- Created on 17 December 2012
How Schools Can Better Address Mental Health in Wake of Sandy Hook Shooting
"Hindsight may be 20/20, but as we look back, it appears Sandy Hook Elementary School was as well-prepared as it could have been for such a horrific scenario," Jennifer Cerbasi told Fox News.
Part of the healing process in a tragedy like this is moving forward and implementing procedures that will prevent another awful situation from happening. There are changes to be made in schools throughout the country – and now is the time to make them.
Our schools need to provide more and consistent counseling for all students.
All children can benefit from having a supportive adult with whom they can talk. We need to emphasize the importance of emotional health in our children and their families.
I believe children with special needs benefit from counseling to support their emotional development and enhance their understanding of the challenges they may face.
One of the worst things I ever heard in a school was, "We are a school for children with autism. We don't offer counseling." This was said in a district with three school psychologists on staff. It is a travesty that this school district only looked at the diagnosis and not the individual needs of the child.
When asked what she thought about the school shooting, a friend's daughter said, "It would be a better idea if the shooter could have somebody that he could talk to when he was feeling upset. It's a good idea to have somebody around all the time to listen."
As I heard these wise words from such a young person, I realized she tackled the question we need to answer: Did Adam Lanza have a support system in place?
Our schools must employ full time psychologists and counselors.
Schools will tell many tales of budget cuts, which often result in reducing non-mandated positions from full to part-time. This is unacceptable. We are dealing with mental health issues on a more consistent basis, and as we tackle the support these children need, we need more resources available around the clock.
Our children need better diagnoses.
Often, parents and schools accept one primary diagnosis and don't worry about others, because the child is receiving appropriate educational services. The Connecticut shooter may have had Asperger's syndrome, but it is not uncommon for people with disabilities to live with more than one disorder.
For example, I see this often in children with autism and possible specific learning disabilities. As students gain language and develop social skills, we get a clearer picture of their academic skills as well. I have seen autistic children who struggle more in one academic area than another, and this may be attributed to a learning disability – not necessarily their autism.
Identifying and diagnosing mental health issues in children is challenging, and we need to better train staff on how to identify risk factors and concerning behaviors.
Our staff must see something and say something.
Many schools hire lunchtime and recess aides to monitor students during these unstructured times. Others utilize staff on a rotating basis. There are often between two and five adults monitoring hundreds of children. It's virtually impossible for the adults to have eyes on everyone.
That said, if staff members see something odd on the playground or in the classroom, they must talk to the child's teacher and the school psychologist. It is important not to pass off all behavior as "kid stuff," even if it means sounding an alarm when there may not be cause for one. This is clearly an instance of 'better safe than sorry.' What may appear as child's play could be an indicator of something more serious.
The time to take our children's mental health seriously is now. Many schools do a great job of supporting their students' needs, while others need to heed warnings to better educate and prepare themselves. We must make emotional health and development a priority in all schools if we hope to raise well-adjusted and healthy children, as well as possibly prevent tragedy from striking.
- Created on 14 December 2012
Study: Half of People Shot By Police Every Year Are Mentally Ill
A new study in a Maine newspaper sheds light on a national problem of police and the fatal shooting of the mentally ill. And the findings are eye-opening.
According to the four-part series in the Portland Press Herald and Maine Sunday Telegram, when police shoot to kill in high pressure situations, very often the targets of deadly force are the mentally ill.
And in the worst crises, law enforcement is unprepared to deal with people with mental health challenges. Proper training and the use of alternate tactics could prevent these tragedies and save lives in the process.
Nationwide, roughly half of the 357 to 500 people shot to death by police officers are mentally ill. Often, the officers were aware of the subject's instability.
In Maine— where five fatal police shootings of the mentally ill last year led to this recent study—42 percent of people shot by police were mentally ill, including 58 percent of those who died from their injuries.
Most of the state's 3,500 officers lacked the training to avert these fatal outcomes, with only 14 of 200 state troopers receiving crisis intervention training to avoid deadly conflicts. Further, the state Attorney General's office, which investigates all police shootings, has ruled each of these shootings—51 deaths out of 101 shootings since 1990—was justified.
The office determines whether a shooting is justified by asking whether the officer reasonably believed deadly force would be used against him or someone else, and whether the officer reasonably believed deadly force was required to prevent it.
However, the review does not consider whether the use of deadly force could have been avoided, civil liability, or whether administrative action is warranted.
Meanwhile, the Maine Legislature established a new system in 2009 to review police shootings. When reviewing shootings by their departments, law enforcement must consider the facts of an incident; whether the relevant policy was clear and effective to cover the given situation; whether improvements are necessary to increase public or officer safety; whether training should be reviewed or revised, and whether equipment or other resources should be revised. Additionally, the team reviewing the incident should follow any contractual provisions regarding the police officers' rights.
But three years and twenty shootings later, neither police agencies nor lawmakers have bothered to read the findings.
A more thorough review could have made a difference in the case of Katherine Paulson, 39. Paulson was shot to death by police in her mother's Kennebunkport home in March 2011 after grabbing a kitchen knife and advancing towards the officer. Paulson, who was adopted and of Alaskan Eskimo heritage, had a history of mental illness and stopped taking her medication. Her mother called the police to have her voluntarily committed, so that she would take her medication. In the report justifying the officer's actions, the Attorney General said, "Ms. Paulson's state of mind, her motivation, or the medical or psychological foundation of her behavior and actions the evening of March 27, 2011 is beyond the scope of this report and beyond the authority and expertise of this office."
In an administrative review, authorities investigating the shooting determined that while the officer had no other choice given Paulson's close proximity, prior knowledge of Paulson's mental illness by the police could have yielded a different outcome.
Similarly, in January 2011 Andrew Landry, 22, was fatally shot at point blank range by a sheriff's deputy after charging at police with a knife at his aunt's house in Lyman, Maine. His grandmother had called the police reporting Landry had been acting oddly. Landry had told relatives that if he had stabbed his cousin she wouldn't bleed because she was a robot, and bad things were coming through electrical appliances in the house. Although the report from the Attorney General concluded the deputy had no choice but to fatally shoot Landry given the imminent threat he posed, his relatives now believe the police aggravated matters by charging into the house and provoking him.
Last year, out of 9 police shootings in Maine, 6 were fatalities, including 5 mentally ill people and one who was drunk.
The statistics coming from Maine pose a challenge to the criminal justice system to assess its handling of the mentally ill. A 2006 U.S. Department of Justice study found that 56 percent of state prisoners, 45 percent of federal prisoners and 64 percent of county jail inmates have mental health issues. In the U.S., there are more mentally ill behind bars than in hospitals or treatment centers, as the mentally ill are three times more likely to be imprisoned than hospitalized. The problem began with the closing of government-run hospitals beginning in the 1980s, leaving few options for those living with mental illness.
Given the cuts to metal health services, the return of traumatized veterans from Iraq and Afghanistan, and the widespread abuse of prescription drugs, the problem of police shootings of the mentally ill will only worsen, the Press Herald study warns.
Source: http://thegrio.com/2012/12/12/study-half-of-people-shot-by-police-every-year-are-mentally-ill/
- Created on 11 December 2012
Partial List of Taxes and Fees in Health Overhaul
Starting in 2014, President Barack Obama's health care law will expand coverage to some 30 million uninsured people. At the same time, insurers will no longer be allowed to turn away those in poor health and virtually every American will be required to have health insurance, through an employer, a government program, or by buying their own.
For the vast majority of people, the health care law won't mean sending more money to the IRS. But the wealthiest 2 percent of Americans will take the biggest hit, starting next year.
And roughly 20 million people eventually will benefit from tax credits that start in 2014 to help them pay insurance premiums.
A look at some of the major taxes and fees, estimated to total nearly $700 billion over 10 years.
— Upper-income households
Starting Jan. 1, individuals making more than $200,000 per year, and couples making more than $250,000 will face a 0.9 percent Medicare tax increase on wages above those threshold amounts.
They'll also face an additional 3.8 percent tax on investment income. Together these are the biggest tax increase in the health care law.
— Employer penalties
Starting in 2014, companies with 50 or more employees that do not offer coverage will face penalties if at least one of their employees receives government-subsidized coverage. The penalty is $2,000 per employee, but a company's first 30 workers don't count toward the total.
— Health care industries
Insurers, drug companies and medical device manufacturers face new fees and taxes.
Companies that make medical equipment sold chiefly through doctors and hospitals, such as pacemakers, artificial hips and coronary stents, will pay a 2.3 percent excise tax on their sales, expected to total $1.7 billion in its first year, 2013. They're trying to get it repealed.
The insurance industry faces an annual fee that starts at $8 billion in its first year, 2014.
Pharmaceutical companies that make or import brand-name drugs are already paying fees that totaled $2.5 billion in 2011, their first year.
— People who don't get health insurance
Nearly 6 million people who don't get health insurance will face tax penalties starting in 2014. The fines will raise $6.9 billion in 2016. Average penalty in that year: about $1,200.
— Indoor tanning devotees
The 10 percent sales tax on indoor tanning sessions took effect in 2010. It's expected to raise $1.5 billion over 10 years.
The 28 million people who visit tanning booths and beds each year — most of them women under 30, according to the Journal of the American Academy of Dermatology— are already paying.
Tanning salons were singled out because of strong medical evidence that exposure to ultraviolet lights increases the risk of skin cancer.
- Created on 13 December 2012
People Worldwide Are Living Longer, But Sicker
(AP) — Nearly everywhere around the world, people are living longer and fewer children are dying. But increasingly, people are grappling with the diseases and disabilities of modern life, according to the most expansive global look so far at life expectancy and the biggest health threats.
The last comprehensive study was in 1990 and the top health problem then was the death of children under 5 — more than 10 million each year. Since then, campaigns to vaccinate kids against diseases like polio and measles have reduced the number of children dying to about 7 million.
Malnutrition was once the main health threat for children. Now, everywhere except Africa, they are much more likely to overeat than to starve.
With more children surviving, chronic illnesses and disabilities that strike later in life are taking a bigger toll, the research said. High blood pressure has become the leading health risk worldwide, followed by smoking and alcohol.
"The biggest contributor to the global health burden isn't premature (deaths), but chronic diseases, injuries, mental health conditions and all the bone and joint diseases," said one of the study leaders, Christopher Murray, director of the Institute of Health Metrics and Evaluation at the University of Washington.
In developed countries, such conditions now account for more than half of the health problems, fueled by an aging population. While life expectancy is climbing nearly everywhere, so too are the number of years people will live with things like vision or hearing loss and mental health issues like depression.
The research appears in seven papers published online Thursday by the journal Lancet. More than 480 researchers in 50 countries gathered data up to 2010 from surveys, censuses and past studies. They used statistical modeling to fill in the gaps for countries with little information. The series was mainly paid for by the Bill & Melinda Gates Foundation.
As in 1990, Japan topped the life expectancy list in 2010, with 79 for men and 86 for women. In the U.S. that year, life expectancy for men was 76 and for women, 81.
The research found wide variations in what's killing people around the world. Some of the most striking findings highlighted by the researchers: — Homicide is the No. 3 killer of men in Latin America; it ranks 20th worldwide. In the U.S., it is the 21st cause of death in men, and in Western Europe, 57th.
— While suicide ranks globally as the 21st leading killer, it is as high as the ninth top cause of death in women across Asia's "suicide belt," from India to China. Suicide ranks 14th in North America and 15th in Western Europe.
— In people aged 15-49, diabetes is a bigger killer in Africa than in Western Europe (8.8 deaths versus 1 death per 100,000).
— Central and Southeast Asia have the highest rates of fatal stroke in young adults at about 15 cases per 100,000 deaths. In North America, the rate is about 3 per 100,000.
Globally, heart disease and stroke remain the top killers. Reflecting an older population, lung cancer moved to the 5th cause of death globally, while other cancers including those of the liver, stomach and colon are also in the top 20. AIDS jumped from the 35th cause of death in 1990 to the sixth leading cause two decades later.
While chronic diseases are killing more people nearly everywhere, the overall trend is the opposite in Africa, where illnesses like AIDS, malaria and tuberculosis are still major threats. And experts warn again shifting too much of the focus away from those ailments.
"It's the nature of infectious disease epidemics that if you turn away from them, they will crop right back up," said Jennifer Cohn, a medical coordinator at Doctors Without Borders.
Still, she acknowledged the need to address the surge of other health problems across Africa. Cohn said the agency was considering ways to treat things like heart disease and diabetes. "The way we treat HIV could be a good model for chronic care," she said.
Others said more concrete information is needed before making any big changes to public health policies.
"We have to take this data with some grains of salt," said Sandy Cairncross, an epidemiologist at the London School of Hygiene and Tropical Medicine.
He said the information in some of the Lancet research was too thin and didn't fully consider all the relevant health risk factors.
"We're getting a better picture, but it's still incomplete," he said.
- Created on 10 December 2012
Black Women Battle Obesity with Dialogue and Action
(AP) — Nicole Ari Parker was motivated by frustration. For Star Jones, it was a matter of life or death. Toni Carey wanted a fresh start after a bad breakup.
All three have launched individual campaigns that reflect an emerging priority for African-American women: finding creative ways to combat the obesity epidemic that threatens their longevity.
African-American women have the highest obesity rate of any group of Americans. Four out of five black women have a body mass index above 25 percent, the threshold for being overweight or obese, according to the Centers for Disease Control and Prevention. By comparison, nearly two-thirds of Americans overall are in this category, the CDC said.
Many black women seem to be unaffected by being generally heavier than other Americans.
Calorie-rich, traditional soul food is a staple in the diets of many African-Americans, and curvy black women are embraced positively through slang praising them as "thick" with a "little meat on their bones," or through songs like the Commodore's "Brick House" or "Bootylicious" by Destiny's Child. A study by the Kaiser Family Foundation and The Washington Post earlier this year found that 66 percent of overweight black women had high self-esteem, while 41 percent of average-sized or thin white women had high self-esteem.
Still, that doesn't mean black women reject the need to become healthier.
Historically black, all-female Spelman College in Atlanta is disbanding its NCAA teams and devoting those resources to a campus-wide wellness program. In an open letter announcing Spelman's "wellness revolution," president Beverly Daniel Tatum cited a campus analysis that found many of Spelman's 2,100 students already have high blood pressure, Type 2 diabetes or other chronic ailments.
"Spelman has an opportunity to change the health trajectory of our students and, through their influence, the communities from which they come," Tatum's letter said.
Jones, who underwent open heart surgery in 2010 at age 47 and now urges awareness about heart disease among black women, was met by an overflow crowd earlier this year when she convened a Congressional Black Caucus Foundation panel on black women and obesity.
"We have to get ourselves out of being conditioned to think that using soft words so we don't hurt peoples' feelings is doing them any favor," Jones said. "Curvy, big-boned, hefty, full-figured, fluffy, chubby. Those are all words designed to make people feel better about themselves. That wasn't helpful to me."
Jones once embraced being large and fabulous, at 5 feet 5 inches tall and 300 pounds. But under that exterior, she said, she was morbidly obese, suffering from extreme fatigue, nausea, lightheadedness, heart palpitations and blurred vision. Now, she advises women to make simple changes such as reducing salt intake, exercising 30 minutes a day, quitting smoking, controlling portion sizes and making nutritious dietary choices.
Nutritionist and author Rovenia M. Brock, known professionally as Dr. Ro, agrees with Jones. She said getting active is only about 20 percent of the fight against obesity. The rest revolves around how much people eat. "Our plates are killing us," she said.
Brock said "food deserts," or urban areas that lack quality supermarkets, are a real obstacle. She suggested getting around that by carpooling with neighbors to stores in areas with higher-quality grocery options or buying food in bulk. She also suggested growing herbs and vegetables in window-box gardens.
"Stop focusing on what's not there, or what you think is not there," Brock said. "We have to get out of this wimpy, 'woe is me' mentality."
While first lady Michelle Obama has encouraged exercise through her "Let's Move" campaign targeting childhood obesity, the spark for this current interest among black women may have been comments last year by Surgeon General Regina Benjamin, who observed publicly that women must stop allowing concern about their hair to prevent them from exercising.
Some black women visit salons as often as every two weeks, investing several hours and anywhere from $50 to several hundreds of dollars each visit — activity that, according to the Black Owned Beauty Supply Association, helps fuel a $9 billion black hair care and cosmetics industry.
In an interview during a health conference in Washington last week, Benjamin said the damage sweat can inflict on costly hairstyles can affect women's willingness to work out, and she hopes to change that. She goes to beauty industry conferences to encourage stylists to create exercise-friendly hairdos.
"I wouldn't say we use it as an excuse, we use it as a barrier," Benjamin said. "And that's not one of the barriers anymore. We're always going to have problems with balancing our lives, but we could take that one out."
Parker, an actress, understands this dilemma well. Out of personal frustration over maintaining both her workout and her hair, she created "Save Your Do" Gymwrap — a headband that can be wrapped around the hair in a way that minimizes sweat and preserves hairstyles.
"Not just as a black woman, but as a woman, since the beginning of time, beauty has been our responsibility," Parker said in an interview. Because of that, she said, exercise has become linked with vanity instead of health.
"We've turned exercise into a weight-loss regimen," Parker said. "No. Exercise is about being grateful for the body you have and sustaining the life you have. ... Take all the hype out of the exercise and think of it as brushing your teeth."
With their mutual family histories of diabetes and high blood pressure in mind, Carey, 28, and her sorority sister Ashley Hicks, 29, co-founded the running club Black Girls Run. Carey also considered it a new beginning after a bad breakup and a move across country. Since 2009, Black Girls Run has amassed 52,000 members who serve as a support system for runners.
Black Girls Run has about 60 groups nationwide that coordinate local races in Atlanta, New York, San Francisco, Washington, D.C, Houston and Greensboro, N.C. Most groups run at least five times a week. Next month, the running club will take its first "Black Girls Run — Preserve the Sexy" tour to cities with high obesity rates. The tour includes health and fitness clinics with information on nutrition, hair maintenance and running gear.
"We found that when you want to get healthy and when you want to be active, it's intimidating," Carey said. "You don't know where to start. There's a little coaxing that has to go along with that."
Parker said once African-American women place value on their bodies and longevity, everything else will follow. It costs her nothing, she said, to walk around an outdoor track with her husband, actor Boris Kodjoe, or run up and down stairs with her headphones.
"One good step breeds another one," Parker said. "You're going to have one less margarita, one less scoop of Thanksgiving macaroni ... and yet you're not doing anything fanatical or dramatic."
Health
