Tag: Mental Health

This College Student Is a Leader in the Fight Against Teen Suicide

Posted on by Anthony Smith

Eight days before Chloe Sorensen won a Young Leader award from Young Minds Advocacy for her work as a suicide prevention advocate, she lost another friend to suicide. For Sorensen, this wasn’t anything new. Sorensen is a recent graduate of Palo Alto’s Henry M. Gunn High School, the Silicon Valley school that made headlines for a spate of suicides in 2009. During Sorensen’s sophomore year alone, four teenagers committed suicide in her school district: one Gunn alum, two current students, and one student who attended crosstown rival Palo Alto High School.

Like others in the community, Sorensen felt waves of shock after each suicide cluster. On-campus grief support helped her to process her emotions. Unfortunately, suicide clusters — defined as three or more suicides in close proximity to each other — have occurred with increasing frequency in Palo Alto, where the rate is four times the national average. But before they began happening at her school, suicide was more or less an abstract concept. “I had a few friends who dealt with mental health conditions, but never dealt with suicide,” Sorensen said. “As a 15 year old, that was a really difficult thing to process because I didn’t understand what was happening. But the way I dealt with that grief, shock and initial pain was by channeling it into something more positive.”

Initially, that meant leaning on existing relationships with family and friends to grieve, and coming up with ways to advocate for mental health at Gunn. Sorensen started the Student Wellness Committee to encourage students to be more aware of their mental health, including a referral system where her peers could refer friends anonymously for in-school counseling. Another successful initiative: Youth Empowerment Seminars, where students learn stress-relief techniques such as mindfulness and breathing exercises.

Soon enough, Sorensen found herself immersed in the mental health advocacy space at the district level, a role that she’s quick to admit “snowballed” over time. After addressing the school board about pressures outside of school that often affect a student’s mental health — and being quoted in local papers as a student advocate and leader in the community — she was approached by national media outlets like NPR and The New York Times. “It was startling, but it was also hard to sit still with the feelings,” said Sorensen. “I’d much rather go out there, do something, and try to make a difference.”

Thanks to people like Sorensen, the past few years have seen progress regarding mental health awareness. In July, Oregon became one of the first states to allow students to be absent from school for a physical or mental illness, joining Utah and Minnesota in a growing movement that tells students it’s okay to admit when they’re struggling. “It’s important for schools to acknowledge that mental health is a critical component of student well-being, [but] it also plays an enormous role in success at school,” said Patrick Gardner, president and founder of Young Minds Advocacy. “It’s a positive step to empower students to act in their own best interest, and not feel they would be penalized for staying home if they believe that’s best for them.”

Not that today’s teens have any shortage of reasons for self-care: In addition to trauma triggered by mass shootings, the current political climate and the omni-present reality of climate change, suicide is the 10th leading cause of death for people ages 10 to 34. In Oregon, it is the state’s second leading cause of death in the same age group. Says Gardner: “Colleges historically haven’t been very good at addressing the mental health needs of their students, and universities typically haven’t been forthcoming in trying to sort that out.”

Gardner founded Young Minds Advocacy in 2012 while working at the National Center for Youth Law, a nonprofit law firm dedicated to helping low-income children achieve their potential. Today, Young Minds works to motivate local communities to address the number one issue facing young people and their families: unmet mental health needs.

While the group’s approach involves a blend of policy research, advocacy, impact litigation and strategic communications, one of its most important functions is providing a platform for teens to have a voice in advocating for mental health. “[Treating illness] as something only a doctor can give you a prescription for is the medical model of dealing with mental health, which has been so problematic in the United States,” Gardner said. “In Oregon, they talk about mental and behavioral health, which is a much broader concept and much more useful and actionable to children and families.”

In many states, students must be 18 to receive treatment without parental consent, which is one reason students are mobilizing to take mental health into their own hands. Though Sorensen wasn’t familiar with Young Minds Advocacy at the time, Gardner’s daughter Annabelle, communications director at Young Minds, contacted her in 2016 about receiving an award for community advocacy after learning about Sorensen’s work in the Palo Alto community.

Now a student at Stanford, Sorensen spends much of her time working with the Stanford Center for Youth Mental Health and Wellbeing on the launch of Allcove, a network of youth mental health centers in Santa Clara County geared toward youth 12 to 25 years of age. In addition to onsite mental health services, basic primary care, wellness services and the educational/career support offered at each center, young people can access a variety of support services without parental consent, including treatment for early psychosis and substance abuse counseling. Sorensen also founded Youth United for Responsible Media Representation, a group of students working to reduce suicide contagion by training the media not to sensationalize coverage in the aftermath of tragedy.

Despite all the work she’s done to raise youth awareness around mental health, Sorensen recognizes how fortunate she is to live in a community where mental health isn’t swept under the rug. She also remains humble about the awards she’s received for her work. “I almost didn’t want to go to that [Young Minds Advocacy] awards ceremony: I didn’t know anyone, and it kind of felt shitty to get an award for suicide prevention when my friend just died,” Sorensen said. “But it reaffirmed that this work is important. The role that Young Minds played in my life was to help me find my voice. They really stood behind me and elevated me at a time I needed that support.”

To learn more about how the Young Minds Advocacy group empowers youth advocates, click here.

More: Confronting Suicide With A Little Manly Humor 

Why Green Classrooms Could Be the Schools of the Future

Posted on by robbie

When Golestan Education took over the old St. Jerome’s Catholic school in El Cerrito, Calif., it looked much like your average suburban parochial school: a nondescript squat building sporting a cross on one side, abutting 18,000 square feet of concrete. There was not a single tree anywhere on the property.
But that was before Golestan co-founder and executive director Yalda Modabbar unveiled her ambitious plans for the space. Now there are four brand-new sunlight-filled classrooms with massive sliding glass walls that open up to what once was an asphalt-slathered playground, an expanse of green with lots of trees, boulders and bales of hay for kids to play on. Between the classrooms and the playground are two tiers of planters – one at kids’ height filled with plants for them to work and play with, the other with flowers to attract hummingbirds. Connecting the greenery outside with the indoor learning space is exactly the point of it all, says Modabber. “When you’re inside, you feel like you’re outside, even on a rainy day.”
Golestan is one of a growing number of schools across the country that are ditching the old 1940s-era asphalt-slathered playground model in favor of trees, flowers and gardens. And the benefits are more than just aesthetic: A growing body of research indicates that having access to green space at school has a direct impact on mental health as well as academic success.
William Sullivan, professor and head of the landscape program at the University of Illinois, has spent much of his career studying the impact of green spaces on human beings. One recent project involved giving high school kids “mentally fatiguing” tests in one of three environments: a room with no windows, a room with windows but no vegetation, and a room with a view of vegetation. In the room with no windows, the students reported the highest stress and made the most errors on the tests, while kids in the room with the view of trees reported the lowest stress and made the fewest errors.

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The combined indoor/outdoor learning space at Golestan brings the outside world indoors, creating an environment that is conducive to learning and improved test scores.

Sullivan is currently working on research that shows that exposure to green space is predictive of graduation rates, standardized test scores and even college attendance. “Having green exposure on school grounds is not a trivial thing in the slightest,” says Sullivan. “The success that a person has in high school puts them on a life course that’s hard to change from.”
The catch: Golestan is a nonprofit where students pay tuition to attend. How can their model work at a public school, where the student body is largely dependent on financial aid?
Hoover Elementary in West Oakland – just a few miles south but a million miles from Golestan, socio-economically speaking – is attempting to find out. It might be a cash-strapped inner-city school where most students qualify for free lunch, but it has devoted over 5,600 square feet of its property to growing fruit, vegetables, herbs, bushes and fruit trees, enough so that they will start supplying the West Oakland farmers market with fresh produce. The local homeless population are free to take whatever is ripe when they walk by.
“We’ve seen a lot of benefits, not just with healthy eating but also with a connection to nature, says Hoover Principal Ashley Martin. “Being in a trauma-saturated community, the garden really offers a space for kids to help them kind of calm down and regulate.”
All of this side-steps another critical feature of green schoolyards: their positive environmental impact. When rain hits concrete, it bounces off and can easily overwhelm sewer systems, leading to runoff that can cause flooding and erosion. Stormwater runoff also picks up and carries with it many different types of pollutants that are found on paved surfaces – fertilizer, motor oil, bacteria and so on. Green schoolyards absorb the rain, mitigating these effects while nourishing local plants and trees, something that could make a big difference in cities that regularly experience flooding exacerbated by climate change.
“I like to see schoolgrounds as a microcosm of the city [we] would like to see,” says Sharon Danks, founder and executive director of Green Schoolyards America, a Berkeley, Calif.-based nonprofit that seeks to grow the green schoolyard movement. To her, schoolyards across America represent a vast resource that few communities have begun to tap: Despite its ubiquity, the exact amount of land public schools occupy is unknown, even to city planners. “Cities are essentially planning with gaping holes in their maps where all the schools are,” Danks says. In other words: If that land were developed in a responsible and sustainable way, we might be able to slow the devastating effects of climate change.
None of this is cheap, of course, but tapping existing climate funds, urban-greening grant programs, and even cap-and-trade money could help pay for greening concrete-slathered jungles. “We need to think about this as park planning and apply infrastructure-scale budgets that we would normally apply to a park or a stormwater project,” Danks says.
But how about in dense urban areas, like in New York City, where the schools often don’t have campuses to work with? Most New York City schools have expansive rooftops that are underutilized, says Vicki Sando, who teaches STEM classes at P.S.41 in Manhattan’s Greenwich Village. Sando was the project and fundraising lead for P.S.41’s green roof, one of the first green school roofs in the city, completed in 2012. “Not all schools are ideal candidates, but the ones that are see multiple benefits,” Sando says. “Our energy usage has gone down about 22 percent with the green roof on there, and the kids are so enthusiastic about going up there and reconnecting with nature in an urban environment.”
Modabber echoes Sando’s enthusiasm. “The younger the child, the more space they need,” she says. “These kids are growing up with a deep love of nature, and they are going to want to preserve it.”
MORE: Ask the Experts: How Can We Fix Early Childhood Education?

Rape Behind Bars: Stopping the Cycle of Violence

Posted on by robbie

Nicole Wolfe was just two months into her life sentence for attempted murder when she says a lieutenant at the Central California Women’s Facility began raping her. About six months later, in the fall of 1998, a nurse at the prison also began sexually assaulting her.
It was hell for Wolfe, who was assaulted continuously for a year while she was at the California prison.
In 2000, Wolfe was transferred to a different prison. There, she met with a counselor and for the first time was able to process all of the abuse she’d faced over the years. She says the counselor, Debora Heaps, changed her life — because Heaps believed her story.
“She was just so open and receptive and gentle and understanding, and had so much information, too,” Wolfe tells NationSwell. “She made me feel like a human… It was like she opened up a path to recovery for the first time in my life. I could see my life could be different, and better.”
Wolfe is hardly alone in having experienced sexual assault while behind bars. The Bureau of Justice Statistics found that four percent of adult inmates in jails and prisons had reported a sexual assault, and about half of those instances of assault were from corrections staff. Mapping that data over the total incarcerated population of the U.S., it’s estimated that 200,000 imprisoned people endure sexual assault each year.
Through the Prison Rape Elimination Act (PREA), which passed in 2003, detention facilities are partnering with their local rape crisis centers to provide support services to incarcerated populations. Those services can take the form of access to a rape crisis hotline, the ability to write letters to rape crisis centers or receive in-person counseling, much like Wolfe was able to receive from Heaps. And counselors like Heaps can accompany inmates to forensic exams if they decide to report an assault.

AN AMBITIOUS BILL

When President George W. Bush signed PREA into law, it was intended to curb the thousands of reported cases of sexual misconduct — a problem that advocates describe as an epidemic — and to establish grants for nonprofits to aid in eliminating rape in prisons.
PREA, though ambitious, was an aspirational piece of legislation that required deep and time-consuming analyses of inmate conditions. And so prison rapes continued: Four years after the bill was passed, the Bureau of Justice Statistics reported that an estimated 70,000 people were abused in prisons the previous year.
In 2013, the Department of Justice updated PREA with a set of standards that required prisons and jails to provide inmates with access to outside counseling or emotional support services. Private and public prisons, local jails, juvenile detention centers, immigrant detention centers, and community corrections facilities must now provide access to outside emotional support services to any inmate who is sexually assaulted in prison and to inmates who experienced past sexual assaults.
Women who face sexual harassment in detention have often faced it before: 86 percent of women in jail report experiencing sexual violence prior to incarceration, according to a 2016 study by the nonprofit research and policy organization Vera Institute of Justice.
But women often don’t come forward about their assaults.
In 1995, only a quarter of U.S. women reported incidents of sexual abuse to police. And even though that number increased to 59 percent in 2005, reports dropped dramatically back to 1990s levels by 2010, according to a 2016 Bureau of Justice Statistics report.

Prison abuse 3
After years in an abusive marriage, it was only when Nicole Wolfe was sentenced to life in prison that she finally felt safe.

Karin Stone, director of client services for Women’s Center High Desert, says people who experience sexual abuse as children or repeated sexual assault usually turn to crime as a coping mechanism.
“If you start to, we call it ‘peel the onion,’ you discover those layers of trauma,” says Stone. “It amazes me sometimes that they’ve survived as long as they have.”
The pattern — abuse, trauma, crime — is one that Stone says will continue to repeat itself even after inmates leave prison if they never receive therapy or learn healthy coping mechanisms.
The quality of support services for incarcerated survivors varies widely across the U.S., but recent data from the Bureau of Justice Statistics indicates that the PREA may be having a positive effect in that more inmates are reporting sexual assault. In 2011, correctional administrators received 8,768 reports of sexual misconduct from inmates. In 2015, that number more than tripled to 24,661 reports.
“You would think that more reports [mean] a rise in incidents,” says Jesse Lerner-Kinglake, communications director at Just Detention International (JDI), an organization devoted to ending sexual abuse behind bars. “But in fact the most important thing that it tells us is that people are coming forward, which is what we want.”

“I WAS LIVING MY WORST NIGHTMARE”

Wolfe says she was first sexually assaulted by a family member when she was only 4 years old. She was assaulted again during her youth and also as a young adult. Part of the problem, she says, is that she grew up in a family where nobody knew what was going on behind closed doors, which is why no one tried to stop the abuse.
“I didn’t know anything different,” she says, adding that sexual abuse “was just a given” in her life.
But abuse tends to follow people throughout their lives.
In 1997, Wolfe says she felt trapped in an abusive marriage, and tried to kill her then-husband in what she described as a desperate act to escape the cycle of abuse. “I couldn’t get away,” she says. “I couldn’t see my way out.” She was sentenced to life in prison for attempted murder. It was only when she was locked up behind bars that she says she finally felt safe.
But that feeling of safety wouldn’t last. Within her first year of incarceration, Wolfe says she was raped by a prison lieutenant. She was afraid to report him because he had power and influence over her life in prison. On Sundays, he ran the gate that inmates had to go through to see visitors, and he would assault her before she went through the gates before her visits. “I would go to my visits just…out of my mind,” says Wolfe. “I was afraid to say anything to anybody because I was serving a life sentence. Nobody ever believed me. Why [would] they believe me now?”
Wolfe felt like she couldn’t trust any of the psychologists who worked for the prison. When she did finally seek care, she was abused yet again by a nurse on staff. For six months, she was repeatedly assaulted by both the lieutenant and the nurse.
“I thought, I’m supposed to be here for the rest of my life, and is this the rest of my life?” she says. “I was living in my worst nightmare.”
Wolfe says the nurse who assaulted her was eventually caught by a prison official and convicted of sex with a confined person. Wolfe then took a risk and told a prison psychologist “in confidence” about the lieutenant, but the psychologist reported it to the prison, and another investigation began. Wolfe doesn’t know the outcome of that investigation.
NationSwell requested records for both the lieutenant and the nurse, but neither were provided by the time of publication. A spokesperson for the California Department of Corrections and Rehabilitation (CDCR) confirmed that the nurse worked for the prison, but said the department could not comment on any investigation. CDCR sent NationSwell the following statement regarding investigations into both the nurse and the lieutenant:
“We can’t speak to the specific allegations mentioned here, but staff sexual misconduct is an issue we take very seriously. The California Department of Corrections and Rehabilitation (CDCR) maintains a zero tolerance for staff sexual misconduct, and thoroughly investigates all allegations. If an investigation proves there was wrongdoing, CDCR staff may face disciplinary action and/or referral for criminal prosecution.”
In 2000, Wolfe was transferred to California Institution for Women, a state prison. It was there where Wolfe met Heaps for the first time. Heaps, who is now the director of programs at Riverside Area Rape Crisis Center, was one of the first counselors sent into prisons to provide in-person therapy to inmates who had been sexually assaulted, and also to inmates who had faced sexual harassment prior to their incarceration.
“From the very beginning, it was like there was someone I could really be completely honest with and feel like I had complete confidentiality,” Wolfe says.

Prison abuse 2
“I don’t know where I would be if it was not for you. I can never thank you enough for the help you gave me,” says a letter from a survivor of prison abuse to a counselor.

ANECDOTAL EVIDENCE OF HELP

An increase in allegations doesn’t mean an increase in justice for survivors. Of the more than 24,000 allegations of sexual violence from inmates in 2015, only 1,473 were substantiated by investigations, according to the Bureau of Justice Statistics report released this past July.
“It shows that the investigations are failing,” says Lerner-Kinglake. “It’s simply not believable that the overwhelming majority of people are making it up or that there wasn’t enough evidence.”
Though there’s no research that proves access to counseling and emotional support helps incarcerated survivors of sexual assault, other rehabilitative programs in prisons and jails have proven to successfully reduce recidivism.
A May 2018 White House report found that mental health programs and substance abuse programs reduce recidivism by 21 percent and 17 percent, respectively. And a number of reports have found that therapy reduces PTSD and anxiety for survivors of rape who aren’t incarcerated.
In lieu of empirical evidence, advocates also point to the experiences they’re having every day with survivors in detention.
Jennifer Jeanquart, a prison rape crisis advocate who works for Sexual Trauma Services of the Midlands in six men’s detention facilities in South Carolina, shared a letter she received from one of the clients she counseled.
“I don’t know where I would be if it was not for you. I can never thank you enough for the help you gave me,” the letter reads. “I’ll always remember you, Mrs. J. You have inspired me to help other people like myself.”
Jessica Seipel, program director at JDI, also wrote letters to a survivor named Joe Booth, who says he was raped by his cellmate. Booth later told Seipel that she was the first person who asked him his name. Staff at the prison had previously only called him by his inmate number. Seipel says she was just doing her job and supporting a survivor, but “little did I know that for this person…my letters were like a lifeline for him that saved his life.”
Heaps says none of her clients ever blamed other people for the crimes they committed, but that counseling helped them discover what led them down that path.
“Trauma is a very complex thing,” Heaps says. “If not processed through counseling and therapy, it can lead down a very dark path of vulnerability and victimization.”
Heaps and Wolfe worked together for more than a year, and Wolfe says that it completely changed her life. In 2013, she was released from prison after multiple appeals to the parole board. She says Heaps gave her the “tool box” she needed to break free of the cycles that led to her abuse.
“If I hadn’t been able to figure out how to live my life without being abused, and if I hadn’t found my voice, then I’d never be where I am today,” Wolfe says. “I could very easily be back in an abusive relationship, killed by an abusive man, or cowering somewhere, afraid of my own shadow. And I’m not.”

Helping Traumatized Kids

Posted on by robbie

It’s been a devastating summer for child migrants. Over 2,000 kids, some only toddlers, have been separated from their families at the border. With no easy way for these kids to be reunited with their families, experts worry that the trauma the kids are experiencing, be it in the court system or in foster care, is inflicting irreversible damage on their developing brains.
“We’re talking about immigrants who are coming out of situations [that are] already traumatic,” says Michèle Neuhaus, Director of the 0-5 Early Childhood Mental Health Initiative for the Child Center of New York. Neuhaus compares such a child to a “seed” that has been watered and nurtured before suddenly being abandoned. “Getting here was traumatic, but they had [someone] protecting them. But now that person is gone.”
Extreme childhood trauma, now called toxic stress, is not a new concept. It was first introduced in the 1980s by Dr. Vincent Felitti, who, along with the Centers for Disease Control and Prevention, recruited over 17,000 patients to study obesity. The project, coined the ACEs Study, was a landmark in epidemiologic research, and showed that childhood trauma was linked to almost every major health problem in the U.S.
But its impact on children is only now under scrutiny since the border crisis intensified last month, when U.S. Attorney General Jeff Sessions announced a zero-tolerance policy toward migration, using the threat of parent-child separation to deter illegal border crossings.
Toxic stress at a young age can do irreparable damage to a child’s development. Research has shown that kids who experience trauma have a higher propensity for disease or depression. Other studies have found a correlation between stress and cancers, including skin and breast cancers and rheumatoid arthritis. Over 1,200 pediatricians across the nation are implementing toxic stress therapy into their practices, according to Jane Stevens, founder of ACEs Connection, an online social and news network dedicated to raising awareness about adverse childhood experiences.
Neuhaus, whose work includes researching bonds between parents and young children, says that such bonds are essential in order for a child to fully develop.

Helping traumatized kids 2
“Any separation from a mother — it’s the most traumatic thing a child can go through,” says child mental health expert Michèle Neuhaus.

“A lot of the trauma [these children are facing] is, what happens next? Any separation from a mother — it’s the most traumatic thing a child can go through. It’s a biological and an emotional bond,” she says.
Though the stress levels these children experience have been well-documented, there is hope that children who experience this trauma can recover from it, so long as the proper therapy is in place.
Stevens says that in order to properly address toxic stress, there needs to be systems in place that actually address the trauma — foremost being a safe environment with parents or a loving caregiver.
“The child needs to be in a safe home,” Stevens tells NationSwell. “When kids get separated from the parents, you understand that that’s extremely traumatic for child and parent.”
If the best way to address toxic stress in children is to put them in a safe environment with people who love them, what do you do when the kids are being subjected to forced separation and trauma, such as those at the center of the border crisis?
Giving children a chance to talk about what they’ve experienced and how they feel about it is key, Neuhaus says. “It helps [us] see how trauma affects [a kid’s] brain and how it affects the behaviors they see.” This storytelling, or building a “trauma narrative,” is an effective tool, she says, in allowing children to take ownership of their trauma and reframe it in an empowering way.
Etiony Aldarondo, an associate dean at the School of Education and Human Development at the University of Miami, created the Immigrant Children Affirmative Network, a booklet that immigrant children can create to tell their stories, along with a board game that helps those children navigate what will happen to them as undocumented migrants in the U.S.
When the source of toxic stress doesn’t directly involve a child’s parents, their role at the outset is still critical.
“Parents are making a lot of honest mistakes,” says Joseph Stachs, a social worker in New York who treats children using a type of therapy called “play” therapy. Speaking generally about the relationships children have with their parents, he says that most kids “have conflicted relationships with their parents.”
Which makes it imperative that parents or caregivers be involved and nurturing in helping treat traumatized children.
For migrant kids, though, that’s not an option, as many of the kids going through immigration courts are facing judges alone, without their parents or even a lawyer by their side. The only hope is that these children are placed with families that recognize the need for supporting kids that are enduring the trauma of family separation.
“Just like a scar will always be there after that accident, it doesn’t define your life,” Neuhaus says. “You can heal from trauma, but it doesn’t go away.”

The Inexpensive Way to Lift New Moms Out of Postpartum Depression

Posted on by robbie

Judy’s first pregnancy was planned, and she was looking forward to having a baby. Yet, halfway through the pregnancy, something changed. She began to feel down and bad about herself. She had less energy and struggled to concentrate. Thinking this was a normal part of pregnancy, she ignored it.
After she delivered her son, it all got worse. She felt as if she was in a black hole of sadness. She often gave her son to her mother, thinking he was better off without her. It wasn’t until a year and a half later, when she came out of the depression on her own, that she realized that she had not been herself.
Judy is a composite figure, based on the thousands of women for whom we have cared for or met during our clinical work and research. Her story demonstrates the profound impact that depression can have on mothers and their children.
Having a baby can be extraordinarily challenging. Women are extremely vulnerable to emotional changes during pregnancy and the year after delivery. In fact, depression is the most common complication of pregnancy. But women often have absolutely no idea they have depression, nor do anyone in their circle of influence, including their medical providers.
We believe there’s a missed opportunity to address depression in obstetric and pediatric settings: settings in which women are seen often during pregnancy and the year after birth. Women like Judy often drown in their illness, without anyone ever speaking to them about the possibility of depression. How and why does the health care system let this happen?

THE COSTS OF UNTREATED DEPRESSION

One in seven women experience depression during pregnancy and after birth. Depression negatively impacts mothers, children and families. It can affect birth outcomes, the way moms bond with their baby and children’s mental health later in life.
When untreated, depression can also lead to tragic outcomes, including suicide or infanticide. In fact, suicide is the leading cause of death among postpartum women with depression.
This illness is also costly. One case of untreated depression is estimated to cost over $22,000 annually per mother and baby pair.
Despite being a common illness with profound negative effects, most depression among pregnant and postpartum women goes unrecognized and untreated. Of the 4 million women who give birth in the U.S. every year, about 14 percent will experience depression. At least 80 percent will not generally get treatment.
There’s historically been no system in place to detect depression or help women get care. But professional societies and policymakers are starting to recommend screenings, while medical practices are beginning to integrate depression into obstetric and pediatric care.
This is a great first step. However, screening is not enough. After screening, the health system must ensure women get appropriately diagnosed and treated. Unfortunately, many providers aren’t trained or equipped with the proper resources to help women with depression, or may be reluctant to do so.

HELPING PROVIDERS HELP MOMS

In response to this need, our team is working on integrating depression into obstetric care in our state.
Our Massachusetts Child Psychiatry Access Program for Moms, launched in July 2014, helps frontline medical providers screen for and treat depression and other mental health concerns among pregnant and postpartum women.
MCPAP for Moms provides training and toolkits for providers, as well as telephone and face-to-face psychiatric consultation. For example, Judy’s obstetric provider could call MCPAP for Moms and talk to a psychiatrist to get guidance on how to treat, and with consultation, decide on a treatment plan that would include therapy. MCPAP for Moms also offers resources directly to women with ongoing mental health care.
Every provider in Massachusetts can access our services free of charge. MCPAP for Moms is funded through the MA Department of Mental Health. It also offers access to mental health care to pregnant and postpartum women in Massachusetts for less than $1 per month per woman. We are now evaluating how the program has affected outcomes for the more than 4,000 patients directly served since launch.
The ConversationTwo other states, Washington and Wisconsin, are starting programs like MCPAP for Moms, and 17 others are seeking funding. Especially exciting, next year’s federal budget includes grant money for other states to establish such programs. We envision a health care system where all providers caring for pregnant and postpartum women are armed with the resources they need to support women with depression.

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Tiffany Moore Simas is an associate professor of obstetrics-gynecology and pediatrics, and Nancy Byatt is an associate professor of psychiatry and obstetrics-gynecology, both at the University of Massachusetts Medical School. This article was originally published on The Conversation. 

My New Mission: Saving Vets Who Can’t Save Themselves

Posted on by robbie

I wish I could’ve saved my soldiers.
I was 22 years old when I became a platoon leader overseeing and taking care of 40 soldiers in combat in 2010. At the time, I had only done one tour — 12 months — in Iraq. But many of my soldiers had served four or five tours and had seen much more than I had.
Our job was to drive up and down the International Highway, which connected Kuwait to Iraq, and build relationships with local Iraqi police and sheiks. But we also had to check for improvised explosives, or IEDs.
We didn’t get all of them. In one case, before heading out on a mission, a U.S. envoy truck came careening into our base, half blown to hell and torn to shreds. In the back: three dead bodies. We had missed an IED.
There’s a lot of guilt in seeing something like that, and it can lead to a major symptom of post-traumatic stress disorder called survivor’s remorse. There is a wear on the brain and the body that goes into being in the military, especially for those deployed.
But were you ever to suggest talking to a therapist, you’d be hard-pressed to find many service members who would take you up on it. In the military, getting mental health treatment is viewed as a weakness — which, besides the negative stigma, is just plain wrong. There were soldiers who’d give therapy a try, only to leave after a single session and say, “I don’t feel better. I need to get back to the unit. I need to help out. This is an hour out of my time when I could be spending that with my family.”
And within a few years, there were people in my unit who had attempted suicide. It’s been seven years since I left Iraq, and in that time we’ve lost two people who were in my unit, one of whom I directly oversaw.
As a platoon leader, I viewed it as my responsibility to take care of our soldiers beyond getting the mission done. But with the news of the suicides came a sense that I had failed as their leader. It was my responsibility to take care of these guys, just like they took care of us.
After I retired from the military in 2015, I went to business school in Philadelphia. It had become my mission to find out how I could make our soldiers know that therapy could actually work for them, if only they would stick with it. Just as you wouldn’t return to your normal, daily routine after breaking an arm and undergoing one session with a physical therapist, neither should you expect to be fully recuperated after one session with a mental health professional.

Chris Molaro (left) served in Iraq as a liaison to local police and sheiks.

But, I soon realized, to get soldiers into therapy and keep them there, they needed to see — physically, with their own eyes — the progress they were making.
I read up on research that showed how you can use EEG technology, which measures electrical activity in the brain, to also measure one’s emotions. That was when a light bulb just went off, like, “Holy shit, you could make mental health as black and white as a broken arm.”
That meant therapists could measure and track the progress of patients, objectively. And by doing so, they could fight that negative stigma and give people more hope.
So I developed NeuroFlow. The idea is simple: Give therapists a technology that uses basic and affordable medical supplies, like EEGs or heart rate monitors, to examine the health of their clients. That way, patients could see how their heart races — literally — in real time as they talk about something traumatic. And then, over the course of their sessions, they would be able to see their heart rate slow down and return to a more relaxed state as they healed.
This is my new mission: helping the veteran community. With 20 vets killing themselves in the U.S. every day, there is still a lot of work to be done. So I can’t quite say my mission is complete … yet.

—

As told to staff writer Joseph Darius Jaafari. This essay has been edited for style and clarity. Read more stories of service here.

Getting Real About Golden Years

Posted on by robbie

Getting old isn’t for the faint of heart. Healthcare is expensive. Extra services are needed. There’s pressure on your adult children to take care of you. (And from their perspective, they’ve got to deal with the mental anguish of watching you try to cope!)
Yes, it’s joyous to lead a long, healthy life, but the operative word is “healthy.” If you’re lingering, not living, I don’t see an upside.
Making it to 100 — or beyond — only makes sense, to me, if you have a high quality of life. If you’re confined to a wheelchair, if someone has to clean you, bathe you and dress you, and if you’re not even aware of your surroundings, living to such a ripe old age doesn’t feel like much of a victory. To enjoy longevity, it’s crucial that we can still give back to others, feel well enough to participate in activities, and enjoy our family and friends.
When my father was 69, he had a stroke. A medevac helicopter rushed him to the hospital, where doctors told us there was a possibility that he’d recover. As a family, we decided to put in a feeding tube.
Had I understood the magnitude of my father’s stroke and been given more clear medical information, I would have made a different decision.
My father lived 14 more years, but he was confined to a wheelchair and had minimal speech capabilities. He suffered. Despite my parents’ long-term health insurance policy, his illness also ate away at their financial resources.
Three years ago, my father finally passed.

Afterward, I thought my mother would have a chance to be healthier and happier, as she was no longer a primary caregiver. Unfortunately, that didn’t happen. Last year, she fell and broke her hip. At the same time her physical health declined, so did her mental health. Now she, too, requires 24-7 care.
Today, my mother resides in a senior living facility. It’s clean and safe. She’s treated with kindness. A nurse visits her once a week and calls me with any problems. But since my mother’s finances were drained from my father’s illness and her long-term insurance doesn’t cover much, I support her. At first, I was optimistic that Medicare would help, but at the end of the day, when someone needs around-the-clock care, the cost is too considerable.
I’m not complaining; many others are in a similar situation. As people live longer, they need to be cared for. That’s the concern with an aging population, and it’s one that should be addressed more seriously.
I think the healthcare crisis we’re in is substantial. It’s a tragedy to see people lose their Medicare while drug prices rise, and to hear about terrible nursing home situations in the news. The longer people live, the more needs they have, and the greater the burden on our entire system.
I doubt that I’m alone in these thoughts. There’s a movement in our country toward hospice services. People want compassionate solutions, not 911 drama. As we have the opportunity to live longer, it will become critical for people in the medical field to come clean with families so that appropriate choices can be made. Hopefully, those decisions will be guided by love.
On the other hand, exactly when the “best” years are in your life depends on you, your career and your interests. Each individual’s journey is different. There’s no prescription for success or happiness.
If I were to live to 100 and still had a good quality of life, I’d continue to engage in enriching, cultural activities. I’d spend my days going to the theater, watching old movies and reading fiction. I’d surround myself with interesting stories, and would hopefully be reading them to my great-grandchildren.
Although I officially retired as president of the Brooklyn Academy of Music in 2015, I recently completed a two-year senior fellowship at The Andrew W. Mellon Foundation. Now, I’m serving as a senior advisor to the Onassis Foundation’s cultural centers in New York and Athens, Greece.
I love what I do, but it’s hard to know if I’ll still be working at the age of 100. Younger people will call the shots at that point, but hopefully I’ll be interesting enough to stick around and contribute to their shining moments.
If so, I’d try to illuminate and educate younger generations without always saying, “In my day…” I’d try not to hold on to the same level of professional intensity I had in my 40s, 50s and 60s.
In return, I’ll hopefully be seen as a visionary in my day — someone who worked hard, did well and added more vitality to the field.
As humans, we can’t go backward. We have to move forward. If it’s intimidating to think about that in big chunks, then we can break it down day by day. To me, that means if I can wake up and feel good, continue to work and be with the people I care about, then I’m lucky.

Karen Brooks Hopkins served as President of the Brooklyn Academy of Music from 1999 until her retirement in 2015 and was an employee of the institution since 1979. She has worked with the Cultural Institutions Group, the Mayor’s Cultural Affairs Advisory Commission and as the Brooklyn Regent for the New York State Education Department. In 2013, Crain’s named her one of the “50 Most Powerful Women in New York.” Karen currently serves on the boards of the Jerome L. Greene and Alexander Onassis Foundations, as Senior Fellow in Residence at the Andrew W. Mellon Foundation and Fellow of the National Center for Arts Research at Southern Methodist University.
This post is paid for by AARP.

Mental Healthcare Resources Target Communities Left Behind, A Tech Giant Wages War Against ISIS and More

Posted on by robbie

 
Rural America Finally Gets Mental Health Help, Governing
The absence of clinics, therapists and psychiatrists in our nation’s small towns have fueled incarceration, self-medicating opioid abuse and suicide. But developments like telemedicine and integration of mental health checkups into primary care visits have the potential to alleviate the psychic crises causing headaches in sparsely populated counties.
Google’s Clever Plan to Stop Aspiring ISIS Recruits, WIRED
The search engine is trying a new strategy to fight the Islamic State’s aggressive online recruiting campaigns. Rather than creating or hiding content, Google simply redirects traffic to videos featuring Muslim religious authorities debunking ISIS apocalyptic theology and undercover clips showing the devastation for Syrian and Iraqi civilians.
Can a Montana Community Run its Own Forest? High Country News
In 2002, to prevent real estate developers from subdividing 142 acres of lakefront property, locals in one small Montana town pooled their money to buy the land for the community. After financial hardships threatened to put the parcel back on the market in 2014, an under-utilized government fund saved the shoreline, preserving the West’s rugged landscape.
MORE: This Common Sense Program Could Be the Future of Mental Healthcare Nationwide
 

The Unlikely Activists Putting a Stop to Sexual Trafficking, A Better Way to Harness the Power of the Sun and More

Posted on by robbie

 
Truckers Take the Wheel in Effort to Halt Sex Trafficking, NPR
Rarely spoken about in America, forced prostitution is typically thought of as a crime that’s committed in other countries but not our own. A new awareness group — Truckers Against Trafficking — teaches those spending their days on interstate highways how to spot enslaved or “owned” young women.
New Concentrating Solar Tower Is Worth Its Salt with 24/7 Power, Scientific American
The sun is a fabulous source of clean, renewable energy, but it has its limitations. Until now. California’s Crescent Dunes’ solar power facility utilizes unique technology that stores enough electricity to power 75,000 homes, even when it’s dark or cloudy — overcoming a problem that’s baffled scientists for decades.
Sandra Bland, One Year Later, The Marshall Project
Bland’s jailhouse death prompted calls to reform the Texas criminal justice system. So far, jailers have been trained in de-escalation techniques, new intake forms are being used statewide and workers must complete annual suicide prevention training. Is reforming bail and how jails deal with mental health issues up next?
MORE: Going Solar Is Cheaper Than Ever. Here’s What You Need to Know About Getting Your Power From the Sun
 

A Problematic Industry Joins the Climate Change Movement, Much-Needed Health Care Reaches the Latino Community and More

Posted on by robbie

 
U.S. Agricultural Secretary Thinks Farmers Can Help Solve Global Warming, Scientific American
Those that work the land inflict some of the worst harm on it. But as a recent report reveals, members of the agriculture community — farmers, ranchers, foresters — are beginning to change their planet-damaging ways. As they reform what they grow and how they grow it means that farmers soon could cease being one of the largest emitters of greenhouse gas pollution.
Students Fill a Gap in Mental Health Care for Immigrants, NPR
For immigrants in need of mental health care, a lack of documentation or insurance often means illnesses remain untreated. Across the nation, understaffed health clinics and universities are joining forces to improve access to services for depression, anxiety and more. Through these partnerships, Master’s and Ph.D. students play a vital role in treating mental illness in the Latino community.
Vermont Becomes First State to Require Drug Makers to Justify Price Hikes, STAT News
Last year, the pharmaceutical industry got a bad rap when Martin Shkreli hiked up the price of an HIV drug by more than 5,000 percent. In response, the Green Mountain state passed a law holding drug companies accountable for price increases. Could this move stunt medical innovation or will it protect citizens from unreasonable costs?