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devices.","imgSizes":{"thumbnail":{"file":"https://ww2.kqed.org/app/uploads/sites/27/2017/08/teenssmartphone_custom-88cb895aee6f4c2127d2a33a27bf211a071ca5e7-160x107.jpg","width":160,"height":107,"mimeType":"image/jpeg"},"medium":{"file":"https://ww2.kqed.org/app/uploads/sites/27/2017/08/teenssmartphone_custom-88cb895aee6f4c2127d2a33a27bf211a071ca5e7-800x533.jpg","width":800,"height":533,"mimeType":"image/jpeg"},"medium_large":{"file":"https://ww2.kqed.org/app/uploads/sites/27/2017/08/teenssmartphone_custom-88cb895aee6f4c2127d2a33a27bf211a071ca5e7-768x512.jpg","width":768,"height":512,"mimeType":"image/jpeg"},"large":{"file":"https://ww2.kqed.org/app/uploads/sites/27/2017/08/teenssmartphone_custom-88cb895aee6f4c2127d2a33a27bf211a071ca5e7-1020x680.jpg","width":1020,"height":680,"mimeType":"image/jpeg"},"fd-lrg":{"file":"https://ww2.kqed.org/app/uploads/sites/27/2017/08/teenssmartphone_custom-88cb895aee6f4c2127d2a33a27bf211a071ca5e7-1920x1279.jpg","width":1920,"height":1279,"mimeType":"image/jpeg"},"fd-med":{"file":"https://ww2.kqed.org/app/uploads/sites/27/2017/08/teenssmartphone_custom-88cb895aee6f4c2127d2a33a27bf211a071ca5e7-1180x786.jpg","width":1180,"height":786,"mimeType":"image/jpeg"},"fd-sm":{"file":"https://ww2.kqed.org/app/uploads/sites/27/2017/08/teenssmartphone_custom-88cb895aee6f4c2127d2a33a27bf211a071ca5e7-960x640.jpg","width":960,"height":640,"mimeType":"image/jpeg"},"post-thumbnail":{"file":"https://ww2.kqed.org/app/uploads/sites/27/2017/08/teenssmartphone_custom-88cb895aee6f4c2127d2a33a27bf211a071ca5e7-672x372.jpg","width":672,"height":372,"mimeType":"image/jpeg"},"twentyfourteen-full-width":{"file":"https://ww2.kqed.org/app/uploads/sites/27/2017/08/teenssmartphone_custom-88cb895aee6f4c2127d2a33a27bf211a071ca5e7-1038x576.jpg","width":1038,"height":576,"mimeType":"image/jpeg"},"xxsmall":{"file":"https://ww2.kqed.org/app/uploads/sites/27/2017/08/teenssmartphone_custom-88cb895aee6f4c2127d2a33a27bf211a071ca5e7-240x160.jpg","width":240,"height":160,"mimeType":"image/jpeg"},"xsmall":{"file":"https://ww2.kqed.org/app/uploads/sites/27/2017/08/teenssmartphone_custom-88cb895aee6f4c2127d2a33a27bf211a071ca5e7-375x250.jpg","width":375,"height":250,"mimeType":"image/jpeg"},"small":{"file":"https://ww2.kqed.org/app/uploads/sites/27/2017/08/teenssmartphone_custom-88cb895aee6f4c2127d2a33a27bf211a071ca5e7-520x346.jpg","width":520,"height":346,"mimeType":"image/jpeg"},"xlarge":{"file":"https://ww2.kqed.org/app/uploads/sites/27/2017/08/teenssmartphone_custom-88cb895aee6f4c2127d2a33a27bf211a071ca5e7-1180x786.jpg","width":1180,"height":786,"mimeType":"image/jpeg"},"full-width":{"file":"https://ww2.kqed.org/app/uploads/sites/27/2017/08/teenssmartphone_custom-88cb895aee6f4c2127d2a33a27bf211a071ca5e7-1920x1279.jpg","width":1920,"height":1279,"mimeType":"image/jpeg"},"guest-author-32":{"file":"https://ww2.kqed.org/app/uploads/sites/27/2017/08/teenssmartphone_custom-88cb895aee6f4c2127d2a33a27bf211a071ca5e7-32x32.jpg","width":32,"height":32,"mimeType":"image/jpeg"},"guest-author-50":{"file":"https://ww2.kqed.org/app/uploads/sites/27/2017/08/teenssmartphone_custom-88cb895aee6f4c2127d2a33a27bf211a071ca5e7-50x50.jpg","width":50,"height":50,"mimeType":"image/jpeg"},"guest-author-64":{"file":"https://ww2.kqed.org/app/uploads/sites/27/2017/08/teenssmartphone_custom-88cb895aee6f4c2127d2a33a27bf211a071ca5e7-64x64.jpg","width":64,"height":64,"mimeType":"image/jpeg"},"guest-author-96":{"file":"https://ww2.kqed.org/app/uploads/sites/27/2017/08/teenssmartphone_custom-88cb895aee6f4c2127d2a33a27bf211a071ca5e7-96x96.jpg","width":96,"height":96,"mimeType":"image/jpeg"},"guest-author-128":{"file":"https://ww2.kqed.org/app/uploads/sites/27/2017/08/teenssmartphone_custom-88cb895aee6f4c2127d2a33a27bf211a071ca5e7-128x128.jpg","width":128,"height":128,"mimeType":"image/jpeg"},"detail":{"file":"https://ww2.kqed.org/app/uploads/sites/27/2017/08/teenssmartphone_custom-88cb895aee6f4c2127d2a33a27bf211a071ca5e7-150x150.jpg","width":150,"height":150,"mimeType":"image/jpeg"},"kqedFullSize":{"file":"https://ww2.kqed.org/app/uploads/sites/27/2017/08/teenssmartphone_custom-88cb895aee6f4c2127d2a33a27bf211a071ca5e7.jpg","width":2047,"height":1364}},"fetchFailed":false,"isLoading":false}},"audioPlayerReducer":{"postId":"stream_live"},"authorsReducer":{"byline_stateofhealth_363257":{"type":"authors","id":"byline_stateofhealth_363257","meta":{"override":true},"slug":"byline_stateofhealth_363257","name":"\u003cstrong>\u003ca 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Her work can also be heard on NPR, \u003cem>Here & Now, \u003c/em>and PRI. Before working in audio, she taught, leading groups of students abroad. One of her favorite jobs was teaching on the Thai-Burmese border, working with immigrants and refugees.\r\n\r\nLaura has won three Northern California Area Emmys along with her Deep Look colleagues. She's won the North Gate Award for Excellence in Audio Reporting and the Gobind Behari Lal Award for a radio documentary about adults with imaginary friends. She's a fellowship junkie, completing the USC Center for Health Journalism's California Fellowship, UC Berkeley's Human Rights Fellowship and the Coro Fellowship in Public Affairs. Laura has a master’s in journalism from UC Berkeley and a master’s in education from Harvard.\r\n\r\nShe likes to eat chocolate for breakfast. She's also open to eating it all day long.","avatar":"https://secure.gravatar.com/avatar/af8e757bb8ce7b7fee6160ba66e37327?s=600&d=blank&r=g","twitter":"lauraklivans","facebook":null,"instagram":null,"linkedin":null,"sites":[{"site":"news","roles":["editor"]},{"site":"stateofhealth","roles":["contributor","editor"]},{"site":"science","roles":["editor"]},{"site":"forum","roles":["editor"]}],"headData":{"title":"Laura Klivans | KQED","description":"Reporter and Host","ogImgSrc":"https://secure.gravatar.com/avatar/af8e757bb8ce7b7fee6160ba66e37327?s=600&d=blank&r=g","twImgSrc":"https://secure.gravatar.com/avatar/af8e757bb8ce7b7fee6160ba66e37327?s=600&d=blank&r=g"},"isLoading":false,"link":"/author/lklivans"},"cfeibel":{"type":"authors","id":"11314","meta":{"index":"authors_1591205172","id":"11314","found":true},"name":"Carrie Feibel","firstName":"Carrie","lastName":"Feibel","slug":"cfeibel","email":"cfeibel@KQED.org","display_author_email":false,"staff_mastheads":[],"title":"KQED Contributor","bio":"Carrie Feibel is a former health editor at KQED, where she has also reported for radio and online. Her stories have appeared on the national NPR shows \u003cem>Morning Edition\u003c/em>, \u003cem>All Things Considered\u003c/em>, and \u003cem>Here & Now\u003c/em>, and on the national website, Kaiser Health News. Her print career included stints at the \u003cem>Houston Chronicle\u003c/em>, \u003cem>The (Bergen) Record,\u003c/em> and the Associated Press in New York City. A native of St. Louis, Feibel attended Cornell University, and earned a master's in journalism from Columbia University.","avatar":"https://secure.gravatar.com/avatar/c64a7e3c9a910e1bffd4ad32a5264aa9?s=600&d=blank&r=g","twitter":"KQEDHealth","facebook":null,"instagram":null,"linkedin":null,"sites":[{"site":"news","roles":["subscriber"]},{"site":"stateofhealth","roles":["administrator"]}],"headData":{"title":"Carrie Feibel | KQED","description":"KQED Contributor","ogImgSrc":"https://secure.gravatar.com/avatar/c64a7e3c9a910e1bffd4ad32a5264aa9?s=600&d=blank&r=g","twImgSrc":"https://secure.gravatar.com/avatar/c64a7e3c9a910e1bffd4ad32a5264aa9?s=600&d=blank&r=g"},"isLoading":false,"link":"/author/cfeibel"}},"breakingNewsReducer":{},"campaignFinanceReducer":{},"firebase":{"requesting":{},"requested":{},"timestamps":{},"data":{},"ordered":{},"auth":{"isLoaded":false,"isEmpty":true},"authError":null,"profile":{"isLoaded":false,"isEmpty":true},"listeners":{"byId":{},"allIds":[]},"isInitializing":false,"errors":[]},"navBarReducer":{"navBarId":"home","fullView":true,"showPlayer":false},"navMenuReducer":{"menus":[{"key":"menu1","items":[{"name":"News","link":"/","type":"title"},{"name":"Politics","link":"/politics"},{"name":"Science","link":"/science"},{"name":"Education","link":"/educationnews"},{"name":"Housing","link":"/housing"},{"name":"Immigration","link":"/immigration"},{"name":"Criminal Justice","link":"/criminaljustice"},{"name":"Silicon Valley","link":"/siliconvalley"},{"name":"Forum","link":"/forum"},{"name":"The California Report","link":"/californiareport"}]},{"key":"menu2","items":[{"name":"Arts & Culture","link":"/arts","type":"title"},{"name":"Critics’ Picks","link":"/thedolist"},{"name":"Cultural Commentary","link":"/artscommentary"},{"name":"Food & Drink","link":"/food"},{"name":"Bay Area Hip-Hop","link":"/bayareahiphop"},{"name":"Rebel Girls","link":"/rebelgirls"},{"name":"Arts Video","link":"/artsvideos"}]},{"key":"menu3","items":[{"name":"Podcasts","link":"/podcasts","type":"title"},{"name":"Bay Curious","link":"/podcasts/baycurious"},{"name":"Rightnowish","link":"/podcasts/rightnowish"},{"name":"The Bay","link":"/podcasts/thebay"},{"name":"On Our Watch","link":"/podcasts/onourwatch"},{"name":"Mindshift","link":"/podcasts/mindshift"},{"name":"Consider This","link":"/podcasts/considerthis"},{"name":"Political Breakdown","link":"/podcasts/politicalbreakdown"}]},{"key":"menu4","items":[{"name":"Live Radio","link":"/radio","type":"title"},{"name":"TV","link":"/tv","type":"title"},{"name":"Events","link":"/events","type":"title"},{"name":"For Educators","link":"/education","type":"title"},{"name":"Support KQED","link":"/support","type":"title"},{"name":"About","link":"/about","type":"title"},{"name":"Help Center","link":"https://kqed-helpcenter.kqed.org/s","type":"title"}]}]},"pagesReducer":{},"postsReducer":{"stream_live":{"type":"live","id":"stream_live","audioUrl":"https://streams.kqed.org/kqedradio","title":"Live Stream","excerpt":"Live Stream information currently unavailable.","link":"/radio","featImg":"","label":{"name":"KQED Live","link":"/"}},"stream_kqedNewscast":{"type":"posts","id":"stream_kqedNewscast","audioUrl":"https://www.kqed.org/.stream/anon/radio/RDnews/newscast.mp3?_=1","title":"KQED Newscast","featImg":"","label":{"name":"88.5 FM","link":"/"}},"stateofhealth_363411":{"type":"posts","id":"stateofhealth_363411","meta":{"index":"posts_1591205157","site":"stateofhealth","id":"363411","score":null,"sort":[1525991676000]},"guestAuthors":[],"slug":"where-do-you-go-when-you-leave-the-hospital-but-are-homeless","title":"Where Do You Go When You Leave the Hospital But Are Homeless?","publishDate":1525991676,"format":"audio","headTitle":"State of Health | KQED News","labelTerm":{"site":"stateofhealth"},"content":"\u003cp>\u003cspan style=\"font-weight: 400\">Suzanne Adams stood outside \u003ca href=\"http://www.catsinc.org/a-woman-s-place.html\" target=\"_blank\" rel=\"noopener\">A Woman’s Place\u003c/a>, a homeless drop-in center in San Francisco. Adams, who works there as a psychologist, pointed to the curb near the front entrance. It's where taxis regularly drop off homeless patients who have just been discharged from the hospital. \u003c/span>\u003c/p>\n\u003cp>\"Generally speaking the driver is kind enough to assist some of these women in exiting the vehicle and grabbing some of their belongings,\" Adams said. \"The patient or client enters in through our door sometimes bewildered and confused as to why they’re here.\"\u003c/p>\n\u003cp>\u003cspan style=\"font-weight: 400\">Many of the women are elderly. Some have never been to A Woman's Place before the taxi drops them off, while others are regulars. Whatever the case, the center just isn’t prepared to take in medically fragile patients straight from the hospital, according to Adams. It’s not a clinic, and it’s not even a shelter. Women and families can stop in to take showers, do laundry or get counseling. There aren’t any beds, just a television set and lots of chairs. \u003c/span>\u003c/p>\n\u003cp>\u003ca href=\"https://leginfo.legislature.ca.gov/faces/billTextClient.xhtml?bill_id=201720180SB1152\" target=\"_blank\" rel=\"noopener\">A bill\u003c/a> under consideration in Sacramento aims to address this practice, which some advocates call \"patient dumping.\" They say hospitals commonly discharge homeless patients by sending them to social service agencies or other nonprofits, and they do this without contacting those locations first.\u003c/p>\n\u003cp>\u003cspan style=\"font-weight: 400\">Adams said this “dumping” happens at least once a week at A Woman's Place. One of the cases that haunts her involves an elderly woman who has a serious mental illness. Recently, the client had deteriorated so much that she couldn’t use the toilet alone. \u003c/span>\u003c/p>\n\u003cp>[ad fullwidth]\u003c/p>\n\u003cp>\"She wasn’t leaving the building under her own accord,\" Adams said. \"She wasn’t accessing food or water without the assistance of other people. She tried to pay me a dollar the other day to go buy her some ramen so that she could eat.\"\u003c/p>\n\u003cp>\u003cspan style=\"font-weight: 400\">Adams sent the woman to the hospital, hoping psychiatric services would help. \u003c/span>\u003c/p>\n\u003cp>\"Unfortunately, less than 24 hours later, she returned here,\" Adams said.\u003c/p>\n\u003cp>\u003cspan style=\"font-weight: 400\">The same client was resting at the center on the day a KQED reporter visited, sitting in a black chair that she favors. Adams said the woman’s mental illness still wasn't well-controlled, so she couldn't speak coherently or consent to an interview. \u003c/span>\u003c/p>\n\u003cp>\"In an ideal world, she would be transferred to a 'board and care' or an assisted living facility, where they could manage her mental health as well as her medical health in a fashion that we simply don’t have the infrastructure for,\" Adams said.\u003c/p>\n\u003cp>\u003cspan style=\"font-weight: 400\">The legislation moving through the state Senate would require that patients be discharged to one of four \"safe and appropriate\" locations: their primary dwelling (as identified by the homeless patient), another health center or hospital, a nonprofit or social service agency that has given written consent to accept the patient, or an alternative spot that the patient has consented to go to, in writing. \u003c/span>\u003c/p>\n\u003cp>\u003cspan style=\"font-weight: 400\">\u003ca href=\"http://sd22.senate.ca.gov/\" target=\"_blank\" rel=\"noopener\">Sen. Ed Hernandez\u003c/a>, D-West Covina, introduced the bill. He said hospitals, as part of society, have obligations to homeless Californians. \u003c/span>\u003c/p>\n\u003cp>\"If they fall down and have a heart attack, and somebody sends them to the hospital, we’re required by law -- which is the humane thing to do -- to treat those individuals,\" said Hernandez, who is an optometrist and chair of the Senate Health Committee. He was referring to a federal law called \u003ca href=\"https://www.acep.org/news-media-top-banner/emtala/#sm.000005tj0xf3geeirxddg2ghqr9qa\" target=\"_blank\" rel=\"noopener\">EMTALA\u003c/a>, which mandates that emergency rooms accept and treat everyone, regardless of ability to pay.\u003c/p>\n\u003cp>But EMTALA doesn't address how patients are discharged from ERs. \"Once they’re treated, the humane thing is to figure out where we’re going to place them, as opposed to just leaving them out in the street immediately,\" Hernandez said.\u003c/p>\n\u003cp>\u003cspan style=\"font-weight: 400\">His bill would require some additional work on the part of ER staffers at California hospitals, such as getting consent from a shelter where the hospital wants to send the patient. \u003c/span>\u003c/p>\n\u003cp>\"I can’t imagine that it’s going to be that costly to pick up the phone,\" Hernandez said.\u003c/p>\n\u003cp>\u003cspan style=\"font-weight: 400\">The legislation also lays out a checklist of things to do before discharge. For example, the patient must be hydrated, have recently eaten and be dressed in weather-appropriate clothing. \u003c/span>\u003c/p>\n\u003cp>\u003cspan style=\"font-weight: 400\">But hospitals are pushing back, saying the list is too specific, and doesn’t give hospital workers enough flexibility to decide what’s right for each patient. \u003c/span>\u003c/p>\n\u003cp>\u003cspan style=\"font-weight: 400\">\u003ca href=\"https://www.calhospital.org/profile/peggy-broussard-wheeler\" target=\"_blank\" rel=\"noopener\">Peggy Wheeler\u003c/a> is the vice president for rural health and governance for the \u003ca href=\"https://www.calhospital.org/\" target=\"_blank\" rel=\"noopener\">California Hospital Association\u003c/a>. She said the bill would put yet another burden on emergency care. \u003c/span>\u003c/p>\n\u003cp>\"Hospital ERs are overcrowded,\" Wheeler said. \"If we had to hold on to a patient in a bed in the ER, that’s one less bed, two less beds, three less beds that would be available for other members of the community that need to come in and use the ER.\"\u003c/p>\n\u003cp>\u003cspan style=\"font-weight: 400\">Adams, the psychologist at A Woman’s Place, thinks the bill is a good step. But she said it doesn’t get at the \u003c/span>\u003cspan style=\"font-weight: 400\">root \u003c/span>\u003cspan style=\"font-weight: 400\">problem, which is that the Bay Area doesn’t have enough options for patients who still need help \u003c/span>\u003cspan style=\"font-weight: 400\">after\u003c/span>\u003cspan style=\"font-weight: 400\"> they leave the hospital. There aren’t enough nursing homes, rehabilitation units or assisted care programs for elderly, low-income or disabled patients. \u003c/span>\u003c/p>\n\u003cp>\"It’s a health insurance issue, it’s an aging issue, it’s a lack of infrastructure and funding,\" Adams said.\u003c/p>\n\u003cp>\u003c/p>\n\u003cp>\u003cspan style=\"font-weight: 400\">Until that gets fixed, Adams fears many patients will continue to shuttle between hospitals, the shelter system and the street. \u003c/span>\u003c/p>\n\n","blocks":[],"excerpt":"Legislation moving through the state Senate would require patients to be released to one of four \"safe and appropriate\" locations.","status":"publish","parent":0,"modified":1525994461,"stats":{"hasAudio":false,"hasVideo":false,"hasChartOrMap":false,"iframeSrcs":[],"hasGoogleForm":false,"hasGallery":false,"hasHearkenModule":false,"hasPolis":false,"paragraphCount":25,"wordCount":957},"headData":{"title":"Where Do You Go When You Leave the Hospital But Are Homeless? | KQED","description":"Legislation moving through the state Senate would require patients to be released to one of four "safe and appropriate" locations.","ogTitle":"","ogDescription":"","ogImgId":"","twTitle":"","twDescription":"","twImgId":"","schema":{"@context":"http://schema.org","@type":"Article","headline":"Where Do You Go When You Leave the Hospital But Are Homeless?","datePublished":"2018-05-10T22:34:36.000Z","dateModified":"2018-05-10T23:21:01.000Z","image":"https://cdn.kqed.org/wp-content/uploads/2020/02/KQED-OG-Image@1x.png"}},"disqusIdentifier":"363411 https://ww2.kqed.org/stateofhealth/?p=363411","disqusUrl":"https://ww2.kqed.org/stateofhealth/2018/05/10/where-do-you-go-when-you-leave-the-hospital-but-are-homeless/","disqusTitle":"Where Do You Go When You Leave the Hospital But Are Homeless?","audioUrl":"https://www.kqed.org/.stream/anon/radio/RDnews/2018/05/KlivansPatientDumping.mp3","path":"/stateofhealth/363411/where-do-you-go-when-you-leave-the-hospital-but-are-homeless","audioDuration":null,"audioTrackLength":null,"parsedContent":[{"type":"contentString","content":"\u003cdiv class=\"post-body\">\u003cp>\u003cp>\u003cspan style=\"font-weight: 400\">Suzanne Adams stood outside \u003ca href=\"http://www.catsinc.org/a-woman-s-place.html\" target=\"_blank\" rel=\"noopener\">A Woman’s Place\u003c/a>, a homeless drop-in center in San Francisco. Adams, who works there as a psychologist, pointed to the curb near the front entrance. It's where taxis regularly drop off homeless patients who have just been discharged from the hospital. \u003c/span>\u003c/p>\n\u003cp>\"Generally speaking the driver is kind enough to assist some of these women in exiting the vehicle and grabbing some of their belongings,\" Adams said. \"The patient or client enters in through our door sometimes bewildered and confused as to why they’re here.\"\u003c/p>\n\u003cp>\u003cspan style=\"font-weight: 400\">Many of the women are elderly. Some have never been to A Woman's Place before the taxi drops them off, while others are regulars. Whatever the case, the center just isn’t prepared to take in medically fragile patients straight from the hospital, according to Adams. It’s not a clinic, and it’s not even a shelter. Women and families can stop in to take showers, do laundry or get counseling. There aren’t any beds, just a television set and lots of chairs. \u003c/span>\u003c/p>\n\u003cp>\u003ca href=\"https://leginfo.legislature.ca.gov/faces/billTextClient.xhtml?bill_id=201720180SB1152\" target=\"_blank\" rel=\"noopener\">A bill\u003c/a> under consideration in Sacramento aims to address this practice, which some advocates call \"patient dumping.\" They say hospitals commonly discharge homeless patients by sending them to social service agencies or other nonprofits, and they do this without contacting those locations first.\u003c/p>\n\u003cp>\u003cspan style=\"font-weight: 400\">Adams said this “dumping” happens at least once a week at A Woman's Place. One of the cases that haunts her involves an elderly woman who has a serious mental illness. Recently, the client had deteriorated so much that she couldn’t use the toilet alone. \u003c/span>\u003c/p>\n\u003cp>\u003c/p>\u003c/div>","attributes":{"named":{},"numeric":[]}},{"type":"component","content":"","name":"ad","attributes":{"named":{"label":"fullwidth"},"numeric":["fullwidth"]}},{"type":"contentString","content":"\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>\"She wasn’t leaving the building under her own accord,\" Adams said. \"She wasn’t accessing food or water without the assistance of other people. She tried to pay me a dollar the other day to go buy her some ramen so that she could eat.\"\u003c/p>\n\u003cp>\u003cspan style=\"font-weight: 400\">Adams sent the woman to the hospital, hoping psychiatric services would help. \u003c/span>\u003c/p>\n\u003cp>\"Unfortunately, less than 24 hours later, she returned here,\" Adams said.\u003c/p>\n\u003cp>\u003cspan style=\"font-weight: 400\">The same client was resting at the center on the day a KQED reporter visited, sitting in a black chair that she favors. Adams said the woman’s mental illness still wasn't well-controlled, so she couldn't speak coherently or consent to an interview. \u003c/span>\u003c/p>\n\u003cp>\"In an ideal world, she would be transferred to a 'board and care' or an assisted living facility, where they could manage her mental health as well as her medical health in a fashion that we simply don’t have the infrastructure for,\" Adams said.\u003c/p>\n\u003cp>\u003cspan style=\"font-weight: 400\">The legislation moving through the state Senate would require that patients be discharged to one of four \"safe and appropriate\" locations: their primary dwelling (as identified by the homeless patient), another health center or hospital, a nonprofit or social service agency that has given written consent to accept the patient, or an alternative spot that the patient has consented to go to, in writing. \u003c/span>\u003c/p>\n\u003cp>\u003cspan style=\"font-weight: 400\">\u003ca href=\"http://sd22.senate.ca.gov/\" target=\"_blank\" rel=\"noopener\">Sen. Ed Hernandez\u003c/a>, D-West Covina, introduced the bill. He said hospitals, as part of society, have obligations to homeless Californians. \u003c/span>\u003c/p>\n\u003cp>\"If they fall down and have a heart attack, and somebody sends them to the hospital, we’re required by law -- which is the humane thing to do -- to treat those individuals,\" said Hernandez, who is an optometrist and chair of the Senate Health Committee. He was referring to a federal law called \u003ca href=\"https://www.acep.org/news-media-top-banner/emtala/#sm.000005tj0xf3geeirxddg2ghqr9qa\" target=\"_blank\" rel=\"noopener\">EMTALA\u003c/a>, which mandates that emergency rooms accept and treat everyone, regardless of ability to pay.\u003c/p>\n\u003cp>But EMTALA doesn't address how patients are discharged from ERs. \"Once they’re treated, the humane thing is to figure out where we’re going to place them, as opposed to just leaving them out in the street immediately,\" Hernandez said.\u003c/p>\n\u003cp>\u003cspan style=\"font-weight: 400\">His bill would require some additional work on the part of ER staffers at California hospitals, such as getting consent from a shelter where the hospital wants to send the patient. \u003c/span>\u003c/p>\n\u003cp>\"I can’t imagine that it’s going to be that costly to pick up the phone,\" Hernandez said.\u003c/p>\n\u003cp>\u003cspan style=\"font-weight: 400\">The legislation also lays out a checklist of things to do before discharge. For example, the patient must be hydrated, have recently eaten and be dressed in weather-appropriate clothing. \u003c/span>\u003c/p>\n\u003cp>\u003cspan style=\"font-weight: 400\">But hospitals are pushing back, saying the list is too specific, and doesn’t give hospital workers enough flexibility to decide what’s right for each patient. \u003c/span>\u003c/p>\n\u003cp>\u003cspan style=\"font-weight: 400\">\u003ca href=\"https://www.calhospital.org/profile/peggy-broussard-wheeler\" target=\"_blank\" rel=\"noopener\">Peggy Wheeler\u003c/a> is the vice president for rural health and governance for the \u003ca href=\"https://www.calhospital.org/\" target=\"_blank\" rel=\"noopener\">California Hospital Association\u003c/a>. She said the bill would put yet another burden on emergency care. \u003c/span>\u003c/p>\n\u003cp>\"Hospital ERs are overcrowded,\" Wheeler said. \"If we had to hold on to a patient in a bed in the ER, that’s one less bed, two less beds, three less beds that would be available for other members of the community that need to come in and use the ER.\"\u003c/p>\n\u003cp>\u003cspan style=\"font-weight: 400\">Adams, the psychologist at A Woman’s Place, thinks the bill is a good step. But she said it doesn’t get at the \u003c/span>\u003cspan style=\"font-weight: 400\">root \u003c/span>\u003cspan style=\"font-weight: 400\">problem, which is that the Bay Area doesn’t have enough options for patients who still need help \u003c/span>\u003cspan style=\"font-weight: 400\">after\u003c/span>\u003cspan style=\"font-weight: 400\"> they leave the hospital. There aren’t enough nursing homes, rehabilitation units or assisted care programs for elderly, low-income or disabled patients. \u003c/span>\u003c/p>\n\u003cp>\"It’s a health insurance issue, it’s an aging issue, it’s a lack of infrastructure and funding,\" Adams said.\u003c/p>\n\u003cp>\u003c/p>\n\u003cp>\u003cspan style=\"font-weight: 400\">Until that gets fixed, Adams fears many patients will continue to shuttle between hospitals, the shelter system and the street. \u003c/span>\u003c/p>\n\n\u003c/div>\u003c/p>","attributes":{"named":{},"numeric":[]}}],"link":"/stateofhealth/363411/where-do-you-go-when-you-leave-the-hospital-but-are-homeless","authors":["8648"],"categories":["stateofhealth_11","stateofhealth_3012","stateofhealth_14","stateofhealth_2746"],"tags":["stateofhealth_3244","stateofhealth_3243","stateofhealth_2808","stateofhealth_719","stateofhealth_68","stateofhealth_2519","stateofhealth_3241","stateofhealth_3242"],"featImg":"stateofhealth_363413","label":"stateofhealth"},"stateofhealth_363257":{"type":"posts","id":"stateofhealth_363257","meta":{"index":"posts_1591205157","site":"stateofhealth","id":"363257","score":null,"sort":[1523662153000]},"guestAuthors":[],"slug":"a-firefighter-in-san-diego-confronts-the-trauma-of-the-job","title":"A Firefighter in San Diego Confronts the Trauma of the Job","publishDate":1523662153,"format":"audio","headTitle":"California Healthline | State of Health | KQED News","labelTerm":{"term":3036,"site":"stateofhealth"},"content":"\u003cp>\u003cem>\u003ca href=\"http://itunes.apple.com/us/podcast/the-california-report-magazine/id1314750545?mt=2\" rel=\"noopener\" target=\"_blank\">Listen to this and more in-depth storytelling by subscribing to The California Report Magazine podcast.\u003c/a>\u003c/em>\u003c/p>\n\u003cp>At 7:30 on a recent morning, Jeremy Forte, a firefighter in Imperial Beach, California, had just wrapped up a 48-hour shift. As the seven-member crew headed home, Forte drove right past a local bar that used to be a favorite haunt. A few years ago, he would have stopped for a drink, or two, or three -- and perhaps stayed on for hours. And he would have had plenty of company.\u003c/p>\n\u003cp>\"There’s nurses from the hospital there getting off work at the same time,\" Forte recalled. \"We’d be drinking with nurses, partying, having a good old time. And we didn’t think anything was wrong. That’s what people do, right? They get off work and have some drinks.\"\u003c/p>\n\u003cp>Jeremy is tall and lanky, with a thin mustache. He’s been a firefighter for 19 years. It’s grueling work, both physically and mentally. For a long time, drinking was how he coped.\u003c/p>\n\u003cp>\"Our motto was work hard, party hard,\" said Forte, now 39. \"We put in 16-hour days and then we’d go drink the rest of the night, and then probably get two hours of sleep. Wake up, you know, half-drunk and go back out on the fire line and fight these fires.\"\u003c/p>\n\u003cp>[ad fullwidth]\u003c/p>\n\u003cp>A few years ago, Forte's drinking got heavier. He started dabbling in cocaine. But he felt he still had it all under control, until he failed a random drug test at work.\u003c/p>\n\u003cp>Forte's station is part of the federal government: his crew fights fires and responds to emergencies in and around a \u003ca href=\"https://www.cnic.navy.mil/regions/cnrsw/installations/navbase_coronado.html\" target=\"_blank\" rel=\"noopener\">naval base\u003c/a> in Imperial Beach. The federal firefighting force has a zero-tolerance policy, and Forte was in danger of losing his job immediately.\u003c/p>\n\u003cp>\"They really could have ended my whole life by turning their backs on me and firing me,\" Forte said. \"And then at that point, I would lose my wife as well, and probably be living with my parents.\"\u003c/p>\n\u003cp>Forte grew up in West Covina. Two \u003ca href=\"http://www.lafd.org/\" target=\"_blank\" rel=\"noopener\">LAFD\u003c/a> firefighters lived on his block. Forte admired them, and loved seeing his next-door neighbors on the local news.\u003c/p>\n\u003cp>\"Doing that sort of thing really intrigued me,\" he recalled. Not only was the job itself exciting, but it also allowed the firefighters to spend plenty of time with their families when they were off-duty.\u003c/p>\n\u003cp>But not everyone believed he could do it. Forte was born with a birth defect: He’s missing some fingers on both hands, and others aren’t fully formed. His whole career, he’s had to prove that he can do everything a firefighter has to do: drive rigs, grip and haul hoses, rescue people.\u003c/p>\n\u003cp>Forte proved the doubters wrong.\u003c/p>\n\u003cfigure id=\"attachment_363270\" class=\"wp-caption aligncenter\" style=\"max-width: 800px\">\u003cimg class=\"size-medium wp-image-363270\" src=\"https://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2018/04/first-responder-trauma-2-800x534.jpg\" alt=\"\" width=\"800\" height=\"534\" srcset=\"https://ww2.kqed.org/app/uploads/sites/27/2018/04/first-responder-trauma-2-800x534.jpg 800w, https://ww2.kqed.org/app/uploads/sites/27/2018/04/first-responder-trauma-2-160x107.jpg 160w, https://ww2.kqed.org/app/uploads/sites/27/2018/04/first-responder-trauma-2-768x513.jpg 768w, https://ww2.kqed.org/app/uploads/sites/27/2018/04/first-responder-trauma-2-1020x681.jpg 1020w, https://ww2.kqed.org/app/uploads/sites/27/2018/04/first-responder-trauma-2-1200x801.jpg 1200w, https://ww2.kqed.org/app/uploads/sites/27/2018/04/first-responder-trauma-2-1180x788.jpg 1180w, https://ww2.kqed.org/app/uploads/sites/27/2018/04/first-responder-trauma-2-960x641.jpg 960w, https://ww2.kqed.org/app/uploads/sites/27/2018/04/first-responder-trauma-2-240x160.jpg 240w, https://ww2.kqed.org/app/uploads/sites/27/2018/04/first-responder-trauma-2-375x250.jpg 375w, https://ww2.kqed.org/app/uploads/sites/27/2018/04/first-responder-trauma-2-520x347.jpg 520w\" sizes=\"(max-width: 800px) 100vw, 800px\">\u003cfigcaption class=\"wp-caption-text\">Jeremy Forte, at fire station No. 14 in Imperial Beach, California, has been a firefighter for 19 years and struggles with PTSD and depression. \u003ccite>(Heidi de Marco/KHN)\u003c/cite>\u003c/figcaption>\u003c/figure>\n\u003cp>After 19 years as a firefighter, it has become crucial to his identity. Losing that career would have been absolutely devastating. After the drug test, Forte hired a private lawyer and asked the department and union for a second chance. He agreed to every condition of a yearlong probation, including enrolling in a recovery program and beginning therapy.\u003c/p>\n\u003cp>\"By the grace of God, I still have my job,\" Forte said. \"I still have people backing me.\"\u003c/p>\n\u003cp>During his recovery, Jeremy was diagnosed with post-traumatic stress disorder and depression. He wasn’t surprised to hear it, and he's not alone.\u003c/p>\n\u003cp>First responders have increased rates of PTSD, depression, substance abuse and suicide due to the stresses they are exposed to on the job. In a \u003ca href=\"http://www.phoenix.edu/about_us/media-center/news/uopx-releases-first-responder-mental-health-survey-results.html\" target=\"_blank\" rel=\"noopener\">recent survey\u003c/a>, 85 percent of first responders reported symptoms related to mental health issues, but only about a third of them sought out professional help.\u003c/p>\n\u003cp>Another \u003ca href=\"http://www.jems.com/articles/print/volume-40/issue-10/features/survey-reveals-alarming-rates-of-ems-provider-stress-and-thoughts-of-suicide.html?c=1\" target=\"_blank\" rel=\"noopener\">survey\u003c/a> revealed 6.6 percent of first responders had attempted suicide, and more than a third had considered suicide. In both cases, those rates are 10 times the national average.\u003c/p>\n\u003cp>\"I always thought, it’s a job, you go do it and you just deal with it, it goes away,\" Forte said. \"But it doesn’t.\"\u003c/p>\n\u003cp>The pain lingers and haunts. Forte learned that when he was 22, at his first job with the forest service. His team fought fires but also rescued backpackers -- and he was surprised by the violence that nature can cause.\u003c/p>\n\u003cp>\"There was a gentleman out camping in the middle of the forest in New Mexico,\" he recalled. \"A piece of the tree broke off and hit him in the neck and broke his neck. And as he hit the ground, he broke his leg. We had to fly there in a helicopter, basically to rescue him.\"\u003c/p>\n\u003cp>But by the time they got there, the hiker had died. It was the first time Forte saw a dead body on the job, a victim of a violent, random accident. The helicopter extracted the body, but then it grew too dark to come back for the hiker's friend, who was uninjured but traumatized and covered in blood. So Forte volunteered to stay with him all night in the woods.\u003c/p>\n\u003cp>After that incident, Forte started having nightmares.\u003c/p>\n\u003cp>\"The things that we see on the job aren’t what everyday people see and so they wouldn’t understand completely what we deal with, and how it can haunt us and stay with us the rest of our lives.\"\u003c/p>\n\u003cfigure id=\"attachment_363276\" class=\"wp-caption alignnone\" style=\"max-width: 800px\">\u003cimg src=\"https://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2018/04/first-responder-trauma-5-800x534.jpg\" alt=\"\" width=\"800\" height=\"534\" class=\"size-medium wp-image-363276\" srcset=\"https://ww2.kqed.org/app/uploads/sites/27/2018/04/first-responder-trauma-5-800x534.jpg 800w, https://ww2.kqed.org/app/uploads/sites/27/2018/04/first-responder-trauma-5-160x107.jpg 160w, https://ww2.kqed.org/app/uploads/sites/27/2018/04/first-responder-trauma-5-768x513.jpg 768w, https://ww2.kqed.org/app/uploads/sites/27/2018/04/first-responder-trauma-5-1020x681.jpg 1020w, https://ww2.kqed.org/app/uploads/sites/27/2018/04/first-responder-trauma-5-1200x801.jpg 1200w, https://ww2.kqed.org/app/uploads/sites/27/2018/04/first-responder-trauma-5-1180x788.jpg 1180w, https://ww2.kqed.org/app/uploads/sites/27/2018/04/first-responder-trauma-5-960x641.jpg 960w, https://ww2.kqed.org/app/uploads/sites/27/2018/04/first-responder-trauma-5-240x160.jpg 240w, https://ww2.kqed.org/app/uploads/sites/27/2018/04/first-responder-trauma-5-375x250.jpg 375w, https://ww2.kqed.org/app/uploads/sites/27/2018/04/first-responder-trauma-5-520x347.jpg 520w\" sizes=\"(max-width: 800px) 100vw, 800px\">\u003cfigcaption class=\"wp-caption-text\">Firefighter Jeremy Forte prepares to perform drills on Jan. 9, 2018. Forte has been a firefighter for 19 years and says the job is grueling, both physically and mentally. \u003ccite>(Heidi de Marco/KHN)\u003c/cite>\u003c/figcaption>\u003c/figure>\n\u003cp>It’s not that firefighters never talk about what they see. They do, but they don’t talk about the pain inside.\u003c/p>\n\u003cp>\"You don’t want to be seen as weak,\" he said. \"So instead ... we’d go have some drinks and joke about it, or, you know, talk about the situation still, but it’s over alcohol.\"\u003c/p>\n\u003cp>After hitting bottom, Jeremy moved his family to a wood cabin in Lake Arrowhead. It’s quiet there, and he can decompress when he isn’t at work.\u003c/p>\n\u003cp>Jeremy is now sober and back in the firehouse full-time. He tries to set an example for younger colleagues by sharing his story, and talking about his emotions more often.\u003c/p>\n\u003cp>\"The current fire crew that I work with now, we’re all very open together,\" he said. \"We’re very tight-knit and we talk about the stuff we see. ... We’re almost like our own counselors.\"\u003c/p>\n\u003cp>Often the men gather in the kitchen to make breakfast before the shift formally starts at 7:30 a.m. Some of the men set the table, while others slice mushrooms, make hash browns or scramble eggs.\u003c/p>\n\u003cp>It ends up being a slow shift, with no emergency calls, so the seven men on duty spend the day checking gear and running drills.\u003c/p>\n\u003cp>Before turning in for the night, they gather again at the kitchen table. Things get serious when the talk turns to suicide among firefighters.\u003c/p>\n\u003cp>Everyone in the room knows a firefighter who killed him or herself, or at least has heard about a recent case.\u003c/p>\n\u003cp>The shift captain, Richard Hernandez, complained that mental health information wasn’t part of the firefighter training.\u003c/p>\n\u003cp>\"There really hasn’t been any direction on how to work with that if somebody is having an issue,\" he said.\u003c/p>\n\u003cp>Hernandez said that his firefighters can get three visits with a counselor per year, but that’s not enough.\u003c/p>\n\u003cp>Another firefighter, Lindsey Nolan, said he wants to learn how to recognize signs or symptoms of PTSD in a co-worker.\u003c/p>\n\u003cp>\"I’d be a lot more comfortable approaching them and talking to them about what may or may not be going on\" if he had some training in it, Nolan said.\u003c/p>\n\u003cp>Another firefighter, Devin Boler, admitted it’s hard to know how -- or when -- to intervene.\u003c/p>\n\u003cp>\"Because we live together, and we’re with each other through Christmas and Thanksgiving and stuff like that, we have to be professional,\" Boler said. But there's also \"a family side to it, where you kind of have to check in with guys and see what’s going on, if they’re having a rough day.\"\u003c/p>\n\u003cp>Firefighters began talking about these issues more after the increase in mass public shootings, according to the \u003ca href=\"http://www.ffbha.org/\" target=\"_blank\" rel=\"noopener\">Firefighter Behavioral Health Alliance\u003c/a>, an Arizona-based nonprofit that provides mental health support and training for firefighters.\u003c/p>\n\u003ch2>A Bittersweet Milestone\u003c/h2>\n\u003cp>Forte has been making the long drive to a drug screening center, in National City, at least twice a month for the past year. It's part of his probation: submitting to a full year of random, and frequent, drug tests.\u003c/p>\n\u003cp>Today was his last visit, though. His probation is ending. Forte will still get random drug tests, but not as often.\u003c/p>\n\u003cp>\"I feel great,\" he said as he drove. \"Not like I’m going to go out and celebrate, if you know what I mean.\"\u003c/p>\n\u003cp>During the drive, Jeremy downed two large coffees. But despite the caffeine, he's too wound up to provide a urine sample. After a few hours, he succeeds, and finally walks out of that clinic for the last time.\u003c/p>\n\u003cp>\"It was a humbling process,\" he reflected, looking back at his year of probation. \"Ultimately, I wanted to get back on track for my family, for my job, for myself.\"\u003c/p>\n\u003cp>\"The biggest reason is my kids,\" he added. \"I wasn’t going to allow this to keep me down, and be some deadbeat dad that didn’t seek help.\"\u003c/p>\n\u003cp>Forte said the culture of silence among first responders has to end. So does the idea that emergency work is about being tough at all costs.\u003c/p>\n\u003cp>[ad floatright]\u003c/p>\n\u003cp>\"Guys shouldn’t feel that way,\" he said. He wants firefighters to think about seeking counseling or mental health assistance as \"the manly thing to do.\"\u003c/p>\n\u003cfigure id=\"attachment_363271\" class=\"wp-caption alignnone\" style=\"max-width: 800px\">\u003cimg src=\"https://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2018/04/first-responder-trauma-1-800x534.jpg\" alt=\"\" width=\"800\" height=\"534\" class=\"size-medium wp-image-363271\" srcset=\"https://ww2.kqed.org/app/uploads/sites/27/2018/04/first-responder-trauma-1-800x534.jpg 800w, https://ww2.kqed.org/app/uploads/sites/27/2018/04/first-responder-trauma-1-160x107.jpg 160w, https://ww2.kqed.org/app/uploads/sites/27/2018/04/first-responder-trauma-1-768x513.jpg 768w, https://ww2.kqed.org/app/uploads/sites/27/2018/04/first-responder-trauma-1-1020x681.jpg 1020w, https://ww2.kqed.org/app/uploads/sites/27/2018/04/first-responder-trauma-1-1200x801.jpg 1200w, https://ww2.kqed.org/app/uploads/sites/27/2018/04/first-responder-trauma-1-1180x788.jpg 1180w, https://ww2.kqed.org/app/uploads/sites/27/2018/04/first-responder-trauma-1-960x641.jpg 960w, https://ww2.kqed.org/app/uploads/sites/27/2018/04/first-responder-trauma-1-240x160.jpg 240w, https://ww2.kqed.org/app/uploads/sites/27/2018/04/first-responder-trauma-1-375x250.jpg 375w, https://ww2.kqed.org/app/uploads/sites/27/2018/04/first-responder-trauma-1-520x347.jpg 520w\" sizes=\"(max-width: 800px) 100vw, 800px\">\u003cfigcaption class=\"wp-caption-text\">Jeremy Forte, at fire station No. 14 in Imperial Beach, Calif., has been a firefighter for 19 years and struggles with PTSD and depression. (Heidi de Marco/KHN)\u003c/figcaption>\u003c/figure>\n\n","blocks":[],"excerpt":"Firefighter Jeremy Forte, who has battled PTSD, depression and substance abuse, says the culture of suffering in silence among first responders has to end.","status":"publish","parent":0,"modified":1523667364,"stats":{"hasAudio":false,"hasVideo":false,"hasChartOrMap":false,"iframeSrcs":[],"hasGoogleForm":false,"hasGallery":false,"hasHearkenModule":false,"hasPolis":false,"paragraphCount":50,"wordCount":1732},"headData":{"title":"A Firefighter in San Diego Confronts the Trauma of the Job | KQED","description":"Firefighter Jeremy Forte, who has battled PTSD, depression and substance abuse, says the culture of suffering in silence among first responders has to end.","ogTitle":"","ogDescription":"","ogImgId":"","twTitle":"","twDescription":"","twImgId":"","schema":{"@context":"http://schema.org","@type":"Article","headline":"A Firefighter in San Diego Confronts the Trauma of the Job","datePublished":"2018-04-13T23:29:13.000Z","dateModified":"2018-04-14T00:56:04.000Z","image":"https://cdn.kqed.org/wp-content/uploads/2020/02/KQED-OG-Image@1x.png"}},"disqusIdentifier":"363257 https://ww2.kqed.org/stateofhealth/?p=363257","disqusUrl":"https://ww2.kqed.org/stateofhealth/2018/04/13/a-firefighter-in-san-diego-confronts-the-trauma-of-the-job/","disqusTitle":"A Firefighter in San Diego Confronts the Trauma of the Job","audioUrl":"https://www.kqed.org/.stream/anon/radio/tcrmag/2018/04/FirefighterTrauma.mp3","nprByline":"\u003cstrong>\u003ca href=\"https://khn.org/news/author/heidi-de-marco/\">Heidi de Marco\u003c/a>\u003c/strong>\u003cbr>California Healthline","path":"/stateofhealth/363257/a-firefighter-in-san-diego-confronts-the-trauma-of-the-job","audioTrackLength":null,"parsedContent":[{"type":"contentString","content":"\u003cdiv class=\"post-body\">\u003cp>\u003cp>\u003cem>\u003ca href=\"http://itunes.apple.com/us/podcast/the-california-report-magazine/id1314750545?mt=2\" rel=\"noopener\" target=\"_blank\">Listen to this and more in-depth storytelling by subscribing to The California Report Magazine podcast.\u003c/a>\u003c/em>\u003c/p>\n\u003cp>At 7:30 on a recent morning, Jeremy Forte, a firefighter in Imperial Beach, California, had just wrapped up a 48-hour shift. As the seven-member crew headed home, Forte drove right past a local bar that used to be a favorite haunt. A few years ago, he would have stopped for a drink, or two, or three -- and perhaps stayed on for hours. And he would have had plenty of company.\u003c/p>\n\u003cp>\"There’s nurses from the hospital there getting off work at the same time,\" Forte recalled. \"We’d be drinking with nurses, partying, having a good old time. And we didn’t think anything was wrong. That’s what people do, right? They get off work and have some drinks.\"\u003c/p>\n\u003cp>Jeremy is tall and lanky, with a thin mustache. He’s been a firefighter for 19 years. It’s grueling work, both physically and mentally. For a long time, drinking was how he coped.\u003c/p>\n\u003cp>\"Our motto was work hard, party hard,\" said Forte, now 39. \"We put in 16-hour days and then we’d go drink the rest of the night, and then probably get two hours of sleep. Wake up, you know, half-drunk and go back out on the fire line and fight these fires.\"\u003c/p>\n\u003cp>\u003c/p>\u003c/div>","attributes":{"named":{},"numeric":[]}},{"type":"component","content":"","name":"ad","attributes":{"named":{"label":"fullwidth"},"numeric":["fullwidth"]}},{"type":"contentString","content":"\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>A few years ago, Forte's drinking got heavier. He started dabbling in cocaine. But he felt he still had it all under control, until he failed a random drug test at work.\u003c/p>\n\u003cp>Forte's station is part of the federal government: his crew fights fires and responds to emergencies in and around a \u003ca href=\"https://www.cnic.navy.mil/regions/cnrsw/installations/navbase_coronado.html\" target=\"_blank\" rel=\"noopener\">naval base\u003c/a> in Imperial Beach. The federal firefighting force has a zero-tolerance policy, and Forte was in danger of losing his job immediately.\u003c/p>\n\u003cp>\"They really could have ended my whole life by turning their backs on me and firing me,\" Forte said. \"And then at that point, I would lose my wife as well, and probably be living with my parents.\"\u003c/p>\n\u003cp>Forte grew up in West Covina. Two \u003ca href=\"http://www.lafd.org/\" target=\"_blank\" rel=\"noopener\">LAFD\u003c/a> firefighters lived on his block. Forte admired them, and loved seeing his next-door neighbors on the local news.\u003c/p>\n\u003cp>\"Doing that sort of thing really intrigued me,\" he recalled. Not only was the job itself exciting, but it also allowed the firefighters to spend plenty of time with their families when they were off-duty.\u003c/p>\n\u003cp>But not everyone believed he could do it. Forte was born with a birth defect: He’s missing some fingers on both hands, and others aren’t fully formed. His whole career, he’s had to prove that he can do everything a firefighter has to do: drive rigs, grip and haul hoses, rescue people.\u003c/p>\n\u003cp>Forte proved the doubters wrong.\u003c/p>\n\u003cfigure id=\"attachment_363270\" class=\"wp-caption aligncenter\" style=\"max-width: 800px\">\u003cimg class=\"size-medium wp-image-363270\" src=\"https://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2018/04/first-responder-trauma-2-800x534.jpg\" alt=\"\" width=\"800\" height=\"534\" srcset=\"https://ww2.kqed.org/app/uploads/sites/27/2018/04/first-responder-trauma-2-800x534.jpg 800w, https://ww2.kqed.org/app/uploads/sites/27/2018/04/first-responder-trauma-2-160x107.jpg 160w, https://ww2.kqed.org/app/uploads/sites/27/2018/04/first-responder-trauma-2-768x513.jpg 768w, https://ww2.kqed.org/app/uploads/sites/27/2018/04/first-responder-trauma-2-1020x681.jpg 1020w, https://ww2.kqed.org/app/uploads/sites/27/2018/04/first-responder-trauma-2-1200x801.jpg 1200w, https://ww2.kqed.org/app/uploads/sites/27/2018/04/first-responder-trauma-2-1180x788.jpg 1180w, https://ww2.kqed.org/app/uploads/sites/27/2018/04/first-responder-trauma-2-960x641.jpg 960w, https://ww2.kqed.org/app/uploads/sites/27/2018/04/first-responder-trauma-2-240x160.jpg 240w, https://ww2.kqed.org/app/uploads/sites/27/2018/04/first-responder-trauma-2-375x250.jpg 375w, https://ww2.kqed.org/app/uploads/sites/27/2018/04/first-responder-trauma-2-520x347.jpg 520w\" sizes=\"(max-width: 800px) 100vw, 800px\">\u003cfigcaption class=\"wp-caption-text\">Jeremy Forte, at fire station No. 14 in Imperial Beach, California, has been a firefighter for 19 years and struggles with PTSD and depression. \u003ccite>(Heidi de Marco/KHN)\u003c/cite>\u003c/figcaption>\u003c/figure>\n\u003cp>After 19 years as a firefighter, it has become crucial to his identity. Losing that career would have been absolutely devastating. After the drug test, Forte hired a private lawyer and asked the department and union for a second chance. He agreed to every condition of a yearlong probation, including enrolling in a recovery program and beginning therapy.\u003c/p>\n\u003cp>\"By the grace of God, I still have my job,\" Forte said. \"I still have people backing me.\"\u003c/p>\n\u003cp>During his recovery, Jeremy was diagnosed with post-traumatic stress disorder and depression. He wasn’t surprised to hear it, and he's not alone.\u003c/p>\n\u003cp>First responders have increased rates of PTSD, depression, substance abuse and suicide due to the stresses they are exposed to on the job. In a \u003ca href=\"http://www.phoenix.edu/about_us/media-center/news/uopx-releases-first-responder-mental-health-survey-results.html\" target=\"_blank\" rel=\"noopener\">recent survey\u003c/a>, 85 percent of first responders reported symptoms related to mental health issues, but only about a third of them sought out professional help.\u003c/p>\n\u003cp>Another \u003ca href=\"http://www.jems.com/articles/print/volume-40/issue-10/features/survey-reveals-alarming-rates-of-ems-provider-stress-and-thoughts-of-suicide.html?c=1\" target=\"_blank\" rel=\"noopener\">survey\u003c/a> revealed 6.6 percent of first responders had attempted suicide, and more than a third had considered suicide. In both cases, those rates are 10 times the national average.\u003c/p>\n\u003cp>\"I always thought, it’s a job, you go do it and you just deal with it, it goes away,\" Forte said. \"But it doesn’t.\"\u003c/p>\n\u003cp>The pain lingers and haunts. Forte learned that when he was 22, at his first job with the forest service. His team fought fires but also rescued backpackers -- and he was surprised by the violence that nature can cause.\u003c/p>\n\u003cp>\"There was a gentleman out camping in the middle of the forest in New Mexico,\" he recalled. \"A piece of the tree broke off and hit him in the neck and broke his neck. And as he hit the ground, he broke his leg. We had to fly there in a helicopter, basically to rescue him.\"\u003c/p>\n\u003cp>But by the time they got there, the hiker had died. It was the first time Forte saw a dead body on the job, a victim of a violent, random accident. The helicopter extracted the body, but then it grew too dark to come back for the hiker's friend, who was uninjured but traumatized and covered in blood. So Forte volunteered to stay with him all night in the woods.\u003c/p>\n\u003cp>After that incident, Forte started having nightmares.\u003c/p>\n\u003cp>\"The things that we see on the job aren’t what everyday people see and so they wouldn’t understand completely what we deal with, and how it can haunt us and stay with us the rest of our lives.\"\u003c/p>\n\u003cfigure id=\"attachment_363276\" class=\"wp-caption alignnone\" style=\"max-width: 800px\">\u003cimg src=\"https://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2018/04/first-responder-trauma-5-800x534.jpg\" alt=\"\" width=\"800\" height=\"534\" class=\"size-medium wp-image-363276\" srcset=\"https://ww2.kqed.org/app/uploads/sites/27/2018/04/first-responder-trauma-5-800x534.jpg 800w, https://ww2.kqed.org/app/uploads/sites/27/2018/04/first-responder-trauma-5-160x107.jpg 160w, https://ww2.kqed.org/app/uploads/sites/27/2018/04/first-responder-trauma-5-768x513.jpg 768w, https://ww2.kqed.org/app/uploads/sites/27/2018/04/first-responder-trauma-5-1020x681.jpg 1020w, https://ww2.kqed.org/app/uploads/sites/27/2018/04/first-responder-trauma-5-1200x801.jpg 1200w, https://ww2.kqed.org/app/uploads/sites/27/2018/04/first-responder-trauma-5-1180x788.jpg 1180w, https://ww2.kqed.org/app/uploads/sites/27/2018/04/first-responder-trauma-5-960x641.jpg 960w, https://ww2.kqed.org/app/uploads/sites/27/2018/04/first-responder-trauma-5-240x160.jpg 240w, https://ww2.kqed.org/app/uploads/sites/27/2018/04/first-responder-trauma-5-375x250.jpg 375w, https://ww2.kqed.org/app/uploads/sites/27/2018/04/first-responder-trauma-5-520x347.jpg 520w\" sizes=\"(max-width: 800px) 100vw, 800px\">\u003cfigcaption class=\"wp-caption-text\">Firefighter Jeremy Forte prepares to perform drills on Jan. 9, 2018. Forte has been a firefighter for 19 years and says the job is grueling, both physically and mentally. \u003ccite>(Heidi de Marco/KHN)\u003c/cite>\u003c/figcaption>\u003c/figure>\n\u003cp>It’s not that firefighters never talk about what they see. They do, but they don’t talk about the pain inside.\u003c/p>\n\u003cp>\"You don’t want to be seen as weak,\" he said. \"So instead ... we’d go have some drinks and joke about it, or, you know, talk about the situation still, but it’s over alcohol.\"\u003c/p>\n\u003cp>After hitting bottom, Jeremy moved his family to a wood cabin in Lake Arrowhead. It’s quiet there, and he can decompress when he isn’t at work.\u003c/p>\n\u003cp>Jeremy is now sober and back in the firehouse full-time. He tries to set an example for younger colleagues by sharing his story, and talking about his emotions more often.\u003c/p>\n\u003cp>\"The current fire crew that I work with now, we’re all very open together,\" he said. \"We’re very tight-knit and we talk about the stuff we see. ... We’re almost like our own counselors.\"\u003c/p>\n\u003cp>Often the men gather in the kitchen to make breakfast before the shift formally starts at 7:30 a.m. Some of the men set the table, while others slice mushrooms, make hash browns or scramble eggs.\u003c/p>\n\u003cp>It ends up being a slow shift, with no emergency calls, so the seven men on duty spend the day checking gear and running drills.\u003c/p>\n\u003cp>Before turning in for the night, they gather again at the kitchen table. Things get serious when the talk turns to suicide among firefighters.\u003c/p>\n\u003cp>Everyone in the room knows a firefighter who killed him or herself, or at least has heard about a recent case.\u003c/p>\n\u003cp>The shift captain, Richard Hernandez, complained that mental health information wasn’t part of the firefighter training.\u003c/p>\n\u003cp>\"There really hasn’t been any direction on how to work with that if somebody is having an issue,\" he said.\u003c/p>\n\u003cp>Hernandez said that his firefighters can get three visits with a counselor per year, but that’s not enough.\u003c/p>\n\u003cp>Another firefighter, Lindsey Nolan, said he wants to learn how to recognize signs or symptoms of PTSD in a co-worker.\u003c/p>\n\u003cp>\"I’d be a lot more comfortable approaching them and talking to them about what may or may not be going on\" if he had some training in it, Nolan said.\u003c/p>\n\u003cp>Another firefighter, Devin Boler, admitted it’s hard to know how -- or when -- to intervene.\u003c/p>\n\u003cp>\"Because we live together, and we’re with each other through Christmas and Thanksgiving and stuff like that, we have to be professional,\" Boler said. But there's also \"a family side to it, where you kind of have to check in with guys and see what’s going on, if they’re having a rough day.\"\u003c/p>\n\u003cp>Firefighters began talking about these issues more after the increase in mass public shootings, according to the \u003ca href=\"http://www.ffbha.org/\" target=\"_blank\" rel=\"noopener\">Firefighter Behavioral Health Alliance\u003c/a>, an Arizona-based nonprofit that provides mental health support and training for firefighters.\u003c/p>\n\u003ch2>A Bittersweet Milestone\u003c/h2>\n\u003cp>Forte has been making the long drive to a drug screening center, in National City, at least twice a month for the past year. It's part of his probation: submitting to a full year of random, and frequent, drug tests.\u003c/p>\n\u003cp>Today was his last visit, though. His probation is ending. Forte will still get random drug tests, but not as often.\u003c/p>\n\u003cp>\"I feel great,\" he said as he drove. \"Not like I’m going to go out and celebrate, if you know what I mean.\"\u003c/p>\n\u003cp>During the drive, Jeremy downed two large coffees. But despite the caffeine, he's too wound up to provide a urine sample. After a few hours, he succeeds, and finally walks out of that clinic for the last time.\u003c/p>\n\u003cp>\"It was a humbling process,\" he reflected, looking back at his year of probation. \"Ultimately, I wanted to get back on track for my family, for my job, for myself.\"\u003c/p>\n\u003cp>\"The biggest reason is my kids,\" he added. \"I wasn’t going to allow this to keep me down, and be some deadbeat dad that didn’t seek help.\"\u003c/p>\n\u003cp>Forte said the culture of silence among first responders has to end. So does the idea that emergency work is about being tough at all costs.\u003c/p>\n\u003cp>\u003c/p>\u003c/div>","attributes":{"named":{},"numeric":[]}},{"type":"component","content":"","name":"ad","attributes":{"named":{"label":"floatright"},"numeric":["floatright"]}},{"type":"contentString","content":"\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>\"Guys shouldn’t feel that way,\" he said. He wants firefighters to think about seeking counseling or mental health assistance as \"the manly thing to do.\"\u003c/p>\n\u003cfigure id=\"attachment_363271\" class=\"wp-caption alignnone\" style=\"max-width: 800px\">\u003cimg src=\"https://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2018/04/first-responder-trauma-1-800x534.jpg\" alt=\"\" width=\"800\" height=\"534\" class=\"size-medium wp-image-363271\" srcset=\"https://ww2.kqed.org/app/uploads/sites/27/2018/04/first-responder-trauma-1-800x534.jpg 800w, https://ww2.kqed.org/app/uploads/sites/27/2018/04/first-responder-trauma-1-160x107.jpg 160w, https://ww2.kqed.org/app/uploads/sites/27/2018/04/first-responder-trauma-1-768x513.jpg 768w, https://ww2.kqed.org/app/uploads/sites/27/2018/04/first-responder-trauma-1-1020x681.jpg 1020w, https://ww2.kqed.org/app/uploads/sites/27/2018/04/first-responder-trauma-1-1200x801.jpg 1200w, https://ww2.kqed.org/app/uploads/sites/27/2018/04/first-responder-trauma-1-1180x788.jpg 1180w, https://ww2.kqed.org/app/uploads/sites/27/2018/04/first-responder-trauma-1-960x641.jpg 960w, https://ww2.kqed.org/app/uploads/sites/27/2018/04/first-responder-trauma-1-240x160.jpg 240w, https://ww2.kqed.org/app/uploads/sites/27/2018/04/first-responder-trauma-1-375x250.jpg 375w, https://ww2.kqed.org/app/uploads/sites/27/2018/04/first-responder-trauma-1-520x347.jpg 520w\" sizes=\"(max-width: 800px) 100vw, 800px\">\u003cfigcaption class=\"wp-caption-text\">Jeremy Forte, at fire station No. 14 in Imperial Beach, Calif., has been a firefighter for 19 years and struggles with PTSD and depression. (Heidi de Marco/KHN)\u003c/figcaption>\u003c/figure>\n\n\u003c/div>\u003c/p>","attributes":{"named":{},"numeric":[]}}],"link":"/stateofhealth/363257/a-firefighter-in-san-diego-confronts-the-trauma-of-the-job","authors":["byline_stateofhealth_363257"],"categories":["stateofhealth_11","stateofhealth_3012","stateofhealth_14","stateofhealth_2746","stateofhealth_1"],"tags":["stateofhealth_3240","stateofhealth_2519"],"affiliates":["stateofhealth_3036"],"featImg":"stateofhealth_363272","label":"stateofhealth_3036"},"stateofhealth_363009":{"type":"posts","id":"stateofhealth_363009","meta":{"index":"posts_1591205157","site":"stateofhealth","id":"363009","score":null,"sort":[1521633630000]},"guestAuthors":[],"slug":"couples-therapists-dish-on-their-own-relationships","title":"Couples’ Therapists Dish on Their Own Relationships","publishDate":1521633630,"format":"audio","headTitle":"State of Health | KQED News","labelTerm":{"site":"stateofhealth"},"content":"\u003cp>Do you ever wonder what your couples’ therapist's own marriage is like? Do they fight over silly stuff, like the rest of us?\u003c/p>\n\u003cp>Harville Hendrix and Helen Hunt have been married for more than 30 years. They work as a \u003ca href=\"http://harvilleandhelen.com/\" target=\"_blank\" rel=\"noopener\">therapeutic team\u003c/a> and, now that their six kids are grown, they’ve been traveling the country teaching a course called \u003ca href=\"https://relationshipsfirst.org/\" target=\"_blank\" rel=\"noopener\">Safe Conversations\u003c/a>.\u003c/p>\n\u003cp>“Talking is the most dangerous thing people do,” Hendrix said during their presentation at a \u003ca href=\"https://lifespanlearn.org/conferences\" target=\"_blank\" rel=\"noopener\">couples’ counseling conference\u003c/a> in Los Angeles. “Listening is the most infrequent.”\u003c/p>\n\u003cp>Instead of calling their work therapy, they prefer “relationship education.” They teach people to look in each others’ eyes and take three deep breaths before talking. And to say things like, “Is now a good time to give you an appreciation?”\u003c/p>\n\u003cp>When they ask the audience in LA to find a partner and try this, people are \u003cem>into\u003c/em> it. It’s a room full of 500 couples’ therapists after all. But Hunt says they do get pushback when they try it with churches at home in Dallas.\u003c/p>\n\u003cp>[ad fullwidth]\u003c/p>\n\u003cp>“Most people think, ‘Oh well, it’s easy for Harville and Helen to talk about it, but they’re not married to a jerk. I’m married to a jerk,’” Hunt said. “That stuff’s never going to work on my marriage.”\u003c/p>\n\u003cp>But Hunt says, she and Hendrix could be jerks, too. For years, they were on the brink of divorce. They griped at each other all the time.\u003c/p>\n\u003cp>They sat on a panel together at the conference with four other couples, all in the relationship therapy business, talking about how they managed to turn things around.\u003c/p>\n\u003cp>“What we finally decided to do was Go Zero Negative,” said Hendrix, quoting one of the catch-phrases from their presentation.\u003c/p>\n\u003cp>“We ended the offhand comments like ‘What? Where’d you get an idea like that?’ Or the stare – like, ‘how could you possibly?’” he said. “And what we discovered was that put downs are endemic in human conversation. I didn’t know that we were being so – like everybody else.”\u003c/p>\n\u003cp>Stopping the negativity is just the start, Hendrix said. Couples have to say nice things to each other, too.\u003c/p>\n\u003cp>“It’s like a garden,” he said. “You can get the weeds out of the garden, you still don’t get any tomatoes. You have to put stuff in.”\u003c/p>\n\u003cp>A lot of therapists laugh when people say, “you must never fight with your spouse.” Psychologist Stan Tatkin and his wife run a therapy institute near LA called the \u003ca href=\"https://thepactinstitute.com/\" target=\"_blank\" rel=\"noopener\">Psychobiological Approach to Couples Therapy (PACT) Institute\u003c/a>.\u003c/p>\n\u003cp>“My daughter will say, “you’re a so-called relationship expert, do you really want to be doing \u003cem>that\u003c/em>?” said Tatkin, his wife sitting next to him on the panel.\u003c/p>\n\u003cp>“That,” for Tatkin, means acting like a three-year old when he’s angry. Getting irritable over his wife’s driving, or generally, taking her for granted.\u003c/p>\n\u003cp>“The patients that I work with are also inspiring to me. And many times I sit through a session and think, ‘I’m going to go home and apologize,’” he said.\u003c/p>\n\u003cp>He and his wife do have fights, he said, but the key is to resolve them quickly. Don’t let things fester.\u003c/p>\n\u003cp>\u003ca href=\"http://drmarionsolomon.com/\" target=\"_blank\" rel=\"noopener\">Marion Solomon\u003c/a>, a psychologist who sees couples in West Hollywood, said she learned from watching her patients \u003cem>what\u003c/em> to fight about.\u003c/p>\n\u003cp>“They argue about things like what restaurant to go to for dinner,” she said. “And after they’ve finished arguing and they agree on it, they argue about ‘How do we get there? What route do we take?’”\u003c/p>\n\u003cp>She studied attachment theory, and learned that people aren’t really fighting over those little things. They’re stuck in dynamics they had with their mother or father that they’ve recreated with their partner.\u003c/p>\n\u003cp>Solomon learned to control her reactions when the little things didn’t matter. If something was really important to her husband and not a big deal to her, she gave in. He did the same for her.\u003c/p>\n\u003cp>\u003c/p>\n\u003cp>“If your partner is under stress, that’s the time to get strong and to get my cortex in line and say I can’t be upset when he’s upset,” she said. In other words, “a good marriage is a partnership where only one partner goes crazy at a time.”\u003c/p>\n\n","blocks":[],"excerpt":"A panel of marriage counselors talk about how their relationships affect their work, and how their work affects their relationships. ","status":"publish","parent":0,"modified":1521674799,"stats":{"hasAudio":false,"hasVideo":false,"hasChartOrMap":false,"iframeSrcs":[],"hasGoogleForm":false,"hasGallery":false,"hasHearkenModule":false,"hasPolis":false,"paragraphCount":24,"wordCount":800},"headData":{"title":"Couples’ Therapists Dish on Their Own Relationships | KQED","description":"A panel of marriage counselors talk about how their relationships affect their work, and how their work affects their relationships. ","ogTitle":"","ogDescription":"","ogImgId":"","twTitle":"","twDescription":"","twImgId":"","schema":{"@context":"http://schema.org","@type":"Article","headline":"Couples’ Therapists Dish on Their Own Relationships","datePublished":"2018-03-21T12:00:30.000Z","dateModified":"2018-03-21T23:26:39.000Z","image":"https://cdn.kqed.org/wp-content/uploads/2020/02/KQED-OG-Image@1x.png"}},"disqusIdentifier":"363009 https://ww2.kqed.org/stateofhealth/?p=363009","disqusUrl":"https://ww2.kqed.org/stateofhealth/2018/03/21/couples-therapists-dish-on-their-own-relationships/","disqusTitle":"Couples’ Therapists Dish on Their Own Relationships","audioUrl":"https://www.kqed.org/.stream/anon/radio/RDnews/2018/03/DemboskyCouplesConference.mp3","path":"/stateofhealth/363009/couples-therapists-dish-on-their-own-relationships","audioTrackLength":null,"parsedContent":[{"type":"contentString","content":"\u003cdiv class=\"post-body\">\u003cp>\u003cp>Do you ever wonder what your couples’ therapist's own marriage is like? Do they fight over silly stuff, like the rest of us?\u003c/p>\n\u003cp>Harville Hendrix and Helen Hunt have been married for more than 30 years. They work as a \u003ca href=\"http://harvilleandhelen.com/\" target=\"_blank\" rel=\"noopener\">therapeutic team\u003c/a> and, now that their six kids are grown, they’ve been traveling the country teaching a course called \u003ca href=\"https://relationshipsfirst.org/\" target=\"_blank\" rel=\"noopener\">Safe Conversations\u003c/a>.\u003c/p>\n\u003cp>“Talking is the most dangerous thing people do,” Hendrix said during their presentation at a \u003ca href=\"https://lifespanlearn.org/conferences\" target=\"_blank\" rel=\"noopener\">couples’ counseling conference\u003c/a> in Los Angeles. “Listening is the most infrequent.”\u003c/p>\n\u003cp>Instead of calling their work therapy, they prefer “relationship education.” They teach people to look in each others’ eyes and take three deep breaths before talking. And to say things like, “Is now a good time to give you an appreciation?”\u003c/p>\n\u003cp>When they ask the audience in LA to find a partner and try this, people are \u003cem>into\u003c/em> it. It’s a room full of 500 couples’ therapists after all. But Hunt says they do get pushback when they try it with churches at home in Dallas.\u003c/p>\n\u003cp>\u003c/p>\u003c/div>","attributes":{"named":{},"numeric":[]}},{"type":"component","content":"","name":"ad","attributes":{"named":{"label":"fullwidth"},"numeric":["fullwidth"]}},{"type":"contentString","content":"\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>“Most people think, ‘Oh well, it’s easy for Harville and Helen to talk about it, but they’re not married to a jerk. I’m married to a jerk,’” Hunt said. “That stuff’s never going to work on my marriage.”\u003c/p>\n\u003cp>But Hunt says, she and Hendrix could be jerks, too. For years, they were on the brink of divorce. They griped at each other all the time.\u003c/p>\n\u003cp>They sat on a panel together at the conference with four other couples, all in the relationship therapy business, talking about how they managed to turn things around.\u003c/p>\n\u003cp>“What we finally decided to do was Go Zero Negative,” said Hendrix, quoting one of the catch-phrases from their presentation.\u003c/p>\n\u003cp>“We ended the offhand comments like ‘What? Where’d you get an idea like that?’ Or the stare – like, ‘how could you possibly?’” he said. “And what we discovered was that put downs are endemic in human conversation. I didn’t know that we were being so – like everybody else.”\u003c/p>\n\u003cp>Stopping the negativity is just the start, Hendrix said. Couples have to say nice things to each other, too.\u003c/p>\n\u003cp>“It’s like a garden,” he said. “You can get the weeds out of the garden, you still don’t get any tomatoes. You have to put stuff in.”\u003c/p>\n\u003cp>A lot of therapists laugh when people say, “you must never fight with your spouse.” Psychologist Stan Tatkin and his wife run a therapy institute near LA called the \u003ca href=\"https://thepactinstitute.com/\" target=\"_blank\" rel=\"noopener\">Psychobiological Approach to Couples Therapy (PACT) Institute\u003c/a>.\u003c/p>\n\u003cp>“My daughter will say, “you’re a so-called relationship expert, do you really want to be doing \u003cem>that\u003c/em>?” said Tatkin, his wife sitting next to him on the panel.\u003c/p>\n\u003cp>“That,” for Tatkin, means acting like a three-year old when he’s angry. Getting irritable over his wife’s driving, or generally, taking her for granted.\u003c/p>\n\u003cp>“The patients that I work with are also inspiring to me. And many times I sit through a session and think, ‘I’m going to go home and apologize,’” he said.\u003c/p>\n\u003cp>He and his wife do have fights, he said, but the key is to resolve them quickly. Don’t let things fester.\u003c/p>\n\u003cp>\u003ca href=\"http://drmarionsolomon.com/\" target=\"_blank\" rel=\"noopener\">Marion Solomon\u003c/a>, a psychologist who sees couples in West Hollywood, said she learned from watching her patients \u003cem>what\u003c/em> to fight about.\u003c/p>\n\u003cp>“They argue about things like what restaurant to go to for dinner,” she said. “And after they’ve finished arguing and they agree on it, they argue about ‘How do we get there? What route do we take?’”\u003c/p>\n\u003cp>She studied attachment theory, and learned that people aren’t really fighting over those little things. They’re stuck in dynamics they had with their mother or father that they’ve recreated with their partner.\u003c/p>\n\u003cp>Solomon learned to control her reactions when the little things didn’t matter. If something was really important to her husband and not a big deal to her, she gave in. He did the same for her.\u003c/p>\n\u003cp>\u003c/p>\n\u003cp>“If your partner is under stress, that’s the time to get strong and to get my cortex in line and say I can’t be upset when he’s upset,” she said. In other words, “a good marriage is a partnership where only one partner goes crazy at a time.”\u003c/p>\n\n\u003c/div>\u003c/p>","attributes":{"named":{},"numeric":[]}}],"link":"/stateofhealth/363009/couples-therapists-dish-on-their-own-relationships","authors":["3205"],"categories":["stateofhealth_11","stateofhealth_12","stateofhealth_3012","stateofhealth_1"],"tags":["stateofhealth_3234","stateofhealth_3232","stateofhealth_2808","stateofhealth_2519","stateofhealth_3233"],"featImg":"stateofhealth_363013","label":"stateofhealth"},"stateofhealth_362850":{"type":"posts","id":"stateofhealth_362850","meta":{"index":"posts_1591205157","site":"stateofhealth","id":"362850","score":null,"sort":[1520240430000]},"guestAuthors":[],"slug":"to-screen-or-not-to-screen-doctors-debate-post-partum-depression-testing","title":"To Screen or Not to Screen? Doctors Debate Post Partum Depression Testing","publishDate":1520240430,"format":"audio","headTitle":"State of Health | KQED News","labelTerm":{"site":"stateofhealth"},"content":"\u003cp>Lawmakers will begin debate next month on a bill that would require doctors to screen new moms for mental health problems – once while they’re pregnant and again, after giving birth.\u003c/p>\n\u003cp>But a lot of doctors don’t like the idea. Many obstetricians and pediatricians are afraid to screen new moms for depression and anxiety.\u003c/p>\n\u003cp>“What are you going to do with those people who screen positive?” said Laura Sirott, an OB/GYN who practices in Pasadena. “Some providers have nowhere to send them.”\u003c/p>\n\u003cp>Of women who screen positive for postpartum depression, 78 percent don’t get mental health treatment, according to a \u003ca href=\"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4618720/\" target=\"_blank\" rel=\"noopener\">2015 study review\u003c/a> published in the journal \u003cem>Obstetrics & Gynecology\u003c/em>. Dr. Sirott’s patients have told her the range of reasons why they don’t take her up on a referral to a psychologist.\u003c/p>\n\u003cp>“Oh, they don’t take my insurance. Or my insurance pays for three visits. I can’t take time off of work to go to those visits. It’s a three-month wait to get in to that person,” she said.\u003c/p>\n\u003cp>[ad fullwidth]\u003c/p>\n\u003cp>And, it’s hard to find a psychiatrist who is trained in the complexities of prescribing medications to pregnant or breastfeeding women, and who is willing to treat them, especially in rural areas.\u003c/p>\n\u003cp>“So it’s very frustrating to ask patients about a problem and then not have any way to solve that problem,” Sirott said.\u003c/p>\n\u003cp>But moms are frustrated, too. After the baby comes, no one asks about them anymore. Wendy Root Askew struggled for years to get pregnant, and when she finally did, her anxiety got worse. She couldn’t stop worrying that something would go wrong.\u003c/p>\n\u003cp>“And then after I had my son, I would have these dreams where someone would come to the door and they would say ‘Well, you know, we’re just going to wait two weeks to see if you get to keep your baby or not,’” she said. “And it really impacted my ability to bond with him.”\u003c/p>\n\u003cp>She likes the bill, \u003ca href=\"http://leginfo.legislature.ca.gov/faces/billTextClient.xhtml?bill_id=201720180AB2193\" target=\"_blank\" rel=\"noopener\">AB 2193\u003c/a>, because it goes beyond mandated screening. It requires health insurance companies to set up case management programs to help moms find a therapist, and to connect obstetricians or pediatricians with a psychiatric expert.\u003c/p>\n\u003cp>“Just like we have case management programs for patients who have diabetes or sleep issues or back pain, a case management program requires the insurance company to take some ownership of making sure their patients are getting the treatment they need to be healthy,” said Root Askew, who is now advocating for the bill on behalf of the group \u003ca href=\"https://www.2020mom.org/\" target=\"_blank\" rel=\"noopener\">2020 Mom\u003c/a>.\u003c/p>\n\u003cp>Health insurance companies haven’t taken a position on the legislation. It’s unclear how much it will cost them to comply, because some already have infrastructure in place for case management programs and some don’t. But there is consensus among insurers and health advocates that such programs save money in the long run.\u003c/p>\n\u003cp>“The sooner that you can get good treatment for a mom, the less expensive that condition will be to manage over the course of the woman’s life and over the course of that child’s life,” Root Askew said.\u003c/p>\n\u003cp>Doctors still have their objections. Under the bill, they could be disciplined for not screening. And screening takes time. Sometimes a doctor asks a mom how she’s sleeping, and she’s in tears for the next 30 minutes.\u003c/p>\n\u003cp>The health care system, and the incentives, aren’t set up for this, said Dr. Sirott.\u003c/p>\n\u003cp>“Currently, I get six dollars for screening a patient,” she said. “By the time I put it on a piece of paper and print it, it’s not worth it.”\u003c/p>\n\u003cp>And it’s not clear it’s worth it to the patients either. Four other states – Illinois, Massachusetts, New Jersey, and West Virginia – have tried mandated screening, and it made no difference in patient outcomes, according to \u003ca href=\"https://ps.psychiatryonline.org/doi/10.1176/appi.ps.201300505?code=ps-site\" target=\"_blank\" rel=\"noopener\">a study\u003c/a> published in \u003cem>Psychiatric Services\u003c/em> in 2015.\u003c/p>\n\u003cp>Even with California’s extra requirements on insurance companies to facilitate care, women could still face high co-pays or limits on therapy sessions. Or, they’re so overwhelmed caring for a newborn, they never leave the house.\u003c/p>\n\u003cp>What does seem to work, according to the study, is when nurses or mental health providers visit new moms at home.\u003c/p>\n\u003cp>“Despite abundant good will, there is no evidence that state policies are addressing this great need,” the study authors wrote.\u003c/p>\n\u003cp>But supporters of the proposed bill say doctors need to start somewhere. Screening is the first step in recognizing the full scope of the problem, said Mountain View psychiatrist \u003ca href=\"https://www.elcaminohospital.org/doctors/nirmaljit-dhami\" target=\"_blank\" rel=\"noopener\">Nirmaljit Dhami\u003c/a>, adding that women should be screened on an ongoing basis throughout pregnancy and for a year after birth, not just once or twice as the bill requires.\u003c/p>\n\u003cp>\u003c/p>\n\u003cp>“I often tell doctors that if you don't know that somebody is suicidal it doesn't mean that their suicidality will go away,” she said. “If you don't ask, the risk is the same.”\u003c/p>\n\n","blocks":[],"excerpt":"A proposed bill would require doctors to screen new moms for depression, and require health insurers to help them get care.","status":"publish","parent":0,"modified":1521474114,"stats":{"hasAudio":false,"hasVideo":false,"hasChartOrMap":false,"iframeSrcs":[],"hasGoogleForm":false,"hasGallery":false,"hasHearkenModule":false,"hasPolis":false,"paragraphCount":24,"wordCount":891},"headData":{"title":"To Screen or Not to Screen? Doctors Debate Post Partum Depression Testing | KQED","description":"A proposed bill would require doctors to screen new moms for depression, and require health insurers to help them get care.","ogTitle":"","ogDescription":"","ogImgId":"","twTitle":"","twDescription":"","twImgId":"","schema":{"@context":"http://schema.org","@type":"Article","headline":"To Screen or Not to Screen? Doctors Debate Post Partum Depression Testing","datePublished":"2018-03-05T09:00:30.000Z","dateModified":"2018-03-19T15:41:54.000Z","image":"https://cdn.kqed.org/wp-content/uploads/2020/02/KQED-OG-Image@1x.png"}},"disqusIdentifier":"362850 https://ww2.kqed.org/stateofhealth/?p=362850","disqusUrl":"https://ww2.kqed.org/stateofhealth/2018/03/05/to-screen-or-not-to-screen-doctors-debate-post-partum-depression-testing/","disqusTitle":"To Screen or Not to Screen? Doctors Debate Post Partum Depression Testing","audioUrl":"https://www.kqed.org/.stream/anon/radio/tcr/2018/03/MandatedPostPartumScreeningDembosky.mp3","path":"/stateofhealth/362850/to-screen-or-not-to-screen-doctors-debate-post-partum-depression-testing","audioTrackLength":null,"parsedContent":[{"type":"contentString","content":"\u003cdiv class=\"post-body\">\u003cp>\u003cp>Lawmakers will begin debate next month on a bill that would require doctors to screen new moms for mental health problems – once while they’re pregnant and again, after giving birth.\u003c/p>\n\u003cp>But a lot of doctors don’t like the idea. Many obstetricians and pediatricians are afraid to screen new moms for depression and anxiety.\u003c/p>\n\u003cp>“What are you going to do with those people who screen positive?” said Laura Sirott, an OB/GYN who practices in Pasadena. “Some providers have nowhere to send them.”\u003c/p>\n\u003cp>Of women who screen positive for postpartum depression, 78 percent don’t get mental health treatment, according to a \u003ca href=\"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4618720/\" target=\"_blank\" rel=\"noopener\">2015 study review\u003c/a> published in the journal \u003cem>Obstetrics & Gynecology\u003c/em>. Dr. Sirott’s patients have told her the range of reasons why they don’t take her up on a referral to a psychologist.\u003c/p>\n\u003cp>“Oh, they don’t take my insurance. Or my insurance pays for three visits. I can’t take time off of work to go to those visits. It’s a three-month wait to get in to that person,” she said.\u003c/p>\n\u003cp>\u003c/p>\u003c/div>","attributes":{"named":{},"numeric":[]}},{"type":"component","content":"","name":"ad","attributes":{"named":{"label":"fullwidth"},"numeric":["fullwidth"]}},{"type":"contentString","content":"\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>And, it’s hard to find a psychiatrist who is trained in the complexities of prescribing medications to pregnant or breastfeeding women, and who is willing to treat them, especially in rural areas.\u003c/p>\n\u003cp>“So it’s very frustrating to ask patients about a problem and then not have any way to solve that problem,” Sirott said.\u003c/p>\n\u003cp>But moms are frustrated, too. After the baby comes, no one asks about them anymore. Wendy Root Askew struggled for years to get pregnant, and when she finally did, her anxiety got worse. She couldn’t stop worrying that something would go wrong.\u003c/p>\n\u003cp>“And then after I had my son, I would have these dreams where someone would come to the door and they would say ‘Well, you know, we’re just going to wait two weeks to see if you get to keep your baby or not,’” she said. “And it really impacted my ability to bond with him.”\u003c/p>\n\u003cp>She likes the bill, \u003ca href=\"http://leginfo.legislature.ca.gov/faces/billTextClient.xhtml?bill_id=201720180AB2193\" target=\"_blank\" rel=\"noopener\">AB 2193\u003c/a>, because it goes beyond mandated screening. It requires health insurance companies to set up case management programs to help moms find a therapist, and to connect obstetricians or pediatricians with a psychiatric expert.\u003c/p>\n\u003cp>“Just like we have case management programs for patients who have diabetes or sleep issues or back pain, a case management program requires the insurance company to take some ownership of making sure their patients are getting the treatment they need to be healthy,” said Root Askew, who is now advocating for the bill on behalf of the group \u003ca href=\"https://www.2020mom.org/\" target=\"_blank\" rel=\"noopener\">2020 Mom\u003c/a>.\u003c/p>\n\u003cp>Health insurance companies haven’t taken a position on the legislation. It’s unclear how much it will cost them to comply, because some already have infrastructure in place for case management programs and some don’t. But there is consensus among insurers and health advocates that such programs save money in the long run.\u003c/p>\n\u003cp>“The sooner that you can get good treatment for a mom, the less expensive that condition will be to manage over the course of the woman’s life and over the course of that child’s life,” Root Askew said.\u003c/p>\n\u003cp>Doctors still have their objections. Under the bill, they could be disciplined for not screening. And screening takes time. Sometimes a doctor asks a mom how she’s sleeping, and she’s in tears for the next 30 minutes.\u003c/p>\n\u003cp>The health care system, and the incentives, aren’t set up for this, said Dr. Sirott.\u003c/p>\n\u003cp>“Currently, I get six dollars for screening a patient,” she said. “By the time I put it on a piece of paper and print it, it’s not worth it.”\u003c/p>\n\u003cp>And it’s not clear it’s worth it to the patients either. Four other states – Illinois, Massachusetts, New Jersey, and West Virginia – have tried mandated screening, and it made no difference in patient outcomes, according to \u003ca href=\"https://ps.psychiatryonline.org/doi/10.1176/appi.ps.201300505?code=ps-site\" target=\"_blank\" rel=\"noopener\">a study\u003c/a> published in \u003cem>Psychiatric Services\u003c/em> in 2015.\u003c/p>\n\u003cp>Even with California’s extra requirements on insurance companies to facilitate care, women could still face high co-pays or limits on therapy sessions. Or, they’re so overwhelmed caring for a newborn, they never leave the house.\u003c/p>\n\u003cp>What does seem to work, according to the study, is when nurses or mental health providers visit new moms at home.\u003c/p>\n\u003cp>“Despite abundant good will, there is no evidence that state policies are addressing this great need,” the study authors wrote.\u003c/p>\n\u003cp>But supporters of the proposed bill say doctors need to start somewhere. Screening is the first step in recognizing the full scope of the problem, said Mountain View psychiatrist \u003ca href=\"https://www.elcaminohospital.org/doctors/nirmaljit-dhami\" target=\"_blank\" rel=\"noopener\">Nirmaljit Dhami\u003c/a>, adding that women should be screened on an ongoing basis throughout pregnancy and for a year after birth, not just once or twice as the bill requires.\u003c/p>\n\u003cp>\u003c/p>\n\u003cp>“I often tell doctors that if you don't know that somebody is suicidal it doesn't mean that their suicidality will go away,” she said. “If you don't ask, the risk is the same.”\u003c/p>\n\n\u003c/div>\u003c/p>","attributes":{"named":{},"numeric":[]}}],"link":"/stateofhealth/362850/to-screen-or-not-to-screen-doctors-debate-post-partum-depression-testing","authors":["3205"],"categories":["stateofhealth_2442","stateofhealth_3012","stateofhealth_14"],"tags":["stateofhealth_3067","stateofhealth_2582","stateofhealth_2947","stateofhealth_2808","stateofhealth_28","stateofhealth_3229","stateofhealth_3212","stateofhealth_68","stateofhealth_3230","stateofhealth_2519","stateofhealth_3228"],"featImg":"stateofhealth_362852","label":"stateofhealth"},"stateofhealth_362521":{"type":"posts","id":"stateofhealth_362521","meta":{"index":"posts_1591205157","site":"stateofhealth","id":"362521","score":null,"sort":[1517130042000]},"guestAuthors":[],"slug":"woman-seeks-help-for-post-partum-depression-the-nurse-calls-the-cops","title":"Woman Seeks Help for Post-Partum Depression. A Nurse Calls the Cops.","publishDate":1517130042,"format":"standard","headTitle":"State of Health | KQED News","labelTerm":{"site":"stateofhealth"},"content":"\u003cp>With her first daughter, everything was fine. But four months after having her second, Jessica Porten started feeling really irritable. Little things would annoy her, like her glider chair.\u003c/p>\n\u003cp>“It had started to squeak,” she said, “And so when I’m sitting there rocking the baby and it’s squeaking, I would just get so angry at that stupid chair.”\u003c/p>\n\u003cp>She read online that this could be a symptom of post-partum depression – a condition that affects up to \u003ca href=\"http://www.chcf.org/projects/2017/improving-maternal-mental-health\">one in five women\u003c/a> in California during or after pregnancy. The rates have spurred state lawmakers to introduce a package of bills to improve mental health screening and treatment for new moms.\u003c/p>\n\u003cp>Porten hopes they help women avoid what she went through.\u003c/p>\n\u003cp>She went to \u003ca href=\"http://www.capitalobgyn.com/\">Capital OB/GYN\u003c/a>, a women’s clinic in Sacramento that takes her Medi-Cal coverage, to talk about medication options and therapy. She admitted to the nurse that she was having some violent thoughts.\u003c/p>\n\u003cp>[ad fullwidth]\u003c/p>\n\u003cp>“I described maybe hitting myself or squeezing the baby too tight,” she said. “But I was very adamant through the entire appointment that I was not going to hurt myself and I was not going to hurt my children.”\u003c/p>\n\u003cp>The nurse called the police. The police escorted Porten and her baby to the Sutter Emergency Room. Hospital staff made her change into a gown and took her purse, but they let her keep her diaper bag for the baby. They put them both in a room, under constant watch.\u003c/p>\n\u003cp>\"It’s like, everybody knows I’m not crazy,\" she said. \"Everybody knows that this is normal, but they’re following protocol.\"\u003c/p>\n\u003cp>Finally, at midnight, 10 hours after she first got to the doctors’ office, a social worker sent her home. She wrote \u003ca href=\"https://www.facebook.com/permalink.php?story_fbid=10213174920945414&id=1166947031\">on Facebook\u003c/a> that the whole thing made her feel like a criminal.\u003c/p>\n\u003cp>“It was all legality,” Porten said. “Everybody was protecting their own liability instead of thinking of me.”\u003c/p>\n\u003cp>Administrators at Capital OB/GYN declined to comment. A spokesman for \u003ca href=\"https://www.sutterhealth.org/\">Sutter Health\u003c/a>, Gary Zavoral, said once a patient arrives in the emergency room for assessment, hospital staff must follow strict protocols.\u003c/p>\n\u003cp>“The process is to make sure everybody is safe: the individual’s safe, the family’s safe, the staff is safe,” he said. “The process does take some hours, so ten hours is not unusual.”\u003c/p>\n\u003cp>When patients reference violent thoughts, it forces doctors to think about things in a different way, said \u003ca href=\"http://profiles.ucsf.edu/melanie.thomas\">Melanie Thomas\u003c/a>, a psychiatrist at UC-San Francisco and Zuckerberg San Francisco General Hospital.\u003c/p>\n\u003cp>\u003ca href=\"http://leginfo.legislature.ca.gov/faces/codes_displaySection.xhtml?sectionNum=5150&lawCode=WIC\" target=\"_blank\" rel=\"noopener\">California law\u003c/a> allows doctors to involuntarily confine a person with a mental disorder if they are a danger to themselves or others. But Thomas says what constitutes imminent danger can be vague.\u003c/p>\n\u003cp>“You can imagine a provider, a social worker, any number of people might interpret that phrase in different ways, about what is necessary to report and what isn’t,” she said.\u003c/p>\n\u003cp>The laws and medical protocols don’t always line up, Thomas said. There have been times she felt asked to put legal reasoning over her clinical judgment.\u003c/p>\n\u003cp>“The fragmented aspects of our system of care make it difficult to get women the help that they really want,” she said.\u003c/p>\n\u003cp>That’s one reason lawmakers in Sacramento are now introducing a package of bills to address maternal mental health. Assemblyman \u003ca href=\"https://ad77.asmrc.org/\">Brian Maienschein\u003c/a>, R-San Diego, is backing two of them. One would require doctors to screen new moms for depression – under current law, it’s voluntary.\u003c/p>\n\u003cp>“The numbers here are so significant that I think it’s something that doctors really should understand and should be prepared to both diagnose and treat,” he said, adding screening also “educates a woman in that situation that this is an issue that may impact her.”\u003c/p>\n\u003cp>Maienschein's \u003ca href=\"http://leginfo.legislature.ca.gov/faces/billTextClient.xhtml?bill_id=201720180AB1893\" target=\"_blank\" rel=\"noopener\">other bill\u003c/a> would direct the state to tap into a new federal pot of money set aside for post-partum programs and awareness campaigns. It was established in the new 21\u003csup>st\u003c/sup> Century Cures Act.\u003c/p>\n\u003cp>\"Getting federal money is a great thing,\" Maienschein said. \"It’s federal money that’s available that I’d like to see California have versus another state.\"\u003c/p>\n\u003cp>The legislation has given Jessica Porten a new purpose. People have told her she should sue Capital OB/GYN for calling the police. But she says no.\u003c/p>\n\u003cp>“I walk into that waiting room and I see tons of Medi-Cal recipients, so they’re all low-income,” she said. \"If I sue, it's only going to cause monetary damages to a facility that is clearly short on resources.\"\u003c/p>\n\u003cp>Instead, Porten will advocate to get the new bills passed in California. She thinks that's the way to help the clinic's physicians and nurses do a better job helping new moms get the care they need.\u003c/p>\n\u003cp>\u003c/p>\n\u003cp>\"I’m not going to take that away,\" she said, \"I’m going to build it up.”\u003c/p>\n\n","blocks":[],"excerpt":"State lawmakers are working on a package of bills to address maternal mental health in California.","status":"publish","parent":0,"modified":1517441619,"stats":{"hasAudio":false,"hasVideo":false,"hasChartOrMap":false,"iframeSrcs":[],"hasGoogleForm":false,"hasGallery":false,"hasHearkenModule":false,"hasPolis":false,"paragraphCount":27,"wordCount":864},"headData":{"title":"Woman Seeks Help for Post-Partum Depression. A Nurse Calls the Cops. | KQED","description":"State lawmakers are working on a package of bills to address maternal mental health in California.","ogTitle":"","ogDescription":"","ogImgId":"","twTitle":"","twDescription":"","twImgId":"","schema":{"@context":"http://schema.org","@type":"Article","headline":"Woman Seeks Help for Post-Partum Depression. A Nurse Calls the Cops.","datePublished":"2018-01-28T09:00:42.000Z","dateModified":"2018-01-31T23:33:39.000Z","image":"https://cdn.kqed.org/wp-content/uploads/2020/02/KQED-OG-Image@1x.png"}},"disqusIdentifier":"362521 https://ww2.kqed.org/stateofhealth/?p=362521","disqusUrl":"https://ww2.kqed.org/stateofhealth/2018/01/28/woman-seeks-help-for-post-partum-depression-the-nurse-calls-the-cops/","disqusTitle":"Woman Seeks Help for Post-Partum Depression. A Nurse Calls the Cops.","path":"/stateofhealth/362521/woman-seeks-help-for-post-partum-depression-the-nurse-calls-the-cops","audioTrackLength":null,"parsedContent":[{"type":"contentString","content":"\u003cdiv class=\"post-body\">\u003cp>\u003cp>With her first daughter, everything was fine. But four months after having her second, Jessica Porten started feeling really irritable. Little things would annoy her, like her glider chair.\u003c/p>\n\u003cp>“It had started to squeak,” she said, “And so when I’m sitting there rocking the baby and it’s squeaking, I would just get so angry at that stupid chair.”\u003c/p>\n\u003cp>She read online that this could be a symptom of post-partum depression – a condition that affects up to \u003ca href=\"http://www.chcf.org/projects/2017/improving-maternal-mental-health\">one in five women\u003c/a> in California during or after pregnancy. The rates have spurred state lawmakers to introduce a package of bills to improve mental health screening and treatment for new moms.\u003c/p>\n\u003cp>Porten hopes they help women avoid what she went through.\u003c/p>\n\u003cp>She went to \u003ca href=\"http://www.capitalobgyn.com/\">Capital OB/GYN\u003c/a>, a women’s clinic in Sacramento that takes her Medi-Cal coverage, to talk about medication options and therapy. She admitted to the nurse that she was having some violent thoughts.\u003c/p>\n\u003cp>\u003c/p>\u003c/div>","attributes":{"named":{},"numeric":[]}},{"type":"component","content":"","name":"ad","attributes":{"named":{"label":"fullwidth"},"numeric":["fullwidth"]}},{"type":"contentString","content":"\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>“I described maybe hitting myself or squeezing the baby too tight,” she said. “But I was very adamant through the entire appointment that I was not going to hurt myself and I was not going to hurt my children.”\u003c/p>\n\u003cp>The nurse called the police. The police escorted Porten and her baby to the Sutter Emergency Room. Hospital staff made her change into a gown and took her purse, but they let her keep her diaper bag for the baby. They put them both in a room, under constant watch.\u003c/p>\n\u003cp>\"It’s like, everybody knows I’m not crazy,\" she said. \"Everybody knows that this is normal, but they’re following protocol.\"\u003c/p>\n\u003cp>Finally, at midnight, 10 hours after she first got to the doctors’ office, a social worker sent her home. She wrote \u003ca href=\"https://www.facebook.com/permalink.php?story_fbid=10213174920945414&id=1166947031\">on Facebook\u003c/a> that the whole thing made her feel like a criminal.\u003c/p>\n\u003cp>“It was all legality,” Porten said. “Everybody was protecting their own liability instead of thinking of me.”\u003c/p>\n\u003cp>Administrators at Capital OB/GYN declined to comment. A spokesman for \u003ca href=\"https://www.sutterhealth.org/\">Sutter Health\u003c/a>, Gary Zavoral, said once a patient arrives in the emergency room for assessment, hospital staff must follow strict protocols.\u003c/p>\n\u003cp>“The process is to make sure everybody is safe: the individual’s safe, the family’s safe, the staff is safe,” he said. “The process does take some hours, so ten hours is not unusual.”\u003c/p>\n\u003cp>When patients reference violent thoughts, it forces doctors to think about things in a different way, said \u003ca href=\"http://profiles.ucsf.edu/melanie.thomas\">Melanie Thomas\u003c/a>, a psychiatrist at UC-San Francisco and Zuckerberg San Francisco General Hospital.\u003c/p>\n\u003cp>\u003ca href=\"http://leginfo.legislature.ca.gov/faces/codes_displaySection.xhtml?sectionNum=5150&lawCode=WIC\" target=\"_blank\" rel=\"noopener\">California law\u003c/a> allows doctors to involuntarily confine a person with a mental disorder if they are a danger to themselves or others. But Thomas says what constitutes imminent danger can be vague.\u003c/p>\n\u003cp>“You can imagine a provider, a social worker, any number of people might interpret that phrase in different ways, about what is necessary to report and what isn’t,” she said.\u003c/p>\n\u003cp>The laws and medical protocols don’t always line up, Thomas said. There have been times she felt asked to put legal reasoning over her clinical judgment.\u003c/p>\n\u003cp>“The fragmented aspects of our system of care make it difficult to get women the help that they really want,” she said.\u003c/p>\n\u003cp>That’s one reason lawmakers in Sacramento are now introducing a package of bills to address maternal mental health. Assemblyman \u003ca href=\"https://ad77.asmrc.org/\">Brian Maienschein\u003c/a>, R-San Diego, is backing two of them. One would require doctors to screen new moms for depression – under current law, it’s voluntary.\u003c/p>\n\u003cp>“The numbers here are so significant that I think it’s something that doctors really should understand and should be prepared to both diagnose and treat,” he said, adding screening also “educates a woman in that situation that this is an issue that may impact her.”\u003c/p>\n\u003cp>Maienschein's \u003ca href=\"http://leginfo.legislature.ca.gov/faces/billTextClient.xhtml?bill_id=201720180AB1893\" target=\"_blank\" rel=\"noopener\">other bill\u003c/a> would direct the state to tap into a new federal pot of money set aside for post-partum programs and awareness campaigns. It was established in the new 21\u003csup>st\u003c/sup> Century Cures Act.\u003c/p>\n\u003cp>\"Getting federal money is a great thing,\" Maienschein said. \"It’s federal money that’s available that I’d like to see California have versus another state.\"\u003c/p>\n\u003cp>The legislation has given Jessica Porten a new purpose. People have told her she should sue Capital OB/GYN for calling the police. But she says no.\u003c/p>\n\u003cp>“I walk into that waiting room and I see tons of Medi-Cal recipients, so they’re all low-income,” she said. \"If I sue, it's only going to cause monetary damages to a facility that is clearly short on resources.\"\u003c/p>\n\u003cp>Instead, Porten will advocate to get the new bills passed in California. She thinks that's the way to help the clinic's physicians and nurses do a better job helping new moms get the care they need.\u003c/p>\n\u003cp>\u003c/p>\n\u003cp>\"I’m not going to take that away,\" she said, \"I’m going to build it up.”\u003c/p>\n\n\u003c/div>\u003c/p>","attributes":{"named":{},"numeric":[]}}],"link":"/stateofhealth/362521/woman-seeks-help-for-post-partum-depression-the-nurse-calls-the-cops","authors":["3205"],"categories":["stateofhealth_11","stateofhealth_3012","stateofhealth_14"],"tags":["stateofhealth_3211","stateofhealth_3212","stateofhealth_2519","stateofhealth_3213"],"featImg":"stateofhealth_362523","label":"stateofhealth"},"stateofhealth_361907":{"type":"posts","id":"stateofhealth_361907","meta":{"index":"posts_1591205157","site":"stateofhealth","id":"361907","score":null,"sort":[1510218031000]},"guestAuthors":[],"slug":"what-vets-want-at-the-end-of-life-is-very-different-from-what-civilians-want","title":"What Vets Want at the End of Life Is Very Different From What Civilians Want","publishDate":1510218031,"format":"audio","headTitle":"State of Health | KQED News","labelTerm":{"site":"stateofhealth"},"content":"\u003cp>A lot of Ron Fleming’s fellow soldiers spent the last five decades trying to forget what they saw and did in Vietnam. Now 74, Fleming has spent most of that time trying to hold on to it. He has never been as proud as he was when he was 21.\u003c/p>\n\u003cp>“I take issue with those who say we lost. We didn’t lose that war,” he said, sitting on the edge of his hospital bed at the \u003ca href=\"https://www.sanfrancisco.va.gov/\" target=\"_blank\" rel=\"noopener\">San Francisco VA medical center\u003c/a>. “Everywhere I went, we literally kicked the crap out of them.”\u003c/p>\n\u003cp>Fleming was a door gunner in the war, hanging out of a helicopter on a strap with a machine gun in his hands. He fought in the Tet Offensive, sometimes 40 hours straight, firing 6,000 rounds a minute. But he never gave much thought to catching one himself.\u003c/p>\n\u003cp>“You see, at 21, you’re bulletproof,” he said. “Dying wasn’t on the agenda.”\u003c/p>\n\u003cp>But now, it is. Fleming has congestive heart failure, arthritis and breathing problems. He often lands in the VA hospital with asthma attacks, and the palliative care team visits him regularly. He thinks about death.\u003c/p>\n\u003cp>[ad fullwidth]\u003c/p>\n\u003cp>“I wish it’d get off its ass and come on me. I’m sick of this crap,” he said, as his heart rate monitor ticked up. “You see, dying’s the easy part. Living is what’s hard.”\u003c/p>\n\u003cp>Fleming has had trouble holding down a job since he got back from the war. He had a girl he lived with for 10 years, but they never married, never had kids. He lives alone in Oakland now. He says he angers easily and is always hypervigilant. About 10 years ago, he was diagnosed with PTSD. More than anything, he says, he suffers from a \"rotten outlook\" on life.\u003c/p>\n\u003cp>“Sometimes I think that now I’m being paid back for all the men I killed,” he said. “I killed a lot of them. More than I can count.”\u003c/p>\n\u003cp>Unlike Fleming, some Vietnam vets don’t find out they have PTSD until they have just months or weeks left to live. Symptoms of terminal illnesses, like pain or breathlessness, can trigger flashbacks, making vets feel as threatened as they did on the battlefield.\u003c/p>\n\u003cp>“The war memories start coming back, they start having nightmares,” said \u003ca href=\"https://profiles.stanford.edu/vj-periyakoil\" target=\"_blank\" rel=\"noopener\">VJ Periyakoil\u003c/a>, a palliative care physician at the VA in Palo Alto. She says opioid medications, like morphine and oxycodone, that are often used for treating pain and breathlessness can make PTSD symptoms worse.\u003c/p>\n\u003cp>“The side effect of those medications, they make you fuzzyheaded,” she said. “Your defenses that you use to cope with the PTSD, which might help repress a lot of the difficult memories, that coping strategy starts to come apart.”\u003c/p>\n\u003cp>She has had patients tell her: “I would much rather tolerate the physical pain, the cancer pain, than take opioids and my defenses crumble.”\u003c/p>\n\u003cp>Some vets see their pain or PTSD as retribution for their work in the line of duty.\u003c/p>\n\u003cp>“Sometimes I’ve had patients refuse medications that might ease their experiences because they feel that they deserve to suffer,” Periyakoil said. “This is redemptive.”\u003c/p>\n\u003cp>The best thing to do in these situations can be to stand down, she said. With weeks left to live, there isn’t enough time to resolve the mental anguish, and staff have to let patients set the pace and tone for their care.\u003c/p>\n\u003cp>But doctors and nurses, just like soldiers, hate doing nothing.\u003c/p>\n\u003cp>“We talk about the moral distress that \u003cem>we \u003c/em>have sometimes about really knowing that we’re doing the right thing for this individual, so that we can be present for \u003cem>their \u003c/em>suffering, the way \u003cem>they\u003c/em> need to do it,” said Patrice Villars, a hospice nurse at the San Francisco VA.\u003c/p>\n\u003cp>For Ron Fleming, death is still likely a couple of years out. His doctors have been begging him, gently, to consider mental health counseling or antidepressants. But he has refused.\u003c/p>\n\u003cp>“I don’t want to take psychiatric drugs. The vets call them the happy pills,” he said. “I don’t want any of those, because they change you. I don’t want to change.”\u003c/p>\n\u003cp>He’s not sure if he deserves to be happy.\u003c/p>\n\u003cp>“That I don’t know,” he said.\u003c/p>\n\u003cp>\u003c/p>\n\u003cp>His pain is what connects him to the past. Fleming was awarded 18 air medals for acts of meritorious achievement and heroism. The loss and grief he experienced in Vietnam are woven into the same memories of victory and glory. He doesn’t want treatment that might make that go away.\u003c/p>\n\n","blocks":[],"excerpt":"Honor and respect can be much more important for dying vets than being comfortable or free of pain.","status":"publish","parent":0,"modified":1510279371,"stats":{"hasAudio":false,"hasVideo":false,"hasChartOrMap":false,"iframeSrcs":[],"hasGoogleForm":false,"hasGallery":false,"hasHearkenModule":false,"hasPolis":false,"paragraphCount":24,"wordCount":817},"headData":{"title":"What Vets Want at the End of Life Is Very Different From What Civilians Want | KQED","description":"Honor and respect can be much more important for dying vets than being comfortable or free of pain.","ogTitle":"","ogDescription":"","ogImgId":"","twTitle":"","twDescription":"","twImgId":"","schema":{"@context":"http://schema.org","@type":"Article","headline":"What Vets Want at the End of Life Is Very Different From What Civilians Want","datePublished":"2017-11-09T09:00:31.000Z","dateModified":"2017-11-10T02:02:51.000Z","image":"https://cdn.kqed.org/wp-content/uploads/2020/02/KQED-OG-Image@1x.png"}},"disqusIdentifier":"361907 https://ww2.kqed.org/stateofhealth/?p=361907","disqusUrl":"https://ww2.kqed.org/stateofhealth/2017/11/09/what-vets-want-at-the-end-of-life-is-very-different-from-what-civilians-want/","disqusTitle":"What Vets Want at the End of Life Is Very Different From What Civilians Want","audioUrl":"https://www.kqed.org/.stream/anon/radio/RDnews/2017/11/DemboskyVetsEndofLife.mp3","path":"/stateofhealth/361907/what-vets-want-at-the-end-of-life-is-very-different-from-what-civilians-want","audioTrackLength":null,"parsedContent":[{"type":"contentString","content":"\u003cdiv class=\"post-body\">\u003cp>\u003cp>A lot of Ron Fleming’s fellow soldiers spent the last five decades trying to forget what they saw and did in Vietnam. Now 74, Fleming has spent most of that time trying to hold on to it. He has never been as proud as he was when he was 21.\u003c/p>\n\u003cp>“I take issue with those who say we lost. We didn’t lose that war,” he said, sitting on the edge of his hospital bed at the \u003ca href=\"https://www.sanfrancisco.va.gov/\" target=\"_blank\" rel=\"noopener\">San Francisco VA medical center\u003c/a>. “Everywhere I went, we literally kicked the crap out of them.”\u003c/p>\n\u003cp>Fleming was a door gunner in the war, hanging out of a helicopter on a strap with a machine gun in his hands. He fought in the Tet Offensive, sometimes 40 hours straight, firing 6,000 rounds a minute. But he never gave much thought to catching one himself.\u003c/p>\n\u003cp>“You see, at 21, you’re bulletproof,” he said. “Dying wasn’t on the agenda.”\u003c/p>\n\u003cp>But now, it is. Fleming has congestive heart failure, arthritis and breathing problems. He often lands in the VA hospital with asthma attacks, and the palliative care team visits him regularly. He thinks about death.\u003c/p>\n\u003cp>\u003c/p>\u003c/div>","attributes":{"named":{},"numeric":[]}},{"type":"component","content":"","name":"ad","attributes":{"named":{"label":"fullwidth"},"numeric":["fullwidth"]}},{"type":"contentString","content":"\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>“I wish it’d get off its ass and come on me. I’m sick of this crap,” he said, as his heart rate monitor ticked up. “You see, dying’s the easy part. Living is what’s hard.”\u003c/p>\n\u003cp>Fleming has had trouble holding down a job since he got back from the war. He had a girl he lived with for 10 years, but they never married, never had kids. He lives alone in Oakland now. He says he angers easily and is always hypervigilant. About 10 years ago, he was diagnosed with PTSD. More than anything, he says, he suffers from a \"rotten outlook\" on life.\u003c/p>\n\u003cp>“Sometimes I think that now I’m being paid back for all the men I killed,” he said. “I killed a lot of them. More than I can count.”\u003c/p>\n\u003cp>Unlike Fleming, some Vietnam vets don’t find out they have PTSD until they have just months or weeks left to live. Symptoms of terminal illnesses, like pain or breathlessness, can trigger flashbacks, making vets feel as threatened as they did on the battlefield.\u003c/p>\n\u003cp>“The war memories start coming back, they start having nightmares,” said \u003ca href=\"https://profiles.stanford.edu/vj-periyakoil\" target=\"_blank\" rel=\"noopener\">VJ Periyakoil\u003c/a>, a palliative care physician at the VA in Palo Alto. She says opioid medications, like morphine and oxycodone, that are often used for treating pain and breathlessness can make PTSD symptoms worse.\u003c/p>\n\u003cp>“The side effect of those medications, they make you fuzzyheaded,” she said. “Your defenses that you use to cope with the PTSD, which might help repress a lot of the difficult memories, that coping strategy starts to come apart.”\u003c/p>\n\u003cp>She has had patients tell her: “I would much rather tolerate the physical pain, the cancer pain, than take opioids and my defenses crumble.”\u003c/p>\n\u003cp>Some vets see their pain or PTSD as retribution for their work in the line of duty.\u003c/p>\n\u003cp>“Sometimes I’ve had patients refuse medications that might ease their experiences because they feel that they deserve to suffer,” Periyakoil said. “This is redemptive.”\u003c/p>\n\u003cp>The best thing to do in these situations can be to stand down, she said. With weeks left to live, there isn’t enough time to resolve the mental anguish, and staff have to let patients set the pace and tone for their care.\u003c/p>\n\u003cp>But doctors and nurses, just like soldiers, hate doing nothing.\u003c/p>\n\u003cp>“We talk about the moral distress that \u003cem>we \u003c/em>have sometimes about really knowing that we’re doing the right thing for this individual, so that we can be present for \u003cem>their \u003c/em>suffering, the way \u003cem>they\u003c/em> need to do it,” said Patrice Villars, a hospice nurse at the San Francisco VA.\u003c/p>\n\u003cp>For Ron Fleming, death is still likely a couple of years out. His doctors have been begging him, gently, to consider mental health counseling or antidepressants. But he has refused.\u003c/p>\n\u003cp>“I don’t want to take psychiatric drugs. The vets call them the happy pills,” he said. “I don’t want any of those, because they change you. I don’t want to change.”\u003c/p>\n\u003cp>He’s not sure if he deserves to be happy.\u003c/p>\n\u003cp>“That I don’t know,” he said.\u003c/p>\n\u003cp>\u003c/p>\n\u003cp>His pain is what connects him to the past. Fleming was awarded 18 air medals for acts of meritorious achievement and heroism. The loss and grief he experienced in Vietnam are woven into the same memories of victory and glory. He doesn’t want treatment that might make that go away.\u003c/p>\n\n\u003c/div>\u003c/p>","attributes":{"named":{},"numeric":[]}}],"link":"/stateofhealth/361907/what-vets-want-at-the-end-of-life-is-very-different-from-what-civilians-want","authors":["3205"],"categories":["stateofhealth_3012","stateofhealth_1"],"tags":["stateofhealth_2847","stateofhealth_2808","stateofhealth_3023","stateofhealth_2519","stateofhealth_2656","stateofhealth_3194","stateofhealth_136","stateofhealth_3193"],"featImg":"stateofhealth_361951","label":"stateofhealth"},"stateofhealth_361766":{"type":"posts","id":"stateofhealth_361766","meta":{"index":"posts_1591205157","site":"stateofhealth","id":"361766","score":null,"sort":[1509133032000]},"guestAuthors":[],"slug":"recreational-or-procreational-study-links-marijuana-use-with-more-frequent-sex","title":"Recreational or Procreational? Study Links Marijuana Use with More Frequent Sex","publishDate":1509133032,"format":"audio","headTitle":"State of Health | KQED News","labelTerm":{"site":"stateofhealth"},"content":"\u003cp>People who smoke marijuana reported having more sexual intercourse than non-users, according to a new study conducted by urologists at the \u003ca href=\"http://med.stanford.edu/\" target=\"_blank\" rel=\"noopener\">Stanford University School of Medicine\u003c/a>.\u003c/p>\n\u003cp>The results were modest but statistically significant: Non-users said they had engaged in sexual intercourse between five and six times in the previous month. Daily pot smokers reported having intercourse around seven times over that same period. The frequency was in-between for people who smoked marijuana less often, on a weekly or monthly basis: they reported having sex more than abstainers, but less than daily users.\u003c/p>\n\u003cp>“I was surprised,” said\u003ca href=\"https://stanfordhealthcare.org/doctors/e/michael-eisenberg.html\" target=\"_blank\" rel=\"noopener\"> Dr. Michael Eisenberg\u003c/a>, the study’s senior author and an assistant professor of urology at Stanford University Medical Center.\u003c/p>\n\u003cp>“The daily users for example, compared to the never users, reported about 20 more sexual encounters a year. So I think that is a significant difference,\" he said.\u003c/p>\n\u003cp>It’s the first study to look at the connection between pot smoking and sex at the population level. To tease out the association, Eisenberg and his co-author Dr. Andrew Sun used survey data drawn from more than 50,000 Americans between the ages of 25 and 45.\u003c/p>\n\u003cp>[ad fullwidth]\u003c/p>\n\u003cp>The data comes from the National Center for Health Statistics at the CDC. Since that survey does not ask about homosexual encounters, the results only apply to straight men and women.\u003c/p>\n\u003cp>Eisenberg decided to do the study because more of his patients had been asking him if smoking marijuana could be contributing to their sexual difficulties. He had previously told them it might, and to abstain just in case. He was basing his assumptions on research about the negative vascular effects of cigarette smoking. In addition, some past studies and case reports have indicated heavy marijuana use may be associated with erectile dysfunction or depressed sperm count.\u003c/p>\n\u003cp>But now Eisenberg is rethinking his advice, at least for some patients.\u003c/p>\n\u003cp>“If somebody is using marijuana to help them for chronic back pain or something like that, there may be other interventions that we can think about targeting,” he said. “Rather than telling them they have to stop, otherwise their sex life is doomed.”\u003c/p>\n\u003cp>For \u003ca href=\"http://sexandthesoma.com/\" target=\"_blank\" rel=\"noopener\">Dr. Holly Richmond\u003c/a>, a sex therapist, the study results are “pretty remarkable.”\u003c/p>\n\u003cp>In her offices in Los Angeles and Portland, Oregon, Richmond has seen mixed results when her clients use marijuana. Some couples tell her that they have more sex when they use pot, but others have less sex.\u003c/p>\n\u003cp>She said those differences are probably attributable to how much pot someone smokes, instead of how often.\u003c/p>\n\u003cp>“Too much can lead to lethargy and really checking out, which does not facilitate [emotional] connection at all, and definitely doesn't encourage sexual activity.”\u003c/p>\n\u003cp>Eisenberg cautioned against drawing unwarranted conclusions from the study, and cited the old statistical adage “correlation does not equal causation.”\u003c/p>\n\u003cp>“This doesn’t mean that if you want to have more sex you should start smoking marijuana,” he said. “That’s definitely not what this data supports.”\u003c/p>\n\u003cp>The study can’t explain what factors are driving the association between pot use and sex, said Dr. Igor Grant, chair of psychiatry and director of the \u003ca href=\"http://www.cmcr.ucsd.edu/\" target=\"_blank\" rel=\"noopener\">Center for Medicinal Cannabis Research\u003c/a> at the University of California San Diego.\u003c/p>\n\u003cp>He said one explanation is that people who use marijuana —or are willing to admit marijuana use in a survey —are more likely to report their sexual encounters, or remember more of them. Grant said marijuana users are also sensation seekers, and may be more driven to have sex.\u003c/p>\n\u003cp>“Drug use is one type of sensation-seeking behavior, and obviously sex is another,” Grant said.\u003c/p>\n\u003cp>Eisenberg agreed that personality and other behaviors could be a factor, but if that was the case, he would expect to see different results from different demographic groups. For example, young and single respondents might be more willing and able to engage in risky or sensation-seeking behavior, when compared to married people with children. But the results held across all categories, including race and ethnicity, educational level, income level, religious affiliation, and family status.\u003c/p>\n\u003cp>“For every group, the more marijuana use that they reported, the more sex they reported as well. So that was really interesting to me, and also made me think that there could potentially be some biologic explanation here,” Eisenberg said.\u003c/p>\n\u003cp>Richmond, the sex therapist, says she wouldn’t advise any client who doesn’t already smoke to start smoking marijuana as a sexual aid. But she said it could be reassuring to her pot-using clients to learn from the study that smoking pot doesn’t appear to \u003cem>decrease\u003c/em> sexual activity.\u003c/p>\n\u003cp>“Individuals and couples look for additional ways to create novelty in the relationship and have fun, and that's now a legal and accessible way to do it,” she said.\u003c/p>\n\u003cp>Medicinal marijuana is now legal in 29 states, and eight of them allow recreational use as well. (The District of Columbia allows both).\u003c/p>\n\u003cp>\u003c/p>\n\u003cp>Dr. Eisenberg said that’s why learning more about the potential side effects of marijuana use is so critical.\u003c/p>\n\n","blocks":[],"excerpt":"A survey shows a positive correlation between pot use and frequency of sex, across all demographic groups. But it's unclear why. ","status":"publish","parent":0,"modified":1509149322,"stats":{"hasAudio":false,"hasVideo":false,"hasChartOrMap":false,"iframeSrcs":[],"hasGoogleForm":false,"hasGallery":false,"hasHearkenModule":false,"hasPolis":false,"paragraphCount":26,"wordCount":874},"headData":{"title":"Recreational or Procreational? Study Links Marijuana Use with More Frequent Sex | KQED","description":"A survey shows a positive correlation between pot use and frequency of sex, across all demographic groups. But it's unclear why. ","ogTitle":"","ogDescription":"","ogImgId":"","twTitle":"","twDescription":"","twImgId":"","schema":{"@context":"http://schema.org","@type":"Article","headline":"Recreational or Procreational? Study Links Marijuana Use with More Frequent Sex","datePublished":"2017-10-27T19:37:12.000Z","dateModified":"2017-10-28T00:08:42.000Z","image":"https://cdn.kqed.org/wp-content/uploads/2020/02/KQED-OG-Image@1x.png"}},"disqusIdentifier":"361766 https://ww2.kqed.org/stateofhealth/?p=361766","disqusUrl":"https://ww2.kqed.org/stateofhealth/2017/10/27/recreational-or-procreational-study-links-marijuana-use-with-more-frequent-sex/","disqusTitle":"Recreational or Procreational? Study Links Marijuana Use with More Frequent Sex","audioUrl":"https://www.kqed.org/.stream/anon/radio/tcr/2017/10/MJSexFeibel171027.mp3","path":"/stateofhealth/361766/recreational-or-procreational-study-links-marijuana-use-with-more-frequent-sex","audioTrackLength":null,"parsedContent":[{"type":"contentString","content":"\u003cdiv class=\"post-body\">\u003cp>\u003cp>People who smoke marijuana reported having more sexual intercourse than non-users, according to a new study conducted by urologists at the \u003ca href=\"http://med.stanford.edu/\" target=\"_blank\" rel=\"noopener\">Stanford University School of Medicine\u003c/a>.\u003c/p>\n\u003cp>The results were modest but statistically significant: Non-users said they had engaged in sexual intercourse between five and six times in the previous month. Daily pot smokers reported having intercourse around seven times over that same period. The frequency was in-between for people who smoked marijuana less often, on a weekly or monthly basis: they reported having sex more than abstainers, but less than daily users.\u003c/p>\n\u003cp>“I was surprised,” said\u003ca href=\"https://stanfordhealthcare.org/doctors/e/michael-eisenberg.html\" target=\"_blank\" rel=\"noopener\"> Dr. Michael Eisenberg\u003c/a>, the study’s senior author and an assistant professor of urology at Stanford University Medical Center.\u003c/p>\n\u003cp>“The daily users for example, compared to the never users, reported about 20 more sexual encounters a year. So I think that is a significant difference,\" he said.\u003c/p>\n\u003cp>It’s the first study to look at the connection between pot smoking and sex at the population level. To tease out the association, Eisenberg and his co-author Dr. Andrew Sun used survey data drawn from more than 50,000 Americans between the ages of 25 and 45.\u003c/p>\n\u003cp>\u003c/p>\u003c/div>","attributes":{"named":{},"numeric":[]}},{"type":"component","content":"","name":"ad","attributes":{"named":{"label":"fullwidth"},"numeric":["fullwidth"]}},{"type":"contentString","content":"\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>The data comes from the National Center for Health Statistics at the CDC. Since that survey does not ask about homosexual encounters, the results only apply to straight men and women.\u003c/p>\n\u003cp>Eisenberg decided to do the study because more of his patients had been asking him if smoking marijuana could be contributing to their sexual difficulties. He had previously told them it might, and to abstain just in case. He was basing his assumptions on research about the negative vascular effects of cigarette smoking. In addition, some past studies and case reports have indicated heavy marijuana use may be associated with erectile dysfunction or depressed sperm count.\u003c/p>\n\u003cp>But now Eisenberg is rethinking his advice, at least for some patients.\u003c/p>\n\u003cp>“If somebody is using marijuana to help them for chronic back pain or something like that, there may be other interventions that we can think about targeting,” he said. “Rather than telling them they have to stop, otherwise their sex life is doomed.”\u003c/p>\n\u003cp>For \u003ca href=\"http://sexandthesoma.com/\" target=\"_blank\" rel=\"noopener\">Dr. Holly Richmond\u003c/a>, a sex therapist, the study results are “pretty remarkable.”\u003c/p>\n\u003cp>In her offices in Los Angeles and Portland, Oregon, Richmond has seen mixed results when her clients use marijuana. Some couples tell her that they have more sex when they use pot, but others have less sex.\u003c/p>\n\u003cp>She said those differences are probably attributable to how much pot someone smokes, instead of how often.\u003c/p>\n\u003cp>“Too much can lead to lethargy and really checking out, which does not facilitate [emotional] connection at all, and definitely doesn't encourage sexual activity.”\u003c/p>\n\u003cp>Eisenberg cautioned against drawing unwarranted conclusions from the study, and cited the old statistical adage “correlation does not equal causation.”\u003c/p>\n\u003cp>“This doesn’t mean that if you want to have more sex you should start smoking marijuana,” he said. “That’s definitely not what this data supports.”\u003c/p>\n\u003cp>The study can’t explain what factors are driving the association between pot use and sex, said Dr. Igor Grant, chair of psychiatry and director of the \u003ca href=\"http://www.cmcr.ucsd.edu/\" target=\"_blank\" rel=\"noopener\">Center for Medicinal Cannabis Research\u003c/a> at the University of California San Diego.\u003c/p>\n\u003cp>He said one explanation is that people who use marijuana —or are willing to admit marijuana use in a survey —are more likely to report their sexual encounters, or remember more of them. Grant said marijuana users are also sensation seekers, and may be more driven to have sex.\u003c/p>\n\u003cp>“Drug use is one type of sensation-seeking behavior, and obviously sex is another,” Grant said.\u003c/p>\n\u003cp>Eisenberg agreed that personality and other behaviors could be a factor, but if that was the case, he would expect to see different results from different demographic groups. For example, young and single respondents might be more willing and able to engage in risky or sensation-seeking behavior, when compared to married people with children. But the results held across all categories, including race and ethnicity, educational level, income level, religious affiliation, and family status.\u003c/p>\n\u003cp>“For every group, the more marijuana use that they reported, the more sex they reported as well. So that was really interesting to me, and also made me think that there could potentially be some biologic explanation here,” Eisenberg said.\u003c/p>\n\u003cp>Richmond, the sex therapist, says she wouldn’t advise any client who doesn’t already smoke to start smoking marijuana as a sexual aid. But she said it could be reassuring to her pot-using clients to learn from the study that smoking pot doesn’t appear to \u003cem>decrease\u003c/em> sexual activity.\u003c/p>\n\u003cp>“Individuals and couples look for additional ways to create novelty in the relationship and have fun, and that's now a legal and accessible way to do it,” she said.\u003c/p>\n\u003cp>Medicinal marijuana is now legal in 29 states, and eight of them allow recreational use as well. (The District of Columbia allows both).\u003c/p>\n\u003cp>\u003c/p>\n\u003cp>Dr. Eisenberg said that’s why learning more about the potential side effects of marijuana use is so critical.\u003c/p>\n\n\u003c/div>\u003c/p>","attributes":{"named":{},"numeric":[]}}],"link":"/stateofhealth/361766/recreational-or-procreational-study-links-marijuana-use-with-more-frequent-sex","authors":["11314"],"categories":["stateofhealth_12","stateofhealth_3012","stateofhealth_2746","stateofhealth_13"],"tags":["stateofhealth_3186","stateofhealth_2808","stateofhealth_2519","stateofhealth_3185","stateofhealth_3187"],"featImg":"stateofhealth_361769","label":"stateofhealth"},"stateofhealth_361724":{"type":"posts","id":"stateofhealth_361724","meta":{"index":"posts_1591205157","site":"stateofhealth","id":"361724","score":null,"sort":[1508953469000]},"guestAuthors":[],"slug":"hospice-scrambled-during-california-wildfires-to-evacuate-patients-determined-to-die-at-home","title":"Hospice Scrambled During Wildfires to Evacuate Patients Determined to Die at Home","publishDate":1508953469,"format":"standard","headTitle":"State of Health | KQED News","labelTerm":{"site":"stateofhealth"},"content":"\u003cp>Even when the fires threatened her home in downtown Sonoma, the elderly woman inside refused to leave. Smoke was everywhere. Her caretaker begged her to heed the mandatory evacuation order.\u003c/p>\n\u003cp>Another woman on the outskirts of town said all the young people telling her to get out were just “making hay” over nothing.\u003c/p>\n\u003cp>“They didn't want to leave because they wanted to die in their home,” said Karna Dawson, a social worker with \u003ca href=\"http://hospicebythebay.org/\" target=\"_blank\" rel=\"noopener\">Hospice by the Bay\u003c/a>. \"They didn't want to leave because they didn't realize the severity of the problem. They didn't want to leave because they were stubborn.”\u003c/p>\n\u003cp>At critical moments, when the worst wildfires in state history were ravaging Wine Country, Dawson and other members of the hospice team had to intervene in several such standoffs with terminally ill clients.\u003c/p>\n\u003cp>“Some people were feeling like if they were going to die they wanted to die in their house, and [were] not really thinking that through very clearly,” she said. “We're not talking about dying of your cancer. We're talking about dying in a fire. And those are two very different deaths.”\u003c/p>\n\u003cp>[ad fullwidth]\u003c/p>\n\u003cp>When the fires broke out Oct. 8, nurses and staff with Hospice by the Bay were providing home care, pain management, and spiritual counseling to 108 patients in Napa and Sonoma counties. Half of those patients had to be evacuated.\u003c/p>\n\u003cp>Under federal rules, hospice agencies that receive payment from the Medicare program are required to have a disaster plan in place for their patients, including how to get bed-bound patients out of their homes.\u003c/p>\n\u003cp>Dawson was at work, enacting the plan, by 4 a.m. on Oct. 9, as the fires exploded across the area. She sat huddled over her laptop at home in Petaluma, wearing her grey pajamas and tattered pink bathrobe. She was talking on two phones at once, trying to find all their patients and ordering ambulances. In some cases, once the ambulances picked up the patients, they just drove away from the fires, to get to safety. The hospice staff had to figure out where exactly they had gone .\u003c/p>\n\u003cp>“It was just a moving target of where people were going and where they were landing,” said Wendy Ranzau, the hospice’s chief operating officer.\u003c/p>\n\u003cp>For many patients, the first stop was a Red Cross evacuation shelter. This required hospice leaders to adjust their goals, while still trying to fulfill the mission of providing patients an opportunity to die with dignity.\u003c/p>\n\u003cp>“Our priority was to make sure that we did not have a patient die in an evacuation center,” Ranzau said. “So even if they can’t die at home, they’re going to die someplace other than a cot in an auditorium.”\u003c/p>\n\u003cfigure id=\"attachment_361727\" class=\"wp-caption aligncenter\" style=\"max-width: 800px\">\u003cimg class=\"size-medium wp-image-361727\" src=\"https://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2017/10/Karna-Dawson-800x600.jpg\" alt=\"\" width=\"800\" height=\"600\">\u003cfigcaption class=\"wp-caption-text\">Karna Dawson helped lead the effort to make sure patients getting care from Hospice by the Bay were safely evacuated during the North Bay wildfires. \u003ccite>(April Dembosky)\u003c/cite>\u003c/figcaption>\u003c/figure>\n\u003cp>Within two days, the hospice had safely relocated all of the patients, even ones who had temporarily ended up in shelters. Some patients went to live with relatives all over the state, from Citrus Heights in the north, to Santa Barbara down south. Some were resettled in assisted living or skilled nursing facilities, with Hospice by the Bay dipping into its reserves to pay the fees, something the Medicare program does not require.\u003c/p>\n\u003cp>But there were a couple of hold-outs who found the shelters surprisingly hospitable.\u003c/p>\n\u003cp>“There was one gentleman who didn't want to leave the shelter. He had lived alone and he was loving the attention. He thought it was great,” Dawson said. “It took us 24 hours and the medics saying 'You can't really stay here.'”\u003c/p>\n\u003cp>Many patients were eventually able to return to their homes. But Ranzau predicts some never will. Either their homes burned down, or there’s no power, or because the are too medically fragile tosurvive another move. One patient lost five pounds in the week after the fire started.\u003c/p>\n\u003cp>“When you think about hospice, our median length of stay is about three weeks,” Ranzau said. “A week in the life of a hospice patient, unfortunately, is a third of their time on hospice. So it just doesn't make sense. You know, is a trauma of transferring again, too much for them?”\u003c/p>\n\u003cp>That means some patients will not have the death they planned, making them a tragic piece of the overall hospice trend: 70 percent of Californians say they want to die at home, but only 32 percent do. Now the Sonoma woman with cancer, whose dying wish was to spend her final days in her own house, will die in a nursing home.\u003c/p>\n\u003cp>“She’s okay. She’s okay,” Dawson said uncertainly, when asked about her status a week after the fires began. “She’s adjusting.”\u003c/p>\n\u003cp>For most of their patients, there just isn’t enough time to adapt to all the changes.\u003c/p>\n\u003cp>\u003c/p>\n\u003cp>“I, or you, can have six months or a year to process this and think it through,” she said. “We can have another fall that's pretty and recover. Where they might not, and likely won’t.”\u003c/p>\n\n","blocks":[],"excerpt":"The fires took away the last wish of scores of terminally ill people: to die peacefully, in their own beds. ","status":"publish","parent":0,"modified":1509068338,"stats":{"hasAudio":false,"hasVideo":false,"hasChartOrMap":false,"iframeSrcs":[],"hasGoogleForm":false,"hasGallery":false,"hasHearkenModule":false,"hasPolis":false,"paragraphCount":22,"wordCount":901},"headData":{"title":"Hospice Scrambled During Wildfires to Evacuate Patients Determined to Die at Home | KQED","description":"The fires took away the last wish of scores of terminally ill people: to die peacefully, in their own beds. ","ogTitle":"","ogDescription":"","ogImgId":"","twTitle":"","twDescription":"","twImgId":"","schema":{"@context":"http://schema.org","@type":"Article","headline":"Hospice Scrambled During Wildfires to Evacuate Patients Determined to Die at Home","datePublished":"2017-10-25T17:44:29.000Z","dateModified":"2017-10-27T01:38:58.000Z","image":"https://cdn.kqed.org/wp-content/uploads/2020/02/KQED-OG-Image@1x.png"}},"disqusIdentifier":"361724 https://ww2.kqed.org/stateofhealth/?p=361724","disqusUrl":"https://ww2.kqed.org/stateofhealth/2017/10/25/hospice-scrambled-during-california-wildfires-to-evacuate-patients-determined-to-die-at-home/","disqusTitle":"Hospice Scrambled During Wildfires to Evacuate Patients Determined to Die at Home","audioUrl":"https://www.kqed.org/.stream/anon/radio/tcr/2017/10/HospiceFireDembosky.mp3","path":"/stateofhealth/361724/hospice-scrambled-during-california-wildfires-to-evacuate-patients-determined-to-die-at-home","audioDuration":null,"audioTrackLength":null,"parsedContent":[{"type":"contentString","content":"\u003cdiv class=\"post-body\">\u003cp>\u003cp>Even when the fires threatened her home in downtown Sonoma, the elderly woman inside refused to leave. Smoke was everywhere. Her caretaker begged her to heed the mandatory evacuation order.\u003c/p>\n\u003cp>Another woman on the outskirts of town said all the young people telling her to get out were just “making hay” over nothing.\u003c/p>\n\u003cp>“They didn't want to leave because they wanted to die in their home,” said Karna Dawson, a social worker with \u003ca href=\"http://hospicebythebay.org/\" target=\"_blank\" rel=\"noopener\">Hospice by the Bay\u003c/a>. \"They didn't want to leave because they didn't realize the severity of the problem. They didn't want to leave because they were stubborn.”\u003c/p>\n\u003cp>At critical moments, when the worst wildfires in state history were ravaging Wine Country, Dawson and other members of the hospice team had to intervene in several such standoffs with terminally ill clients.\u003c/p>\n\u003cp>“Some people were feeling like if they were going to die they wanted to die in their house, and [were] not really thinking that through very clearly,” she said. “We're not talking about dying of your cancer. We're talking about dying in a fire. And those are two very different deaths.”\u003c/p>\n\u003cp>\u003c/p>\u003c/div>","attributes":{"named":{},"numeric":[]}},{"type":"component","content":"","name":"ad","attributes":{"named":{"label":"fullwidth"},"numeric":["fullwidth"]}},{"type":"contentString","content":"\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>When the fires broke out Oct. 8, nurses and staff with Hospice by the Bay were providing home care, pain management, and spiritual counseling to 108 patients in Napa and Sonoma counties. Half of those patients had to be evacuated.\u003c/p>\n\u003cp>Under federal rules, hospice agencies that receive payment from the Medicare program are required to have a disaster plan in place for their patients, including how to get bed-bound patients out of their homes.\u003c/p>\n\u003cp>Dawson was at work, enacting the plan, by 4 a.m. on Oct. 9, as the fires exploded across the area. She sat huddled over her laptop at home in Petaluma, wearing her grey pajamas and tattered pink bathrobe. She was talking on two phones at once, trying to find all their patients and ordering ambulances. In some cases, once the ambulances picked up the patients, they just drove away from the fires, to get to safety. The hospice staff had to figure out where exactly they had gone .\u003c/p>\n\u003cp>“It was just a moving target of where people were going and where they were landing,” said Wendy Ranzau, the hospice’s chief operating officer.\u003c/p>\n\u003cp>For many patients, the first stop was a Red Cross evacuation shelter. This required hospice leaders to adjust their goals, while still trying to fulfill the mission of providing patients an opportunity to die with dignity.\u003c/p>\n\u003cp>“Our priority was to make sure that we did not have a patient die in an evacuation center,” Ranzau said. “So even if they can’t die at home, they’re going to die someplace other than a cot in an auditorium.”\u003c/p>\n\u003cfigure id=\"attachment_361727\" class=\"wp-caption aligncenter\" style=\"max-width: 800px\">\u003cimg class=\"size-medium wp-image-361727\" src=\"https://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2017/10/Karna-Dawson-800x600.jpg\" alt=\"\" width=\"800\" height=\"600\">\u003cfigcaption class=\"wp-caption-text\">Karna Dawson helped lead the effort to make sure patients getting care from Hospice by the Bay were safely evacuated during the North Bay wildfires. \u003ccite>(April Dembosky)\u003c/cite>\u003c/figcaption>\u003c/figure>\n\u003cp>Within two days, the hospice had safely relocated all of the patients, even ones who had temporarily ended up in shelters. Some patients went to live with relatives all over the state, from Citrus Heights in the north, to Santa Barbara down south. Some were resettled in assisted living or skilled nursing facilities, with Hospice by the Bay dipping into its reserves to pay the fees, something the Medicare program does not require.\u003c/p>\n\u003cp>But there were a couple of hold-outs who found the shelters surprisingly hospitable.\u003c/p>\n\u003cp>“There was one gentleman who didn't want to leave the shelter. He had lived alone and he was loving the attention. He thought it was great,” Dawson said. “It took us 24 hours and the medics saying 'You can't really stay here.'”\u003c/p>\n\u003cp>Many patients were eventually able to return to their homes. But Ranzau predicts some never will. Either their homes burned down, or there’s no power, or because the are too medically fragile tosurvive another move. One patient lost five pounds in the week after the fire started.\u003c/p>\n\u003cp>“When you think about hospice, our median length of stay is about three weeks,” Ranzau said. “A week in the life of a hospice patient, unfortunately, is a third of their time on hospice. So it just doesn't make sense. You know, is a trauma of transferring again, too much for them?”\u003c/p>\n\u003cp>That means some patients will not have the death they planned, making them a tragic piece of the overall hospice trend: 70 percent of Californians say they want to die at home, but only 32 percent do. Now the Sonoma woman with cancer, whose dying wish was to spend her final days in her own house, will die in a nursing home.\u003c/p>\n\u003cp>“She’s okay. She’s okay,” Dawson said uncertainly, when asked about her status a week after the fires began. “She’s adjusting.”\u003c/p>\n\u003cp>For most of their patients, there just isn’t enough time to adapt to all the changes.\u003c/p>\n\u003cp>\u003c/p>\n\u003cp>“I, or you, can have six months or a year to process this and think it through,” she said. “We can have another fall that's pretty and recover. Where they might not, and likely won’t.”\u003c/p>\n\n\u003c/div>\u003c/p>","attributes":{"named":{},"numeric":[]}}],"link":"/stateofhealth/361724/hospice-scrambled-during-california-wildfires-to-evacuate-patients-determined-to-die-at-home","authors":["3205"],"categories":["stateofhealth_11","stateofhealth_12","stateofhealth_3012"],"tags":["stateofhealth_3184","stateofhealth_2808","stateofhealth_3023","stateofhealth_2519","stateofhealth_3183"],"featImg":"stateofhealth_361764","label":"stateofhealth"},"stateofhealth_360720":{"type":"posts","id":"stateofhealth_360720","meta":{"index":"posts_1591205157","site":"stateofhealth","id":"360720","score":null,"sort":[1502237507000]},"guestAuthors":[],"slug":"how-smartphones-are-making-kids-unhappy","title":"How Smartphones Are Making Kids Unhappy","publishDate":1502237507,"format":"standard","headTitle":"State of Health | KQED News","labelTerm":{"site":"stateofhealth"},"content":"\u003cp>For the first time, a generation of children is going through adolescence with smartphones ever-present. \u003ca href=\"http://www.psychology.sdsu.edu/people/jean-twenge/\">Jean Twenge\u003c/a>, a professor of psychology at San Diego State University, has a name for these young people born between 1995 and 2012: \"iGen.\"\u003c/p>\n\u003cp>She says members of this generation are physically safer than those who came before them. They drink less, they learn to drive later and they're holding off on having sex. But psychologically, she argues, they are far more vulnerable.\u003c/p>\n\u003cp>\"It's not an exaggeration to describe iGen as being on the brink of the worst mental health crisis in decades,\" she writes in a \u003ca href=\"https://www.theatlantic.com/magazine/archive/2017/09/has-the-smartphone-destroyed-a-generation/534198/\">story\u003c/a> in \u003cem>The Atlantic, \u003c/em>adapted from her \u003ca href=\"http://www.simonandschuster.com/books/iGen/Jean-M-Twenge/9781501151989\">forthcoming book\u003c/a>. And she says it's largely because of smartphones.\u003c/p>\n\u003cp>Twenge spoke to \u003cem>All Things Considered\u003c/em> about her research and her conclusions. This interview has been edited for length and clarity.\u003c/p>\n\u003cp>\u003c!-- iframe plugin v.4.3 wordpress.org/plugins/iframe/ -->\u003cbr>\n\u003ciframe src=\"https://www.npr.org/player/embed/542016165/542087124\" width=\"100%\" height=\"290\" frameborder=\"0\" scrolling=\"no\" title=\"NPR embedded audio player\" class=\"iframe-class\">\u003c/iframe>\u003c/p>\n\u003chr>\n\u003cp>\u003cstrong>How does teen behavior now differ from generations past?\u003c/strong>\u003c/p>\n\u003cp>[ad fullwidth]\u003c/p>\n\u003cp>Today's teens are just not spending as much time with their friends in person, face-to-face, where they can really read each others' emotions and get that social support. And we know from lots and lots of research that spending time with other people in person is one of the best predictors for psychological well-being and one of the best protections against having mental health issues.\u003c/p>\n\u003cp>\u003cstrong>What is this generation facing that worries you so much?\u003c/strong>\u003c/p>\n\u003cp>iGen is showing mental health issues across a wide variety of indicators. They're more likely than young people just five or 10 years ago to say that they're anxious, that they have symptoms of depression, that they have thought about suicide or have even [attempted] suicide. So across the board, there's a really consistent trend with mental health issues increasing among teens.\u003c/p>\n\u003cp>\u003cstrong>Is it specifically the smartphone, or is it social media? Or is it the number of hours per day spent on these things?\u003c/strong>\u003c/p>\n\u003cp>So, you look at the pattern of loneliness. It suddenly begins to increase around 2012. And the majority of Americans had a cell phone by the end of 2012, according to the \u003ca href=\"http://www.pewinternet.org/2013/06/05/smartphone-ownership-2013/\">Pew Center\u003c/a>.\u003c/p>\n\u003cp>Given that using social media for more hours is linked to more loneliness, and that smartphones were used by the majority of Americans around 2012, and that's the same time loneliness increases, that's very suspicious. You can't absolutely prove causation, but by a bunch of different studies, there's this connection between spending a lot of time on social media and feeling lonely.\u003c/p>\n\u003cp>\u003cstrong>How much of a factor is parenting?\u003c/strong>\u003c/p>\n\u003cp>So I was somewhat surprised when I interviewed iGen teens how many of them are deeply aware of the negative effects of smartphones. Parenting is playing a role. I think many parents are worried about their teens driving, and going out with their friends and drinking. Yet parents are often not worrying about their teen who stays at home but is on their phone all the time. But they should be worried about that. I think parents are worried about the wrong thing.\u003c/p>\n\u003cp>\u003cstrong>Can you propose solutions that might help people?\u003c/strong>\u003c/p>\n\u003cp>The first is just awareness that spending a lot of time on the phone is not harmless and that if you're spending a lot of time on the phone, then it may take away from activities that might be more beneficial for psychological well-being, like spending time with people in person.\u003c/p>\n\u003cp>\u003c/p>\n\u003cp>Then for parents, I think it is [a] good idea to put off giving your child a smartphone as long as you can. If you feel they need a phone, say, for riding a bus, you can get them a flip phone. They still sell them. And then once your teen has a smartphone, there are apps that allow parents to restrict the number of hours a day that teens are on the smartphone, and also what time of day they use it.\u003c/p>\n\u003cdiv class=\"fullattribution\">Copyright 2017 NPR. To see more, visit http://www.npr.org/.\u003cimg src=\"https://www.google-analytics.com/__utm.gif?utmac=UA-5828686-4&utmdt=How+Smartphones+Are+Making+Kids+Unhappy&utme=8(APIKey)9(MDAxOTAwOTE4MDEyMTkxMDAzNjczZDljZA004)\">\u003c/div>\n\n","blocks":[],"excerpt":"Psychologist Jean Twenge has seen dramatic shifts in behavior among children who go through adolescence with smartphones.","status":"publish","parent":0,"modified":1502240736,"stats":{"hasAudio":false,"hasVideo":false,"hasChartOrMap":true,"iframeSrcs":["https://www.npr.org/player/embed/542016165/542087124"],"hasGoogleForm":false,"hasGallery":false,"hasHearkenModule":false,"hasPolis":false,"paragraphCount":19,"wordCount":667},"headData":{"title":"How Smartphones Are Making Kids Unhappy | KQED","description":"Psychologist Jean Twenge has seen dramatic shifts in behavior among children who go through adolescence with smartphones.","ogTitle":"","ogDescription":"","ogImgId":"","twTitle":"","twDescription":"","twImgId":"","schema":{"@context":"http://schema.org","@type":"Article","headline":"How Smartphones Are Making Kids Unhappy","datePublished":"2017-08-09T00:11:47.000Z","dateModified":"2017-08-09T01:05:36.000Z","image":"https://cdn.kqed.org/wp-content/uploads/2020/02/KQED-OG-Image@1x.png"}},"disqusIdentifier":"360720 https://ww2.kqed.org/stateofhealth/?p=360720","disqusUrl":"https://ww2.kqed.org/stateofhealth/2017/08/08/how-smartphones-are-making-kids-unhappy/","disqusTitle":"How Smartphones Are Making Kids Unhappy","nprByline":"\u003ca href=\"http://www.npr.org/people/4986687/audie-cornish\" target=\"_blank\">Audie Cornish\u003c/a>","nprImageAgency":"Image Source/Getty Images","nprStoryId":"542016165","nprApiLink":"http://api.npr.org/query?id=542016165&apiKey=MDAxOTAwOTE4MDEyMTkxMDAzNjczZDljZA004","nprHtmlLink":"http://www.npr.org/sections/health-shots/2017/08/07/542016165/how-smartphones-are-making-kids-unhappy?ft=nprml&f=542016165","nprRetrievedStory":"1","nprPubDate":"Mon, 07 Aug 2017 18:50:00 -0400","nprStoryDate":"Mon, 07 Aug 2017 17:35:00 -0400","nprLastModifiedDate":"Tue, 08 Aug 2017 08:17:27 -0400","nprAudio":"https://ondemand.npr.org/anon.npr-mp3/npr/atc/2017/08/20170807_atc_smartphones_and_teens.mp3?orgId=1&topicId=1128&d=291&p=2&story=542016165&t=progseg&e=541985440&seg=16&ft=nprml&f=542016165","nprAudioM3u":"http://api.npr.org/m3u/1542087124-4cf612.m3u?orgId=1&topicId=1128&d=291&p=2&story=542016165&t=progseg&e=541985440&seg=16&ft=nprml&f=542016165","path":"/stateofhealth/360720/how-smartphones-are-making-kids-unhappy","audioUrl":"https://ondemand.npr.org/anon.npr-mp3/npr/atc/2017/08/20170807_atc_smartphones_and_teens.mp3?orgId=1&topicId=1128&d=291&p=2&story=542016165&t=progseg&e=541985440&seg=16&ft=nprml&f=542016165","audioTrackLength":null,"parsedContent":[{"type":"contentString","content":"\u003cdiv class=\"post-body\">\u003cp>\u003cp>For the first time, a generation of children is going through adolescence with smartphones ever-present. \u003ca href=\"http://www.psychology.sdsu.edu/people/jean-twenge/\">Jean Twenge\u003c/a>, a professor of psychology at San Diego State University, has a name for these young people born between 1995 and 2012: \"iGen.\"\u003c/p>\n\u003cp>She says members of this generation are physically safer than those who came before them. They drink less, they learn to drive later and they're holding off on having sex. But psychologically, she argues, they are far more vulnerable.\u003c/p>\n\u003cp>\"It's not an exaggeration to describe iGen as being on the brink of the worst mental health crisis in decades,\" she writes in a \u003ca href=\"https://www.theatlantic.com/magazine/archive/2017/09/has-the-smartphone-destroyed-a-generation/534198/\">story\u003c/a> in \u003cem>The Atlantic, \u003c/em>adapted from her \u003ca href=\"http://www.simonandschuster.com/books/iGen/Jean-M-Twenge/9781501151989\">forthcoming book\u003c/a>. And she says it's largely because of smartphones.\u003c/p>\n\u003cp>Twenge spoke to \u003cem>All Things Considered\u003c/em> about her research and her conclusions. This interview has been edited for length and clarity.\u003c/p>\n\u003cp>\u003c!-- iframe plugin v.4.3 wordpress.org/plugins/iframe/ -->\u003cbr>\n\u003ciframe src=\"https://www.npr.org/player/embed/542016165/542087124\" width=\"100%\" height=\"290\" frameborder=\"0\" scrolling=\"no\" title=\"NPR embedded audio player\" class=\"iframe-class\">\u003c/iframe>\u003c/p>\n\u003chr>\n\u003cp>\u003cstrong>How does teen behavior now differ from generations past?\u003c/strong>\u003c/p>\n\u003cp>\u003c/p>\u003c/div>","attributes":{"named":{},"numeric":[]}},{"type":"component","content":"","name":"ad","attributes":{"named":{"label":"fullwidth"},"numeric":["fullwidth"]}},{"type":"contentString","content":"\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>Today's teens are just not spending as much time with their friends in person, face-to-face, where they can really read each others' emotions and get that social support. And we know from lots and lots of research that spending time with other people in person is one of the best predictors for psychological well-being and one of the best protections against having mental health issues.\u003c/p>\n\u003cp>\u003cstrong>What is this generation facing that worries you so much?\u003c/strong>\u003c/p>\n\u003cp>iGen is showing mental health issues across a wide variety of indicators. They're more likely than young people just five or 10 years ago to say that they're anxious, that they have symptoms of depression, that they have thought about suicide or have even [attempted] suicide. So across the board, there's a really consistent trend with mental health issues increasing among teens.\u003c/p>\n\u003cp>\u003cstrong>Is it specifically the smartphone, or is it social media? Or is it the number of hours per day spent on these things?\u003c/strong>\u003c/p>\n\u003cp>So, you look at the pattern of loneliness. It suddenly begins to increase around 2012. And the majority of Americans had a cell phone by the end of 2012, according to the \u003ca href=\"http://www.pewinternet.org/2013/06/05/smartphone-ownership-2013/\">Pew Center\u003c/a>.\u003c/p>\n\u003cp>Given that using social media for more hours is linked to more loneliness, and that smartphones were used by the majority of Americans around 2012, and that's the same time loneliness increases, that's very suspicious. You can't absolutely prove causation, but by a bunch of different studies, there's this connection between spending a lot of time on social media and feeling lonely.\u003c/p>\n\u003cp>\u003cstrong>How much of a factor is parenting?\u003c/strong>\u003c/p>\n\u003cp>So I was somewhat surprised when I interviewed iGen teens how many of them are deeply aware of the negative effects of smartphones. Parenting is playing a role. I think many parents are worried about their teens driving, and going out with their friends and drinking. Yet parents are often not worrying about their teen who stays at home but is on their phone all the time. But they should be worried about that. I think parents are worried about the wrong thing.\u003c/p>\n\u003cp>\u003cstrong>Can you propose solutions that might help people?\u003c/strong>\u003c/p>\n\u003cp>The first is just awareness that spending a lot of time on the phone is not harmless and that if you're spending a lot of time on the phone, then it may take away from activities that might be more beneficial for psychological well-being, like spending time with people in person.\u003c/p>\n\u003cp>\u003c/p>\n\u003cp>Then for parents, I think it is [a] good idea to put off giving your child a smartphone as long as you can. If you feel they need a phone, say, for riding a bus, you can get them a flip phone. They still sell them. And then once your teen has a smartphone, there are apps that allow parents to restrict the number of hours a day that teens are on the smartphone, and also what time of day they use it.\u003c/p>\n\u003cdiv class=\"fullattribution\">Copyright 2017 NPR. To see more, visit http://www.npr.org/.\u003cimg src=\"https://www.google-analytics.com/__utm.gif?utmac=UA-5828686-4&utmdt=How+Smartphones+Are+Making+Kids+Unhappy&utme=8(APIKey)9(MDAxOTAwOTE4MDEyMTkxMDAzNjczZDljZA004)\">\u003c/div>\n\n\u003c/div>\u003c/p>","attributes":{"named":{},"numeric":[]}}],"link":"/stateofhealth/360720/how-smartphones-are-making-kids-unhappy","authors":["byline_stateofhealth_360720"],"categories":["stateofhealth_11","stateofhealth_3012","stateofhealth_1"],"tags":["stateofhealth_3068","stateofhealth_2808","stateofhealth_68","stateofhealth_2519","stateofhealth_3147","stateofhealth_3148"],"featImg":"stateofhealth_360721","label":"stateofhealth"}},"programsReducer":{"possible":{"id":"possible","title":"Possible","info":"Possible is hosted by entrepreneur Reid Hoffman and writer Aria Finger. Together in Possible, Hoffman and Finger lead enlightening discussions about building a brighter collective future. 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