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In Sacramento, an innovative program seeks to reach that group directly and easily: through the simple phone call.\u003c/p>\n\u003cp>One of the program’s clients is John, a 29-year-old student at Sacramento’s American River College. Today, he describes himself as happy-go-lucky. But a year ago, he had lost two jobs, was facing bankruptcy and had to move in with friends.\u003c/p>\n\u003cp>Already feeling “emotionally and mentally stripped,” he was then was diagnosed with HIV. “That took away pretty much the last thing that I had, which I thought was my health,” he recalls.\u003c/p>\n\u003cp>[ad fullwidth]\u003c/p>\n\u003cp>One day last August, he reached an end. Feeling he was “tired of doing this,” he decided to take his own life.\u003c/p>\n\u003cp>“In my room, I wrote out my note,” he remembered. “I got all my medication out on my bed and I just started taking it. And … All of a sudden, what I just realized is here I am laying here on my floor. … I think, ‘Oh My God, what am I doing? What am I doing?’”\u003c/p>\n\u003cp>He called out for help, and his roommates called 9-1-1.\u003c/p>\n\u003cp>He woke up in downtown Sacramento at Sutter General Hospital's emergency department with nurses pumping his stomach. He recovered. But before he was discharged, he was visited by a social worker, who told him about a unique program that would match him with a suicide prevention specialist. John signed up. That person would give him a call every few days for a month just to check in.\u003c/p>\n\u003cp>“Ultimately, I knew that I had a cushion for support,” John said about receiving those calls. “I knew that if I was having a hard time, I absolutely had somebody available there.”\u003c!--more-->\u003c/p>\n\u003cp>The program is a partnership between Sutter Medical Center and WellSpace Health. Calls are made from a \u003ca href=\"http://www.theeffort.org/suicide_prevention.htm\">WellSpace Health\u003c/a> clinic in South Sacramento. It’s Roop Dhillon’s job to call people like John who have recently been to the ER for thinking about suicide or attempting it.\u003c/p>\n\u003cp>“A lot of times that [ER] visit alone could be a pretty overwhelming experience,” said Dhillon. “What we’ve heard from a lot of participants is their hardest part of leaving the emergency room was feeling alone once they got home.”\u003c/p>\n\u003cp>What makes the ED Follow Up Program innovative is that it is proactive. Dhillon calls people who have just gotten been discharged. People who are vulnerable. People who are most likely to try to take their own lives again.\u003c/p>\n\u003cp>Dhillon calls her clients from the same room where the clinic runs \u003ca href=\"http://www.theeffort.org/suicide_prevention.htm\">a more traditional 24-hour crisis hotline\u003c/a>. The outreach program has served about 300 people so far, and none have died from suicide.\u003c/p>\n\u003cp>Liseanne Wick, who manages suicide prevention and crisis services at the clinic, was drawn to suicide prevention over a decade ago after her brother took his own life.\u003c/p>\n\u003cp>“Personally, it will never bring my brother back, but it really brings meaning to that experience knowing that we’ve affected the lives of thousands, literally, over the last 10 years, probably tens of thousands,” she said.\u003c/p>\n\u003cp>Wick can’t know if a crisis hotline or the Follow Up Program would have helped her brother, but she’s sure the clinic is helping people now. “We know that statistically; we know that anecdotally from our experience,” she says. “I can’t speak for my brother, if he would have called or if he had knowledge of suicide hotlines. I wish he would have, though, because I know that it makes a difference, and we save lives on a daily basis.”\u003c/p>\n\u003cp>Indeed, John sounds like a convert when talking about how the follow-up program helped him. He said when he would see the number pop-up on his cell phone, it would remind him to pause. To assess how he was doing. And to realize he wasn’t alone in the world.\u003c/p>\n\u003cp>\u003c/p>\n\u003cp>“So if you’re at a point where it just makes more sense to end it all because it’s not worth bothering anymore,” he said, speaking to those who may be considering hurting themselves. “Just pick up a phone and reach out to somebody for help. Let them tell you why it’s worth the bother.”\u003cem>\u003cbr>\n\u003c/em>\u003c/p>\n\n",
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"excerpt": "Every day in California, nine people die by suicide. Both in California and nationwide, suicide is the 10th leading cause of death. According to a recent study, more than half a million adults in California seriously thought about killing themselves in 2009. Last fall, the California Mental Health Services Authority launched a statewide campaign called Know the Signs as part of a larger suicide prevention initiative.\r\n\r\nOne of the highest risk groups for suicide is people who have previously attempted suicide. In Sacramento, a new program seeks to reach that group directly and easily: through the simple phone call.",
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"description": "Every day in California, nine people die by suicide. Both in California and nationwide, suicide is the 10th leading cause of death. According to a recent study, more than half a million adults in California seriously thought about killing themselves in 2009. Last fall, the California Mental Health Services Authority launched a statewide campaign called Know the Signs as part of a larger suicide prevention initiative.\r\n\r\nOne of the highest risk groups for suicide is people who have previously attempted suicide. In Sacramento, a new program seeks to reach that group directly and easily: through the simple phone call.",
"title": "Preventing Subsequent Suicide Attempts One Phone Call at a Time | KQED",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003cp>\u003cstrong>By Lauren M. Whaley\u003c/strong>, \u003ca href=\"http://centerforhealthreporting.org\" target=\"_blank\">CHCF Center for Health Reporting\u003c/a>\u003c/p>\n\u003cp>Every day in California, nine people die by suicide. Both in California and nationwide, suicide is the 10th leading cause of death. According to \u003ca href=\"http://newsroom.ucla.edu/portal/ucla/more-than-half-a-million-california-241841.aspx\">a recent study\u003c/a>, in 2009, more than a half-million adults in California seriously thought about killing themselves. Last fall, the California Mental Health Services Authority launched a statewide campaign called \u003ca href=\"http://www.suicideispreventable.org/\">Know the Signs\u003c/a> as part of a larger suicide prevention initiative.\u003c/p>\n\u003cp>One of the highest risk groups for suicide is people who have previously attempted suicide. In Sacramento, an innovative program seeks to reach that group directly and easily: through the simple phone call.\u003c/p>\n\u003cp>One of the program’s clients is John, a 29-year-old student at Sacramento’s American River College. Today, he describes himself as happy-go-lucky. But a year ago, he had lost two jobs, was facing bankruptcy and had to move in with friends.\u003c/p>\n\u003cp>Already feeling “emotionally and mentally stripped,” he was then was diagnosed with HIV. “That took away pretty much the last thing that I had, which I thought was my health,” he recalls.\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>One day last August, he reached an end. Feeling he was “tired of doing this,” he decided to take his own life.\u003c/p>\n\u003cp>“In my room, I wrote out my note,” he remembered. “I got all my medication out on my bed and I just started taking it. And … All of a sudden, what I just realized is here I am laying here on my floor. … I think, ‘Oh My God, what am I doing? What am I doing?’”\u003c/p>\n\u003cp>He called out for help, and his roommates called 9-1-1.\u003c/p>\n\u003cp>He woke up in downtown Sacramento at Sutter General Hospital's emergency department with nurses pumping his stomach. He recovered. But before he was discharged, he was visited by a social worker, who told him about a unique program that would match him with a suicide prevention specialist. John signed up. That person would give him a call every few days for a month just to check in.\u003c/p>\n\u003cp>“Ultimately, I knew that I had a cushion for support,” John said about receiving those calls. “I knew that if I was having a hard time, I absolutely had somebody available there.”\u003c!--more-->\u003c/p>\n\u003cp>The program is a partnership between Sutter Medical Center and WellSpace Health. Calls are made from a \u003ca href=\"http://www.theeffort.org/suicide_prevention.htm\">WellSpace Health\u003c/a> clinic in South Sacramento. It’s Roop Dhillon’s job to call people like John who have recently been to the ER for thinking about suicide or attempting it.\u003c/p>\n\u003cp>“A lot of times that [ER] visit alone could be a pretty overwhelming experience,” said Dhillon. “What we’ve heard from a lot of participants is their hardest part of leaving the emergency room was feeling alone once they got home.”\u003c/p>\n\u003cp>What makes the ED Follow Up Program innovative is that it is proactive. Dhillon calls people who have just gotten been discharged. People who are vulnerable. People who are most likely to try to take their own lives again.\u003c/p>\n\u003cp>Dhillon calls her clients from the same room where the clinic runs \u003ca href=\"http://www.theeffort.org/suicide_prevention.htm\">a more traditional 24-hour crisis hotline\u003c/a>. The outreach program has served about 300 people so far, and none have died from suicide.\u003c/p>\n\u003cp>Liseanne Wick, who manages suicide prevention and crisis services at the clinic, was drawn to suicide prevention over a decade ago after her brother took his own life.\u003c/p>\n\u003cp>“Personally, it will never bring my brother back, but it really brings meaning to that experience knowing that we’ve affected the lives of thousands, literally, over the last 10 years, probably tens of thousands,” she said.\u003c/p>\n\u003cp>Wick can’t know if a crisis hotline or the Follow Up Program would have helped her brother, but she’s sure the clinic is helping people now. “We know that statistically; we know that anecdotally from our experience,” she says. “I can’t speak for my brother, if he would have called or if he had knowledge of suicide hotlines. I wish he would have, though, because I know that it makes a difference, and we save lives on a daily basis.”\u003c/p>\n\u003cp>Indeed, John sounds like a convert when talking about how the follow-up program helped him. He said when he would see the number pop-up on his cell phone, it would remind him to pause. To assess how he was doing. And to realize he wasn’t alone in the world.\u003c/p>\n\u003cp>\u003c/p>\n\u003cp>“So if you’re at a point where it just makes more sense to end it all because it’s not worth bothering anymore,” he said, speaking to those who may be considering hurting themselves. “Just pick up a phone and reach out to somebody for help. Let them tell you why it’s worth the bother.”\u003cem>\u003cbr>\n\u003c/em>\u003c/p>\n\n\u003c/div>\u003c/p>",
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"disqusTitle": "Wounded Veterans Find Comfort, Hope in Cooking Class",
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"content": "\u003cp>\u003cstrong>By Mina Kim\u003c/strong>\u003c/p>\n\u003cfigure id=\"attachment_11242\" class=\"wp-caption alignleft\" style=\"max-width: 300px\">\u003ca href=\"http://ww2.kqed.org/stateofhealth/2013/03/08/wounded-veterans-find-comfort-hope-in-cooking-class/rs4123_photo_kronmark_fish/\" rel=\"attachment wp-att-11242\">\u003cimg class=\"size-medium wp-image-11242\" title=\"\" src=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2013/03/RS4123_photo_Kronmark_fish-300x225.jpg\" alt=\"Chef Lars Kronmark teaches veterans how to remove the skin of a fish; part of a four-day "boot camp" at Napa's Culinary Institute of America where injured veterans and their spouses learn healthy cooking tips. (Mina Kim/KQED)\" width=\"300\" height=\"225\">\u003c/a>\u003cfigcaption class=\"wp-caption-text\">Chef Lars Kronmark teaches veterans how to remove the skin of a fish; part of a four-day \"boot camp\" at Napa's Culinary Institute of America where injured veterans and their spouses learn healthy cooking tips. (Mina Kim/KQED)\u003c/figcaption>\u003c/figure>\n\u003cp>In a stainless-steel teaching kitchen deep within the old stone walls of the elite Culinary Institute of America in Napa Valley, acclaimed chef Lars Kronmark pulls a piece of fat from the cavity of a raw, whole chicken.\u003c/p>\n\u003cp>“A big chunk of fat like that, it doesn’t really hurt to leave it in there,” Kronmark said. “But in the end of the day, that’s still going to be too much fat.”\u003c/p>\n\u003cp>It looks like a standard cooking class. But this is an unusual class for an unusual group of students. It’s a healthy cooking “boot camp” designed for wounded veterans of the Iraq and Afghanistan wars with a goal of helping veterans connect with each other and learn to eat healthier.\u003c/p>\n\u003cp>Six military veterans and their spouses dressed in white chef’s coats and hats watch Kronmark closely. His healthy cooking techniques are welcome tips to the group of 12, including veteran James McQuoid, who lives with post-traumatic stress disorder.\u003c/p>\n\u003cp>[ad fullwidth]\u003c/p>\n\u003cp>“I’m of the larger variety,” McQuoid said. “A couple years ago, I didn’t care about my health. I was very reclusive and what not, but through therapy and stuff I’ve come to realize — I’ve got a younger child — I want to be around a bit longer, and I’m really not helping myself at all.”\u003c/p>\n\u003cfigure id=\"attachment_11245\" class=\"wp-caption alignright\" style=\"max-width: 300px\">\u003ca href=\"http://ww2.kqed.org/stateofhealth/2013/03/08/wounded-veterans-find-comfort-hope-in-cooking-class/rs4121_photo_dinner-served/\" rel=\"attachment wp-att-11245\">\u003cimg class=\"size-medium wp-image-11245\" title=\"\" src=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2013/03/RS4121_photo_dinner-served-300x225.jpg\" alt=\"A healthy dinner is served at Napa's Culinary Institute of America healthy-cooking boot camp for injured veterans. (Mina Kim/KQED)\" width=\"300\" height=\"225\">\u003c/a>\u003cfigcaption class=\"wp-caption-text\">A healthy dinner is served at Napa's Culinary Institute of America healthy-cooking boot camp for injured veterans. (Mina Kim/KQED)\u003c/figcaption>\u003c/figure>\n\u003cp>Federal officials estimate more than 70 percent of the veterans receiving care in the VA are overweight or obese. McQuoid’s doctor recommended he get more omega-3 fatty acids by eating fish instead of fatty meats.\u003c/p>\n\u003cp>“But I didn’t know how to cook fish,” McQuoid said. “After being here though, I can cook fish!”\u003c/p>\n\u003cp>The four-day boot camp is a program of the Wounded Warrior Project, a nonprofit that serves injured veterans transitioning to civilian life. The camp’s days begin with lectures on subjects like the physiology of taste and end with vets and their partners preparing dishes for dinner. Today’s menu includes roast chicken with lemon and rosemary, Baja fish tacos, and pork loin cooked in a pomegranate glaze.\u003c!--more-->\u003c/p>\n\u003cp>\u003cstrong>Invisible Wounds\u003c/strong>\u003c/p>\n\u003cp>Yet, the program is playing a much bigger role than helping veterans eat better. Julia Valentour, health and wellness coordinator at the Wounded Warrior Project’s San Diego office, said there’s a waiting list for the classes that often helps veterans break through the isolation they feel when they return from war.\u003c/p>\n\u003cp>“I don’t think people realize what [veterans] go through and how much they sacrifice for us,” Valentour said. “You’re not hearing about the war on TV everyday, so you tend to forget that it’s still going on.”\u003c/p>\n\u003cp>At one cooking station a young man in a wheelchair with prosthetic legs, quietly peels sweet potatoes. Another veteran purses his lips in concentration as he chops cilantro using only one hand. But for many of the veterans, their wounds are not visible.\u003c/p>\n\u003cp>Tiffany Rush-Green who flew in from Phoenix for the class with her husband Yancy Green, a Marine, said this is the first time she’s seen her husband smile in a long time.\u003c/p>\n\u003cp>“Finally we can do something together, and take our time and just be a team so we can find that common ground,” Rush-Green said. “I am not a veteran, so a lot of times I can’t relate to him on certain issues, but cooking I think we’re going to be able to relate to each other on.”\u003c/p>\n\u003cp>Yancy Green said his wife is happy because she won’t have to do all the cooking anymore.\u003c/p>\n\u003cp>“I have no more excuses after this week,” he said.\u003c/p>\n\u003cp>For Renee Hampton and her husband — who asked not to give his name because he’s on active duty — being here is a dream come true. Hampton said her husband learned to cook when he was five and always wanted to be a chef, but chemicals used in the war robbed him of his ability to smell and taste. Still, it hasn’t dampened his experience in the class.\u003c/p>\n\u003cp>“I absolutely love this,” he said. “Besides, all my life, I’ve always wanted one of these [chef] jackets, and now I get one.”\u003c/p>\n\u003cp>For Culinary Institute chef Kronmark, the service members humble him in ways he hasn’t felt before.\u003c/p>\n\u003cp>“Makes you remember how lucky you are,” Kronmark said. “It’s really amazing.”\u003c/p>\n\u003cp>The next class is scheduled for May, and will be for spouses or caregivers of veterans.\u003c/p>\n\u003cp>\u003c/p>\n\u003cp>\u003cstrong>Listen to Mina Kim's story:\u003c/strong>\u003cbr>\n\u003cobject width=\"335\" height=\"85\">\u003cparam name=\"movie\" value=\"http://www.kqed.org/assets/flash/kqedplayer.swf\">\u003cparam name=\"flashvars\" value=\"file=http://www.kqed.org/radio/archives/R201303081630c.xml\">\u003cembed src=\"http://www.kqed.org/assets/flash/kqedplayer.swf\" type=\"application/x-shockwave-flash\" width=\"335\" height=\"85\" flashvars=\"file=http://www.kqed.org/radio/archives/R201303081630c.xml\">\u003c/embed>\u003c/object>\u003c/p>\n\n",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003cp>\u003cstrong>By Mina Kim\u003c/strong>\u003c/p>\n\u003cfigure id=\"attachment_11242\" class=\"wp-caption alignleft\" style=\"max-width: 300px\">\u003ca href=\"http://ww2.kqed.org/stateofhealth/2013/03/08/wounded-veterans-find-comfort-hope-in-cooking-class/rs4123_photo_kronmark_fish/\" rel=\"attachment wp-att-11242\">\u003cimg class=\"size-medium wp-image-11242\" title=\"\" src=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2013/03/RS4123_photo_Kronmark_fish-300x225.jpg\" alt=\"Chef Lars Kronmark teaches veterans how to remove the skin of a fish; part of a four-day "boot camp" at Napa's Culinary Institute of America where injured veterans and their spouses learn healthy cooking tips. (Mina Kim/KQED)\" width=\"300\" height=\"225\">\u003c/a>\u003cfigcaption class=\"wp-caption-text\">Chef Lars Kronmark teaches veterans how to remove the skin of a fish; part of a four-day \"boot camp\" at Napa's Culinary Institute of America where injured veterans and their spouses learn healthy cooking tips. (Mina Kim/KQED)\u003c/figcaption>\u003c/figure>\n\u003cp>In a stainless-steel teaching kitchen deep within the old stone walls of the elite Culinary Institute of America in Napa Valley, acclaimed chef Lars Kronmark pulls a piece of fat from the cavity of a raw, whole chicken.\u003c/p>\n\u003cp>“A big chunk of fat like that, it doesn’t really hurt to leave it in there,” Kronmark said. “But in the end of the day, that’s still going to be too much fat.”\u003c/p>\n\u003cp>It looks like a standard cooking class. But this is an unusual class for an unusual group of students. It’s a healthy cooking “boot camp” designed for wounded veterans of the Iraq and Afghanistan wars with a goal of helping veterans connect with each other and learn to eat healthier.\u003c/p>\n\u003cp>Six military veterans and their spouses dressed in white chef’s coats and hats watch Kronmark closely. His healthy cooking techniques are welcome tips to the group of 12, including veteran James McQuoid, who lives with post-traumatic stress disorder.\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>“I’m of the larger variety,” McQuoid said. “A couple years ago, I didn’t care about my health. I was very reclusive and what not, but through therapy and stuff I’ve come to realize — I’ve got a younger child — I want to be around a bit longer, and I’m really not helping myself at all.”\u003c/p>\n\u003cfigure id=\"attachment_11245\" class=\"wp-caption alignright\" style=\"max-width: 300px\">\u003ca href=\"http://ww2.kqed.org/stateofhealth/2013/03/08/wounded-veterans-find-comfort-hope-in-cooking-class/rs4121_photo_dinner-served/\" rel=\"attachment wp-att-11245\">\u003cimg class=\"size-medium wp-image-11245\" title=\"\" src=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2013/03/RS4121_photo_dinner-served-300x225.jpg\" alt=\"A healthy dinner is served at Napa's Culinary Institute of America healthy-cooking boot camp for injured veterans. (Mina Kim/KQED)\" width=\"300\" height=\"225\">\u003c/a>\u003cfigcaption class=\"wp-caption-text\">A healthy dinner is served at Napa's Culinary Institute of America healthy-cooking boot camp for injured veterans. (Mina Kim/KQED)\u003c/figcaption>\u003c/figure>\n\u003cp>Federal officials estimate more than 70 percent of the veterans receiving care in the VA are overweight or obese. McQuoid’s doctor recommended he get more omega-3 fatty acids by eating fish instead of fatty meats.\u003c/p>\n\u003cp>“But I didn’t know how to cook fish,” McQuoid said. “After being here though, I can cook fish!”\u003c/p>\n\u003cp>The four-day boot camp is a program of the Wounded Warrior Project, a nonprofit that serves injured veterans transitioning to civilian life. The camp’s days begin with lectures on subjects like the physiology of taste and end with vets and their partners preparing dishes for dinner. Today’s menu includes roast chicken with lemon and rosemary, Baja fish tacos, and pork loin cooked in a pomegranate glaze.\u003c!--more-->\u003c/p>\n\u003cp>\u003cstrong>Invisible Wounds\u003c/strong>\u003c/p>\n\u003cp>Yet, the program is playing a much bigger role than helping veterans eat better. Julia Valentour, health and wellness coordinator at the Wounded Warrior Project’s San Diego office, said there’s a waiting list for the classes that often helps veterans break through the isolation they feel when they return from war.\u003c/p>\n\u003cp>“I don’t think people realize what [veterans] go through and how much they sacrifice for us,” Valentour said. “You’re not hearing about the war on TV everyday, so you tend to forget that it’s still going on.”\u003c/p>\n\u003cp>At one cooking station a young man in a wheelchair with prosthetic legs, quietly peels sweet potatoes. Another veteran purses his lips in concentration as he chops cilantro using only one hand. But for many of the veterans, their wounds are not visible.\u003c/p>\n\u003cp>Tiffany Rush-Green who flew in from Phoenix for the class with her husband Yancy Green, a Marine, said this is the first time she’s seen her husband smile in a long time.\u003c/p>\n\u003cp>“Finally we can do something together, and take our time and just be a team so we can find that common ground,” Rush-Green said. “I am not a veteran, so a lot of times I can’t relate to him on certain issues, but cooking I think we’re going to be able to relate to each other on.”\u003c/p>\n\u003cp>Yancy Green said his wife is happy because she won’t have to do all the cooking anymore.\u003c/p>\n\u003cp>“I have no more excuses after this week,” he said.\u003c/p>\n\u003cp>For Renee Hampton and her husband — who asked not to give his name because he’s on active duty — being here is a dream come true. Hampton said her husband learned to cook when he was five and always wanted to be a chef, but chemicals used in the war robbed him of his ability to smell and taste. Still, it hasn’t dampened his experience in the class.\u003c/p>\n\u003cp>“I absolutely love this,” he said. “Besides, all my life, I’ve always wanted one of these [chef] jackets, and now I get one.”\u003c/p>\n\u003cp>For Culinary Institute chef Kronmark, the service members humble him in ways he hasn’t felt before.\u003c/p>\n\u003cp>“Makes you remember how lucky you are,” Kronmark said. “It’s really amazing.”\u003c/p>\n\u003cp>The next class is scheduled for May, and will be for spouses or caregivers of veterans.\u003c/p>\n\u003cp>\u003c/p>\n\u003cp>\u003cstrong>Listen to Mina Kim's story:\u003c/strong>\u003cbr>\n\u003cobject width=\"335\" height=\"85\">\u003cparam name=\"movie\" value=\"http://www.kqed.org/assets/flash/kqedplayer.swf\">\u003cparam name=\"flashvars\" value=\"file=http://www.kqed.org/radio/archives/R201303081630c.xml\">\u003cembed src=\"http://www.kqed.org/assets/flash/kqedplayer.swf\" type=\"application/x-shockwave-flash\" width=\"335\" height=\"85\" flashvars=\"file=http://www.kqed.org/radio/archives/R201303081630c.xml\">\u003c/embed>\u003c/object>\u003c/p>\n\n\u003c/div>\u003c/p>",
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"disqusTitle": "After Newtown Shootings: Questions about Mental Health Insurance Coverage",
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"content": "\u003cp>By Jenny Gold, \u003ca href=\"http://www.kaiserhealthnews.org/Stories/2012/December/18/Mental-Health-Insurance-Coverage-Questions-After-Shooting.aspx\" target=\"_blank\">Kaiser Health News\u003c/a>\u003c/p>\n\u003cfigure id=\"attachment_9564\" class=\"wp-caption alignleft\" style=\"max-width: 300px\">\u003ca href=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2012/12/PresObamaNewtownOlivier-DoulieryGetty-Images.1.jpg\">\u003cimg class=\"size-full wp-image-9564\" title=\"President Obama Visits Newtown, CT, Consoles Families Of Shooting Victims\" src=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2012/12/PresObamaNewtownOlivier-DoulieryGetty-Images.1.jpg\" alt=\"President Obama speaks at an interfaith vigil for the shooting victims at Sandy Hook Elementary School (Olivier Douliery-Pool/Getty Images).\" width=\"300\" height=\"199\">\u003c/a>\u003cfigcaption class=\"wp-caption-text\">President Obama speaks at an interfaith vigil for the shooting victims at Sandy Hook Elementary School (Olivier Douliery-Pool/Getty Images).\u003c/figcaption>\u003c/figure>\n\u003cp>On Monday White House spokesman Jay Carney pointed to the federal health law as evidence that the administration has already started to tackle the issue. Mental health issues are \"clearly a factor that needs to be addressed in some of these cases of horrific violence,\" Carney said. \"Obamacare, if you will, has ensured that mental health services are a part of the services\" provided under the health law.\u003c/p>\n\u003cp>While the Affordable Care Act, along with the Mental Health Parity Act of 2008, go a long way toward assuring coverage for most Americans, some gaps remain.\u003c/p>\n\u003cp>Here are some answers to frequently asked questions about mental health coverage:\u003c/p>\n\u003cp>\u003cstrong>Didn't the Mental Health Parity Act already guarantee coverage for Americans with insurance?\u003c/strong>\u003c/p>\n\u003cp>[ad fullwidth]\u003c/p>\n\u003cp>The \u003ca href=\"http://www.kaiserhealthnews.org/features/insuring-your-health/mental-health-coverage.aspx\" target=\"_self\">Mental Health Parity and Addiction Equity Act\u003c/a>, signed into law in 2008, \u003ca href=\"http://archpsyc.jamanetwork.com/article.aspx?articleid=208673\" target=\"_blank\">made a big dent\u003c/a> in the problem of mental health coverage. But it depends on how you get your insurance\u003c/p>\n\u003cul>\n\u003cli>\u003cstrong>Large Employers (more than 50 workers): \u003c/strong>If large companies include mental health services in their insurance plans, they must cover those services at same or higher level as other medical conditions. That means that the plans could not provide fewer inpatient hospital days or require higher out-of-pocket costs, more cost sharing or separate deductibles for mental health conditions. But Paul N. Samuels, director and president of the Legal Action Center, says that some people still aren't receiving equal coverage, and the law is not always enforced. \"That's a problem we're really concerned about,\" he says. Note that large employers are not \u003cem>required \u003c/em>to offer mental health insurance, but most do.\u003c/li>\n\u003cli>\u003cstrong>Small Business/Individual Plans: \u003c/strong>Not included in the Parity Act.\u003c/li>\n\u003c/ul>\n\u003cp>In short, whether you have mental health coverage in an employer-sponsored insurance plan depends on where you work.\u003c/p>\n\u003cp>\u003cstrong>What if I don't have mental health coverage in my employer’s insurance plan? Will the ACA change that?\u003c/strong>\u003c/p>\n\u003cp>Small group and individual plans will be required to offer the coverage in 2014 through health exchanges created under the law. But employers with 50 or more workers can continue to not offer the benefits.\u003c/p>\n\u003cp>\u003cstrong>I'm planning to buy an insurance plan through one of the new exchanges. What kind of mental health coverage will I have?\u003c/strong>\u003c/p>\n\u003cp>Again, as noted above, all plans sold in the exchanges \u003ca href=\"http://www.kaiserhealthnews.org/Stories/2012/December/18/www.ncsl.org/documents/health/MHparity&mandates.pdf%20\">will be required\u003c/a> to provide coverage for mental health and substance abuse. The exchanges will be open to individuals and small businesses.\u003c/p>\n\u003cp>The same rules will apply to small group and individual plans purchased outside of the exchange.\u003c/p>\n\u003cp>In other words, beginning in 2014, if you (or your small employer) are purchasing any new insurance plan, coverage will include mental health benefits on par with any other medical condition.\u003c/p>\n\u003cp>\u003cstrong>I'll be covered under the Medicaid expansion authorized by the law. What kind of mental health coverage will I get?\u003c/strong>\u003c/p>\n\u003cp>If you earn less than 138 percent of the federal poverty level (about $32,809 for a family of four), you may be newly eligible for Medicaid coverage in 2014. Like people who purchase coverage through the exchange, new Medicaid beneficiaries will receive mental health benefits on par with other medical or surgical needs.\u003c/p>\n\u003cp>\u003cstrong>What problems might arise?\u003c/strong>\u003c/p>\n\u003cp>While the ACA \"provides enormous potential and opportunity to make sure than many millions more Americans obtain the services they need,\" says Samuels, \"that will only happen if the implementation of those reforms is effective.\" Samuels worries that the rules from HHS will not be clear or strong enough to make the parity laws meaningful. He also worries about getting everyone who is eligible for coverage enrolled, particularly those with severe mental health disorders who be may homeless or living on the fringes of society.\u003c/p>\n\u003cp>Access to treatment will likely also remain a serious stumbling block. As many as 30 million people are expected to gain insurance coverage beginning in 2014. Of those, the U.S. Substance Abuse and Mental Health Services Administration \u003ca href=\"http://www.samhsa.gov/samhsanewsletter/Volume_18_Number_5/HealthReform.aspx\">estimates that 6 to 10 million will have untreated mental illnesses\u003c/a> or addiction, adding additional demands to a system that is already overwhelmed. Patients may experience long wait times to see a psychiatrist, for example, and may require additional investments to expand the mental health workforce.\u003c/p>\n\u003cp>\u003cstrong>Learn More: KQED Forum \u003ca href=\"http://www.kqed.org/a/forum/R201212171000\" target=\"_blank\">Shooting Puts Spotlight on Mental Health\u003c/a>\u003c/strong>\u003c/p>\n\u003cp>\u003c/p>\n\u003cp>\u003cobject width=\"335\" height=\"85\" classid=\"d27cdb6e-ae6d-11cf-96b8-444553540000\" codebase=\"http://download.macromedia.com/pub/shockwave/cabs/flash/swflash.cab#version=6,0,40,0\">\u003cparam name=\"flashvars\" value=\"file=http://www.kqed.org/radio/archives/R201212171000.xml\">\u003cparam name=\"src\" value=\"http://www.kqed.org/assets/flash/kqedplayer.swf\">\u003cembed width=\"335\" height=\"85\" type=\"application/x-shockwave-flash\" src=\"http://www.kqed.org/assets/flash/kqedplayer.swf\" flashvars=\"file=http://www.kqed.org/radio/archives/R201212171000.xml\">\u003c/embed>\u003c/object>\u003c/p>\n\n",
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"excerpt": "In his speech at the memorial service for the Newtown victims, President Obama included mental health in calling for a national response to the massacre, a conversation that so far has focused on gun control. \"I will use whatever power this office holds to engage my fellow citizens -- from law enforcement to mental health professionals to parents and educators -- in an effort aimed at preventing more tragedies like this,\" the president said.\r\n\r\nOn Monday White House spokesman Jay Carney pointed to the federal health law as evidence that the administration has already started to tackle the issue. Mental health issues are \"clearly a factor that needs to be addressed in some of these cases of horrific violence,\" Carney said. \"Obamacare, if you will, has ensured that mental health services are a part of the services\" provided under the health law.",
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"description": "In his speech at the memorial service for the Newtown victims, President Obama included mental health in calling for a national response to the massacre, a conversation that so far has focused on gun control. "I will use whatever power this office holds to engage my fellow citizens -- from law enforcement to mental health professionals to parents and educators -- in an effort aimed at preventing more tragedies like this," the president said.\r\n\r\nOn Monday White House spokesman Jay Carney pointed to the federal health law as evidence that the administration has already started to tackle the issue. Mental health issues are "clearly a factor that needs to be addressed in some of these cases of horrific violence," Carney said. "Obamacare, if you will, has ensured that mental health services are a part of the services" provided under the health law.",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003cp>By Jenny Gold, \u003ca href=\"http://www.kaiserhealthnews.org/Stories/2012/December/18/Mental-Health-Insurance-Coverage-Questions-After-Shooting.aspx\" target=\"_blank\">Kaiser Health News\u003c/a>\u003c/p>\n\u003cfigure id=\"attachment_9564\" class=\"wp-caption alignleft\" style=\"max-width: 300px\">\u003ca href=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2012/12/PresObamaNewtownOlivier-DoulieryGetty-Images.1.jpg\">\u003cimg class=\"size-full wp-image-9564\" title=\"President Obama Visits Newtown, CT, Consoles Families Of Shooting Victims\" src=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2012/12/PresObamaNewtownOlivier-DoulieryGetty-Images.1.jpg\" alt=\"President Obama speaks at an interfaith vigil for the shooting victims at Sandy Hook Elementary School (Olivier Douliery-Pool/Getty Images).\" width=\"300\" height=\"199\">\u003c/a>\u003cfigcaption class=\"wp-caption-text\">President Obama speaks at an interfaith vigil for the shooting victims at Sandy Hook Elementary School (Olivier Douliery-Pool/Getty Images).\u003c/figcaption>\u003c/figure>\n\u003cp>On Monday White House spokesman Jay Carney pointed to the federal health law as evidence that the administration has already started to tackle the issue. Mental health issues are \"clearly a factor that needs to be addressed in some of these cases of horrific violence,\" Carney said. \"Obamacare, if you will, has ensured that mental health services are a part of the services\" provided under the health law.\u003c/p>\n\u003cp>While the Affordable Care Act, along with the Mental Health Parity Act of 2008, go a long way toward assuring coverage for most Americans, some gaps remain.\u003c/p>\n\u003cp>Here are some answers to frequently asked questions about mental health coverage:\u003c/p>\n\u003cp>\u003cstrong>Didn't the Mental Health Parity Act already guarantee coverage for Americans with insurance?\u003c/strong>\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>The \u003ca href=\"http://www.kaiserhealthnews.org/features/insuring-your-health/mental-health-coverage.aspx\" target=\"_self\">Mental Health Parity and Addiction Equity Act\u003c/a>, signed into law in 2008, \u003ca href=\"http://archpsyc.jamanetwork.com/article.aspx?articleid=208673\" target=\"_blank\">made a big dent\u003c/a> in the problem of mental health coverage. But it depends on how you get your insurance\u003c/p>\n\u003cul>\n\u003cli>\u003cstrong>Large Employers (more than 50 workers): \u003c/strong>If large companies include mental health services in their insurance plans, they must cover those services at same or higher level as other medical conditions. That means that the plans could not provide fewer inpatient hospital days or require higher out-of-pocket costs, more cost sharing or separate deductibles for mental health conditions. But Paul N. Samuels, director and president of the Legal Action Center, says that some people still aren't receiving equal coverage, and the law is not always enforced. \"That's a problem we're really concerned about,\" he says. Note that large employers are not \u003cem>required \u003c/em>to offer mental health insurance, but most do.\u003c/li>\n\u003cli>\u003cstrong>Small Business/Individual Plans: \u003c/strong>Not included in the Parity Act.\u003c/li>\n\u003c/ul>\n\u003cp>In short, whether you have mental health coverage in an employer-sponsored insurance plan depends on where you work.\u003c/p>\n\u003cp>\u003cstrong>What if I don't have mental health coverage in my employer’s insurance plan? Will the ACA change that?\u003c/strong>\u003c/p>\n\u003cp>Small group and individual plans will be required to offer the coverage in 2014 through health exchanges created under the law. But employers with 50 or more workers can continue to not offer the benefits.\u003c/p>\n\u003cp>\u003cstrong>I'm planning to buy an insurance plan through one of the new exchanges. What kind of mental health coverage will I have?\u003c/strong>\u003c/p>\n\u003cp>Again, as noted above, all plans sold in the exchanges \u003ca href=\"http://www.kaiserhealthnews.org/Stories/2012/December/18/www.ncsl.org/documents/health/MHparity&mandates.pdf%20\">will be required\u003c/a> to provide coverage for mental health and substance abuse. The exchanges will be open to individuals and small businesses.\u003c/p>\n\u003cp>The same rules will apply to small group and individual plans purchased outside of the exchange.\u003c/p>\n\u003cp>In other words, beginning in 2014, if you (or your small employer) are purchasing any new insurance plan, coverage will include mental health benefits on par with any other medical condition.\u003c/p>\n\u003cp>\u003cstrong>I'll be covered under the Medicaid expansion authorized by the law. What kind of mental health coverage will I get?\u003c/strong>\u003c/p>\n\u003cp>If you earn less than 138 percent of the federal poverty level (about $32,809 for a family of four), you may be newly eligible for Medicaid coverage in 2014. Like people who purchase coverage through the exchange, new Medicaid beneficiaries will receive mental health benefits on par with other medical or surgical needs.\u003c/p>\n\u003cp>\u003cstrong>What problems might arise?\u003c/strong>\u003c/p>\n\u003cp>While the ACA \"provides enormous potential and opportunity to make sure than many millions more Americans obtain the services they need,\" says Samuels, \"that will only happen if the implementation of those reforms is effective.\" Samuels worries that the rules from HHS will not be clear or strong enough to make the parity laws meaningful. He also worries about getting everyone who is eligible for coverage enrolled, particularly those with severe mental health disorders who be may homeless or living on the fringes of society.\u003c/p>\n\u003cp>Access to treatment will likely also remain a serious stumbling block. As many as 30 million people are expected to gain insurance coverage beginning in 2014. Of those, the U.S. Substance Abuse and Mental Health Services Administration \u003ca href=\"http://www.samhsa.gov/samhsanewsletter/Volume_18_Number_5/HealthReform.aspx\">estimates that 6 to 10 million will have untreated mental illnesses\u003c/a> or addiction, adding additional demands to a system that is already overwhelmed. Patients may experience long wait times to see a psychiatrist, for example, and may require additional investments to expand the mental health workforce.\u003c/p>\n\u003cp>\u003cstrong>Learn More: KQED Forum \u003ca href=\"http://www.kqed.org/a/forum/R201212171000\" target=\"_blank\">Shooting Puts Spotlight on Mental Health\u003c/a>\u003c/strong>\u003c/p>\n\u003cp>\u003c/p>\n\u003cp>\u003cobject width=\"335\" height=\"85\" classid=\"d27cdb6e-ae6d-11cf-96b8-444553540000\" codebase=\"http://download.macromedia.com/pub/shockwave/cabs/flash/swflash.cab#version=6,0,40,0\">\u003cparam name=\"flashvars\" value=\"file=http://www.kqed.org/radio/archives/R201212171000.xml\">\u003cparam name=\"src\" value=\"http://www.kqed.org/assets/flash/kqedplayer.swf\">\u003cembed width=\"335\" height=\"85\" type=\"application/x-shockwave-flash\" src=\"http://www.kqed.org/assets/flash/kqedplayer.swf\" flashvars=\"file=http://www.kqed.org/radio/archives/R201212171000.xml\">\u003c/embed>\u003c/object>\u003c/p>\n\n\u003c/div>\u003c/p>",
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"disqusTitle": "Clinic for the Homeless to Open in Oakland",
"title": "Clinic for the Homeless to Open in Oakland",
"headTitle": "State of Health | KQED News",
"content": "\u003cfigure id=\"attachment_7967\" class=\"wp-caption alignleft\" style=\"max-width: 300px\">\u003ca href=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2012/08/Wendy-Georges-Planning-Session.jpg\">\u003cimg class=\"size-medium wp-image-7967\" title=\"Wendy Georges Planning Session\" src=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2012/08/Wendy-Georges-Planning-Session-300x225.jpg\" alt=\"\" width=\"300\" height=\"225\">\u003c/a>\u003cfigcaption class=\"wp-caption-text\">Wendy Georges (second from the left) leads a planning session for the new TRUST Clinic (Photo: David Modersbach)\u003c/figcaption>\u003c/figure>\n\u003cp>\u003cstrong>By Alvin Tran \u003c/strong>\u003c/p>\n\u003cp>Alameda County has new plans in store for its homeless population – it intends to open an integrated medical clinic in downtown Oakland.\u003c/p>\n\u003cp>The TRUST Clinic is one of the county's newest projects and involves the collaboration of several agencies including Alameda County’s \u003ca href=\"http://www.acphd.org/hchp.aspx\" target=\"_blank\">Health Care for the Homeless Program\u003c/a>, \u003ca href=\"http://alamedasocialservices.org/public/index.cfm\" target=\"_blank\">Social Services Agency\u003c/a> and \u003ca href=\"http://www.acbhcs.org/\" target=\"_blank\">Behavioral Health Services\u003c/a>.\u003c/p>\n\u003cp>But unlike other clinics in Alameda County, TRUST will be one of just two which will offer integrated health services, including primary care, behavioral health, case management with housing assistance, and medical-legal partnerships.\u003c/p>\n\u003cp>“This clinic is a very innovative idea. It’s not something that’s being done in very many places,” said Dr. Michael Boroff, a clinical psychologist who will be working at the clinic. “It embraces the integrated health care ... with medical and mental health and all of these different aspects of services combining and working together as a team.”\u003c/p>\n\u003cp>[ad fullwidth]\u003c/p>\n\u003cp>\u003c!--more-->\u003c/p>\n\u003cp>“I’d be hard-pressed to identify the population who needs these services more than the homeless population that we’re going to be serving,” Boroff added. And that population is large -- more than 4,000 people in 2011, according to a report by \u003ca href=\"http://www.everyonehome.org/resources_homeless_count11.html\" target=\"_blank\">EveryOne Home\u003c/a>, an advocacy group.\u003c/p>\n\u003cp>Wendy Georges, the TRUST Clinic Manager, said many homeless people deal with a variety of health and behavioral problems. Homeless individuals might have mental illness and substance abuse issues, they may have difficulty keeping track of their medical appointments, and might struggle in social settings.\u003c/p>\n\u003cp>The TRUST Clinic is intended to be a place where people can get a variety of services for up to 24 months. The hope is that during this time, patients will achieve financial and housing stability and be prepared to transition to other permanent clinics in Oakland.\u003c/p>\n\u003cp>“What we’re hoping to do in the TRUST Clinic is to address all of those problems across a spectrum -- stabilize their health, stabilize their mental health, offer effective substance abuse and interventions for addiction, provide legal advocacy to people so that they can successfully transition off of (General Assistance), get on to insurance which will then increase their access to medical care, mental health care,” Georges explained.\u003c/p>\n\u003cp>While many homeless individuals are current recipients of \u003ca href=\"http://www.alamedasocialservices.org/public/services/financial_assistance/general_assistance/index.cfm\" target=\"_blank\">General Assistance\u003c/a>, also known as welfare, Georges said that many of them are still unable to obtain adequate health services. TRUST will help enroll individuals in other areas of assistance.\u003c/p>\n\u003cp>“If they get on to Social Security, Supplemental Security Income -- SSI -- or SSDI, they'll have access, automatic access, then to Medi-Cal and, in some instances, to Medicare,” Georges said.\u003c/p>\n\u003cp>But when more people become insured, there will be other challenges to face.\u003c/p>\n\u003cp>According to Georges, more than 56,000 people in Alameda County will become eligible for health insurance once President Obama's \u003ca href=\"http://ww2.kqed.org/stateofhealth/wp-admin/www.healthcare.gov\" target=\"_blank\">Affordable Care Act\u003c/a> takes full effect in California.\u003c/p>\n\u003cp>“The demand outweighs the supply,” Georges said, adding that the current community clinic system in Alameda County will continue to be overburdened with patients from the safety net population –- a population in need which lacks health insurance.\u003c/p>\n\u003cp>This is where the TRUST Clinic comes into play. Georges describes the clinic as the “safety net for the safety net.”\u003c/p>\n\u003cp>“By redirecting the homeless population to the TRUST Clinic we relieve the burden on our community health network and enhance an already inadequate safety net system in Alameda County,” Georges explained later in an email. “Our clients/patients already have difficulties gaining access to the system and fitting in even when they do. We are establishing the (clinic) with just such clients/patients in mind, so truly to function as a safety net for the safety net.”\u003c/p>\n\u003cp>While the bricks and mortar clinic opens in 2013, Alameda’s homeless population does not have to wait until then to begin receiving the TRUST Clinic’s integrated health services. Starting Tuesday staff members of the clinic, including a nurse practitioner and a clinical psychologist, began offering part-time, interim mental health services at two locations in Oakland.\u003c/p>\n\u003cp>\u003c/p>\n\u003cp>“We’re going to start with mental health and we’re going to begin this building up process, get our mechanisms in place,” Georges said. “It’s a little bit of a practice run for a ramp up to full scale services.\"\u003c/p>\n\n",
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"description": "By Alvin Tran Alameda County has new plans in store for its homeless population – it intends to open an integrated medical clinic in downtown Oakland. The TRUST Clinic is one of the county's newest projects and involves the collaboration of several agencies including Alameda County’s Health Care for the Homeless Program, Social Services Agency",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003cfigure id=\"attachment_7967\" class=\"wp-caption alignleft\" style=\"max-width: 300px\">\u003ca href=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2012/08/Wendy-Georges-Planning-Session.jpg\">\u003cimg class=\"size-medium wp-image-7967\" title=\"Wendy Georges Planning Session\" src=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2012/08/Wendy-Georges-Planning-Session-300x225.jpg\" alt=\"\" width=\"300\" height=\"225\">\u003c/a>\u003cfigcaption class=\"wp-caption-text\">Wendy Georges (second from the left) leads a planning session for the new TRUST Clinic (Photo: David Modersbach)\u003c/figcaption>\u003c/figure>\n\u003cp>\u003cstrong>By Alvin Tran \u003c/strong>\u003c/p>\n\u003cp>Alameda County has new plans in store for its homeless population – it intends to open an integrated medical clinic in downtown Oakland.\u003c/p>\n\u003cp>The TRUST Clinic is one of the county's newest projects and involves the collaboration of several agencies including Alameda County’s \u003ca href=\"http://www.acphd.org/hchp.aspx\" target=\"_blank\">Health Care for the Homeless Program\u003c/a>, \u003ca href=\"http://alamedasocialservices.org/public/index.cfm\" target=\"_blank\">Social Services Agency\u003c/a> and \u003ca href=\"http://www.acbhcs.org/\" target=\"_blank\">Behavioral Health Services\u003c/a>.\u003c/p>\n\u003cp>But unlike other clinics in Alameda County, TRUST will be one of just two which will offer integrated health services, including primary care, behavioral health, case management with housing assistance, and medical-legal partnerships.\u003c/p>\n\u003cp>“This clinic is a very innovative idea. It’s not something that’s being done in very many places,” said Dr. Michael Boroff, a clinical psychologist who will be working at the clinic. “It embraces the integrated health care ... with medical and mental health and all of these different aspects of services combining and working together as a team.”\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>\u003c!--more-->\u003c/p>\n\u003cp>“I’d be hard-pressed to identify the population who needs these services more than the homeless population that we’re going to be serving,” Boroff added. And that population is large -- more than 4,000 people in 2011, according to a report by \u003ca href=\"http://www.everyonehome.org/resources_homeless_count11.html\" target=\"_blank\">EveryOne Home\u003c/a>, an advocacy group.\u003c/p>\n\u003cp>Wendy Georges, the TRUST Clinic Manager, said many homeless people deal with a variety of health and behavioral problems. Homeless individuals might have mental illness and substance abuse issues, they may have difficulty keeping track of their medical appointments, and might struggle in social settings.\u003c/p>\n\u003cp>The TRUST Clinic is intended to be a place where people can get a variety of services for up to 24 months. The hope is that during this time, patients will achieve financial and housing stability and be prepared to transition to other permanent clinics in Oakland.\u003c/p>\n\u003cp>“What we’re hoping to do in the TRUST Clinic is to address all of those problems across a spectrum -- stabilize their health, stabilize their mental health, offer effective substance abuse and interventions for addiction, provide legal advocacy to people so that they can successfully transition off of (General Assistance), get on to insurance which will then increase their access to medical care, mental health care,” Georges explained.\u003c/p>\n\u003cp>While many homeless individuals are current recipients of \u003ca href=\"http://www.alamedasocialservices.org/public/services/financial_assistance/general_assistance/index.cfm\" target=\"_blank\">General Assistance\u003c/a>, also known as welfare, Georges said that many of them are still unable to obtain adequate health services. TRUST will help enroll individuals in other areas of assistance.\u003c/p>\n\u003cp>“If they get on to Social Security, Supplemental Security Income -- SSI -- or SSDI, they'll have access, automatic access, then to Medi-Cal and, in some instances, to Medicare,” Georges said.\u003c/p>\n\u003cp>But when more people become insured, there will be other challenges to face.\u003c/p>\n\u003cp>According to Georges, more than 56,000 people in Alameda County will become eligible for health insurance once President Obama's \u003ca href=\"http://ww2.kqed.org/stateofhealth/wp-admin/www.healthcare.gov\" target=\"_blank\">Affordable Care Act\u003c/a> takes full effect in California.\u003c/p>\n\u003cp>“The demand outweighs the supply,” Georges said, adding that the current community clinic system in Alameda County will continue to be overburdened with patients from the safety net population –- a population in need which lacks health insurance.\u003c/p>\n\u003cp>This is where the TRUST Clinic comes into play. Georges describes the clinic as the “safety net for the safety net.”\u003c/p>\n\u003cp>“By redirecting the homeless population to the TRUST Clinic we relieve the burden on our community health network and enhance an already inadequate safety net system in Alameda County,” Georges explained later in an email. “Our clients/patients already have difficulties gaining access to the system and fitting in even when they do. We are establishing the (clinic) with just such clients/patients in mind, so truly to function as a safety net for the safety net.”\u003c/p>\n\u003cp>While the bricks and mortar clinic opens in 2013, Alameda’s homeless population does not have to wait until then to begin receiving the TRUST Clinic’s integrated health services. Starting Tuesday staff members of the clinic, including a nurse practitioner and a clinical psychologist, began offering part-time, interim mental health services at two locations in Oakland.\u003c/p>\n\u003cp>\u003c/p>\n\u003cp>“We’re going to start with mental health and we’re going to begin this building up process, get our mechanisms in place,” Georges said. “It’s a little bit of a practice run for a ramp up to full scale services.\"\u003c/p>\n\n\u003c/div>\u003c/p>",
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"disqusTitle": "Mobile Health Vans Care for Alameda's Homeless ",
"title": "Mobile Health Vans Care for Alameda's Homeless ",
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"content": "\u003cp>\u003cstrong>\u003cspan style=\"font-size: small\">\u003cspan style=\"color: #000000\">\u003cspan style=\"font-family: Times New Roman\">By Alvin Tran\u003c/span>\u003c/span>\u003c/span>\u003c/strong>\u003c/p>\n\u003cfigure id=\"attachment_7791\" class=\"wp-caption alignleft\" style=\"max-width: 300px\">\u003ca href=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2012/08/IMG_0154.jpg\">\u003cimg class=\"size-medium wp-image-7791 \" title=\"Alameda County Mobile Health Services Unit van, set up to treat patients in downtown, Berkeley\" src=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2012/08/IMG_0154-300x225.jpg\" alt=\"\" width=\"300\" height=\"225\">\u003c/a>\u003cfigcaption class=\"wp-caption-text\">Alameda County Mobile Health Services Unit van, set up to treat patients in downtown Berkeley. (Photo: Alvin Tran)\u003c/figcaption>\u003c/figure>\n\u003cp>The walking wounded wander the streets of Alameda County.\u003c/p>\n\u003cp>They are people who are homeless and live day to day in public parks and shelters. They are people in need of support for mental health issues and drug and alcohol addiction. And says Addie Brown, they are also one of the most difficult groups of patients to treat.\u003c/p>\n\u003cp>Brown would know. She oversees the operation of the Mobile Health Services Van headed by the \u003ca href=\"http://www.acphd.org/hchp.aspx\">Alameda County Health Care for the Homeless Program\u003c/a> (ACHCHP). The van travels throughout Alameda County serving approximately 160 homeless individuals each month. A team of healthcare providers, including nurse practitioners and social workers, provide no-cost primary care and support services, such as counseling and testing for sexually transmitted diseases.\u003c/p>\n\u003cp>“Over the years, we’ve saved a lot of lives. A lot of clients come with conditions that would have gone untreated had we not gone out there. We’ve been able to help them with their medical issues and getting them hooked up to the appropriate clinic, or doctor, or specialty care,” Brown explained.\u003c!--more-->\u003c/p>\n\u003cp>[ad fullwidth]\u003c/p>\n\u003cp>Reggie Evans came to the van to get treated for his allergies. As a street vendor who sells homemade jewelry on the streets in downtown Berkeley, Reggie said he often encounters passersby who ignore and discriminate against him for being homeless. But on the van, it's different. “They’re not snotty. They don't judge you,” Reggie told me.\u003c/p>\n\u003cp>But despite the mobile team's success in treating the homeless over the years, there has been a growth of patients with untreated mental health conditions and drug and alcohol addiction.\u003c/p>\n\u003cp>Not altogether surprisingly, Brown says these patients often fail to follow through with their medical referrals and go on with their lives -- untreated.\u003c/p>\n\u003cp>“Those are the hardest clients to work with and the hardest clients to get a positive outcome with because of their struggles with mental health and substance abuse,” Brown said.\u003c/p>\n\u003cp>Gerald Walker, a mental health specialist from \u003ca title=\"http://www.acbhcs.org/\" href=\"http://www.acbhcs.org/\" target=\"_blank\">Alameda County Behavioral Health Services Agency\u003c/a>, counsels mentally ill patients and helps them seek proper treatment. Walker began working for the van on a part-time basis in 1991 to help patients with mental illnesses. While he cannot treat them, he can refer them to the appropriate care.\u003c/p>\n\u003cp>“Part of our job is to teach them to become better patients,” Walker said.\u003c/p>\n\u003cp>He described the van’s mentally ill patients as “treatment resistant individuals,” because it is up to them to decide if they want to get treated for their conditions.\u003c/p>\n\u003cp>“They haven’t come to a point where they want to admit that they have a mental illness,” said Walker. “It’s almost impossible to treat someone who is telling you that the problem does not exist.\u003c/p>\n\u003cp>Even with the current challenges, Walker remains optimistic and points to Alameda County and the state of California’s current push to combine behavioral health care and primary care in treating patients.\u003c/p>\n\u003cp>“We are a few steps ahead of many others because we ... realized that this has been a problem for a really long time. We’ve been putting systems together that can address that,” Walker explained.\u003c/p>\n\u003cp>Still, the systems do not support all patients equally.\u003c/p>\n\u003cp>“In Alameda County right now, we have a pretty strong system of care for people that have a serious mental illness,\" said \u003ca title=\"http://www.acphd.org/hchp/contact-information.aspx\" href=\"http://www.acphd.org/hchp/contact-information.aspx\" target=\"_blank\">David Modersbach\u003c/a>, Director of ACHCHP. \"That could be something like schizophrenia or very severe depression or other sometimes organic mental illnesses. However, persons that have a low acuity mental illness such as depression, anxiety, personality disorders -- these mental illnesses don’t qualify them for low cost care.\"\u003c/p>\n\u003cp>Modersbach calls these patients the “walking wounded” because they don’t have access to support services and care that other community members “take for granted.”\u003c/p>\n\u003cp>To address these patients, Modersbach said his team is working with Alameda County Behavioral Health Care Services to explore expanding the current mental health services being offered.\u003c/p>\n\u003cp>Part of this potential expansion includes adding psychiatrists and licensed clinical social workers to the Health Services Vans so they can directly treat mentally ill patients.\u003c/p>\n\u003cp>“What we would like to do is have a system where we’re able to provide some sort of treatment for people at the places where homeless people are,” Modersbach explained.\u003c/p>\n\u003cp>\u003c/p>\n\u003cp>While ACHCHP and Behavioral Health Care Services are still in the planning stage of the expansion, Modersbach said he remains optimistic and hopes to see the expansion happen in early 2013.\u003c/p>\n\n",
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"excerpt": "The walking wounded wander the streets of Alameda County.\r\n\r\nThey are people who are homeless and live day to day in public parks and shelters. They are people in need of support for mental health issues and drug and alcohol addiction. And says Addie Brown, they are also one of the most difficult groups of patients to treat. \r\n\r\nBrown would know. She oversees the operation the Mobile Health Services Van headed by the Alameda County Health Care for the Homeless Program (ACHCHP). The van travels throughout Alameda County serving approximately 160 patients each month. A team of healthcare providers, including nurse of practitioners and social workers, provide no-cost primary care and support services, such as counseling and testing for sexually transmitted diseases, to homeless individuals.\r\n",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003cp>\u003cstrong>\u003cspan style=\"font-size: small\">\u003cspan style=\"color: #000000\">\u003cspan style=\"font-family: Times New Roman\">By Alvin Tran\u003c/span>\u003c/span>\u003c/span>\u003c/strong>\u003c/p>\n\u003cfigure id=\"attachment_7791\" class=\"wp-caption alignleft\" style=\"max-width: 300px\">\u003ca href=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2012/08/IMG_0154.jpg\">\u003cimg class=\"size-medium wp-image-7791 \" title=\"Alameda County Mobile Health Services Unit van, set up to treat patients in downtown, Berkeley\" src=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2012/08/IMG_0154-300x225.jpg\" alt=\"\" width=\"300\" height=\"225\">\u003c/a>\u003cfigcaption class=\"wp-caption-text\">Alameda County Mobile Health Services Unit van, set up to treat patients in downtown Berkeley. (Photo: Alvin Tran)\u003c/figcaption>\u003c/figure>\n\u003cp>The walking wounded wander the streets of Alameda County.\u003c/p>\n\u003cp>They are people who are homeless and live day to day in public parks and shelters. They are people in need of support for mental health issues and drug and alcohol addiction. And says Addie Brown, they are also one of the most difficult groups of patients to treat.\u003c/p>\n\u003cp>Brown would know. She oversees the operation of the Mobile Health Services Van headed by the \u003ca href=\"http://www.acphd.org/hchp.aspx\">Alameda County Health Care for the Homeless Program\u003c/a> (ACHCHP). The van travels throughout Alameda County serving approximately 160 homeless individuals each month. A team of healthcare providers, including nurse practitioners and social workers, provide no-cost primary care and support services, such as counseling and testing for sexually transmitted diseases.\u003c/p>\n\u003cp>“Over the years, we’ve saved a lot of lives. A lot of clients come with conditions that would have gone untreated had we not gone out there. We’ve been able to help them with their medical issues and getting them hooked up to the appropriate clinic, or doctor, or specialty care,” Brown explained.\u003c!--more-->\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>Reggie Evans came to the van to get treated for his allergies. As a street vendor who sells homemade jewelry on the streets in downtown Berkeley, Reggie said he often encounters passersby who ignore and discriminate against him for being homeless. But on the van, it's different. “They’re not snotty. They don't judge you,” Reggie told me.\u003c/p>\n\u003cp>But despite the mobile team's success in treating the homeless over the years, there has been a growth of patients with untreated mental health conditions and drug and alcohol addiction.\u003c/p>\n\u003cp>Not altogether surprisingly, Brown says these patients often fail to follow through with their medical referrals and go on with their lives -- untreated.\u003c/p>\n\u003cp>“Those are the hardest clients to work with and the hardest clients to get a positive outcome with because of their struggles with mental health and substance abuse,” Brown said.\u003c/p>\n\u003cp>Gerald Walker, a mental health specialist from \u003ca title=\"http://www.acbhcs.org/\" href=\"http://www.acbhcs.org/\" target=\"_blank\">Alameda County Behavioral Health Services Agency\u003c/a>, counsels mentally ill patients and helps them seek proper treatment. Walker began working for the van on a part-time basis in 1991 to help patients with mental illnesses. While he cannot treat them, he can refer them to the appropriate care.\u003c/p>\n\u003cp>“Part of our job is to teach them to become better patients,” Walker said.\u003c/p>\n\u003cp>He described the van’s mentally ill patients as “treatment resistant individuals,” because it is up to them to decide if they want to get treated for their conditions.\u003c/p>\n\u003cp>“They haven’t come to a point where they want to admit that they have a mental illness,” said Walker. “It’s almost impossible to treat someone who is telling you that the problem does not exist.\u003c/p>\n\u003cp>Even with the current challenges, Walker remains optimistic and points to Alameda County and the state of California’s current push to combine behavioral health care and primary care in treating patients.\u003c/p>\n\u003cp>“We are a few steps ahead of many others because we ... realized that this has been a problem for a really long time. We’ve been putting systems together that can address that,” Walker explained.\u003c/p>\n\u003cp>Still, the systems do not support all patients equally.\u003c/p>\n\u003cp>“In Alameda County right now, we have a pretty strong system of care for people that have a serious mental illness,\" said \u003ca title=\"http://www.acphd.org/hchp/contact-information.aspx\" href=\"http://www.acphd.org/hchp/contact-information.aspx\" target=\"_blank\">David Modersbach\u003c/a>, Director of ACHCHP. \"That could be something like schizophrenia or very severe depression or other sometimes organic mental illnesses. However, persons that have a low acuity mental illness such as depression, anxiety, personality disorders -- these mental illnesses don’t qualify them for low cost care.\"\u003c/p>\n\u003cp>Modersbach calls these patients the “walking wounded” because they don’t have access to support services and care that other community members “take for granted.”\u003c/p>\n\u003cp>To address these patients, Modersbach said his team is working with Alameda County Behavioral Health Care Services to explore expanding the current mental health services being offered.\u003c/p>\n\u003cp>Part of this potential expansion includes adding psychiatrists and licensed clinical social workers to the Health Services Vans so they can directly treat mentally ill patients.\u003c/p>\n\u003cp>“What we would like to do is have a system where we’re able to provide some sort of treatment for people at the places where homeless people are,” Modersbach explained.\u003c/p>\n\u003cp>\u003c/p>\n\u003cp>While ACHCHP and Behavioral Health Care Services are still in the planning stage of the expansion, Modersbach said he remains optimistic and hopes to see the expansion happen in early 2013.\u003c/p>\n\n\u003c/div>\u003c/p>",
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"disqusTitle": "Bridging the Gap: Disparities in Mental Health Care for African-Americans",
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"content": "\u003cfigure id=\"attachment_7477\" class=\"wp-caption alignleft\" style=\"max-width: 298px\">\u003ca href=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2012/07/AAHISBC-meeting.jpg\">\u003cimg class=\"size-full wp-image-7477\" title=\"(Courtesy: African American Health Institute San Bernardino County)\" src=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2012/07/AAHISBC-meeting.jpg\" alt=\"(Courtesy: African American Health Institute San Bernardino County)\" width=\"298\" height=\"210\">\u003c/a>\u003cfigcaption class=\"wp-caption-text\">(Courtesy: African American Health Institute San Bernardino County)\u003c/figcaption>\u003c/figure>\n\u003cp>African-Americans in California are less likely than white people to \u003ca href=\"http://www.apa.org/about/gr/issues/minority/access.aspx\" target=\"_blank\">get the mental health care\u003c/a> they need. State public health officials have lacked a good road map on how to change those disparities, until now. A statewide study released today looks at ways to \u003ca href=\"http://www.aahi-sbc.org/Afi-Am_Population_Report_.php\" target=\"_blank\">reduce disparities\u003c/a> in mental health care for black Californians.\u003c/p>\n\u003cp>The \u003ca href=\"http://www.aahi-sbc.org/Afi-Am_Population_Report_.php\" target=\"_blank\">report\u003c/a>, commissioned by the California Department of Mental Health, sifted through more than a decade of literature on why African-Americans in California aren't getting adequate mental health care. A major reason is poverty and all of the barriers to getting health care that come with it.\u003c/p>\n\u003cp>Diane Woods is the lead author of the study and the founding president of the \u003ca href=\"http://www.aahi-sbc.org/\" target=\"_blank\">African American Health Institute of San Bernardino County.\u003c/a>\u003c/p>\n\u003cp>\"It is unpleasant to admit, but some people do not receive appropriate services,\" Woods said.\u003c/p>\n\u003cp>The Northern California city of Richmond is nearly 27 percent African American, and has many pockets of low-income neighborhoods. Anne Cevallos is a therapist at \u003ca href=\"http://www.rubiconprograms.org/\" target=\"_blank\">Rubicon\u003c/a>, a nonprofit in Richmond that offers treatment and housing for people mental illnesses. She says her clients face multiple barriers to treatment.\u003c/p>\n\u003cp>[ad fullwidth]\u003c/p>\n\u003cp>\"From a mental health perspective there could be triggers,\" Cevallos said. \"Not having enough to eat, domestic violence, neighborhood violence, never learning to cope.\"\u003c/p>\n\u003cp>\u003c!--more-->Cevallos said almost all of her Richmond patients have lived through traumatic experiences. Like Dorothy Perkins. Now in her 60s, Perkins said she first started suffering from depression when she was 12 years old. That's when her alcoholic father started sexually abusing her. Decades later, after her husband died of untreated diabetes, she says living with that depression became too painful. She started using crack to escape and eventually ended up living on the streets of North Richmond.\u003c/p>\n\u003cp>\"And it was really hard out there. I mean, a black woman on the streets, elderly ... It’s very dangerous.\"\u003c/p>\n\u003cp>Perkins finally got the help she needed at Rubicon. But that's often not the case. Study author Diane Woods says that while poverty plays a significant role in blacks not having access to mental health care -- like in Dorothy Perkins' case -- there's much more to the picture. Like racism.\u003c/p>\n\u003cp>Of the 1,195 black study participants, most reported experiencing some level of ongoing racism regardless of their education or income. \"So these constant micro-aggressions, this constant bombardment of a negative, negative, negative, negative, is something that we have to deal with continually,\" said Woods. \"And of course, that works on your psyche, about who you are as a person and about how you fit in society and this whole idea that anything you do is never valued and it’s looked down upon.\"\u003c/p>\n\u003cp>Then there's the stigma long associated with seeking mental health services. And that, Woods says, can further alienate black people from a society that already marginalizes them.\u003c/p>\n\u003cp>\"The respondents in our particular study indicated it had to do with symbolism,\" Woods said. \"They do not like to be put in categories with diagnoses like bipolar, schizophrenia, that doesn’t mean anything to them. That conjures up someone who is dependent, some who is not a viable or productive individual in society. All of these mental images of someone who out of control.\"\u003c/p>\n\u003cp>The study offered a series of recommendations on addressing stigma and bridging the mental health care gap. For starters, more black providers are urgently needed. African-Americans make up 13 percent of the U.S. population but are only two percent of all psychologists, according to the \u003ca title=\"http://www.apa.org/about/gr/issues/minority/access.aspx\" href=\"http://www.apa.org/about/gr/issues/minority/access.aspx\" target=\"_blank\">2001 Surgeon General’s Report\u003c/a>.\u003c/p>\n\u003cp>The study also suggests incorporating group therapy sessions for some black patients. Woods says many of the study participants didn’t like the standard one-on-one model of mental health care. They preferred a community model, because black culture, she said, embraces a broad idea of family.\u003c/p>\n\u003cp>\"We congregate together as groups and we like to be in groups. We like to interact with other people of like-mind and of like-thought,\" Woods said. \"The concept that even though you are not biologically related to an individual, because of our culture, and you come from African heritage, you come from a larger family. So you hear the terms, ‘brother, sister.’\"\u003c/p>\n\u003cp>Group therapy and supportive community housing helped Dorothy Perkins stop using drugs and work through her depression, she said.\u003c/p>\n\u003cp>\"We talk about things we’re going through,\" Perkins said. \"And then you get the feedback in the groups. If you’re going through something and you talk about it in the group you get the feedback. And that helps too.\"\u003c/p>\n\u003cp>\u003c/p>\n\u003cp>\u003cstrong>\u003cem>Another version of this story ran on KQED Radio. Listen here:\u003c/em>\u003c/strong>\u003cbr>\n[audio:http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2012/07/Black-Mental-Health-Disparities.mp3|titles=mentalhealth]\u003c/p>\n\n",
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"excerpt": "While African-Americans in California are more likely to suffer from mental problems than whites, they're less likely to get the mental health care they need. State public health officials have lacked a good road map on how to change those disparities, until now. A statewide study released today looks at ways to reduce disparities in mental health care for black Californians.\r\n\r\nThe report, commissioned by the California Department of Mental Health, sifted through more than a decade of literature on why African-Americans in California aren't getting mental health care they need. A major reason is poverty and all of the barriers to getting health care that come with it.",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003cfigure id=\"attachment_7477\" class=\"wp-caption alignleft\" style=\"max-width: 298px\">\u003ca href=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2012/07/AAHISBC-meeting.jpg\">\u003cimg class=\"size-full wp-image-7477\" title=\"(Courtesy: African American Health Institute San Bernardino County)\" src=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2012/07/AAHISBC-meeting.jpg\" alt=\"(Courtesy: African American Health Institute San Bernardino County)\" width=\"298\" height=\"210\">\u003c/a>\u003cfigcaption class=\"wp-caption-text\">(Courtesy: African American Health Institute San Bernardino County)\u003c/figcaption>\u003c/figure>\n\u003cp>African-Americans in California are less likely than white people to \u003ca href=\"http://www.apa.org/about/gr/issues/minority/access.aspx\" target=\"_blank\">get the mental health care\u003c/a> they need. State public health officials have lacked a good road map on how to change those disparities, until now. A statewide study released today looks at ways to \u003ca href=\"http://www.aahi-sbc.org/Afi-Am_Population_Report_.php\" target=\"_blank\">reduce disparities\u003c/a> in mental health care for black Californians.\u003c/p>\n\u003cp>The \u003ca href=\"http://www.aahi-sbc.org/Afi-Am_Population_Report_.php\" target=\"_blank\">report\u003c/a>, commissioned by the California Department of Mental Health, sifted through more than a decade of literature on why African-Americans in California aren't getting adequate mental health care. A major reason is poverty and all of the barriers to getting health care that come with it.\u003c/p>\n\u003cp>Diane Woods is the lead author of the study and the founding president of the \u003ca href=\"http://www.aahi-sbc.org/\" target=\"_blank\">African American Health Institute of San Bernardino County.\u003c/a>\u003c/p>\n\u003cp>\"It is unpleasant to admit, but some people do not receive appropriate services,\" Woods said.\u003c/p>\n\u003cp>The Northern California city of Richmond is nearly 27 percent African American, and has many pockets of low-income neighborhoods. Anne Cevallos is a therapist at \u003ca href=\"http://www.rubiconprograms.org/\" target=\"_blank\">Rubicon\u003c/a>, a nonprofit in Richmond that offers treatment and housing for people mental illnesses. She says her clients face multiple barriers to treatment.\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>\"From a mental health perspective there could be triggers,\" Cevallos said. \"Not having enough to eat, domestic violence, neighborhood violence, never learning to cope.\"\u003c/p>\n\u003cp>\u003c!--more-->Cevallos said almost all of her Richmond patients have lived through traumatic experiences. Like Dorothy Perkins. Now in her 60s, Perkins said she first started suffering from depression when she was 12 years old. That's when her alcoholic father started sexually abusing her. Decades later, after her husband died of untreated diabetes, she says living with that depression became too painful. She started using crack to escape and eventually ended up living on the streets of North Richmond.\u003c/p>\n\u003cp>\"And it was really hard out there. I mean, a black woman on the streets, elderly ... It’s very dangerous.\"\u003c/p>\n\u003cp>Perkins finally got the help she needed at Rubicon. But that's often not the case. Study author Diane Woods says that while poverty plays a significant role in blacks not having access to mental health care -- like in Dorothy Perkins' case -- there's much more to the picture. Like racism.\u003c/p>\n\u003cp>Of the 1,195 black study participants, most reported experiencing some level of ongoing racism regardless of their education or income. \"So these constant micro-aggressions, this constant bombardment of a negative, negative, negative, negative, is something that we have to deal with continually,\" said Woods. \"And of course, that works on your psyche, about who you are as a person and about how you fit in society and this whole idea that anything you do is never valued and it’s looked down upon.\"\u003c/p>\n\u003cp>Then there's the stigma long associated with seeking mental health services. And that, Woods says, can further alienate black people from a society that already marginalizes them.\u003c/p>\n\u003cp>\"The respondents in our particular study indicated it had to do with symbolism,\" Woods said. \"They do not like to be put in categories with diagnoses like bipolar, schizophrenia, that doesn’t mean anything to them. That conjures up someone who is dependent, some who is not a viable or productive individual in society. All of these mental images of someone who out of control.\"\u003c/p>\n\u003cp>The study offered a series of recommendations on addressing stigma and bridging the mental health care gap. For starters, more black providers are urgently needed. African-Americans make up 13 percent of the U.S. population but are only two percent of all psychologists, according to the \u003ca title=\"http://www.apa.org/about/gr/issues/minority/access.aspx\" href=\"http://www.apa.org/about/gr/issues/minority/access.aspx\" target=\"_blank\">2001 Surgeon General’s Report\u003c/a>.\u003c/p>\n\u003cp>The study also suggests incorporating group therapy sessions for some black patients. Woods says many of the study participants didn’t like the standard one-on-one model of mental health care. They preferred a community model, because black culture, she said, embraces a broad idea of family.\u003c/p>\n\u003cp>\"We congregate together as groups and we like to be in groups. We like to interact with other people of like-mind and of like-thought,\" Woods said. \"The concept that even though you are not biologically related to an individual, because of our culture, and you come from African heritage, you come from a larger family. So you hear the terms, ‘brother, sister.’\"\u003c/p>\n\u003cp>Group therapy and supportive community housing helped Dorothy Perkins stop using drugs and work through her depression, she said.\u003c/p>\n\u003cp>\"We talk about things we’re going through,\" Perkins said. \"And then you get the feedback in the groups. If you’re going through something and you talk about it in the group you get the feedback. And that helps too.\"\u003c/p>\n\u003cp>\u003c/p>\n\u003cp>\u003cstrong>\u003cem>Another version of this story ran on KQED Radio. Listen here:\u003c/em>\u003c/strong>\u003cbr>\n\u003c/p>\u003c/div>",
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"disqusTitle": "Tackling Mental Health Disparities Among California's Latinos",
"title": "Tackling Mental Health Disparities Among California's Latinos",
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"content": "\u003cfigure id=\"attachment_6829\" class=\"wp-caption alignleft\" style=\"max-width: 300px\">\u003ca href=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2012/06/farmlabor20120427.jpg\">\u003cimg class=\"size-medium wp-image-6829\" title=\"Immigrant Laborers Harvest California's Produce\" src=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2012/06/farmlabor20120427-300x164.jpg\" alt=\"\" width=\"300\" height=\"164\">\u003c/a>\u003cfigcaption class=\"wp-caption-text\">Lali Moheno & her family worked the fields in Modesto. Three of her family members had untreated mental health problems. (Sandy Huffaker/Getty Images)\u003c/figcaption>\u003c/figure>\n\u003cp>Lali Moheno went to school in Texas as a kid. But she, her parents, and her six siblings would bus to Modesto, California every summers to work the fields. Then in late August or September, her parents would put her and her siblings back in a bus to Texas. Mohseno worked the fields all the way through graduating from the University of Texas.\u003c/p>\n\u003cp>\"Life was hard,\" said Moheno said during a press conference at UC Davis. \"We had three family members who had mental health issues. But of course, in our family, we didn't recognize it. They'd say, '\u003cem>Ese? Esta un poquito loco\u003c/em> [Him? He's a little crazy]\u003cem>.\u003c/em> Don't pay attention to him. We don't know what to do with him. He just follows us into the migrant camps.\"\u003c/p>\n\u003cp>Moheno said her family didn't know that visiting a psychologist or psychiatrist was even an option. That's why she became a health activist working with farmworkers in Visalia. And that's why she participated in a series of community forums looking at Latino mental health care disparities.\u003c/p>\n\u003caside class=\"pullquote alignleft\">\"Often when someone suffers from depression, unfortunately some family members -- and I have seen it in churches also -- they say it's because of the weak character that they have, or they haven't prayed hard enough.\"\u003c/aside>\n\u003cp>The result of the forums is a UC Davis study released this week, \u003ca title=\"http://www.ucdmc.ucdavis.edu/newsroom/pdf/Latino_mental_health_report-6-25-2012.pdf\" href=\"http://www.ucdmc.ucdavis.edu/newsroom/pdf/Latino_mental_health_report-6-25-2012.pdf\" target=\"_blank\">Community-Defined Solutions for Mental Health Care Disparities\u003c/a>. Researchers highlight a variety of methods to close the mental health care gaps for Latinos in California.\u003c/p>\n\u003cp>Latinos make up over one-third of the nation’s population, and they're the largest racial or ethnic group in California. But they're also one of the most under-served communities in the state when it comes to getting mental health care.\u003c/p>\n\u003cp>[ad fullwidth]\u003c/p>\n\u003cp>Access to health insurance, transportation and language services all play into it. As does stigma associated with getting mental health care. Access to care also fluctuates based on ethnicity: Latinos of Mexican descent are \u003ca title=\"http://ps.psychiatryonline.org/article.aspx?Volume=59&page=1264&journalID=18\" href=\"http://ps.psychiatryonline.org/article.aspx?Volume=59&page=1264&journalID=18\" target=\"_blank\">less likely to get mental health care\u003c/a> than other Latino groups, like Puerto Ricans. The report says about eighty-five percent of Mexican immigrants who need mental health services remain untreated.\u003c/p>\n\u003cp>\u003c!--more-->The study recommendations range from using social media sites like Twitter and Facebook, to producing \u003cem>fotonovelas\u003c/em> -- stories using images and audio to promote a better understanding of mental health issues.\u003c/p>\n\u003cp>I spoke with \u003ca title=\"http://www.ucdmc.ucdavis.edu/search/faculty/biodetail.asp?bioid=1148&searchtype=3&fromsearchlist=yes\" href=\"http://www.ucdmc.ucdavis.edu/search/faculty/biodetail.asp?bioid=1148&searchtype=3&fromsearchlist=yes\" target=\"_blank\">Sergio Aguilar-Gaxiola\u003c/a>, the lead author and Director of the \u003ca title=\"http://www.ucdmc.ucdavis.edu/crhd/\" href=\"http://www.ucdmc.ucdavis.edu/crhd/\" target=\"_blank\">UC Davis Center for Reducing Health Disparities\u003c/a>, about the study's recommendations on how to reduce these mental health disparities. We focused on two methods in particular: training school personnel working with young Latinos about possible mental health issues in their students; and teaching families and religious leaders about mental health problems and stigma -- so that they can educate others.\u003c/p>\n\u003cp>More than half of California’s elementary children are of Latino origin, according to the California Department of Education. Aguilar-Gaxiola said that many start developing mental health problems at a young age, adding that about 50 percent of severe mental illness are identified by age 15.\u003c/p>\n\u003cp>But instead of providing troubled children with counseling options, Aguilar-Gaxiola said they often get disciplined at school as the 'problem kids,' or even as bullies, instead. He said if schools used available curricula to teach educators how to identify things like depression and anxiety, they'd have a better chance of flagging it in their students.\u003c/p>\n\u003cp>\"I think there is a unique opportunity in the school settings to have early interventions and screenings for kids that may be manifesting some behavioral problems. Depression screening, for example. It can be the teacher that is trained on how to deliver this information. Or it can be the school nurse. Some should be familiar with this information. \"\u003c/p>\n\u003cp>Aguilar-Gaxiola said and a clinical psychologist recently met with the principal and teachers of a school in Sacramento to give them a tutorial about mental health disorders in adolescents.\u003c/p>\n\u003cp>\"It was a an eye opener for us in terms of the questions we got from the teachers,\" he said. \"They didn't know that mental illnesses could manifest through certain kinds of behaviors.\"\u003c/p>\n\u003cp>Another barrier to care is stigma. Aguilar-Gaxiola told me most of the Latino participants in the UC Davis study associated mental illness with being ‘crazy,’ like Lali Moheno's family had done. He also found that prayer was the number one thing that participants said they turned to when they had problems like depression. Aguilar-Caxiola said while it's fine to turn to family or religion for help with mental illness, sometimes therapy or other mental health support is also needed.\u003c/p>\n\u003cp>\"Often when someone suffers from depression, unfortunately some family members -- and I have seen it in churches also -- they say it's because of the weak character that they have, or they haven't prayed hard enough. Sending the message that they would change if they would only put there will to work. Well it doesn't work like that.\"\u003c/p>\n\u003cp>Aguilar-Gaxiola said telling people with depression to toughen up, or to use their will, could actually make their depression worse. He said educating priests and family members that, in addition to prayer, they could also look at psychiatric and psychotherapy options, could help change the dialogue about mental health both in the church and in the home.\u003c/p>\n\u003cp>\u003c/p>\n\u003cp>\"We need to reach out much more to religious leaders. Not only priests, but rabbis and pastors, and work with them to learn how to identify and deal with mental illness.\"\u003c/p>\n\n",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003cfigure id=\"attachment_6829\" class=\"wp-caption alignleft\" style=\"max-width: 300px\">\u003ca href=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2012/06/farmlabor20120427.jpg\">\u003cimg class=\"size-medium wp-image-6829\" title=\"Immigrant Laborers Harvest California's Produce\" src=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2012/06/farmlabor20120427-300x164.jpg\" alt=\"\" width=\"300\" height=\"164\">\u003c/a>\u003cfigcaption class=\"wp-caption-text\">Lali Moheno & her family worked the fields in Modesto. Three of her family members had untreated mental health problems. (Sandy Huffaker/Getty Images)\u003c/figcaption>\u003c/figure>\n\u003cp>Lali Moheno went to school in Texas as a kid. But she, her parents, and her six siblings would bus to Modesto, California every summers to work the fields. Then in late August or September, her parents would put her and her siblings back in a bus to Texas. Mohseno worked the fields all the way through graduating from the University of Texas.\u003c/p>\n\u003cp>\"Life was hard,\" said Moheno said during a press conference at UC Davis. \"We had three family members who had mental health issues. But of course, in our family, we didn't recognize it. They'd say, '\u003cem>Ese? Esta un poquito loco\u003c/em> [Him? He's a little crazy]\u003cem>.\u003c/em> Don't pay attention to him. We don't know what to do with him. He just follows us into the migrant camps.\"\u003c/p>\n\u003cp>Moheno said her family didn't know that visiting a psychologist or psychiatrist was even an option. That's why she became a health activist working with farmworkers in Visalia. And that's why she participated in a series of community forums looking at Latino mental health care disparities.\u003c/p>\n\u003caside class=\"pullquote alignleft\">\"Often when someone suffers from depression, unfortunately some family members -- and I have seen it in churches also -- they say it's because of the weak character that they have, or they haven't prayed hard enough.\"\u003c/aside>\n\u003cp>The result of the forums is a UC Davis study released this week, \u003ca title=\"http://www.ucdmc.ucdavis.edu/newsroom/pdf/Latino_mental_health_report-6-25-2012.pdf\" href=\"http://www.ucdmc.ucdavis.edu/newsroom/pdf/Latino_mental_health_report-6-25-2012.pdf\" target=\"_blank\">Community-Defined Solutions for Mental Health Care Disparities\u003c/a>. Researchers highlight a variety of methods to close the mental health care gaps for Latinos in California.\u003c/p>\n\u003cp>Latinos make up over one-third of the nation’s population, and they're the largest racial or ethnic group in California. But they're also one of the most under-served communities in the state when it comes to getting mental health care.\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>Access to health insurance, transportation and language services all play into it. As does stigma associated with getting mental health care. Access to care also fluctuates based on ethnicity: Latinos of Mexican descent are \u003ca title=\"http://ps.psychiatryonline.org/article.aspx?Volume=59&page=1264&journalID=18\" href=\"http://ps.psychiatryonline.org/article.aspx?Volume=59&page=1264&journalID=18\" target=\"_blank\">less likely to get mental health care\u003c/a> than other Latino groups, like Puerto Ricans. The report says about eighty-five percent of Mexican immigrants who need mental health services remain untreated.\u003c/p>\n\u003cp>\u003c!--more-->The study recommendations range from using social media sites like Twitter and Facebook, to producing \u003cem>fotonovelas\u003c/em> -- stories using images and audio to promote a better understanding of mental health issues.\u003c/p>\n\u003cp>I spoke with \u003ca title=\"http://www.ucdmc.ucdavis.edu/search/faculty/biodetail.asp?bioid=1148&searchtype=3&fromsearchlist=yes\" href=\"http://www.ucdmc.ucdavis.edu/search/faculty/biodetail.asp?bioid=1148&searchtype=3&fromsearchlist=yes\" target=\"_blank\">Sergio Aguilar-Gaxiola\u003c/a>, the lead author and Director of the \u003ca title=\"http://www.ucdmc.ucdavis.edu/crhd/\" href=\"http://www.ucdmc.ucdavis.edu/crhd/\" target=\"_blank\">UC Davis Center for Reducing Health Disparities\u003c/a>, about the study's recommendations on how to reduce these mental health disparities. We focused on two methods in particular: training school personnel working with young Latinos about possible mental health issues in their students; and teaching families and religious leaders about mental health problems and stigma -- so that they can educate others.\u003c/p>\n\u003cp>More than half of California’s elementary children are of Latino origin, according to the California Department of Education. Aguilar-Gaxiola said that many start developing mental health problems at a young age, adding that about 50 percent of severe mental illness are identified by age 15.\u003c/p>\n\u003cp>But instead of providing troubled children with counseling options, Aguilar-Gaxiola said they often get disciplined at school as the 'problem kids,' or even as bullies, instead. He said if schools used available curricula to teach educators how to identify things like depression and anxiety, they'd have a better chance of flagging it in their students.\u003c/p>\n\u003cp>\"I think there is a unique opportunity in the school settings to have early interventions and screenings for kids that may be manifesting some behavioral problems. Depression screening, for example. It can be the teacher that is trained on how to deliver this information. Or it can be the school nurse. Some should be familiar with this information. \"\u003c/p>\n\u003cp>Aguilar-Gaxiola said and a clinical psychologist recently met with the principal and teachers of a school in Sacramento to give them a tutorial about mental health disorders in adolescents.\u003c/p>\n\u003cp>\"It was a an eye opener for us in terms of the questions we got from the teachers,\" he said. \"They didn't know that mental illnesses could manifest through certain kinds of behaviors.\"\u003c/p>\n\u003cp>Another barrier to care is stigma. Aguilar-Gaxiola told me most of the Latino participants in the UC Davis study associated mental illness with being ‘crazy,’ like Lali Moheno's family had done. He also found that prayer was the number one thing that participants said they turned to when they had problems like depression. Aguilar-Caxiola said while it's fine to turn to family or religion for help with mental illness, sometimes therapy or other mental health support is also needed.\u003c/p>\n\u003cp>\"Often when someone suffers from depression, unfortunately some family members -- and I have seen it in churches also -- they say it's because of the weak character that they have, or they haven't prayed hard enough. Sending the message that they would change if they would only put there will to work. Well it doesn't work like that.\"\u003c/p>\n\u003cp>Aguilar-Gaxiola said telling people with depression to toughen up, or to use their will, could actually make their depression worse. He said educating priests and family members that, in addition to prayer, they could also look at psychiatric and psychotherapy options, could help change the dialogue about mental health both in the church and in the home.\u003c/p>\n\u003cp>\u003c/p>\n\u003cp>\"We need to reach out much more to religious leaders. Not only priests, but rabbis and pastors, and work with them to learn how to identify and deal with mental illness.\"\u003c/p>\n\n\u003c/div>\u003c/p>",
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"disqusTitle": "PTSD Among Middle Eastern Refugees in California",
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"content": "\u003cfigure id=\"attachment_6195\" class=\"wp-caption alignleft\" style=\"max-width: 300px\">\u003ca href=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2012/05/iran-protest1.jpg\">\u003cimg class=\"size-medium wp-image-6195\" title=\"Iranians protest in San Francisco. (Steve Rhodes: Flickr)\" src=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2012/05/iran-protest1-300x200.jpg\" alt=\"Iranians protest in San Francisco. (Steve Rhodes: Flickr)\" width=\"300\" height=\"200\">\u003c/a>\u003cfigcaption class=\"wp-caption-text\">Iranians protest in San Francisco. (Steve Rhodes: Flickr)\u003c/figcaption>\u003c/figure>\n\u003cp>California has resettled more \u003ca href=\"http://www.acf.hhs.gov/programs/orr/data/refugee_arrival_data.htm\" target=\"_blank\">Middle Eastern refugees\u003c/a> over the past decade than any other state in the U.S. In Northern California, Santa Clara County is a resettlement hub for Middle Eastern refugees -- more than 1,300 have moved there since 2006. The majority of these refugees are from Iran and Iraq, and many carry memories of past trauma with them.\u003c/p>\n\u003cp>Twenty-four year old Iraqi refugee Jasmine said she definitely brought her past memories with her to California. Jasmine (not her real name) and her family fled Iraq in 2006 after insurgents killed her father in a drive-by shooting. She said they escaped to Syria, then resettled in San Jose three years later.\u003c/p>\n\u003cp>\"You left your home. You left the place that you belong to. Your people who loved there,\" Jasmine said. \"Sometimes I feel like everything for me after Iraq is different: the roads, the air, the dust. I know back home. The dust of back home. I know the air of back home.\"\u003c/p>\n\u003caside class=\"pullquote alignleft\">\"What happened will remain like a scar inside yourself. Especially like we saw a lot of stuff not normal ... Like people killed in front of your eye. I don’t believe I’m going to forget them.\"\u003c/aside>\n\u003cp>Jasmine said she was in survival mode in Iraq and experienced a delayed reaction to the stress of war. But when she did land in America, depression hit Jasmine hard.\u003c/p>\n\u003cp>\u003c!--more-->\"What happened will remain like a scar inside yourself. Especially like we saw a lot of stuff not normal,\" Jasmine told me. \"Like dead people in the street. People killed in front of your eye. I don’t believe I’m going to forget them.\"\u003c/p>\n\u003cp>[ad fullwidth]\u003c/p>\n\u003cp>After two years in the U.S. Jasmine was diagnosed with \u003ca href=\"http://www.ncbi.nlm.nih.gov/pubmedhealth/PMH0001923/\" target=\"_blank\">post-traumatic stress disorder\u003c/a>, or PTSD. Now she's getting counseling at \u003ca title=\"http://cst.aaci.org/\" href=\"http://cst.aaci.org/\" target=\"_blank\">Centers for Survivors of Torture\u003c/a> (CST) in San Jose. But Jasmine said most of her Iraqi peers shy away from treatment because Iraqi culture, like many others, often considers mental health problems shameful.\u003c/p>\n\u003cp>Jasmine said therapy has given her tools to help her avoid reliving traumatic moments -- a common symptom of PTSD. She says even though she can’t forget her past, she is learning how to deal with it through various activities, like doing crafts. \"Especially like when I’m over-thinking I go to crochet,\" she said.\u003c/p>\n\u003cp>Though many Middle Eastern refugees are Iraqis who have fled war-related violence, in the past decade the largest number of Middle Eastern refugees in California are actually from Iran. More than 15,000 Iranian refugees have moved to California since 2006. Many Iranians suffer religious and political persecution. And they face many of the same social and cultural taboos about seeking mental health care as Iraqi refugees.\u003c/p>\n\u003cp>Azin Izadifar, a 45-year-old Iranian refugee, came to the U.S. in 2009 seeking asylum. She had been arrested for participating in secret meetings during \u003ca title=\"http://en.wikipedia.org/wiki/Iranian_Revolution\" href=\"http://en.wikipedia.org/wiki/Iranian_Revolution\" target=\"_blank\">Iran’s 1979 revolution\u003c/a>, and spent the next three years being tortured in Iran’s notorious \u003ca title=\"http://en.wikipedia.org/wiki/Evin_Prison\" href=\"http://en.wikipedia.org/wiki/Evin_Prison\" target=\"_blank\">Evin Prison\u003c/a>. She continued to have run-ins with the Iranian government after her release, so she eventually sought asylum in the U.S. She said even though she was in America and felt safe, life was difficult. She said her nightmares about her time in Evin Prison followed her to San Jose.\u003c/p>\n\u003cp>“It had become so normal for me that I couldn't even understand that there was a problem there –- I had a sleep disorder. And it could be related to the trauma I had in prison,” said Izadifar. \"Then I realize, 'OK, that's a sign of PTSD.'\"\u003c/p>\n\u003cp>Izadifar eventually saw a therapist and was indeed diagnosed with PTSD. She said she sees the same PTSD symptoms in many newly arrived Iranian refugees -- even among people who were never imprisoned. But most of them, she said, aren’t seeking therapy.\u003c/p>\n\u003cp>“There’s a tendency in our culture to underestimate that and say, ‘Okay, that was past. Now we are in a free society. We have to live our lives. We have to buy a car and get a job and just be normal.'”\u003c/p>\n\u003cp>Izadifar and Jasmine are not alone. Most refugees have been exposed to violence and trauma unheard of in the west. In the U.S., seeing a counselor is more widely accepted, but many in the refugee community would never think that way, said \u003ca href=\"http://www.sharrockmft.com/\" target=\"_blank\">Sally Sharrock\u003c/a>, a former therapist with Centers for Survivors of Torture. She said refugees more likely to go to first ask a family member or a physician for help.\u003c/p>\n\u003cp>As part of a federal refugee package, people are entitled to medical \u003cem>and\u003c/em> mental health care. Sharrock’s job was to get people into counseling and to keep them coming back after their first session. She said her sessions often began with practical support. “A lot of people are really actually more interested in being able to find a job and support their family and find good housing before they’re ready for any kind of psychological supportive services or therapy.”\u003c/p>\n\u003cp>To keep refugees coming back, Sharrock said she avoided using terms that might be associated with a mental illness, like “depression,” or “anxiety.” She said she’s found that one term seems to work across the board -- \"stress.\"\u003c/p>\n\u003cp>“Often times we find the word 'stress' works for people,” Sharrock said. “I may then ask them how they’ve been affected by stress, how they’ve been coping with it in their own culture up until now. And our conversation will kind of progress from there.”\u003c/p>\n\u003cp>Izadifar, the Iranian refugee, said the therapy at CST helped her finds tools to work through her healing process. She said she's now writing a memoir as a form of therapy. Izadifar said it's not hard to pull up those memories, because the wounds of trauma never fully disappear.\u003c/p>\n\u003cp>[ad floatright]\u003c/p>\n\u003cp>“The wound will always be there, but there's a difference between a wound that has not healed –- that has not been exposed to the sun -- to a wound that's been healed and now you see a scar. It's different. The wound will be there, but you’re not as sensitive, it's not as painful.”\u003c/p>\n\n",
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"excerpt": "California has resettled more Middle Eastern refugees over the past decade than any other state in the country. In Northern California, Santa Clara County in the South Bay is a resettlement hub for Middle Eastern refugees – more than 1,300 moved there since 2006. The majority of this refugees come from Iran and Iraq. And many carry traumatizing memories with them to the U.S.",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003cfigure id=\"attachment_6195\" class=\"wp-caption alignleft\" style=\"max-width: 300px\">\u003ca href=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2012/05/iran-protest1.jpg\">\u003cimg class=\"size-medium wp-image-6195\" title=\"Iranians protest in San Francisco. (Steve Rhodes: Flickr)\" src=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2012/05/iran-protest1-300x200.jpg\" alt=\"Iranians protest in San Francisco. (Steve Rhodes: Flickr)\" width=\"300\" height=\"200\">\u003c/a>\u003cfigcaption class=\"wp-caption-text\">Iranians protest in San Francisco. (Steve Rhodes: Flickr)\u003c/figcaption>\u003c/figure>\n\u003cp>California has resettled more \u003ca href=\"http://www.acf.hhs.gov/programs/orr/data/refugee_arrival_data.htm\" target=\"_blank\">Middle Eastern refugees\u003c/a> over the past decade than any other state in the U.S. In Northern California, Santa Clara County is a resettlement hub for Middle Eastern refugees -- more than 1,300 have moved there since 2006. The majority of these refugees are from Iran and Iraq, and many carry memories of past trauma with them.\u003c/p>\n\u003cp>Twenty-four year old Iraqi refugee Jasmine said she definitely brought her past memories with her to California. Jasmine (not her real name) and her family fled Iraq in 2006 after insurgents killed her father in a drive-by shooting. She said they escaped to Syria, then resettled in San Jose three years later.\u003c/p>\n\u003cp>\"You left your home. You left the place that you belong to. Your people who loved there,\" Jasmine said. \"Sometimes I feel like everything for me after Iraq is different: the roads, the air, the dust. I know back home. The dust of back home. I know the air of back home.\"\u003c/p>\n\u003caside class=\"pullquote alignleft\">\"What happened will remain like a scar inside yourself. Especially like we saw a lot of stuff not normal ... Like people killed in front of your eye. I don’t believe I’m going to forget them.\"\u003c/aside>\n\u003cp>Jasmine said she was in survival mode in Iraq and experienced a delayed reaction to the stress of war. But when she did land in America, depression hit Jasmine hard.\u003c/p>\n\u003cp>\u003c!--more-->\"What happened will remain like a scar inside yourself. Especially like we saw a lot of stuff not normal,\" Jasmine told me. \"Like dead people in the street. People killed in front of your eye. I don’t believe I’m going to forget them.\"\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>After two years in the U.S. Jasmine was diagnosed with \u003ca href=\"http://www.ncbi.nlm.nih.gov/pubmedhealth/PMH0001923/\" target=\"_blank\">post-traumatic stress disorder\u003c/a>, or PTSD. Now she's getting counseling at \u003ca title=\"http://cst.aaci.org/\" href=\"http://cst.aaci.org/\" target=\"_blank\">Centers for Survivors of Torture\u003c/a> (CST) in San Jose. But Jasmine said most of her Iraqi peers shy away from treatment because Iraqi culture, like many others, often considers mental health problems shameful.\u003c/p>\n\u003cp>Jasmine said therapy has given her tools to help her avoid reliving traumatic moments -- a common symptom of PTSD. She says even though she can’t forget her past, she is learning how to deal with it through various activities, like doing crafts. \"Especially like when I’m over-thinking I go to crochet,\" she said.\u003c/p>\n\u003cp>Though many Middle Eastern refugees are Iraqis who have fled war-related violence, in the past decade the largest number of Middle Eastern refugees in California are actually from Iran. More than 15,000 Iranian refugees have moved to California since 2006. Many Iranians suffer religious and political persecution. And they face many of the same social and cultural taboos about seeking mental health care as Iraqi refugees.\u003c/p>\n\u003cp>Azin Izadifar, a 45-year-old Iranian refugee, came to the U.S. in 2009 seeking asylum. She had been arrested for participating in secret meetings during \u003ca title=\"http://en.wikipedia.org/wiki/Iranian_Revolution\" href=\"http://en.wikipedia.org/wiki/Iranian_Revolution\" target=\"_blank\">Iran’s 1979 revolution\u003c/a>, and spent the next three years being tortured in Iran’s notorious \u003ca title=\"http://en.wikipedia.org/wiki/Evin_Prison\" href=\"http://en.wikipedia.org/wiki/Evin_Prison\" target=\"_blank\">Evin Prison\u003c/a>. She continued to have run-ins with the Iranian government after her release, so she eventually sought asylum in the U.S. She said even though she was in America and felt safe, life was difficult. She said her nightmares about her time in Evin Prison followed her to San Jose.\u003c/p>\n\u003cp>“It had become so normal for me that I couldn't even understand that there was a problem there –- I had a sleep disorder. And it could be related to the trauma I had in prison,” said Izadifar. \"Then I realize, 'OK, that's a sign of PTSD.'\"\u003c/p>\n\u003cp>Izadifar eventually saw a therapist and was indeed diagnosed with PTSD. She said she sees the same PTSD symptoms in many newly arrived Iranian refugees -- even among people who were never imprisoned. But most of them, she said, aren’t seeking therapy.\u003c/p>\n\u003cp>“There’s a tendency in our culture to underestimate that and say, ‘Okay, that was past. Now we are in a free society. We have to live our lives. We have to buy a car and get a job and just be normal.'”\u003c/p>\n\u003cp>Izadifar and Jasmine are not alone. Most refugees have been exposed to violence and trauma unheard of in the west. In the U.S., seeing a counselor is more widely accepted, but many in the refugee community would never think that way, said \u003ca href=\"http://www.sharrockmft.com/\" target=\"_blank\">Sally Sharrock\u003c/a>, a former therapist with Centers for Survivors of Torture. She said refugees more likely to go to first ask a family member or a physician for help.\u003c/p>\n\u003cp>As part of a federal refugee package, people are entitled to medical \u003cem>and\u003c/em> mental health care. Sharrock’s job was to get people into counseling and to keep them coming back after their first session. She said her sessions often began with practical support. “A lot of people are really actually more interested in being able to find a job and support their family and find good housing before they’re ready for any kind of psychological supportive services or therapy.”\u003c/p>\n\u003cp>To keep refugees coming back, Sharrock said she avoided using terms that might be associated with a mental illness, like “depression,” or “anxiety.” She said she’s found that one term seems to work across the board -- \"stress.\"\u003c/p>\n\u003cp>“Often times we find the word 'stress' works for people,” Sharrock said. “I may then ask them how they’ve been affected by stress, how they’ve been coping with it in their own culture up until now. And our conversation will kind of progress from there.”\u003c/p>\n\u003cp>Izadifar, the Iranian refugee, said the therapy at CST helped her finds tools to work through her healing process. She said she's now writing a memoir as a form of therapy. Izadifar said it's not hard to pull up those memories, because the wounds of trauma never fully disappear.\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>“The wound will always be there, but there's a difference between a wound that has not healed –- that has not been exposed to the sun -- to a wound that's been healed and now you see a scar. It's different. The wound will be there, but you’re not as sensitive, it's not as painful.”\u003c/p>\n\n\u003c/div>\u003c/p>",
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"disqusTitle": "Federal Court Dismisses Veterans' Suit over Mental Health Care",
"title": "Federal Court Dismisses Veterans' Suit over Mental Health Care",
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"content": "\u003cfigure id=\"attachment_5674\" class=\"wp-caption aligncenter\" style=\"max-width: 620px\">\u003ca href=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2012/05/SoldiersonPatrolinIraq_USArmy_Flickr.jpg\">\u003cimg class=\"size-large wp-image-5674\" title=\"Soldiers on patrol in Iraq. (Photo: U.S. Army)\" src=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2012/05/SoldiersonPatrolinIraq_USArmy_Flickr-620x434.jpg\" alt=\"Soldiers on patrol in Iraq. (Photo: U.S. Army)\" width=\"620\" height=\"434\">\u003c/a>\u003cfigcaption class=\"wp-caption-text\">Soldiers on patrol in Iraq. (Photo: U.S. Army)\u003c/figcaption>\u003c/figure>\n\u003cp>In a \u003ca title=\"http://www.ca9.uscourts.gov/datastore/opinions/2012/05/07/08-16728.pdf\" href=\"http://www.ca9.uscourts.gov/datastore/opinions/2012/05/07/08-16728.pdf\" target=\"_blank\">final decision\u003c/a> five years in the making, a federal appeals court in San Francisco ruled Monday that the courts lack jurisdiction to order changes in the way the Veterans Administration handles mental health claims.\u003c/p>\n\u003cp>As the \u003ca title=\"http://www.sfgate.com/cgi-bin/article.cgi?f=/c/a/2012/05/08/MN7K1OEJ78.DTL\" href=\"http://www.sfgate.com/cgi-bin/article.cgi?f=/c/a/2012/05/08/MN7K1OEJ78.DTL\" target=\"_blank\">San Francisco Chronicle reports\u003c/a>:\u003c/p>\n\u003cblockquote>\u003cp>Two veterans groups said in a 2007 lawsuit that the VA had made mental health care virtually unavailable to thousands of discharged soldiers through perfunctory exams, long waits for referrals and treatment, and a prolonged medical benefits process in which vets can't hire lawyers.\u003c/p>\n\u003cp>At a trial in 2008, Department of Veterans Affairs documents showed that the system took an average of 4.4 years to review veterans' health care claims, that more than 1,400 veterans who had been denied coverage died in one six-month period while their appeals were pending, and that 18 veterans per day were committing suicide, much higher than the rate among the general population.\u003c!--more-->\u003c/p>\u003c/blockquote>\n\u003cp>The District Court which heard the case in 2008 ruled that the legal remedies to the veterans' complaints lay with Congress or the Department of Veterans Affairs -- and not the courts. Last year a three judge panel overturned the District Court ruling. The Obama Administration requested the full Ninth Circuit Court consider the question, and yesterday's decision confirmed the original District Court finding.\u003c/p>\n\u003cp>In a press release today, veterans groups expressed frustration with the decision:\u003c/p>\n\u003cblockquote>\u003cp>Sandy Cook, the Vice-Chair for \u003ca title=\"http://www.veteransunitedfortruth.org/\" href=\"http://www.veteransunitedfortruth.org/\" target=\"_blank\">Plaintiff Veterans United for Truth\u003c/a> (VUFT), remarked: \"The message that this decision sends to the VA is that it can continue its unconstitutional practices unchecked by the power of the Courts. It would not be an exaggeration to call it a carte blanche approval for the VA to continue to mishandle, mistreat, and stiff our veterans.\"\u003c/p>\n\u003cp>Bob Handy, the President of VUFT, added: \"I should never underestimate the ability of our Courts to weave some rationale that leaves veterans out in the cold or on the street, homeless and destitute, without any recourse. It is no wonder that the suicide rate is so high.\"\u003c/p>\n\u003cp>[\u003ca title=\"http://veteransforcommonsense.org/\" href=\"http://veteransforcommonsense.org/\" target=\"_blank\">Veterans for Common Sense\u003c/a>] Executive Director, Patrick Bellon, said “I was always taught our Constitution trumps statutes and that our Courts were our last bastions to preserve our liberties; today, that promise has proved hollow, and all I hear is the continuing echoes of men and woman in distress. We should all feel their pain. This day will be remembered as the day our country turned its back on our veterans. VCS vows to fight this heartbreaking decision all the way to the end, because 18 of our veterans commit suicide every day.”\u003c/p>\u003c/blockquote>\n\u003cp>In April the VA\u003ca title=\"http://ww2.kqed.org/stateofhealth/2012/04/20/va-adds-mental-health-clinicians/\" href=\"http://ww2.kqed.org/stateofhealth/2012/04/20/va-adds-mental-health-clinicians/\" target=\"_blank\"> announced plans\u003c/a> to add 1,600 mental health clinicians to veterans hospitals across the country to help meet the growing need for mental health care, especially among veterans returning from service in Iraq and Afghanistan.\u003c/p>\n\u003cp>[ad fullwidth]\u003c/p>\n\u003cp>The week after the VA's announcement, its own Inspector General issued a \u003ca title=\"http://www.va.gov/oig/pubs/VAOIG-12-00900-168.pdf\" href=\"http://www.va.gov/oig/pubs/VAOIG-12-00900-168.pdf\" target=\"_blank\">lengthy report\u003c/a> finding that too many veterans were waiting too long for mental health care. Worse, the report found that the VA did not have a \"reliable and accurate method of determining whether they are providing patients timely access to mental health services.\" The Inspector General found just over half of new patients waited 50 days to be evaluated. VA rules require a full mental health evaluation for new patients in 14 days. About a third of patients then had longer than required waits to begin treatment.\u003c/p>\n\u003cp>\u003c/p>\n\u003cp>Writing for the majority in yesterday's 10-1 decision, \u003ca title=\"http://law.unlv.edu/faculty/jay-bybee.html\" href=\"http://law.unlv.edu/faculty/jay-bybee.html\" target=\"_blank\">Judge Jay Bybee\u003c/a> acknowledged the merits of the veterans' case:\u003c/p>\n\u003cblockquote>\u003cp>VCS’s complaint sounds a plaintive cry for help, but it has been misdirected to us. As much as we may wish for expeditious improvement in the way the VA handles mental health care and service-related disability compensation, we cannot exceed our jurisdiction to accomplish it. ... Such responsibilities are left to Congress and the Executive.\u003c/p>\u003c/blockquote>\n\n",
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"excerpt": "In a final decision five years in the making, a federal appeals court in San Francisco ruled Monday that the courts lack jurisdiction to order changes in the way the Veterans Administration handles mental health claims.\r\n\r\nAs the San Francisco Chronicle reports:\r\n\r\nTwo veterans groups said in a 2007 lawsuit that the VA had made mental health care virtually unavailable to thousands of discharged soldiers through perfunctory exams, long waits for referrals and treatment, and a prolonged medical benefits process in which vets can't hire lawyers.",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003cfigure id=\"attachment_5674\" class=\"wp-caption aligncenter\" style=\"max-width: 620px\">\u003ca href=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2012/05/SoldiersonPatrolinIraq_USArmy_Flickr.jpg\">\u003cimg class=\"size-large wp-image-5674\" title=\"Soldiers on patrol in Iraq. (Photo: U.S. Army)\" src=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2012/05/SoldiersonPatrolinIraq_USArmy_Flickr-620x434.jpg\" alt=\"Soldiers on patrol in Iraq. (Photo: U.S. Army)\" width=\"620\" height=\"434\">\u003c/a>\u003cfigcaption class=\"wp-caption-text\">Soldiers on patrol in Iraq. (Photo: U.S. Army)\u003c/figcaption>\u003c/figure>\n\u003cp>In a \u003ca title=\"http://www.ca9.uscourts.gov/datastore/opinions/2012/05/07/08-16728.pdf\" href=\"http://www.ca9.uscourts.gov/datastore/opinions/2012/05/07/08-16728.pdf\" target=\"_blank\">final decision\u003c/a> five years in the making, a federal appeals court in San Francisco ruled Monday that the courts lack jurisdiction to order changes in the way the Veterans Administration handles mental health claims.\u003c/p>\n\u003cp>As the \u003ca title=\"http://www.sfgate.com/cgi-bin/article.cgi?f=/c/a/2012/05/08/MN7K1OEJ78.DTL\" href=\"http://www.sfgate.com/cgi-bin/article.cgi?f=/c/a/2012/05/08/MN7K1OEJ78.DTL\" target=\"_blank\">San Francisco Chronicle reports\u003c/a>:\u003c/p>\n\u003cblockquote>\u003cp>Two veterans groups said in a 2007 lawsuit that the VA had made mental health care virtually unavailable to thousands of discharged soldiers through perfunctory exams, long waits for referrals and treatment, and a prolonged medical benefits process in which vets can't hire lawyers.\u003c/p>\n\u003cp>At a trial in 2008, Department of Veterans Affairs documents showed that the system took an average of 4.4 years to review veterans' health care claims, that more than 1,400 veterans who had been denied coverage died in one six-month period while their appeals were pending, and that 18 veterans per day were committing suicide, much higher than the rate among the general population.\u003c!--more-->\u003c/p>\u003c/blockquote>\n\u003cp>The District Court which heard the case in 2008 ruled that the legal remedies to the veterans' complaints lay with Congress or the Department of Veterans Affairs -- and not the courts. Last year a three judge panel overturned the District Court ruling. The Obama Administration requested the full Ninth Circuit Court consider the question, and yesterday's decision confirmed the original District Court finding.\u003c/p>\n\u003cp>In a press release today, veterans groups expressed frustration with the decision:\u003c/p>\n\u003cblockquote>\u003cp>Sandy Cook, the Vice-Chair for \u003ca title=\"http://www.veteransunitedfortruth.org/\" href=\"http://www.veteransunitedfortruth.org/\" target=\"_blank\">Plaintiff Veterans United for Truth\u003c/a> (VUFT), remarked: \"The message that this decision sends to the VA is that it can continue its unconstitutional practices unchecked by the power of the Courts. It would not be an exaggeration to call it a carte blanche approval for the VA to continue to mishandle, mistreat, and stiff our veterans.\"\u003c/p>\n\u003cp>Bob Handy, the President of VUFT, added: \"I should never underestimate the ability of our Courts to weave some rationale that leaves veterans out in the cold or on the street, homeless and destitute, without any recourse. It is no wonder that the suicide rate is so high.\"\u003c/p>\n\u003cp>[\u003ca title=\"http://veteransforcommonsense.org/\" href=\"http://veteransforcommonsense.org/\" target=\"_blank\">Veterans for Common Sense\u003c/a>] Executive Director, Patrick Bellon, said “I was always taught our Constitution trumps statutes and that our Courts were our last bastions to preserve our liberties; today, that promise has proved hollow, and all I hear is the continuing echoes of men and woman in distress. We should all feel their pain. This day will be remembered as the day our country turned its back on our veterans. VCS vows to fight this heartbreaking decision all the way to the end, because 18 of our veterans commit suicide every day.”\u003c/p>\u003c/blockquote>\n\u003cp>In April the VA\u003ca title=\"http://ww2.kqed.org/stateofhealth/2012/04/20/va-adds-mental-health-clinicians/\" href=\"http://ww2.kqed.org/stateofhealth/2012/04/20/va-adds-mental-health-clinicians/\" target=\"_blank\"> announced plans\u003c/a> to add 1,600 mental health clinicians to veterans hospitals across the country to help meet the growing need for mental health care, especially among veterans returning from service in Iraq and Afghanistan.\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>The week after the VA's announcement, its own Inspector General issued a \u003ca title=\"http://www.va.gov/oig/pubs/VAOIG-12-00900-168.pdf\" href=\"http://www.va.gov/oig/pubs/VAOIG-12-00900-168.pdf\" target=\"_blank\">lengthy report\u003c/a> finding that too many veterans were waiting too long for mental health care. Worse, the report found that the VA did not have a \"reliable and accurate method of determining whether they are providing patients timely access to mental health services.\" The Inspector General found just over half of new patients waited 50 days to be evaluated. VA rules require a full mental health evaluation for new patients in 14 days. About a third of patients then had longer than required waits to begin treatment.\u003c/p>\n\u003cp>\u003c/p>\n\u003cp>Writing for the majority in yesterday's 10-1 decision, \u003ca title=\"http://law.unlv.edu/faculty/jay-bybee.html\" href=\"http://law.unlv.edu/faculty/jay-bybee.html\" target=\"_blank\">Judge Jay Bybee\u003c/a> acknowledged the merits of the veterans' case:\u003c/p>\n\u003cblockquote>\u003cp>VCS’s complaint sounds a plaintive cry for help, but it has been misdirected to us. As much as we may wish for expeditious improvement in the way the VA handles mental health care and service-related disability compensation, we cannot exceed our jurisdiction to accomplish it. ... Such responsibilities are left to Congress and the Executive.\u003c/p>\u003c/blockquote>\n\n\u003c/div>\u003c/p>",
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"disqusTitle": "VA Adds Mental Health Clinicians",
"title": "VA Adds Mental Health Clinicians",
"headTitle": "State of Health | KQED News",
"content": "\u003cfigure id=\"attachment_5315\" class=\"wp-caption alignleft\" style=\"max-width: 300px\">\u003ca href=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2012/04/veteran.gif\">\u003cimg class=\"size-full wp-image-5315\" title=\"veteran\" src=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2012/04/veteran.gif\" alt=\"\" width=\"300\" height=\"300\" srcset=\"https://ww2.kqed.org/app/uploads/sites/27/2012/04/veteran.gif 300w, https://ww2.kqed.org/app/uploads/sites/27/2012/04/veteran-32x32.gif 32w, https://ww2.kqed.org/app/uploads/sites/27/2012/04/veteran-64x64.gif 64w, https://ww2.kqed.org/app/uploads/sites/27/2012/04/veteran-96x96.gif 96w, https://ww2.kqed.org/app/uploads/sites/27/2012/04/veteran-128x128.gif 128w, https://ww2.kqed.org/app/uploads/sites/27/2012/04/veteran-75x75.gif 75w\" sizes=\"(max-width: 300px) 100vw, 300px\">\u003c/a>\u003cfigcaption class=\"wp-caption-text\">The need for mental health services among veterans has increased 35% since 2007. (Getty Images)\u003c/figcaption>\u003c/figure>\n\u003cp>The Department of Veterans Affairs \u003ca href=\"http://www.va.gov/opa/pressrel/pressrelease.cfm?id=2302\">has announced \u003c/a>that it will add 1,600 mental health clinicians and 300 support staff to veterans hospitals across the country to help contend with the rising demand for mental health care among returning veterans. That's an almost 10% increase in mental health staff and is sorely needed at hospitals that can't keep up with the requests for appointments. In some places, wait time for care is much longer than the VA's 14 day policy, the subject of a report by the department's inspector general to be released next week.\u003c/p>\n\u003cp>Northern California may be faring slightly better than the rest of the country on mental health issues. “In Northern California we have many veterans coming back. We also have a lot of staff,\" said Robin Jackson, a spokeswoman for the \u003ca href=\"http://www.northerncalifornia.va.gov/\">Department of Veterans Affairs Northern California Health Care System\u003c/a>. \"We’ve tripled our mental health staff in the last 4 years. So we many be ahead of the curve,” she added. Jackson said that staff in Northern California realized that traumatic brain injury and other mental trauma would be the most common illnesses in returning Iraq and Afghanistan veterans, so they ramped up their staffing to meet the need.\u003c!--more-->\u003c/p>\n\u003cp>Northern California VA's are meeting the department's 14 day timeline to see veterans in need of mental health treatment, according to Jackson. She also said they've been doing some innovative things to help veterans feel comfortable using the VA, and to diagnosis them early. “We do a post deployment health reassessment,” Jackson said, citing the recent return of a National Guard unit where all members were given the health assessment. \"They get familiar with what we have to offer and feel comfortable to come back,” she added. Jackson says California has always been at the forefront of practices like these because of the state's large veterans population, especially in Southern California.\u003c/p>\n\u003caside class=\"pullquote alignright\">\"We’ve tripled our mental health staff in the last 4 years. So we many be ahead of the curve.\"\u003c/aside>\n\u003cp>Southern California has seen a sharp increase in mental health need, almost doubling the number of patients between 2006 to the present. Dr. Peter Hauser, mental health program coordinator for the Southern California network of VA health care facilities, estimates that 20 to 30 percent of returning veterans from Iraq will have Post Traumatic Stress Disorder (PTSD). He added that the VA network expects more demand as former soldiers try to reintegrate into civilian life and experience employment difficulties that exacerbate existing traumas.\u003c/p>\n\u003cp>Dr. Hauser expects his region to get 111 new mental health professionals. \"We are working hard to fill all existing vacancies and ramp up recruiting to hire new staff and create outpatient mental health teams that enhance continuity of care,\" he wrote in an email. Southern California has had a \u003ca href=\"http://www.usatoday.com/news/military/story/2012-04-19/veterans-hiring-mental-health-workers/54418514/1\">hard time filling vacancies\u003c/a> on its mental health staff that already exist. Dr. Hauser cited high cost of living in Southern California, salary competition from private networks and overal budgetary contraints as reasons why recruiting and filling psychiatrist positions has been difficult.\u003c/p>\n\u003cp>[ad fullwidth]\u003c/p>\n\u003cp>The Department of Veterans Affairs as whole has \u003ca href=\"http://www.nytimes.com/2012/04/20/us/veterans-affairs-dept-to-increase-mental-health-staffing.html?_r=1\">come under fire\u003c/a> for long wait times and inadequate care, problems the new staff are meant to address. \"History shows that the costs of war will continue to grow for a decade or more after the operational missions in Iraq and Afghanistan have ended,\" Department Secretary \u003ca href=\"http://www.va.gov/opa/bios/secretary.asp\">Eric Shinseki\u003c/a> said in a statement. \"As more veterans return home, we must ensure that all veterans have access to quality mental health care.\"\u003c/p>\n\u003cp>\u003c/p>\n\u003cp>The VA treats 1.3 million veterans for mental health problems nationwide, 400,000 of whom are returning from Iraq and Afghanistan. Since 2009, the VA has increased the mental health budget by 39%, but that may not be enough. The number of veterans seeking mental health help has increased 35% since 2007. The new staff will be paid for out of the VA's existing budget.\u003c/p>\n\n",
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"description": "The Department of Veterans Affairs has announced that it will add 1,600 mental health clinicians and 300 support staff to veterans hospitals across the country to help contend with the rising demand for mental health care among returning veterans. That's an almost 10% increase in mental health staff and is sorely needed at hospitals that",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003cfigure id=\"attachment_5315\" class=\"wp-caption alignleft\" style=\"max-width: 300px\">\u003ca href=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2012/04/veteran.gif\">\u003cimg class=\"size-full wp-image-5315\" title=\"veteran\" src=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2012/04/veteran.gif\" alt=\"\" width=\"300\" height=\"300\" srcset=\"https://ww2.kqed.org/app/uploads/sites/27/2012/04/veteran.gif 300w, https://ww2.kqed.org/app/uploads/sites/27/2012/04/veteran-32x32.gif 32w, https://ww2.kqed.org/app/uploads/sites/27/2012/04/veteran-64x64.gif 64w, https://ww2.kqed.org/app/uploads/sites/27/2012/04/veteran-96x96.gif 96w, https://ww2.kqed.org/app/uploads/sites/27/2012/04/veteran-128x128.gif 128w, https://ww2.kqed.org/app/uploads/sites/27/2012/04/veteran-75x75.gif 75w\" sizes=\"(max-width: 300px) 100vw, 300px\">\u003c/a>\u003cfigcaption class=\"wp-caption-text\">The need for mental health services among veterans has increased 35% since 2007. (Getty Images)\u003c/figcaption>\u003c/figure>\n\u003cp>The Department of Veterans Affairs \u003ca href=\"http://www.va.gov/opa/pressrel/pressrelease.cfm?id=2302\">has announced \u003c/a>that it will add 1,600 mental health clinicians and 300 support staff to veterans hospitals across the country to help contend with the rising demand for mental health care among returning veterans. That's an almost 10% increase in mental health staff and is sorely needed at hospitals that can't keep up with the requests for appointments. In some places, wait time for care is much longer than the VA's 14 day policy, the subject of a report by the department's inspector general to be released next week.\u003c/p>\n\u003cp>Northern California may be faring slightly better than the rest of the country on mental health issues. “In Northern California we have many veterans coming back. We also have a lot of staff,\" said Robin Jackson, a spokeswoman for the \u003ca href=\"http://www.northerncalifornia.va.gov/\">Department of Veterans Affairs Northern California Health Care System\u003c/a>. \"We’ve tripled our mental health staff in the last 4 years. So we many be ahead of the curve,” she added. Jackson said that staff in Northern California realized that traumatic brain injury and other mental trauma would be the most common illnesses in returning Iraq and Afghanistan veterans, so they ramped up their staffing to meet the need.\u003c!--more-->\u003c/p>\n\u003cp>Northern California VA's are meeting the department's 14 day timeline to see veterans in need of mental health treatment, according to Jackson. She also said they've been doing some innovative things to help veterans feel comfortable using the VA, and to diagnosis them early. “We do a post deployment health reassessment,” Jackson said, citing the recent return of a National Guard unit where all members were given the health assessment. \"They get familiar with what we have to offer and feel comfortable to come back,” she added. Jackson says California has always been at the forefront of practices like these because of the state's large veterans population, especially in Southern California.\u003c/p>\n\u003caside class=\"pullquote alignright\">\"We’ve tripled our mental health staff in the last 4 years. So we many be ahead of the curve.\"\u003c/aside>\n\u003cp>Southern California has seen a sharp increase in mental health need, almost doubling the number of patients between 2006 to the present. Dr. Peter Hauser, mental health program coordinator for the Southern California network of VA health care facilities, estimates that 20 to 30 percent of returning veterans from Iraq will have Post Traumatic Stress Disorder (PTSD). He added that the VA network expects more demand as former soldiers try to reintegrate into civilian life and experience employment difficulties that exacerbate existing traumas.\u003c/p>\n\u003cp>Dr. Hauser expects his region to get 111 new mental health professionals. \"We are working hard to fill all existing vacancies and ramp up recruiting to hire new staff and create outpatient mental health teams that enhance continuity of care,\" he wrote in an email. Southern California has had a \u003ca href=\"http://www.usatoday.com/news/military/story/2012-04-19/veterans-hiring-mental-health-workers/54418514/1\">hard time filling vacancies\u003c/a> on its mental health staff that already exist. Dr. Hauser cited high cost of living in Southern California, salary competition from private networks and overal budgetary contraints as reasons why recruiting and filling psychiatrist positions has been difficult.\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>The Department of Veterans Affairs as whole has \u003ca href=\"http://www.nytimes.com/2012/04/20/us/veterans-affairs-dept-to-increase-mental-health-staffing.html?_r=1\">come under fire\u003c/a> for long wait times and inadequate care, problems the new staff are meant to address. \"History shows that the costs of war will continue to grow for a decade or more after the operational missions in Iraq and Afghanistan have ended,\" Department Secretary \u003ca href=\"http://www.va.gov/opa/bios/secretary.asp\">Eric Shinseki\u003c/a> said in a statement. \"As more veterans return home, we must ensure that all veterans have access to quality mental health care.\"\u003c/p>\n\u003cp>\u003c/p>\n\u003cp>The VA treats 1.3 million veterans for mental health problems nationwide, 400,000 of whom are returning from Iraq and Afghanistan. Since 2009, the VA has increased the mental health budget by 39%, but that may not be enough. The number of veterans seeking mental health help has increased 35% since 2007. The new staff will be paid for out of the VA's existing budget.\u003c/p>\n\n\u003c/div>\u003c/p>",
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"disqusTitle": "Veterans with PTSD at Risk of Prescription Opioid Abuse",
"title": "Veterans with PTSD at Risk of Prescription Opioid Abuse",
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"content": "\u003cfigure id=\"attachment_3555\" class=\"wp-caption alignleft\" style=\"max-width: 300px\">\u003ca href=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2012/03/PillsGenericGetty060611.jpg\">\u003cimg class=\"size-medium wp-image-3555\" title=\"Veterans with PTSD are more likely to be prescribed opioid drugs for pain relief. (Photo: Jupiter Images)\" src=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2012/03/PillsGenericGetty060611-300x200.jpg\" alt=\"\" width=\"300\" height=\"200\">\u003c/a>\u003cfigcaption class=\"wp-caption-text\">Veterans with PTSD are more likely than other vets to be prescribed opioid drugs for pain relief. (Photo: Jupiter Images)\u003c/figcaption>\u003c/figure>\n\u003cp>Across the country, there's been a greater understanding of \u003ca title=\"http://www.iom.edu/Reports/2011/Relieving-Pain-in-America-A-Blueprint-for-Transforming-Prevention-Care-Education-Research.aspx\" href=\"http://www.iom.edu/Reports/2011/Relieving-Pain-in-America-A-Blueprint-for-Transforming-Prevention-Care-Education-Research.aspx\" target=\"_blank\">treating pain\u003c/a>. The prescription of opioid pain relievers--drugs like codeine, vicodin or morphine--has nearly doubled since 1994. But at the same time, \u003ca title=\"http://www.cdc.gov/mmwr/preview/mmwrhtml/mm6043a4.htm\" href=\"http://www.cdc.gov/mmwr/preview/mmwrhtml/mm6043a4.htm\" target=\"_blank\">prescription opioid abuse, overdose and death\u003c/a> has also increased dramatically. The same trends are true for veterans of the Iraq and Afghanistan wars. Today, due to medical advances and improvements in combat protective gear, higher numbers of veterans of these wars are surviving injuries. But once home, they continue to suffer both pain and mental health problems. They are often prescribed opioid pain relievers.\u003c/p>\n\u003cp>But little has been known about mental health disorders and the prescribing of opioids to veterans. Researchers at the San Francisco Veterans Affairs Medical Center and UCSF set out to address this question and found that veterans with mental health problems were more likely to be prescribed opioid drugs than veterans without mental health issues.\u003c!--more-->\u003c/p>\n\u003cp>The study, published Tuesday in the \u003ca title=\"http://jama.ama-assn.org/content/307/9/940.short\" href=\"http://jama.ama-assn.org/content/307/9/940.short\" target=\"_blank\">Journal of the American Medical Association\u003c/a>, reviewed information from more than 140,000 Iraq and Afghanistan war veterans who were diagnosed with pain. Veterans without mental health problems were prescribed opioids much less frequently--about 6.5 percent of them received these prescriptions. That rate went up to 11.7 percent in veterans with a mental health diagnosis. And the rate was highest--17.8 percent--for veterans with Post-Traumatic Stress Disorder (PTSD).\u003c/p>\n\u003cp>The study also showed that all veterans that were prescribed opioids had a higher risk of misusing their prescription opioid by either over-dosing, having drug-related accidents, hurting oneself, or other things that would cause them to end up in the Emergency Room. That risk was the greatest among those with PTSD.\u003c/p>\n\u003cp>Lead author \u003ca title=\"http://profiles.ucsf.edu/ProfileDetails.aspx?Person=4802489\" href=\"http://profiles.ucsf.edu/ProfileDetails.aspx?Person=4802489\" target=\"_blank\">Karen Seal\u003c/a> is a physician at the San Francisco Veterans Affairs Medical Center and a professor at UCSF. She says the study results are troubling. \"The message to me is to keep redoubling our efforts to really have conversations with patients about these risks, and really provide them alternatives to just taking Vicodin or oxycodone or morphine, which has become very, very common in our society.\"\u003c/p>\n\u003cp>[ad fullwidth]\u003c/p>\n\u003cp>Seal says there were clear patterns in the data showing that Veterans Affairs (VA) patients with PTSD were more at risk for being on higher doses of opioids, and for longer periods of time. PTSD patients also had a higher risk of being prescribed two or more opioids simultaneously, and were more likely to get early refills on medications. She says getting early refills is a good indication that veterans may be abusing drugs by taking more than prescribed.\u003c/p>\n\u003cp>Seal says the VA often offers alternatives to opioid pain medication first, such as anti-inflammatory drugs, physical therapy, complementary alternative medicine, and various relaxation techniques. She says in her own practice, she's found that when she approaches her patients about alternatives to opioid prescriptions, many patients say they would rather avoid the opioids and try these alternative therapies first.\u003c/p>\n\u003cp>\"They particularly like going to physical therapy,\" Seal said. \"And actually trying -- usually for the first time -- modalities like acupuncture, chiropractory, relaxation, and even in some case psychotherapy that's really meant to address their pain and PTSD, or other mental health problems, simultaneously.\"\u003c/p>\n\u003cp>But Seal cautions that these alternative methods don't\u003cem> \u003c/em>always work. Some patients require opioid medication to relieve their pain. \"In those cases you would still prescribe [opioids] to relieve pain and suffering, but you would do so in a way that you are assessing for risk, and you are monitoring their use of the medication.\"\u003c/p>\n\u003cp>In the study, the authors note that the VA has guidelines that \"urge caution in opioid prescribing\" in people with substance abuse issues.\u003c/p>\n\u003cp>\u003c/p>\n\u003cp>The Department of Veterans Affairs issued a written statement in response to the study saying it \"agrees with the recommendation that VA continue to build upon its current approach to treating patients who have both pain and PTSD. This includes expanding \u003ca title=\"http://www.va.gov/primarycare/pcmh/\" href=\"http://www.va.gov/primarycare/pcmh/\" target=\"_blank\">Patient Aligned Care Teams\u003c/a> (PACTs) that align primary care physicians with nurses, mental health providers, pharmacists and social workers. VA is committed to ensuring Veterans receive the quality care and benefits they have earned.\"\u003c/p>\n\n",
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"excerpt": "Across the country, there's been a greater understanding of treating pain. The prescription of opioid pain relievers--drugs like codeine, vicodin or morphine--has nearly doubled since 1994. But at the same time, prescription opioid abuse, overdose and death has also increased dramatically. The same trends are true for veterans of the Iraq and Afghanistan wars. Today, due to medical advances and improvements in combat protective gear, higher numbers of veterans of these wars are surviving injuries. But once home, they continue to suffer both pain and mental health problems. They are often prescribed opioid pain relievers.\r\n",
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"description": "Across the country, there's been a greater understanding of treating pain. The prescription of opioid pain relievers--drugs like codeine, vicodin or morphine--has nearly doubled since 1994. But at the same time, prescription opioid abuse, overdose and death has also increased dramatically. The same trends are true for veterans of the Iraq and Afghanistan wars. Today, due to medical advances and improvements in combat protective gear, higher numbers of veterans of these wars are surviving injuries. But once home, they continue to suffer both pain and mental health problems. They are often prescribed opioid pain relievers.\r\n",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003cfigure id=\"attachment_3555\" class=\"wp-caption alignleft\" style=\"max-width: 300px\">\u003ca href=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2012/03/PillsGenericGetty060611.jpg\">\u003cimg class=\"size-medium wp-image-3555\" title=\"Veterans with PTSD are more likely to be prescribed opioid drugs for pain relief. (Photo: Jupiter Images)\" src=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2012/03/PillsGenericGetty060611-300x200.jpg\" alt=\"\" width=\"300\" height=\"200\">\u003c/a>\u003cfigcaption class=\"wp-caption-text\">Veterans with PTSD are more likely than other vets to be prescribed opioid drugs for pain relief. (Photo: Jupiter Images)\u003c/figcaption>\u003c/figure>\n\u003cp>Across the country, there's been a greater understanding of \u003ca title=\"http://www.iom.edu/Reports/2011/Relieving-Pain-in-America-A-Blueprint-for-Transforming-Prevention-Care-Education-Research.aspx\" href=\"http://www.iom.edu/Reports/2011/Relieving-Pain-in-America-A-Blueprint-for-Transforming-Prevention-Care-Education-Research.aspx\" target=\"_blank\">treating pain\u003c/a>. The prescription of opioid pain relievers--drugs like codeine, vicodin or morphine--has nearly doubled since 1994. But at the same time, \u003ca title=\"http://www.cdc.gov/mmwr/preview/mmwrhtml/mm6043a4.htm\" href=\"http://www.cdc.gov/mmwr/preview/mmwrhtml/mm6043a4.htm\" target=\"_blank\">prescription opioid abuse, overdose and death\u003c/a> has also increased dramatically. The same trends are true for veterans of the Iraq and Afghanistan wars. Today, due to medical advances and improvements in combat protective gear, higher numbers of veterans of these wars are surviving injuries. But once home, they continue to suffer both pain and mental health problems. They are often prescribed opioid pain relievers.\u003c/p>\n\u003cp>But little has been known about mental health disorders and the prescribing of opioids to veterans. Researchers at the San Francisco Veterans Affairs Medical Center and UCSF set out to address this question and found that veterans with mental health problems were more likely to be prescribed opioid drugs than veterans without mental health issues.\u003c!--more-->\u003c/p>\n\u003cp>The study, published Tuesday in the \u003ca title=\"http://jama.ama-assn.org/content/307/9/940.short\" href=\"http://jama.ama-assn.org/content/307/9/940.short\" target=\"_blank\">Journal of the American Medical Association\u003c/a>, reviewed information from more than 140,000 Iraq and Afghanistan war veterans who were diagnosed with pain. Veterans without mental health problems were prescribed opioids much less frequently--about 6.5 percent of them received these prescriptions. That rate went up to 11.7 percent in veterans with a mental health diagnosis. And the rate was highest--17.8 percent--for veterans with Post-Traumatic Stress Disorder (PTSD).\u003c/p>\n\u003cp>The study also showed that all veterans that were prescribed opioids had a higher risk of misusing their prescription opioid by either over-dosing, having drug-related accidents, hurting oneself, or other things that would cause them to end up in the Emergency Room. That risk was the greatest among those with PTSD.\u003c/p>\n\u003cp>Lead author \u003ca title=\"http://profiles.ucsf.edu/ProfileDetails.aspx?Person=4802489\" href=\"http://profiles.ucsf.edu/ProfileDetails.aspx?Person=4802489\" target=\"_blank\">Karen Seal\u003c/a> is a physician at the San Francisco Veterans Affairs Medical Center and a professor at UCSF. She says the study results are troubling. \"The message to me is to keep redoubling our efforts to really have conversations with patients about these risks, and really provide them alternatives to just taking Vicodin or oxycodone or morphine, which has become very, very common in our society.\"\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>Seal says there were clear patterns in the data showing that Veterans Affairs (VA) patients with PTSD were more at risk for being on higher doses of opioids, and for longer periods of time. PTSD patients also had a higher risk of being prescribed two or more opioids simultaneously, and were more likely to get early refills on medications. She says getting early refills is a good indication that veterans may be abusing drugs by taking more than prescribed.\u003c/p>\n\u003cp>Seal says the VA often offers alternatives to opioid pain medication first, such as anti-inflammatory drugs, physical therapy, complementary alternative medicine, and various relaxation techniques. She says in her own practice, she's found that when she approaches her patients about alternatives to opioid prescriptions, many patients say they would rather avoid the opioids and try these alternative therapies first.\u003c/p>\n\u003cp>\"They particularly like going to physical therapy,\" Seal said. \"And actually trying -- usually for the first time -- modalities like acupuncture, chiropractory, relaxation, and even in some case psychotherapy that's really meant to address their pain and PTSD, or other mental health problems, simultaneously.\"\u003c/p>\n\u003cp>But Seal cautions that these alternative methods don't\u003cem> \u003c/em>always work. Some patients require opioid medication to relieve their pain. \"In those cases you would still prescribe [opioids] to relieve pain and suffering, but you would do so in a way that you are assessing for risk, and you are monitoring their use of the medication.\"\u003c/p>\n\u003cp>In the study, the authors note that the VA has guidelines that \"urge caution in opioid prescribing\" in people with substance abuse issues.\u003c/p>\n\u003cp>\u003c/p>\n\u003cp>The Department of Veterans Affairs issued a written statement in response to the study saying it \"agrees with the recommendation that VA continue to build upon its current approach to treating patients who have both pain and PTSD. This includes expanding \u003ca title=\"http://www.va.gov/primarycare/pcmh/\" href=\"http://www.va.gov/primarycare/pcmh/\" target=\"_blank\">Patient Aligned Care Teams\u003c/a> (PACTs) that align primary care physicians with nurses, mental health providers, pharmacists and social workers. VA is committed to ensuring Veterans receive the quality care and benefits they have earned.\"\u003c/p>\n\n\u003c/div>\u003c/p>",
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"info": "What kind of no sabo word is Hyphenación? For us, it’s about living within a hyphenation. Like being a third-gen Mexican-American from the Texas border now living that Bay Area Chicano life. Like Xorje! Each week we bring together a couple of hyphenated Latinos to talk all about personal life choices: family, careers, relationships, belonging … everything is on the table. ",
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"info": "Our flagship program, helmed by Kai Ryssdal, examines what the day in money delivered, through stories, conversations, newsworthy numbers and more. Updated Monday through Friday at about 3:30 p.m. PT.",
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"info": "The MindShift podcast explores the innovations in education that are shaping how kids learn. Hosts Ki Sung and Katrina Schwartz introduce listeners to educators, researchers, parents and students who are developing effective ways to improve how kids learn. We cover topics like how fed-up administrators are developing surprising tactics to deal with classroom disruptions; how listening to podcasts are helping kids develop reading skills; the consequences of overparenting; and why interdisciplinary learning can engage students on all ends of the traditional achievement spectrum. This podcast is part of the MindShift education site, a division of KQED News. KQED is an NPR/PBS member station based in San Francisco. You can also visit the MindShift website for episodes and supplemental blog posts or tweet us \u003ca href=\"https://twitter.com/MindShiftKQED\">@MindShiftKQED\u003c/a> or visit us at \u003ca href=\"/mindshift\">MindShift.KQED.org\u003c/a>",
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"info": "For decades, the process for how police police themselves has been inconsistent – if not opaque. In some states, like California, these proceedings were completely hidden. After a new police transparency law unsealed scores of internal affairs files, our reporters set out to examine these cases and the shadow world of police discipline. On Our Watch brings listeners into the rooms where officers are questioned and witnesses are interrogated to find out who this system is really protecting. Is it the officers, or the public they've sworn to serve?",
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"tagline": "Politics from a personal perspective",
"info": "Political Breakdown is a new series that explores the political intersection of California and the nation. Each week hosts Scott Shafer and Marisa Lagos are joined with a new special guest to unpack politics -- with personality — and offer an insider’s glimpse at how politics happens.",
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"possible": {
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"title": "Possible",
"info": "Possible is hosted by entrepreneur Reid Hoffman and writer Aria Finger. Together in Possible, Hoffman and Finger lead enlightening discussions about building a brighter collective future. The show features interviews with visionary guests like Trevor Noah, Sam Altman and Janette Sadik-Khan. Possible paints an optimistic portrait of the world we can create through science, policy, business, art and our shared humanity. It asks: What if everything goes right for once? How can we get there? Each episode also includes a short fiction story generated by advanced AI GPT-4, serving as a thought-provoking springboard to speculate how humanity could leverage technology for good.",
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"pri-the-world": {
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"title": "PRI's The World: Latest Edition",
"info": "Each weekday, host Marco Werman and his team of producers bring you the world's most interesting stories in an hour of radio that reminds us just how small our planet really is.",
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"imageSrc": "https://cdn.kqed.org/wp-content/uploads/2024/04/The-World-Podcast-Tile-360x360-1.jpg",
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},
"radiolab": {
"id": "radiolab",
"title": "Radiolab",
"info": "A two-time Peabody Award-winner, Radiolab is an investigation told through sounds and stories, and centered around one big idea. In the Radiolab world, information sounds like music and science and culture collide. Hosted by Jad Abumrad and Robert Krulwich, the show is designed for listeners who demand skepticism, but appreciate wonder. WNYC Studios is the producer of other leading podcasts including Freakonomics Radio, Death, Sex & Money, On the Media and many more.",
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},
"reveal": {
"id": "reveal",
"title": "Reveal",
"info": "Created by The Center for Investigative Reporting and PRX, Reveal is public radios first one-hour weekly radio show and podcast dedicated to investigative reporting. Credible, fact based and without a partisan agenda, Reveal combines the power and artistry of driveway moment storytelling with data-rich reporting on critically important issues. The result is stories that inform and inspire, arming our listeners with information to right injustices, hold the powerful accountable and improve lives.Reveal is hosted by Al Letson and showcases the award-winning work of CIR and newsrooms large and small across the nation. In a radio and podcast market crowded with choices, Reveal focuses on important and often surprising stories that illuminate the world for our listeners.",
"airtime": "SAT 4pm-5pm",
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"officialWebsiteLink": "https://www.revealnews.org/episodes/",
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},
"rightnowish": {
"id": "rightnowish",
"title": "Rightnowish",
"tagline": "Art is where you find it",
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