time. We cannot take them,” said Jeanny Leung, who runs a board-and-care home in Sacramento.\u003c/p>\n\u003cfigure id=\"attachment_11919832\" class=\"wp-caption aligncenter\" style=\"max-width: 800px\">\u003ca href=\"https://ww2.kqed.org/app/uploads/sites/10/2022/07/Screen-Shot-2022-07-18-at-4.32.06-PM.png\">\u003cimg loading=\"lazy\" decoding=\"async\" class=\"size-medium wp-image-11919832\" src=\"https://ww2.kqed.org/app/uploads/sites/10/2022/07/Screen-Shot-2022-07-18-at-4.32.06-PM-800x526.png\" alt=\"A woman wearing a purple/pink shirt with designs stands outside with bushes behind her.\" width=\"800\" height=\"526\" srcset=\"https://cdn.kqed.org/wp-content/uploads/sites/10/2022/07/Screen-Shot-2022-07-18-at-4.32.06-PM-800x526.png 800w, https://cdn.kqed.org/wp-content/uploads/sites/10/2022/07/Screen-Shot-2022-07-18-at-4.32.06-PM-1020x671.png 1020w, https://cdn.kqed.org/wp-content/uploads/sites/10/2022/07/Screen-Shot-2022-07-18-at-4.32.06-PM-160x105.png 160w, https://cdn.kqed.org/wp-content/uploads/sites/10/2022/07/Screen-Shot-2022-07-18-at-4.32.06-PM-1536x1011.png 1536w, https://cdn.kqed.org/wp-content/uploads/sites/10/2022/07/Screen-Shot-2022-07-18-at-4.32.06-PM.png 1544w\" sizes=\"(max-width: 800px) 100vw, 800px\">\u003c/a>\u003cfigcaption class=\"wp-caption-text\">Jeanny Leung outside Praise Care Home in Sacramento on Thursday, June 23, 2022. \u003ccite>(Nina Riggio/CalMatters)\u003c/cite>\u003c/figcaption>\u003c/figure>\n\u003ch2>‘Squeezing blood from a turnip’\u003c/h2>\n\u003cp>Housing isn’t the only big concern counties are raising. To run, CARE Court requires staff and resources.\u003c/p>\n\u003cp>Some counties say they fear that, without new funding, the program will end up draining resources from other populations, potentially including children and youth.\u003c/p>\n\u003cp>Cabrera, of the California Behavioral Health Directors Association, uses phrases like “squeezing blood from a turnip” and “robbing Peter to pay Paul.”\u003c/p>\n\u003cp>“We’re at our limit in terms of what we can do,” she said. “We need more resources to do more.”\u003c/p>\n\u003cp>The proposal’s proponents argue that there’s plenty of money to get things up and running. They say county mental health systems have had a huge influx of taxpayer dollars in the past two years, thanks to the Mental Health Services Act, a 1% tax on incomes over $1 million that was enacted in 2004.\u003c/p>\n\u003cp>“Our millionaires in California seem to be doing very well for themselves,” said Karen Larsen, CEO of the Steinberg Institute, a nonprofit focusing on mental health policy, which supports the proposal. She notes that revenues from the tax have hit historic highs — they were at more than $4 billion this past year.\u003c/p>\n\u003cp>For two decades prior to assuming her current role, Larsen served as director of Yolo County’s Health and Human Services Agency. She believes counties can afford the costs of the new program.\u003c/p>\n\u003cp>“If they can prove they don’t have enough resources, I’d love to see it,” she said.\u003c/p>\n\u003cp>Phebe Bell, Nevada County’s behavioral health director, said she was indeed able to tap the influx of Mental Health Services Act funding to purchase a new house, providing beds for six people who were unhoused. But strict rules often limit what that pot of money can be used for, she said.\u003c/p>\n\u003cp>If the county has to pivot to focus on CARE Court mandates, she worries about who won’t be served.\u003c/p>\n\u003cp>“Many of our people are only stable because we have someone coming twice a day to deliver their meds and check in with them and make sure their furniture is upright,” she said.\u003c/p>\n\u003cp>When her county examined their full service partnership program, they found that more than a third of the 78 people in their program at any given moment were inadequately housed, with many sleeping on the streets.\u003c/p>\n\u003cp>“I don’t have a single empty bed in our system of care,” she said. “Who exactly are we incorrectly prioritizing in our work right now?”\u003c/p>\n\u003cp>Both sides agree on one specific challenge: a massive shortage of mental health providers.\u003c/p>\n\u003cp>At the beginning of the pandemic, many counties worried they’d face significant shortfalls and preemptively laid off mental health workers.\u003c/p>\n\u003cp>Now, as need surges, staffing has simply not kept pace. Counties are finding themselves losing bidding wars for therapists being courted by everyone from school districts to telehealth start-ups to major providers like Kaiser. Burnout is driving others from the field entirely.\u003c/p>\n\u003cp>Some counties now face vacancy rates of 30% to 40% in their behavioral health workforce, and many of the nonprofits they contract with are in the same situation, Larsen said.\u003c/p>\n\u003cp>“I think it’s the biggest issue we face in mental health and substance use right now,” she said.\u003c/p>\n\u003cp>This year’s budget includes $1.5 billion to build out the state’s entire health care workforce, including hundreds of millions that target behavioral health.\u003c/p>\n\u003cp>The state’s public guardians and conservators also have eyed the CARE Court proposal warily. While they are not officially affected by the proposal, they say they expect the program could lead to a surge in new referrals.\u003c/p>\n\u003cp>The programs are already severely underfunded and understaffed, said Scarlet Hughes, executive director of the California State Association of Public Administrators, Public Guardians, and Public Conservators. Right now, caseloads hover at 65 to 85 individuals per caseworker, though in some counties they’re as high as 135. That translates into visiting a client every three or four months, she said.\u003c/p>\n\u003cp>“Any impact to our members is going to be significant because they’re underwater already,” she said.\u003c/p>\n\u003ch2>What’s next?\u003c/h2>\n\u003cp>Questions over implementation, in addition to the ongoing debate over civil liberties, have been woven through CARE Court’s journey from the start. That hasn’t stopped the Legislature from voting overwhelmingly in the bill’s favor. It is expected to easily clear its final hurdles: an appropriations vote later this summer, a floor-wide vote in the Assembly and a signature from the author, the governor himself.\u003c/p>\n\u003cp>But despite their ongoing questions, counties have conceded that CARE Court is coming whether they like it or not. They know they’re not likely getting any more money for housing and staffing. For now, they’re using the appropriations process to \u003ca href=\"https://www.counties.org/sites/main/files/file-attachments/sb_1338_joint_concerns_asm_approps_letter_7-13-22.pdf?1657743565\">petition for more time and tools\u003c/a> to implement the program.\u003c/p>\n\u003cp>The administration acknowledges that counties around the state face severe shortages. But it remains committed to the idea of a better way to serve the people who are struggling the most.\u003c/p>\n\u003cp>“California has done this before,” Ghaly said. “We’ve stepped up for the most vulnerable, the most overlooked many, many times. And we can do it again.”\u003c/p>\n\u003cp>[ad fullwidth]\u003c/p>\n\u003cp>[ad floatright]\u003c/p>\n",
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"excerpt": "While lawmakers are still enthusiastic about Gov. Gavin Newsom's CARE Court, county officials are worried they don't have the resources to implement the idea.",
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"title": "County Officials Are Skeptical Over Gov. Newsom's CARE Court Program | KQED",
"description": "While lawmakers are still enthusiastic about Gov. Gavin Newsom's CARE Court, county officials are worried they don't have the resources to implement the idea.",
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"headline": "County Officials Are Skeptical Over Gov. Newsom's CARE Court Program",
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"nprByline": "\u003ca href=\"https://calmatters.org/author/jocelyn-wiener/\">Jocelyn Wiener\u003c/a> and \u003ca href=\"https://calmatters.org/author/manuela-tobias/\">Manuela Tobias\u003c/a>",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003cp>In early March, Gov. Gavin Newsom unveiled a controversial proposal to compel people with serious mental health issues into care and housing.\u003c/p>\n\u003cp>Mental health advocates, mayors and family members who stood alongside him at the press conference at a San José behavioral health treatment program heralded the plan, known as CARE Court, as a visionary move.\u003c/p>\n\u003cp>But some county officials say they were stunned.\u003c/p>\n\u003cp>“They really sprung it on everybody,” said Farah McDaid Ting, public affairs director at the California State Association of Counties, who said lawmakers didn’t consult with or even give her organization a heads-up.\u003c/p>\u003c/div>",
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"content": "‘I worry if it houses some but leaves others out, are we just reshuffling things?’",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>Four months later, the bill to establish CARE Court has sailed through all of its policy committees in the Legislature, secured unanimous approval from the Senate in May and is widely expected to become law later this summer. CARE Court — short for \u003ca href=\"https://www.gov.ca.gov/2022/03/03/governor-newsom-launches-new-plan-to-help-californians-struggling-with-mental-health-challenges-homelessness/\">Community Assistance, Recovery and Empowerment Court\u003c/a> — has garnered enthusiastic support from leaders of more than 45 cities, many of whom face fiery criticism over their handling of homelessness. Many family members, who for decades have felt stymied by strict eligibility rules for conservatorship, also are celebrating the new plan.\u003c/p>\n\u003cp>But county representatives continue to ring alarm bells about their ability to implement the proposal, especially as an aggressive timeline comes into focus. A handful of counties have registered support for the proposal, including Marin, Contra Costa and San Diego.\u003c/p>\n\u003cp>Many of the counties’ concerns come in the form of questions: Will the necessary housing be available? Where can they find the outreach workers and therapists needed to serve the population, given massive statewide shortages of both? What happens to all the struggling people who want housing and treatment, and already can’t get it?\u003c/p>\n\u003cp>Disability rights advocates are raising fundamental questions about the very premise of CARE Court: Is it effective to compel people into care? Is involuntary treatment a violation of their civil rights?\u003c/p>\n\u003cp>But many of those who support the concept say the more practical questions feel especially pressing right now, as the Legislature continues its deliberations. While many details are still in flux, the gist of the proposal remains the same as initially outlined. Anyone from family members to first responders could petition a civil court to create a court-ordered care plan for people who meet specific criteria.\u003c/p>\n\u003cp>These include a diagnosis of schizophrenia or other psychotic disorders, along with being at risk of harming themselves or others or being unlikely to survive on their own. Participants would receive legal counsel and a range of mental health services, medication and supportive housing. Following a series of check-ins during a yearlong period, the participant could either graduate or be referred to an additional year of treatment. If a person refuses to comply, or “fails out,” they could be considered by the court for \u003ca href=\"https://calmatters.org/justice/2021/07/britney-spears-conservatorship/\">conservatorship\u003c/a>.\u003c/p>\n\u003cp>Conversations about CARE Court have been peppered with frequent references to people living on California’s sidewalks and under its freeway overpasses. But the administration hasn’t been clear about how much of a dent the proposal would make in the state’s massive homelessness crisis. Prior to the pandemic, more than 161,000 people in the state were estimated to be homeless on any given night; that number has likely grown since. The administration says the program will serve 7,000 to 12,000 people with the most acute mental health needs. Homelessness isn’t a prerequisite to participate.\u003c/p>\u003c/div>",
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"content": "\u003cdiv class=\"post-body\">\u003cp>The administration also says the proposal represents a crucial step toward addressing one of the state’s great moral and policy failings: the vast ranks of unhoused people languishing with serious mental illness and without care.\u003c/p>\n\u003cp>“What CARE Court is saying is we must create a pathway wherein these individuals that live in the shadows and often die in the shadows become a priority group,” said Dr. Mark Ghaly, secretary of the California Health and Human Services Agency, who has been championing the program on behalf of the Newsom administration.\u003c/p>\n\u003cp>CARE Court’s supporters say no more time can be wasted. Judge Stephen Manley, who started the state’s first mental health court in Santa Clara County nearly 25 years ago, notes the growing percentage of people in local jails and prisons with serious mental illnesses. Only by mandating that counties prioritize this population, he said, will anything change.\u003c/p>\n\u003cp>“People are always telling me it can’t be done,” he said. “To me it is a tragedy that we repeatedly, year after year after year after year, talk about this issue, do nothing, and all these individuals end up in the criminal justice system.”\u003c/p>\n\u003ch2>Is there enough housing or will there be?\u003c/h2>\n\u003cp>Perhaps the most prominent question that has emerged among legislators and advocates is whether there is enough housing available to get the CARE Court program started.\u003c/p>\n\u003cp>Short answer: No.\u003c/p>\n\u003cp>But the state believes that bringing CARE Court participants to the front of the line, along with making unprecedented investments in housing this year, will allow counties to meet the needs of this population. Opponents fear others awaiting voluntary services will be bumped to the back of the line, leaving their needs to intensify.\u003c/p>\n\u003cp>“I worry if it houses some but leaves others out, are we just reshuffling things?” said Margot Kushel, director of the Benioff Homelessness and Housing Initiative at Zuckerberg San Francisco General Hospital and Trauma Center.\u003c/p>\n\u003cp>While the new budget deal includes $65 million this year and $49 million in ongoing annual funding to cover training, court costs and legal representation, counties say the proposal doesn’t include any new funding for housing or services.\u003c/p>\n\u003cp>“There’s a new door being built onto a small house,” Ting said. “There’s no square footage, there’s no nothing, just a new door. That’s what’s kind of frustrating about the premise.”\u003c/p>\n\u003cp>The administration points skeptics to a $14 billion multiyear homelessness budget put together before the proposal’s announcement — which includes about $5 billion to build thousands of mental health treatment beds and homeless housing. This year’s budget includes $1.5 billion for interim treatment beds to hold patients over while permanent units come online. In response to counties’ concerns that even the bridge beds won’t be ready in time, the bill’s authors recently said counties would be phased into the program over two years, starting in July 2023.\u003c/p>\n\u003cp>Sen. Susan Talamantes Eggman, the bill’s co-author and a Stockton Democrat, says she believes counties are unhappy with the proposal because it finally holds them to account. It requires that they provide the care and housing a participant needs and, if they don’t, face court fines of $1,000 per day. The money, collected by the state treasury, would eventually fund local services for the people CARE Court targets.\u003c/p>\n\u003cp>“We’re not just saying the person has the obligation to accept, we’re saying the system has the obligation to treat,” Eggman said during a recent hearing.\u003c/p>\n\u003cp>Counties counter that these penalties will only take away from their already limited resources to treat people.\u003c/p>\n\u003cp>While the bill says a county has to provide services during the program, courts can’t enforce a participant’s post-graduation plans. Advocates worry that without guaranteed housing, people will wind up back on the streets, in emergency rooms and county jails.\u003c/p>\n\u003cp>“We’re going to release them back into the streets but we expect them to continue to adhere to the care plan and continue to be taking medication,” said Shonique Williams, a statewide organizer for Dignity and Power Now, who opposes the proposal. “But they’re going back into survival mode.”\u003c/p>\n\u003cp>The state doesn’t keep any sort of waitlist or even a count of treatment beds and housing that’s available to people exiting homelessness. As a result, it’s impossible to gauge the exact shortage in each county.\u003c/p>\n\u003cp>But a state-commissioned report released in January found that \u003ca href=\"https://www.dhcs.ca.gov/Pages/Assessing-the-Continuum-of-Care-for-Behavioral-Health-Services-in-California.aspx\">more than 80% of counties need more mental health treatment beds and homeless housing\u003c/a>. A 2021 study from the RAND Corporation, a nonprofit think tank\u003cstrong>,\u003c/strong> showed \u003ca href=\"https://www.rand.org/pubs/research_reports/RRA1824-1-v2.html\">the state lacks 5,000 psychiatric hospital beds and another 3,000 beds at residential treatment facilities and board-and-care homes\u003c/a>. The shortage is most pronounced in the San Joaquin Valley and for patients with additional medical needs.\u003c/p>\n\u003cp>Michelle Doty Cabrera, executive director of the California Behavioral Health Directors Association, said one recent survey showed counties had 14,000 unhoused individuals with serious mental illnesses voluntarily participating in full service partnership programs. But they couldn’t find housing for more than half of these individuals, in part because many were screened out for reasons related to their mental health conditions, she said.\u003c/p>\n\u003cp>In Sacramento County, beds are increasingly rare at board-and-care facilities, where residents receive housing, 24-hour care and three daily meals.\u003c/p>\n\u003cp>“It is a needle in a haystack right now,” said Terry Fiscus, a behavioral health worker at Turning Point, which contracts with the county.\u003c/p>\n\u003cp>The less calm and rule-abiding the patient, the less chance they have of getting or keeping a spot, he said. On top of that, \u003ca href=\"https://calmatters.org/projects/board-and-care-homes-closing-in-california-mental-health-crisis/\">facilities have been closing at a rapid clip\u003c/a> as housing prices soar and government-set reimbursement rates remain stagnant.\u003c/p>\n\u003cp>“There are a lot of people that want to come in all the time. We cannot take them,” said Jeanny Leung, who runs a board-and-care home in Sacramento.\u003c/p>\n\u003cfigure id=\"attachment_11919832\" class=\"wp-caption aligncenter\" style=\"max-width: 800px\">\u003ca href=\"https://ww2.kqed.org/app/uploads/sites/10/2022/07/Screen-Shot-2022-07-18-at-4.32.06-PM.png\">\u003cimg loading=\"lazy\" decoding=\"async\" class=\"size-medium wp-image-11919832\" src=\"https://ww2.kqed.org/app/uploads/sites/10/2022/07/Screen-Shot-2022-07-18-at-4.32.06-PM-800x526.png\" alt=\"A woman wearing a purple/pink shirt with designs stands outside with bushes behind her.\" width=\"800\" height=\"526\" srcset=\"https://cdn.kqed.org/wp-content/uploads/sites/10/2022/07/Screen-Shot-2022-07-18-at-4.32.06-PM-800x526.png 800w, https://cdn.kqed.org/wp-content/uploads/sites/10/2022/07/Screen-Shot-2022-07-18-at-4.32.06-PM-1020x671.png 1020w, https://cdn.kqed.org/wp-content/uploads/sites/10/2022/07/Screen-Shot-2022-07-18-at-4.32.06-PM-160x105.png 160w, https://cdn.kqed.org/wp-content/uploads/sites/10/2022/07/Screen-Shot-2022-07-18-at-4.32.06-PM-1536x1011.png 1536w, https://cdn.kqed.org/wp-content/uploads/sites/10/2022/07/Screen-Shot-2022-07-18-at-4.32.06-PM.png 1544w\" sizes=\"(max-width: 800px) 100vw, 800px\">\u003c/a>\u003cfigcaption class=\"wp-caption-text\">Jeanny Leung outside Praise Care Home in Sacramento on Thursday, June 23, 2022. \u003ccite>(Nina Riggio/CalMatters)\u003c/cite>\u003c/figcaption>\u003c/figure>\n\u003ch2>‘Squeezing blood from a turnip’\u003c/h2>\n\u003cp>Housing isn’t the only big concern counties are raising. To run, CARE Court requires staff and resources.\u003c/p>\n\u003cp>Some counties say they fear that, without new funding, the program will end up draining resources from other populations, potentially including children and youth.\u003c/p>\n\u003cp>Cabrera, of the California Behavioral Health Directors Association, uses phrases like “squeezing blood from a turnip” and “robbing Peter to pay Paul.”\u003c/p>\n\u003cp>“We’re at our limit in terms of what we can do,” she said. “We need more resources to do more.”\u003c/p>\n\u003cp>The proposal’s proponents argue that there’s plenty of money to get things up and running. They say county mental health systems have had a huge influx of taxpayer dollars in the past two years, thanks to the Mental Health Services Act, a 1% tax on incomes over $1 million that was enacted in 2004.\u003c/p>\n\u003cp>“Our millionaires in California seem to be doing very well for themselves,” said Karen Larsen, CEO of the Steinberg Institute, a nonprofit focusing on mental health policy, which supports the proposal. She notes that revenues from the tax have hit historic highs — they were at more than $4 billion this past year.\u003c/p>\n\u003cp>For two decades prior to assuming her current role, Larsen served as director of Yolo County’s Health and Human Services Agency. She believes counties can afford the costs of the new program.\u003c/p>\n\u003cp>“If they can prove they don’t have enough resources, I’d love to see it,” she said.\u003c/p>\n\u003cp>Phebe Bell, Nevada County’s behavioral health director, said she was indeed able to tap the influx of Mental Health Services Act funding to purchase a new house, providing beds for six people who were unhoused. But strict rules often limit what that pot of money can be used for, she said.\u003c/p>\n\u003cp>If the county has to pivot to focus on CARE Court mandates, she worries about who won’t be served.\u003c/p>\n\u003cp>“Many of our people are only stable because we have someone coming twice a day to deliver their meds and check in with them and make sure their furniture is upright,” she said.\u003c/p>\n\u003cp>When her county examined their full service partnership program, they found that more than a third of the 78 people in their program at any given moment were inadequately housed, with many sleeping on the streets.\u003c/p>\n\u003cp>“I don’t have a single empty bed in our system of care,” she said. “Who exactly are we incorrectly prioritizing in our work right now?”\u003c/p>\n\u003cp>Both sides agree on one specific challenge: a massive shortage of mental health providers.\u003c/p>\n\u003cp>At the beginning of the pandemic, many counties worried they’d face significant shortfalls and preemptively laid off mental health workers.\u003c/p>\n\u003cp>Now, as need surges, staffing has simply not kept pace. Counties are finding themselves losing bidding wars for therapists being courted by everyone from school districts to telehealth start-ups to major providers like Kaiser. Burnout is driving others from the field entirely.\u003c/p>\n\u003cp>Some counties now face vacancy rates of 30% to 40% in their behavioral health workforce, and many of the nonprofits they contract with are in the same situation, Larsen said.\u003c/p>\n\u003cp>“I think it’s the biggest issue we face in mental health and substance use right now,” she said.\u003c/p>\n\u003cp>This year’s budget includes $1.5 billion to build out the state’s entire health care workforce, including hundreds of millions that target behavioral health.\u003c/p>\n\u003cp>The state’s public guardians and conservators also have eyed the CARE Court proposal warily. While they are not officially affected by the proposal, they say they expect the program could lead to a surge in new referrals.\u003c/p>\n\u003cp>The programs are already severely underfunded and understaffed, said Scarlet Hughes, executive director of the California State Association of Public Administrators, Public Guardians, and Public Conservators. Right now, caseloads hover at 65 to 85 individuals per caseworker, though in some counties they’re as high as 135. That translates into visiting a client every three or four months, she said.\u003c/p>\n\u003cp>“Any impact to our members is going to be significant because they’re underwater already,” she said.\u003c/p>\n\u003ch2>What’s next?\u003c/h2>\n\u003cp>Questions over implementation, in addition to the ongoing debate over civil liberties, have been woven through CARE Court’s journey from the start. That hasn’t stopped the Legislature from voting overwhelmingly in the bill’s favor. It is expected to easily clear its final hurdles: an appropriations vote later this summer, a floor-wide vote in the Assembly and a signature from the author, the governor himself.\u003c/p>\n\u003cp>But despite their ongoing questions, counties have conceded that CARE Court is coming whether they like it or not. They know they’re not likely getting any more money for housing and staffing. For now, they’re using the appropriations process to \u003ca href=\"https://www.counties.org/sites/main/files/file-attachments/sb_1338_joint_concerns_asm_approps_letter_7-13-22.pdf?1657743565\">petition for more time and tools\u003c/a> to implement the program.\u003c/p>\n\u003cp>The administration acknowledges that counties around the state face severe shortages. But it remains committed to the idea of a better way to serve the people who are struggling the most.\u003c/p>\n\u003cp>“California has done this before,” Ghaly said. “We’ve stepped up for the most vulnerable, the most overlooked many, many times. And we can do it again.”\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"slug": "a-new-mental-health-crisis-line-launches-on-saturday-is-california-ready-to-operate-it",
"title": "A New Mental Health Crisis Line Launches on Saturday. Is California Ready to Operate It?",
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"content": "\u003cp>A new three-digit mental health crisis line goes live in California and across the country on Saturday, July 16, offering help to people who are feeling suicidal or anxious, or are hearing voices.\u003c/p>\n\u003cp>The new, easier-to-remember number — 988 — will officially replace the longstanding 10-digit 800 number for the \u003ca href=\"https://988lifeline.org/current-events/the-lifeline-and-988/\">National Suicide Prevention Lifeline\u003c/a>. And in California, it will connect callers to one of 13 call centers in the state.\u003c/p>\n\u003cp>In addition to offering emotional support from trained counselors by phone or text, as the Lifeline has traditionally done for years, 988 also is intended to replace 911 for psychiatric emergencies — in which mental health staff, rather than police, would respond in person. The capacity to facilitate that by the upcoming launch date, however, will vary widely by region.\u003c/p>\n\u003cp>[pullquote align=\"right\" size=\"medium\" citation=\"Angela Kimball, senior vice president of policy and advocacy, Inseparable\"]‘Will it work perfectly? No, because changing crisis response won’t happen overnight. And it won’t happen without all of us demanding that policymakers at every level of government step up and invest.’[/pullquote]“Will it work perfectly? No, because changing crisis response won’t happen overnight,” says Angela Kimball, who directs advocacy at \u003ca href=\"https://www.inseparable.us/who-we-are/\">Inseparable\u003c/a>, a mental health policy coalition. “And it won’t happen without all of us demanding that policymakers at every level of government step up and invest.”\u003c/p>\n\u003cp>Rather than treating mental health crises as public safety issues warranting law enforcement — many of which have ended tragically — Kimball believes that the compassionate help her son, Alex, received in 2017 during a manic episode he was having should serve as a model for effective crisis response.\u003c/p>\n\u003cp>[ad fullwidth]\u003c/p>\n\u003cp>“He’d ripped out cabinets in his house. He’d smashed the stove into pieces with a sledgehammer,” Kimball said during a recent webinar on the 988 rollout. “He was telling me that soap was poison and that he was being surveilled. He accused me of conspiring with the government against him.”\u003c/p>\n\u003cp>With help from a friend, Kimball got through to a local mental health crisis line in Portland, Oregon, where Alex lives. A mobile team came to his house, calmed him down and convinced him to go to the hospital.\u003c/p>\n\u003cp>“An incredibly kind and wise clinician spoke gently and respectfully to Alex,” Kimball says. “They didn’t talk in terms that were clinical, like paranoia, delusions or rapid cycling, bipolar. Instead, the lead clinician said, ‘Alex, I’m hearing that you haven’t slept for days and that things are getting kind of intense. Am I getting that right?’”\u003c/p>\n\u003cp>While this is an ideal scenario for how the new crisis line could eventually work, it won’t be the reality in many counties in California for at least a few years. Some cities and counties, including a handful in the Bay Area, \u003ca href=\"https://myusf.usfca.edu/caps/self-help-resources/mobile-crisis\">have already started to build mobile crisis response teams\u003c/a>, but those vary widely in terms of capacity, hours of availability and the types of calls they respond to. Other areas of the state, though, have little or nothing in place, due in part to delays in federal funding. And that means that many callers who need immediate in-person help likely will be routed back to 911.\u003c/p>\n\u003cp>But such 911 intervention will be still be rare, says Michelle Doty Cabrera, executive director of the \u003ca href=\"https://static1.squarespace.com/static/5b1065c375f9ee699734d898/t/623e553b9b30c457a57fa405/1648252219303/CBHDA_988_Overview_March2022.pdf\">County Behavioral Health Directors Association of California\u003c/a>.\u003c/p>\n\u003cp>“When a person calls 911, they are expecting help to come to them,” she says. “If a person’s calling a national suicide prevention hotline for emotional support, they may not want anyone to know who they are, let alone where they’re at in that moment.”\u003c/p>\n\u003cp>For now, Cabrera adds, volunteers and staff at the call centers won’t be able to figure out where callers are located, even if they want to, because the system is organized by area code, not geographic location.\u003c/p>\n\u003cp>“So let’s say you moved to California from Washington, D.C., and you decided to keep your D.C. cellphone number,” Cabrera says. “You would be routed to the Washington, D.C., 988 call center, not to the one where you live, here in California. D.C. is not going to know anything about what local resources exist for you here and vice versa.”\u003c/p>\n\u003cp>[aside label=\"related coverage\" tag=\"mental-health\"]The 988 crisis line was created through \u003ca href=\"https://www.npr.org/sections/health-shots/2020/10/19/925447354/new-law-creates-988-hotline-for-mental-health-emergencies\">rare bipartisan federal legislation\u003c/a> enacted in October 2020, with the goal of improving access to suicide prevention and crisis resources. But the bill allocated only a minimal amount of funding for states to implement it. In December 2021, President Biden allocated $284 million to states for start-up costs like upgrading telephone infrastructure and hiring more staff for call centers. Some federal money also will be available next year through Medicaid to help build mobile crisis response teams.\u003c/p>\n\u003cp>For its part, California already has earmarked $28 million in the state budget to get the call centers ready. But like most other states, it will have to figure out how to sustain the service in the long term.\u003c/p>\n\u003cp>Under one recently introduced state bill — \u003ca href=\"https://leginfo.legislature.ca.gov/faces/billVotesClient.xhtml?bill_id=202120220AB988\">AB 988\u003c/a> — landline and mobile phone users in California would initially pay an additional $0.08 per line, per month, and up to $0.30 per month in future years. The telecom industry, however, opposes the bill, and its fate is unclear.\u003c/p>\n\u003cp>Some mental health advocates also argue investing money in the crisis line is not the best use of scarce mental health dollars. They say the government is placing too much attention on crisis response and not enough on crisis prevention — akin to pouring resources into treating heart attacks without doing enough to help people lower their cholesterol and blood pressure to prevent the heart attack in the first place.\u003c/p>\n\u003cp>“I have such a concern that we are creating a crisis-system-industrial-complex,” Keris Myrick, an advocate who has schizophrenia, says on an episode of her mental health podcast \u003ca href=\"https://unapologeticallyblackunicorns.podbean.com/\">Unapologetically Black Unicorns\u003c/a>.\u003c/p>\n\u003cp>It doesn’t make sense to wait until someone is about to fall off a cliff to help them, Myrick says, arguing that government programs and health systems need to intervene more effectively in the earlier stages of mental illness.\u003c/p>\n\u003cp>[ad floatright]\u003c/p>\n\u003cp>Crisis is more tangible, and easier for people to hold on to, she adds, saying, “And that’s maybe easier to resolve in the short term than the prevention stuff that becomes about fixing a lot of social ills.”\u003c/p>\n\n",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003cp>A new three-digit mental health crisis line goes live in California and across the country on Saturday, July 16, offering help to people who are feeling suicidal or anxious, or are hearing voices.\u003c/p>\n\u003cp>The new, easier-to-remember number — 988 — will officially replace the longstanding 10-digit 800 number for the \u003ca href=\"https://988lifeline.org/current-events/the-lifeline-and-988/\">National Suicide Prevention Lifeline\u003c/a>. And in California, it will connect callers to one of 13 call centers in the state.\u003c/p>\n\u003cp>In addition to offering emotional support from trained counselors by phone or text, as the Lifeline has traditionally done for years, 988 also is intended to replace 911 for psychiatric emergencies — in which mental health staff, rather than police, would respond in person. The capacity to facilitate that by the upcoming launch date, however, will vary widely by region.\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"order": 1
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"id": "code-switch-life-kit",
"title": "Code Switch / Life Kit",
"info": "\u003cem>Code Switch\u003c/em>, which listeners will hear in the first part of the hour, has fearless and much-needed conversations about race. Hosted by journalists of color, the show tackles the subject of race head-on, exploring how it impacts every part of society — from politics and pop culture to history, sports and more.\u003cbr />\u003cbr />\u003cem>Life Kit\u003c/em>, which will be in the second part of the hour, guides you through spaces and feelings no one prepares you for — from finances to mental health, from workplace microaggressions to imposter syndrome, from relationships to parenting. The show features experts with real world experience and shares their knowledge. Because everyone needs a little help being human.\u003cbr />\u003cbr />\u003ca href=\"https://www.npr.org/podcasts/510312/codeswitch\">\u003cem>Code Switch\u003c/em> offical site and podcast\u003c/a>\u003cbr />\u003ca href=\"https://www.npr.org/lifekit\">\u003cem>Life Kit\u003c/em> offical site and podcast\u003c/a>\u003cbr />",
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"meta": {
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"id": "commonwealth-club",
"title": "Commonwealth Club of California Podcast",
"info": "The Commonwealth Club of California is the nation's oldest and largest public affairs forum. As a non-partisan forum, The Club brings to the public airwaves diverse viewpoints on important topics. The Club's weekly radio broadcast - the oldest in the U.S., dating back to 1924 - is carried across the nation on public radio stations and is now podcasting. Our website archive features audio of our recent programs, as well as selected speeches from our long and distinguished history. This podcast feed is usually updated twice a week and is always un-edited.",
"airtime": "THU 10pm, FRI 1am",
"imageSrc": "https://cdn.kqed.org/wp-content/uploads/2024/04/Commonwealth-Club-Podcast-Tile-360x360-1.jpg",
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"meta": {
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"source": "Commonwealth Club of California"
},
"link": "/radio/program/commonwealth-club",
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"google": "https://podcasts.google.com/feed/aHR0cDovL3d3dy5jb21tb253ZWFsdGhjbHViLm9yZy9hdWRpby9wb2RjYXN0L3dlZWtseS54bWw",
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},
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"id": "forum",
"title": "Forum",
"tagline": "The conversation starts here",
"info": "KQED’s live call-in program discussing local, state, national and international issues, as well as in-depth interviews.",
"airtime": "MON-FRI 9am-11am, 10pm-11pm",
"imageSrc": "https://cdn.kqed.org/wp-content/uploads/2024/04/Forum-Podcast-Tile-703x703-1.jpg",
"imageAlt": "KQED Forum with Mina Kim and Alexis Madrigal",
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"order": 9
},
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"google": "https://podcasts.google.com/feed/aHR0cHM6Ly9mZWVkcy5tZWdhcGhvbmUuZm0vS1FJTkM5NTU3MzgxNjMz",
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"id": "freakonomics-radio",
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"officialWebsiteLink": "http://freakonomics.com/",
"airtime": "SUN 1am-2am, SAT 3pm-4pm",
"meta": {
"site": "radio",
"source": "WNYC"
},
"link": "/radio/program/freakonomics-radio",
"subscribe": {
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"apple": "https://itunes.apple.com/us/podcast/freakonomics-radio/id354668519",
"tuneIn": "https://tunein.com/podcasts/WNYC-Podcasts/Freakonomics-Radio-p272293/",
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},
"fresh-air": {
"id": "fresh-air",
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"info": "Hosted by Terry Gross, \u003cem>Fresh Air from WHYY\u003c/em> is the Peabody Award-winning weekday magazine of contemporary arts and issues. One of public radio's most popular programs, Fresh Air features intimate conversations with today's biggest luminaries.",
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"meta": {
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"link": "/radio/program/fresh-air",
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"apple": "https://itunes.apple.com/WebObjects/MZStore.woa/wa/viewPodcast?s=143441&mt=2&id=214089682&at=11l79Y&ct=nprdirectory",
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"info": "A live production of NPR and WBUR Boston, in collaboration with stations across the country, Here & Now reflects the fluid world of news as it's happening in the middle of the day, with timely, in-depth news, interviews and conversation. Hosted by Robin Young, Jeremy Hobson and Tonya Mosley.",
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"rss": "https://feeds.npr.org/510051/podcast.xml"
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},
"hidden-brain": {
"id": "hidden-brain",
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"info": "Shankar Vedantam uses science and storytelling to reveal the unconscious patterns that drive human behavior, shape our choices and direct our relationships.",
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"airtime": "SUN 7pm-8pm",
"meta": {
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"source": "NPR"
},
"link": "/radio/program/hidden-brain",
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},
"how-i-built-this": {
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"title": "How I Built This with Guy Raz",
"info": "Guy Raz dives into the stories behind some of the world's best known companies. How I Built This weaves a narrative journey about innovators, entrepreneurs and idealists—and the movements they built.",
"imageSrc": "https://ww2.kqed.org/news/wp-content/uploads/sites/10/2018/05/howIBuiltThis.png",
"officialWebsiteLink": "https://www.npr.org/podcasts/510313/how-i-built-this",
"airtime": "SUN 7:30pm-8pm",
"meta": {
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},
"link": "/radio/program/how-i-built-this",
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"apple": "https://itunes.apple.com/us/podcast/how-i-built-this-with-guy-raz/id1150510297?mt=2",
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"hyphenacion": {
"id": "hyphenacion",
"title": "Hyphenación",
"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. ",
"imageSrc": "https://cdn.kqed.org/wp-content/uploads/2025/03/Hyphenacion_FinalAssets_PodcastTile.png",
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"officialWebsiteLink": "/podcasts/hyphenacion",
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"order": 15
},
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},
"jerrybrown": {
"id": "jerrybrown",
"title": "The Political Mind of Jerry Brown",
"tagline": "Lessons from a lifetime in politics",
"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. ",
"imageSrc": "https://cdn.kqed.org/wp-content/uploads/2024/04/The-Political-Mind-of-Jerry-Brown-Podcast-Tile-703x703-1.jpg",
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"officialWebsiteLink": "/podcasts/jerrybrown",
"meta": {
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"order": 18
},
"link": "/podcasts/jerrybrown",
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},
"latino-usa": {
"id": "latino-usa",
"title": "Latino USA",
"airtime": "MON 1am-2am, SUN 6pm-7pm",
"info": "Latino USA, the radio journal of news and culture, is the only national, English-language radio program produced from a Latino perspective.",
"imageSrc": "https://ww2.kqed.org/radio/wp-content/uploads/sites/50/2018/04/latinoUsa.jpg",
"officialWebsiteLink": "http://latinousa.org/",
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"link": "/radio/program/latino-usa",
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"apple": "https://itunes.apple.com/WebObjects/MZStore.woa/wa/viewPodcast?s=143441&mt=2&id=79681317&at=11l79Y&ct=nprdirectory",
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"rss": "https://feeds.npr.org/510016/podcast.xml"
}
},
"marketplace": {
"id": "marketplace",
"title": "Marketplace",
"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",
"imageSrc": "https://cdn.kqed.org/wp-content/uploads/2024/04/Marketplace-Podcast-Tile-360x360-1.jpg",
"officialWebsiteLink": "https://www.marketplace.org/",
"meta": {
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"source": "American Public Media"
},
"link": "/radio/program/marketplace",
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},
"masters-of-scale": {
"id": "masters-of-scale",
"title": "Masters of Scale",
"info": "Masters of Scale is an original podcast in which LinkedIn co-founder and Greylock Partner Reid Hoffman sets out to describe and prove theories that explain how great entrepreneurs take their companies from zero to a gazillion in ingenious fashion.",
"airtime": "Every other Wednesday June 12 through October 16 at 8pm (repeats Thursdays at 2am)",
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"officialWebsiteLink": "https://mastersofscale.com/",
"meta": {
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"source": "WaitWhat"
},
"link": "/radio/program/masters-of-scale",
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"apple": "http://mastersofscale.app.link/",
"rss": "https://rss.art19.com/masters-of-scale"
}
},
"mindshift": {
"id": "mindshift",
"title": "MindShift",
"tagline": "A podcast about the future of learning and how we raise our kids",
"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>",
"imageSrc": "https://cdn.kqed.org/wp-content/uploads/2024/04/Mindshift-Podcast-Tile-703x703-1.jpg",
"imageAlt": "KQED MindShift: How We Will Learn",
"officialWebsiteLink": "/mindshift/",
"meta": {
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"source": "kqed",
"order": 12
},
"link": "/podcasts/mindshift",
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"google": "https://podcasts.google.com/feed/aHR0cHM6Ly9mZWVkcy5tZWdhcGhvbmUuZm0vS1FJTkM1NzY0NjAwNDI5",
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}
},
"morning-edition": {
"id": "morning-edition",
"title": "Morning Edition",
"info": "\u003cem>Morning Edition\u003c/em> takes listeners around the country and the world with multi-faceted stories and commentaries every weekday. Hosts Steve Inskeep, David Greene and Rachel Martin bring you the latest breaking news and features to prepare you for the day.",
"airtime": "MON-FRI 3am-9am",
"imageSrc": "https://cdn.kqed.org/wp-content/uploads/2024/04/Morning-Edition-Podcast-Tile-360x360-1.jpg",
"officialWebsiteLink": "https://www.npr.org/programs/morning-edition/",
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"link": "/radio/program/morning-edition"
},
"onourwatch": {
"id": "onourwatch",
"title": "On Our Watch",
"tagline": "Deeply-reported investigative journalism",
"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?",
"imageSrc": "https://cdn.kqed.org/wp-content/uploads/2024/04/On-Our-Watch-Podcast-Tile-703x703-1.jpg",
"imageAlt": "On Our Watch from NPR and KQED",
"officialWebsiteLink": "/podcasts/onourwatch",
"meta": {
"site": "news",
"source": "kqed",
"order": 11
},
"link": "/podcasts/onourwatch",
"subscribe": {
"apple": "https://podcasts.apple.com/podcast/id1567098962",
"google": "https://podcasts.google.com/feed/aHR0cHM6Ly9mZWVkcy5ucHIub3JnLzUxMDM2MC9wb2RjYXN0LnhtbD9zYz1nb29nbGVwb2RjYXN0cw",
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"stitcher": "https://www.stitcher.com/show/on-our-watch",
"rss": "https://feeds.npr.org/510360/podcast.xml"
}
},
"on-the-media": {
"id": "on-the-media",
"title": "On The Media",
"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",
"airtime": "SUN 2pm-3pm, MON 12am-1am",
"imageSrc": "https://ww2.kqed.org/radio/wp-content/uploads/sites/50/2018/04/onTheMedia.png",
"officialWebsiteLink": "https://www.wnycstudios.org/shows/otm",
"meta": {
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"source": "wnyc"
},
"link": "/radio/program/on-the-media",
"subscribe": {
"apple": "https://itunes.apple.com/us/podcast/on-the-media/id73330715?mt=2",
"tuneIn": "https://tunein.com/radio/On-the-Media-p69/",
"rss": "http://feeds.wnyc.org/onthemedia"
}
},
"pbs-newshour": {
"id": "pbs-newshour",
"title": "PBS NewsHour",
"info": "Analysis, background reports and updates from the PBS NewsHour putting today's news in context.",
"airtime": "MON-FRI 3pm-4pm",
"imageSrc": "https://cdn.kqed.org/wp-content/uploads/2024/04/PBS-News-Hour-Podcast-Tile-360x360-1.jpg",
"officialWebsiteLink": "https://www.pbs.org/newshour/",
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"source": "pbs"
},
"link": "/radio/program/pbs-newshour",
"subscribe": {
"apple": "https://itunes.apple.com/us/podcast/pbs-newshour-full-show/id394432287?mt=2",
"tuneIn": "https://tunein.com/radio/PBS-NewsHour---Full-Show-p425698/",
"rss": "https://www.pbs.org/newshour/feeds/rss/podcasts/show"
}
},
"perspectives": {
"id": "perspectives",
"title": "Perspectives",
"tagline": "KQED's series of daily listener commentaries since 1991",
"info": "KQED's series of daily listener commentaries since 1991.",
"imageSrc": "https://cdn.kqed.org/wp-content/uploads/2025/01/Perspectives_Tile_Final.jpg",
"imageAlt": "KQED Perspectives",
"officialWebsiteLink": "/perspectives/",
"meta": {
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"source": "kqed",
"order": 14
},
"link": "/perspectives",
"subscribe": {
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"npr": "https://www.npr.org/podcasts/432309616/perspectives",
"rss": "https://ww2.kqed.org/perspectives/category/perspectives/feed/",
"google": "https://podcasts.google.com/feed/aHR0cHM6Ly93dzIua3FlZC5vcmcvcGVyc3BlY3RpdmVzL2NhdGVnb3J5L3BlcnNwZWN0aXZlcy9mZWVkLw"
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},
"planet-money": {
"id": "planet-money",
"title": "Planet Money",
"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.",
"airtime": "SUN 3pm-4pm",
"imageSrc": "https://ww2.kqed.org/radio/wp-content/uploads/sites/50/2018/04/planetmoney.jpg",
"officialWebsiteLink": "https://www.npr.org/sections/money/",
"meta": {
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"source": "npr"
},
"link": "/radio/program/planet-money",
"subscribe": {
"npr": "https://rpb3r.app.goo.gl/M4f5",
"apple": "https://itunes.apple.com/us/podcast/planet-money/id290783428?mt=2",
"tuneIn": "https://tunein.com/podcasts/Business--Economics-Podcasts/Planet-Money-p164680/",
"rss": "https://feeds.npr.org/510289/podcast.xml"
}
},
"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.",
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