Live Updates: Grieving Families Prepare for Funerals of Victims of Day Care Rampage

Hannah Beech

Credit…Lauren Decicca/Getty Images

Thailand has a vibrant medical system, particularly for an upper-middle income nation. But that strength does not extend to mental health services. A string of mass shootings committed by security personnel in recent years has highlighted concerns about the psychological fitness of members of the military and the police, who must hew to strict hierarchies and endure low pay.

Panya Kamrab, 34, who was identified by the Royal Thai Police as the gunman in the mass shooting at the day care center in northeastern Thailand on Thursday, was an officer in the force until he was dismissed in June for drug possession.

A mere 2.3 percent of Thailand’s health expenditures are allocated for mental health, according to the World Health Organization. Thailand, with a population of about 70 million, had only 656 psychiatrists and 422 psychologists in the entire country, according to the W.H.O.’s Mental Health Atlas 2020. The Royal Thai Police alone has roughly 220,000 officers.

Mr. Panya was set to go on trial on Friday, and the 9-millimeter pistol used in the attack was legally owned, the police said.

“He abused drugs and was very stressed and upset about his career, his position, his status,” said Kritsanapong Phutrakul, the chair of the faculty of criminology and justice administration at Rangsit University and a police lieutenant colonel. “To reduce the risk to Thai society, his gun should have been taken away from him when he was fired.”

Military-style hierarchies are imposed on many facets of Thai society, from schools to offices. The chains of command can leave lower rank-and-file people with little recourse if they disagree with superiors’ orders.

Credit…Royal Thai Police, via Getty Images

Outside the security forces themselves, the military’s influence is profound. Prayuth Chan-ocha, the prime minister of Thailand, is a former army chief who took power in a coup. His deputy is also a former army chief.

And the nation is trained to pay obeisance to the Thai royal family. Courtiers crawl along the floor in a submissive pose in front of senior royals. A notoriously tough lèse-majesté law makes it a crime to defame senior members of the monarchy, and a long list of people have been jailed for such offenses.

Dissatisfaction with institutional strictures prompted students to protest in recent years, at first demanding an easing of rules on hairstyles and dress. The rallies expanded to encompass calls for reforms to the government and the monarchy.

The perils of such a rigid society may have helped catalyze what, until Thursday, had been the deadliest mass shooting by a single perpetrator in Thai history. Two years ago, Sgt. Major Jakrapanth Thomma went on a killing spree at a shopping mall and army base, killing 29 people and wounding 58 others. He was angered by a financial dispute with the family of his superior officer, according to the country’s then army chief. Members of that family refused to pay him money he was owed, he told friends. He had run out of options, he told them.

The soldier was shot dead by the authorities, ending the attack. But questions lingered about why he had targeted civilians at a shopping mall after killing people on a military base.

Last month, a police lieutenant general opened fire in a military school in Bangkok, killing two people.

“From a security risk perspective, we have to better check the mental health of people who own guns,” said Lieutenant Colonel Kritsanapong.

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British Ruling Pins Blame on Social Media for Teenager’s Suicide

In January 2019, Mr. Russell went public with Molly’s story. Outraged that his young daughter could view such bleak content so easily and convinced that it had played a role in her death, he sat for a TV interview with the BBC that resulted in front-page stories across British newsstands.

Mr. Russell, a television director, urged the coroner reviewing Molly’s case to go beyond what is often a formulaic process, and to explore the role of social media. Mr. Walker agreed after seeing a sample of Molly’s social media history.

That resulted in a yearslong effort to get access to Molly’s social media data. The family did not know her iPhone passcode, but the London police were able to bypass it to extract 30,000 pages of material. After a lengthy battle, Meta agreed to provide more than 16,000 pages from her Instagram, such a volume that it delayed the start of the inquest. Merry Varney, a lawyer with the Leigh Day law firm who worked on the case through a legal aid program, said it had taken more than 1,000 hours to review the content.

What they found was that Molly had lived something of a double life. While she was a regular teenager to family, friends and teachers, her existence online was much bleaker.

In the six months before Molly died, she shared, liked or saved 16,300 pieces of content on Instagram. About 2,100 of those posts, or about 12 per day, were related to suicide, self-harm and depression, according to data that Meta disclosed to her family. Many accounts she interacted with were dedicated to sharing only depressive and suicidal material, often using hashtags that linked to other explicit content.

Many posts glorified inner struggle, hiding emotional duress and telling others “I’m fine.” Molly went on binges of liking and saving graphic depictions of suicide and self-harm, once after 3 a.m., according to a timeline of her Instagram usage.

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How a Hospital Chain Used a Poor Neighborhood to Turn Huge Profits

RICHMOND, Va. — In late July, Norman Otey was rushed by ambulance to Richmond Community Hospital. The 63-year-old was doubled over in pain and babbling incoherently. Blood tests suggested septic shock, a grave emergency that required the resources and expertise of an intensive care unit.

But Richmond Community, a struggling hospital in a predominantly Black neighborhood, had closed its I.C.U. in 2017.

It took several hours for Mr. Otey to be transported to another hospital, according to his sister, Linda Jones-Smith. He deteriorated on the way there, and later died of sepsis. Two people who cared for Mr. Otey said the delay had most likely contributed to his death.

the hospital’s financial data.

More than half of all hospitals in the United States are set up as nonprofits, a designation that allows them to make money but avoid paying taxes. Although Bon Secours has taken a financial hit this year like many other hospital systems, the chain made nearly $1 billion in profit last year at its 50 hospitals in the United States and Ireland and was sitting on more than $9 billion in cash reserves. It avoids at least $440 million in federal, state and local taxes every year that it would otherwise have to pay, according to an analysis by the Lown Institute, a nonpartisan think tank.

In exchange for the tax breaks, the Internal Revenue Service requires nonprofit hospitals to provide a benefit to their communities. But an investigation by The New York Times found that many of the country’s largest nonprofit hospital systems have drifted far from their charitable roots. The hospitals operate like for-profit companies, fixating on revenue targets and expansions into affluent suburbs.

borrowing tricks from business consultants, have trained staff to squeeze payments from poor patients who should be eligible for free care.

John M. Starcher Jr., made about $6 million in 2020, according to the most recent tax filings.

“Our mission is clear — to extend the compassionate ministry of Jesus by improving the health and well-being of our communities and bring good help to those in need, especially people who are poor, dying and underserved,” the spokeswoman, Maureen Richmond, said. Bon Secours did not comment on Mr. Otey’s case.

In interviews, doctors, nurses and former executives said the hospital had been given short shrift, and pointed to a decade-old development deal with the city of Richmond as another example.

In 2012, the city agreed to lease land to Bon Secours at far below market value on the condition that the chain expand Richmond Community’s facilities. Instead, Bon Secours focused on building a luxury apartment and office complex. The hospital system waited a decade to build the promised medical offices next to Richmond Community, breaking ground only this year.

founded in 1907 by Black doctors who were not allowed to work at the white hospitals across town. In the 1930s, Dr. Jackson’s grandfather, Dr. Isaiah Jackson, mortgaged his house to help pay for an expansion of the hospital. His father, also a doctor, would take his children to the hospital’s fund-raising telethons.

Cassandra Newby-Alexander at Norfolk State University.

got its first supermarket.

according to research done by Virginia Commonwealth University. The public bus route to St. Mary’s, a large Bon Secours facility in the northwest part of the city, takes more than an hour. There is no public transportation from the East End to Memorial Regional, nine miles away.

“It became impossible for me to send people to the advanced heart valve clinic at St. Mary’s,” said Dr. Michael Kelly, a cardiologist who worked at Richmond Community until Bon Secours scaled back the specialty service in 2019. He said he had driven some patients to the clinic in his own car.

Richmond Community has the feel of an urgent-care clinic, with a small waiting room and a tan brick facade. The contrast with Bon Secours’s nearby hospitals is striking.

At the chain’s St. Francis Medical Center, an Italianate-style compound in a suburb 18 miles from Community, golf carts shuttle patients from the lobby entrance, past a marble fountain, to their cars.

after the section of the federal law that authorized it, allows hospitals to buy drugs from manufacturers at a discount — roughly half the average sales price. The hospitals are then allowed to charge patients’ insurers a much higher price for the same drugs.

The theory behind the law was that nonprofit hospitals would invest the savings in their communities. But the 340B program came with few rules. Hospitals did not have to disclose how much money they made from sales of the discounted drugs. And they were not required to use the revenues to help the underserved patients who qualified them for the program in the first place.

In 2019, more than 2,500 nonprofit and government-owned hospitals participated in the program, or more than half of all hospitals in the country, according to the independent Medicare Payment Advisory Commission.

in wealthier neighborhoods, where patients with generous private insurance could receive expensive drugs, but on paper make the clinics extensions of poor hospitals to take advantage of 340B.

to a price list that hospitals are required to publish. That is nearly $22,000 profit on a single vial. Adults need two vials per treatment course.

work has shown that hospitals participating in the 340B program have increasingly opened clinics in wealthier areas since the mid-2000s.

were unveiling a major economic deal that would bring $40 million to Richmond, add 200 jobs and keep the Washington team — now known as the Commanders — in the state for summer training.

The deal had three main parts. Bon Secours would get naming rights and help the team build a training camp and medical offices on a lot next to Richmond’s science museum.

The city would lease Bon Secours a prime piece of real estate that the chain had long coveted for $5,000 a year. The parcel was on the city’s west side, next to St. Mary’s, where Bon Secours wanted to build medical offices and a nursing school.

Finally, the nonprofit’s executives promised city leaders that they would build a 25,000-square-foot medical office building next to Richmond Community Hospital. Bon Secours also said it would hire 75 local workers and build a fitness center.

“It’s going to be a quick timetable, but I think we can accomplish it,” the mayor at the time, Dwight C. Jones, said at the news conference.

Today, physical therapy and doctors’ offices overlook the football field at the training center.

On the west side of Richmond, Bon Secours dropped its plans to build a nursing school. Instead, it worked with a real estate developer to build luxury apartments on the site, and delayed its plans to build medical offices. Residents at The Crest at Westhampton Commons, part of the $73 million project, can swim in a saltwater pool and work out on communal Peloton bicycles. On the ground floor, an upscale Mexican restaurant serves cucumber jalapeño margaritas and a Drybar offers salon blowouts.

have said they plan to house mental health, hospice and other services there.

a cardiologist and an expert on racial disparities in amputation, said many people in poor, nonwhite communities faced similar delays in getting the procedure. “I am not surprised by what’s transpired with this patient at all,” he said.

Because Ms. Scarborough does not drive, her nephew must take time off work every time she visits the vascular surgeon, whose office is 10 miles from her home. Richmond Community would have been a five-minute walk. Bon Secours did not comment on her case.

“They have good doctors over there,” Ms. Scarborough said of the neighborhood hospital. “But there does need to be more facilities and services over there for our community, for us.”

Susan C. Beachy contributed research.

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Counselors And Cops Working Together Can Save Lives

Co-responder teams of police and mental health experts can better meet the needs of people in mental health crisis.

One night last June, 22-year-old Christian Glass called 911 for help with his stranded car. A little over an hour later he was dead.

 Asked about weapons, Glass mentions tools his family says he used as an amateur geologist. 

“I have two knives and a hammer, um, and a rubber mallet. I guess that’s a weapon?,” Glass said. “I’m not dangerous. I will keep my hands completely visible.”

But when deputies in Colorado’s Clear Creek County show up, Glass tells them he’s too scared to get out of his car. 

Then they see the knife.

Over about the next hour, officers try to get him out. 

Glass smiles — even makes a heart with his hands — but stays in the car. 

Officers seem to realize glass is having a mental health crisis. A Colorado State Patrol sergeant notes Glass hasn’t done anything wrong. 

“If there’s no crime and he’s not suicidal, homicidal or a great danger, then there’s no reason to contact him,” the sergeant says.

 But for reasons that are unclear and now under investigation, officers eventually smash the car window. 

What happens next is chaos, and then tragedy. 

Officers shoot beanbags and tasers. 

Finally, a deputy opens fire.

The next moments are too disturbing for TV. Even the police appear stunned. 

Glass’ family says he was a gentle soul, an artist who had bouts of depression. His parents blame police for escalating a situation they say was never truly dangerous. 

“We’re a very gentle, quiet family,” said Christian’s mother Sally Glass. “So that level of aggression and those officers really wasn’t in his world. He would have really struggled with that, you know, that would have been outside his comfort zone even to be spoken like that and treated like that.”

Nationwide last year, 101 people “behaving erratically” or having a mental health crisis were killed by police. What happened to Glass is exactly what many police departments across the country say they’re trying harder to prevent.

In Douglas County Colorado, Zachary Zepeski and Kalie Bryant are part of an innovative partnership. He’s a sheriff’s deputy, and she’s a licensed professional counselor with a master’s degree in mental health counseling. 

They’re part of what’s called a co-responder team. Handling not only mental health calls, but as their shift starts, also checking in on people they’ve dealt with before. 

“Sounds like they are concerned she may be ‘slipping’ is the word they use, again, into a mental health crisis,” Bryant said. “So we are just following up to see how she’s doing. To see what support we can offer her.”

Next, they get called to help with someone who appears to be in crisis.

As they arrive, a sergeant tells them the man may still be inside his home. 

The man has committed no crime, but Zepeski and Bryant need to make sure he’s OK.

But rather than barge inside, potentially making things worse, the team holds off.

“We don’t try to go in an agitate a situation anymore,” Zepeski said. “There was no crime. The things that were broken were his own, you can break your own stuff. So that’s why we didn’t really force the issue.”

Eventually, they find out the man already left. But their work is just beginning.

“Now is kind of a waiting game,” Zepeski said. “We will keep this one on our radar so now we’ll know if something happens at this address again, that we have an idea of what’s going on inside that apartment.”

“I feel like that we have the ability to develop a relationship with these people and truly get to know them so that they know that they can call for us if they need it,” Bryant said.

In one year across Colorado, teams like this one responded to 15,000 calls and made nearly 8,000 follow-up visits.

Douglas County Sheriff Tony Spurlock says before “co-responder” teams, people having a mental health crisis often ended up behind bars. 

“We’re talking misdemeanor crimes, and these people were in the jail,” Spurlock said. “Not a place for someone who has a mental health disorder. We’re not equipped in the jail to treat them, or quite frankly even to house them.”

But more than half of Colorado’s counties do not have “co-responder” teams, including Clear Creek where Christian Glass was killed. His family wants officers held accountable. 

“Christian’s killing is a stain on Clear Creek County and on Colorado,” said Christian’s father Simon Glass. “It was a murder by a Colorado official. It cannot stand.”

Newsy reached out to the Clear Creek County Sheriff’s Department. They declined to give is an interview or statement. The district attorney and state investigators are now reviewing the case to see if any officers should face criminal charges. And the FBI and Justice Department tell Newsy they are aware of the case and will “take appropriate action” if they find evidence of federal criminal civil rights violations.

Source: newsy.com

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Why Is There A Shortage Of Psychiatrists?

As the number of people dealing with mental health challenges increases, it’s putting a strain on psychiatrists and mental health professionals.

More American adults are seeking resources for help in getting treatment for mental health. A new CDC survey finds the trend is higher among adults 18 to 44. 

But with an increase in patients comes a new strain on mental health professionals, on psychiatrists. 

The Association of American Medical Colleges says the current shortfall is at 6%. That’s expected to be between 14,000 and 32,000 psychiatrists by 2024.  

Forensic psychiatry specialist Dr. Abdi Tinwalla, as president of the Illinois Psychiatric Society, has seen how the shortage of psychiatrists has reached a crisis point.  

“The prevalence of mental illness in the population is increasing, the American population is increasing. So year over year so far we have more doctors going into retirement than doctors coming into the workforce,” said Tinwalla. 

Another factor in the shortage, he says, is feeding the pipeline — as in residencies. These take place after medical school in a hospital or clinic and provide doctors with crucial hands-on training.

Dr. Tinwalla says there’s growing interest in the field but financial barriers are posing steep challenges. 

“This year itself there were twice the number of people wanting to go in than the seats they had available. The biggest barrier for that is funding and, you know, the government funding for these programs has not increased in the last couple of years,” said Tinwalla.   

It’s actually been decades. The Balanced Budget Act of 1997 capped the number of residents each teaching hospital is eligible to receive Medicare-funded reimbursements for. 

Individual institutions are responsible for any additional slots. Though there is a new federal push to bolster the medical workforce. The “Resident Physician Shortage Reduction Act”, which Democratic Senator Bob Menendez introduced in 2021, would expand Medicare funding for thousands of residency positions. 

But despite support from medical groups and organizations, the bill’s future is uncertain, with minimal movement since introduced. 

The demands of the job are also pushing some psychiatrists to rethink their careers.  

A 2022 meta-analysis published in the Journal of Affective Disorders found that nearly half of psychiatrists experience burnout.  

It cited lack of resources and lack of autonomy as contributors to feelings of professional exhaustion.  

“Part of us experience it in our lives, if we don’t deal with it appropriately it does lead to shortage in our careers so I definitely think burnout so if you ask me if it’s a real phenomenon? It’s a yes,” said Tinwalla. 

Despite the reasons for the shortage, Dr. Tinwalla say he sees solutions including collaborative care which involves a team approach. 

“Collaborative care has been popular in the last decade, its the care in which is given by the primary care physician in his office, in collaboration with a behavioral care manager and a psychiatrist is a consultant over the phone or video or whatever,” he said. 

He also says technology is opening doors for treatment with telemedicine. And he’s encouraged insurers are more likely to cover mental health appointments than in years past.  

“Well I’m hoping with the collaborative care model and hopefully with the telepsychiatry we are doing we are going to bridge some of those care gaps that we are having right now,” he said.  

Source: newsy.com

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Breakthrough Device Could Ease Deep Depression

A very small group of just several hundred Americans is trying an at-home medical treatment involving electrical stimulation of part of the brain.

It looks a little “weird science.” 

But the headpiece that Susan Meiklejohn dons daily is giving her head peace— peace and relief from the deep, debilitating depression from which she has suffered most of her life. 

SUSAN MEIKLEJOHN: I had a very, very stressful — overwhelmingly stressful — childhood. I had a violent father. And at 11, was the first time I had suicidal ideation.   

NEWSY’S JASON BELLINI: How old are you now?   

MEIKLEJOHN: 68. So, I’ve never gotten past the ideation phase. I’ve never attempted suicide. But I certainly have been enmeshed in that ideation.  

Meiklejohn, a retired college professor and amateur artist, is one of nearly three million adults in America with depression that does not respond to medication. Now she’s one of a very small group — just several hundred — trying an at-home medical treatment involving electrical stimulation of part of the brain.  

BELLINI: How many medications have you tried?   

MEIKLEJOHN: I’d say 10. … I have always been very, very eager to do what it takes to get out of this.

So she tried ketamine—most commonly used in anesthesia—forking over $16,000 out of pocket to see whether the new psychedelic treatment, now being offered in hundreds of U.S. clinics, could provide her with some relief. It did, but not for long. 

“It makes you feel great,” Meiklejohn said. “So, that lasted for about three days. And then it’s right back again.”

Back again to suicidal ideation. Then, a few months ago, Meiklejohn heard about a new treatment protocol — one she could try at home.

It’s provided by a team led by Leigh Charvet, who is a neuropsychologist at NYU Langone Health. She’s pioneering research in transcranial direct current stimulation (tDCS) as a treatment for a wide range of neurological disorders, depression among them. 

“I have to say, of all of our experience with tDCS, the response in the depression trial has been absolutely remarkable,” Charvet said.

And the treatment is considered low-risk enough to let Newsy’s Jason Bellinni try it, powered up. 

At his lab, at the City College of New York, Marom Bikson develops cutting edge methods of “neuromodulation.”

“Neuromodulation as a field is the use of devices to deliver energy in a controlled way to the nervous system to change the body,” he said. “When you think something, when you feel something, it’s all electricity. We’re adding electricity into that mix. So, it’s sort of, maybe not a surprise that an electrical organ is sensitive to electricity coming in.”

BELLINI: What do you think is most exciting right now when it comes to this field generally? 

MAROM BIKSON: One is more and more sophisticated technologies that can deliver energy to the nervous system in a more intentional and targeted way. So, more and more specificity.  

To demonstrate, Bikson suited Bellini up for an experiment to see if targeted electrical stimulation can improve one’s concentration while doing a boring, repetitive task. 

BELLINI: Is there a sweet spot you’re trying to hit? 

“This electrode here is roughly over a part of your brain called the dorsolateral prefrontal cortex,” Bikson said.

That’s an area of the brain associated with problem solving, attention switching, memory management and inhibition.  

BIKSON: Now, you’re at the full current, can you feel it? 

BELLINI: I feel the itchiness, that’s for sure. 

Itchiness, where the electrode touched Bellini’s scalp, which he says went away within a few minutes. He had no other sensation beyond that.  

As far as the game, as shown to Bellini in an analysis afterward, stimulation appeared to improve his performance a bit. Depression treatments target the same brain area as that experiment.  

“We have developed a hypothesis that this energy may not directly affect the neurons of the brain, but actually affect the blood vessels in the brain,” Bikson said.

They headed over to an MRI machine, where they set Bellini up to capture what the stimulation does inside his head.  

The areas in red showed an increase in blood flow. But how that may impact people with depression and other neurological diseases remains a medical mystery. 

BIKSON: It works, but it also works on the most difficult people, people who have been failed by conventional medicines.  

BELLINI: But not everyone?

BIKSON: But not everyone. And then, there’s the opportunity, right? Just like with medications, with neuromodulation, you’re thinking, “How can I make this work better? How can I capture the people who did not respond? And even for the people who did respond, can I do better for them still?”

Today, another approach to stimulation, called “repetitive transcranial magnetic stimulation,” or repetitive TMS, is both FDA approved and widely available. But it requires a series of sessions over days or weeks. And larger studies are needed to determine how long improvements last. 

“I’m very interested in creating something that is as effective as that. But you can use it at home still under prescription,” Bikson said.

NYU is using a device developed in partnership with Bikson that can be positioned properly remotely.

BELLINI: You haven’t done this long enough to know how long it will last?   

LEIGH CHARVET: No. … We know that more is better. We don’t know if you reach a plateau or If you have remission in depression. Do you need to continue or do you need to taper it?   

Meiklejohn has been using it daily, while meditating, for more than three months. 

BELLINI: When did you start to notice changes?  

MEIKLEJOHN: I’d say after about three weeks. 

BELLINI: Has the suicide ideation gone away? 

MEIKLEJOHN: Not completely, no. You know, when I dip, I dip. … The difference is, I bounce back in a day or two. 

Meiklejohn hopes she’ll continue to be a portrait of hope.

Newsy’s mental health initiative “America’s Breakdown: Confronting Our Mental Health Crisis” brings you deeply personal and thoughtfully told stories on the state of mental health care in the U.S. Click here to learn more.

Source: newsy.com

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Mental Health America: Texas Ranks Last In Mental Health Care Access

Canutillo Independent School District and Kingsville Independent School District try to get a handle on mental health care for students in need.

The old saying is “everything is bigger in Texas” — including its problems. 

Mental health ranks atop.  

In the wake of the Uvalde massacre, conservative politicians are waving away talk of gun control and stressing that mental health is the real culprit. And in boastful Texas, mental health is a big problem.  

Mental Health America ranks Texas dead last in access to mental health care. The Kaiser Family Health Foundation found that Texans suffer depression at higher-than-average rates. 

In data released by the Texas Education Agency, more than half of Lone Star schools don’t have a psychologist or access to telehealth.

Texas has also opted out of Medicaid expansion under the Affordable Care Act. In various studies, that amounts to tens of billions of dollars in federal funding, which could insure more than a million Texans and provide reimbursements for mental health professionals.  

Canutillo Independent School District is north of El Paso, Texas. It’s like Uvalde, with a supermajority Hispanic population and a mental health desert. It’s chief concern is access for those services for its 6,200 students 

“So, one of the things that is most important is social workers, counselors and prevention specialists working together,” social worker Rosario Olivera said.

The school district is Title I funded, meaning more than 40% of its students fall below the poverty line.

Administrators grappled with various problems across 10 schools, like how to get students access to medical care and in a pandemic, access to mental health and more counselors.

“We do the best we can do to service children of highest need,” Olivera continued. “However, it’s the same thing as with counselors. The ratio is very high.”

In Canutillo, it meant a pilot program of bringing in social workers and social work interns from the University of Texas El Paso.

“For every campus that has 350 students, you need one counselor. The majority of our campuses have 500 and above,” Canutillo Independent School District Director of Student Support Services Monica Reyes said.

Another glaring indicator in mental health access is poverty.

“This is typically what you’ll see: A mobile home with six or seven family members in it,” said Francisco Mendez with Familia Triunfadores.

In the colonias of San Elizario, access to mental health is a question of whether there are any therapists close by. But oftentimes, the answer is no. 

“It’s really difficult for them,” Mendez said. “They’ll have to drive at least 35 miles to El Paso.”  

In Kingsville, Texas, the schools have one mental health professional for more than 2,800  students.

Tracy Warren is a licensed school specialist psychologist, or LSSP. She’s an intern completing her doctorate. The challenge for Kingsville Independent School District is holding on to her and getting more people like her.

“We are trying to let everybody know how important mental health is and that if we don’t have the mental health foundation, the education is not going to take place,” Warren said. 

She is the front line. The school district leans on nonprofits to help kids outside of class. 

“There are a lot more anxious students this year than I’ve ever seen,” Warren continued. “We actually had a student that was at one of our campuses — he’s 4, going into Pre-K. First day of school, he stopped outside to count the police cars that he can see to ensure that he was safe before he came into school.”

The small school district’s leader, Superintendent Cissy Reynolds-Perez, says more mental health professionals and counselors need to be trained to work in rural schools.

“It’s very difficult because not everybody wants to come out to this area,” she said. “You know, you have your metropolitan areas, which I’m not saying it’s easier, but there are more resources there.”

At nearby Texas A&M Kingsville, the school has opened an institute for rural mental health.

Steve Bain is the director of the Rural Mental Health Institute. His goal is to create a mental health graduate student counselor pipeline direct to public schools.

“We have an opportunity now to reverse this trend of being last, or toward the last, in terms of accessibility of mental health services,” he said. “Only about 25% of students in K-12 who suffer from depression are getting mental health services. And depression has increased among our student population in the last five to eight years, significantly so.”

In Texas, licensed school specialty psychologists and social workers can be mental health caregivers to emotionally fraught kids, but there is a catch.

“Texas Education Agency has not recognized social workers as TEA employees yet, per se. We don’t have a specific job description, like teachers or counselors do,” Olivera said. 

That means school districts miss out on funding and insurance reimbursements when social workers provide mental health care for kids.

Newsy’s mental health initiative “America’s Breakdown: Confronting Our Mental Health Crisis” brings you deeply personal and thoughtfully told stories on the state of mental health care in the U.S. Click here to learn more.

Source: newsy.com

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Hospital ERs Struggle To Treat Surge Of Mental Health Patients

A Newsy investigation finds more Americans are going to the ER during a mental health crisis, and why they aren’t getting the help they need.

More Americans going through a mental health crisis are seeking care in hospital emergency rooms not always equipped to give the psychiatric care they need, a Newsy investigation has learned. 

Breia Birch, 44, suffers from bipolar, post-traumatic stress and dissociative identity disorders. 

She began thinking about suicide after her mother’s death in 2017. 

“I remember sitting down at my table and getting my pills out,” Birch said. “I started to separate out the ones that would hurt or hurt me out of the pile of pills. I was trying to kill myself.”

She went to her local emergency room in Manhattan, Kansas, for help. 

“Unfortunately, there aren’t many places in Kansas where you can go and get screened. You have to go to the ER,” Birch said.  

Across the country, mental health-related ER visits shot up 66 percent from 2013-2018, according to a study published in the Western Journal of Emergency Medicine. 

“Our rooms are full,” said Robyn Chadwick, president of Ascension Via Christi St. Joseph hospital in Wichita, Kansas. 

“Every single day in this facility, we have patients who are suicidal or homicidal,” Chadwick said. “On a good day, there will be 10 behavioral health patients waiting in the emergency room. On a really bad day, there might be 30.”

Nationally, bed capacity for psychiatric patients has plummeted in recent decades. 

Care outside the hospital can also be hard to find. An audit from the Government Accountability Office this spring found mental health patients with insurance “experience challenges finding in-network providers.” 

Patients also face a shortage of psychiatrists willing to accept Medicaid. Emergency rooms are also coping with a surge in behavioral health visits related to substance abuse. 

“Substance abuse and mental health have always gone hand-in-hand,” Chadwick said. 

Patients with nowhere else to go are flooding emergency rooms.

“Whatever that mental illness is, if you can’t get help, the situation gets worse, it escalates,” Chadwick said. “The emergency room is the safety net for everything.” 

The problem is, hospital emergency rooms are struggling with the influx of patients who, like Birch, are desperate for help. 

The ER closest to her in Manhattan, Kansas, was like many nationwide that don’t have a behavioral health unit. 

“They couldn’t find me anywhere to go for mental health,” Birch said. 

She was so desperate for care, she steered herself in a wheelchair toward traffic outside the ER so she could get into a state hospital. 

“I did what I had to do to get help,” Birch said. 

A Newsy analysis of data from the Centers for Disease Control and Prevention found of all psychiatric patients who go to the ER, about 11 percent leave without a follow-up plan for care.

Eleven percent may not sound like much, but it equals hundreds of thousands of patients in mental distress leaving the ER without a referral for future treatment. 

Chadwick says too many hospitals are not able to meet the need. 

The hospital she leads in Wichita built a new space to expand behavioral health treatment. 

“There are special screws used that cannot be pried out because a screw could then be used to harm yourself,” Chadwick said. 

To prevent suicide by hanging, doors have special handles. Televisions mounted to the wall don’t have exposed cords. 

The build-out took money: about $60 million. It also took determination.

“It has become very personal,” Chadwick said. “My oldest daughter, who’s now 22, attempted suicide twice as a freshman in high school. And it really hit home. She’s what drives me to make sure that everyone who needs care gets it.” 

Outside the hospital, leaders in Sedgwick County surrounding Wichita established a rapid response team to help with mental health related 911 calls when people may not need the ER.

They also set aside $15 million for a new mental health community crisis center. 

County Commissioner Lacey Cruse envisions an area between the hospital and jail could be used to help psychiatric patients before they need emergency help. 

“What we need really is like sort of a one-stop-shop,” Cruse said. “Let’s make sure they have transportation and get there. And then let’s follow up with them. You can’t teach someone to swim when they’re in the middle of the ocean drowning.”

The county has not settled on when or where to build the new center. 

Medication and a caregiver are helping Birch’s mental health, four years after struggling for emergency room care.  

“I have to keep reminding myself that I really don’t have too much to complain about right now,” Birch said. “I’m just doing a lot better now and I just hope I stay on this path.” 

If you need to talk to someone, call the National Suicide Prevention Lifeline by dialing 988 or text “HOME” to the Crisis Text Line at 741741.

Source: newsy.com

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Teen Suicide Crisis: Colorado Parents Work To Reduce State’s High Rate

Parents are sharing their tragedies in hopes of reducing suicide in Colorado. It’s the No. 1 cause of death for kids and young adults in the state.

Vicky Goodwin says February 4, 2021, is the day her world changed forever. 

“It was a Thursday morning. I got up, took my dog for a walk. I remember walking in,” she said. “Then, I walked down the hall to Jonathan’s room and opened the door, and he wasn’t in his bed, and I walked into his room and then I found him.”

Jonathan Goodwin was just 15. 

“Jonathan was incredibly bright, funny, quirky, a wonderful friend. He was a twin. He and his brother were really close,” Goodwin continued. 

But for reasons he kept hidden, Jonathan took his own life. His mom says nobody knows why. 

“It doesn’t matter how it happens. It doesn’t matter if there were signs or if there weren’t signs,” Goodwin said. “It’s just, you know, losing a child is as bad as every parent thinks that it would be.”

In the U.S., the rate of young people dying by suicide increased nearly 60% between 2007 and 2018. Researchers say trends are especially alarming among Black youth. 

In Goodwin’s home state of Colorado, suicide is the No. 1 cause of death for kids and young adults.

COVID-19 turned life upside down. Teens — already under the usual adolescent pressures of life, school, social media— are now dealing with a year-and-a-half of chronic pandemic stress. 

“I’ve never seen anything like this,” Children’s Hospital Colorado Clinical Child Psychologist Jenna Glover said. “I’ve never seen this number of children who need help in mental health services. And I’ve never seen this many kids be in acute crisis.”

It’s gotten so bad that in 2021, for the first time in its 117-year history, Children’s Hospital Colorado declared a “state of emergency” for youth mental health. 

“We’re seeing lots of kids come in with depression and anxiety, really nervous about starting the school year,” Glover continued. “So, real sense of hopelessness and not knowing how to solve their problems other than, ‘I just got to get out of this.'”

Experts say the reasons behind the nationwide jump in teen suicide over the last decade are varied and hard to pin down. Social media, money or family problems, even fear of school shootings and worry about climate change can all add up.  

Making it worse, says Glover, is a shortage of professional help. 

“There are not enough mental health services,” she said. “Catching kids early on — screening them in pediatrician offices, screening them at school and when they have just the beginnings of symptoms, getting them into preventative programs, and doing immediate intervention, so they don’t show up at the emergency department — we just need more of that.”

Short of professional help, experts say one of the most effective ways to prevent suicide is to talk about it. 

“It is the most common myth that asking about suicide will increase it,” Glover said. “What we know is asking about suicide will absolutely decrease the risk of it and it keeps your kids safe.” 

If teens are reluctant to talk to adults, the hope is they’ll talk to other teens. 

Marin McKinney is a teen ambassador for a suicide prevention group called Robbie’s Hope, giving advice to other kids and adults, too. 

“It’s OK to not be OK,” Marin said. “And a lot of us … we do go through bad days and tough situations. But there’s always someone out there who wants to listen and talk to you. … I would tell a parent to not overreact or overcomplicate the situation.”

Kari Eckert and her husband started Robbie’s Hope after losing their son in 2018. 

Their home in Golden, Colorado, is now headquarters for an all-out effort to get kids and adults help to prevent suicide. They do everything from producing free guides on how to talk about it to lobbying state lawmakers for new laws.  Several states, including Colorado, now allow teens to miss school to take a mental health day.

 “Just really really good tips and it’s written by teens. … Kids bring this to the table and say, ‘It’s important to me. I shouldn’t have to lie about why I can’t be in school today,'” Eckert said. “We aren’t just about saying that teen suicide is a problem. We want to bring resources to this … We want to reduce teen suicide rates by 50% by 2028. That’s a big goal.”

For now, Goodwin is taking things day by day, hoping that being open about her tragedy helps other parents to not feel so alone.  

“I guess focusing on something positive, focusing on the gift that we have — the gift that we had — with him makes the hard days a lot easier,” she said. “Secrets are toxic. And we felt that the only way that we could make losing a child worse is by passing that burden on to our other children, and being open and choosing to talk about it has been, I think, good for all of us. We just want to help one family.”

Newsy’s mental health initiative “America’s Breakdown: Confronting Our Mental Health Crisis” brings you deeply personal and thoughtfully told stories on the state of mental health care in the U.S. Click here to learn more.

Source: newsy.com

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