The Child Mind BlogBrainstorm
Mental and Physical Health Care: Equal Under Law, Still Separate
April 7, 2015 Harry Kimball
A report from the National Alliance of Mental Illness casts a pall on the dream of mental health parity—the federally legislated mandate that insurers reimburse mental health care providers at the same rate as those health professionals who treat physical illness. A key NAMI finding (based on a survey of consumers) is that insurance companies deny mental health claims twice as often as they do physical illness claims, based on questions about "medical necessity."
From NPR: "Basically, they look at someone's care and ask is it really medically necessary. And advocates say they're applying those sorts of cost-control techniques way more stringently on the mental health side and the substance abuse side than they are on the physical health side."
However, according to NAMI, there is no reason to think that the "medical necessity" of mental health care should be any different from physical care. The Mental Health Parity and Addiction Equity Act was intended to erase this disconnect. As the NAMI report says, "the reasonable expectation is that reported denials of care for mental health, substance use, and medical care would be roughly equal."
Not so. The survey shows that 29% of families "had been denied mental health care on the basis of medical necessity, more than twice the percentage who reported being denied general medical care."
The law (or the difficulty enforcing it) is not all to blame for the poor state of mental health care in the United States, NAMI admits. There aren't enough professionals; the ones we have are understandably wary of working with stingy insurance companies; and the lack of a robust mental health system means that many needy children and families go unrecognized.
But for the families who do reach a professional, we hope we can do better than turning them away because treating a mental illness isn't a "medical necessity."View Comments | Add Comment
Why It's So Hard to Say Yes to Help
March 31, 2015 Danielle Veith
This is a guest post from Danielle Veith, who blogs about staying sane while raising kids at Crazy Like a Mom.
For new parents, one of the best things ever invented is the date-night-swap.
My husband and I discovered this when our daughter was two, swapping nights out with the parents of our daughter's closest friend. My preferred trade was when it all happened in the same weekend: "I'll watch your daughter while you go out on Friday night and you'll watch mine while we go out on Saturday night."
Parents save money on hiring a sitter, get to spend time together and the kids get to see each other two days in a row. Win-win-win. I liked when it was clean and neat and we were all even at the end of the weekend.
When it wasn't all wrapped up in a weekend, I was less fond of the arrangement. I hated feeling like I owed someone. Or worse, like someone owed me (who wants to feel both slighted and petty?).
Then, something happened that changed everything.
A few months after our son was born, my husband had a procedure that meant he couldn't pick up anything more than 10 pounds for two weeks. Which meant the daily kid-rearing duties were all on me. And taking care of my husband. And the nighttime parenting. My son had never been a great sleeper, but at that age, he was waking up six times a night. All on me.
I tried to do everything—for the kids, for my husband—and am usually at my best when this kind of rallying is needed. That lasted about two weeks. Then I crashed. I was so tired, I could not function. My arms were so weak, I could hardly lift my heavy little boy and was afraid of carrying him up and down the stairs. I hid in the kitchen and cried a lot.
I stink at asking for help. At least I used to. When we had our second baby, someone gave me the best-advice-ever: "If someone offers help, don't say no." I made a vow to follow it, no matter how hard. Many times, I even had to say aloud, "I'm only saying yes, because I promised myself I won't say no to help."
So, when my daughter's preschool offered to organize other families to bring dinners while my husband recovered, I said yes. When they let us out of our fundraising obligation, which would be taken on by other families, we said no at first. We could manage. Their response was amazing, "Even if you think you could do it, it's more important to spend time together as a family at a time like this." So, we said yes. And thank you.
Then I told my friends we were having a really hard time. I swear to you that moms came out of the woodwork.
There were dinners, playdates, help with bedtime, grocery shopping, offers to pick up whatever we needed from Target. A friend came over and gave me a massage. My best mom friends moved a moms' night out to my living room floor, because I couldn't leave the kids alone, even after bedtime, with a husband who couldn't pick them up if they cried. They helped with bathtime and even read my kids bedtime stories.
It was amazing. And humbling. And I had to say yes. I needed help.
For a while, I couldn't envision ever being able to function on my own again. To take care of my kids, to make meals, do laundry, it all seemed quite unbearable. Life felt so overwhelming that the idea that I would ever me able to manage my day-to-day and also help someone else was unimaginable.
So, I said yes. I accepted help from people knowing I couldn't return the favor. I had never been in that position before. I owed people, and I couldn't repay.
And it's all that got me through. Impossibly, somehow that time passed. Life isn't like that now. Honestly, I wasn't sure I'd make it. I did, but not on my own.
So now, it's different. Every time I can make someone dinner, take someone's kid for an afternoon, offer whatever help is needed, I say yes. It's not as if I never made dinner for a new mom or helped out when a friend was sick, but it's not the same as before. I want to help in ways that will never be repaid.
It's really just a basic way that communities function, but it was all new to me. I'd never lived in one place very long or attended church or any of those things that give people a community.
Of course, I'd heard all the "It takes a village" talk, but suddenly I knew what it felt like to have a village, to be a village.
I'm not saying I suddenly turned into Mother Theresa, but I did stop counting. No one owes me a thing.
Danielle Veith is a poet and writer who blogs at Crazy Like a Mom about staying sane while raising kids. She lives with her two small children and husband in the Washington DC area.View Comments | Add Comment
Demi Lovato Does It Again
March 20, 2015 Caroline Miller
In the past we've admired the way Demi Lovato has talked openly about her struggles with addiction, bulimia, and cutting. When the singer and former Disney star went into treatment in 2010, she was diagnosed with bipolar disorder, and she went public about that, too. This week she celebrated 3 years of sobriety and did it in a spectacular way—with a benefit concert in Los Angeles for her scholarship fund to help people get care for mental illness.
Lovato has courage to match her big voice and killer smile, and the support she extends to other young women who are struggling is priceless.
And there's more: To celebrate her 3-year milestone, Lovato and her boyfriend Wilmer Valderrama exchanged romantic Instagram posts. Hers read:
I wish I could put into words how grateful I am for this man right here. But my love has grown to a level that words could never possibly express how much this man completes me. He's loved me the way I never thought I deserved to be loved and with this day marking my 3rd year sober. After sharing my ups, putting up with my downs and supporting my recovery... he still never takes credit and I want the world to know how incredible his soul is. I really wouldn't be alive today without him. I love you Wilmer.
Lovato is only 22 years old, but she already understands that no one survives these challenges alone. She's needed help—everyone needs help—and the empathy and support she's gotten has been critical in her recovery. Maybe that's why she's been so generous about extending a hand to other people who are struggling.View Comments | Add Comment
Depression in Comics
March 17, 2015 Beth Arky
There is nothing funny about depression, but comics are a uniquely effective way to communicate what depression feels like. Proof can be found in this BuzzFeed post featuring 21 comics that capture the frustration and real pain the disorder brings to adults, children, and teens.
While the majority of the cartoons cover depression in a general sense—the way it's poo-poo'd as if it weren't a "real" disease, the loss of interest in things one once enjoyed, the struggle to just get out of bed, let alone function—a couple focus directly on what it's like to be depressed as a young person.
One comic, about the difficulties of trying to share your feelings with family by Moose Kleenex, shows a teen trying to open up by saying, "I'm feeling depressed lately..." to which her mom responds, "Oh don't be silly. You have everything in the world going for you," effectively shutting down her child. A week later, the picture is entirely different. As the kid stares out the car window, listless and disengaged, the now worried-looking parent asks, "How come you don't tell me anything?"
In another, about the struggles of being a student dealing with depression by Paralanalysis, the character says, "I found it so very stressful when depression made it difficult to go to school.... The experience was quite jarring for me, because I had always been a bit of a teacher's pet. But I fear there are thousands who felt a little like I did. Who don't turn in essays...not because they want to misbehave...but because it is taking all of their strength not to run and cry."
These eloquent cartoons speak volumes as to the importance of keeping the lines of communication open with kids about their feelings—and taking these feelings seriously.
Read more about how to help depressed teenagers here.View Comments | Add Comment
Stop Worrying About Those College Rejection Letters
March 16, 2015 Caroline Miller
New York Times columnist Frank Bruni has written a terrific piece on the experience millions of high school seniors are about to have in the next few weeks: being rejected by their first choice colleges. And sometimes their second, third, and fourth.
It's a particularly good column because Bruni nails how brutal the experience can feel to these kids, and yet how being forced to depart from the script they had imagined for the next chapter of their lives can actually help them thrive.
For one thing, being in a somewhat less competitive and entitled atmosphere can enable them to develop more confidence and enterprise. There can be an advantage to being around kids not, to use his rather delicate phrase, "as showily gifted."
For another thing, the experience of rejection itself can turn out to be surprisingly liberating. He quotes one student who said she felt "worthless" after her top five schools turned her down. But she discovered that rejection, like a lot of pain, was fleeting. And once she found her footing at her fallback school, she had lost the fear of rejection that holds so many of us back.
"As a result, she told Bruni, "I applied for things fearlessly." This young woman went on to be accepted into Teach for America and recently launched a new charter school. "I never would have had the strength, drive or fearlessness to take such a risk if I hadn't been rejected so intensely before," she said. "There's a beauty to that kind of rejection, because it allows you to find the strength within."
Bruni argues that rejection can help kids develop grit—that quality of perseverance and resourcefulness that has been linked to success in life, not just in school. But he's also arguing that that it's a fallacy that elite schools are the fast track (or the only track) to a rewarding and successful life. It may come from our worship of brands, or our tendency to measure our own worth by our kids' achievements. But it does our kids a disservice to make them think their lives hinge on this particular lottery.
Bruni urges parents to let kids know, before the rejections and acceptances roll in, that they won't be a measure of their worth or their future potential.
Read more about how to help kids deal with rejection.View Comments | Add Comment
#TheDress and Autism
Feb. 27, 2015 Rachel Ehmke
The thing everyone and their mother was talking about on Thursday (besides the escaped llamas) was the dress. You know the one. At first I thought it was whitish/goldish, but then I decided it was probably blueish/blackish after all. I hear Taylor Swift and Kanye agree. Wired has posted a scientific explanation of the controversy, which has to do with how we interpret light and color. They also give what they say is a definitive answer.
The cool thing about the dress, and what made it the enigmatic Mona Lisa of the week, wasn't the dress itself but how we each interpreted it. It was a very effective reminder that we all can be stumped by our senses at times, and we are all capable of experiencing the same things very differently. Which is nothing new to those who think a lot about sensory processing and autism.
Emily Willingham, a science writer we admire, thought the controversy was pretty familiar. She posted to Twitter:
Ari Ne'eman, president of the Autistic Self Advocacy Network, agreed. Ne'eman said Dressgate is "a really good way of acknowledging that people see things differently, perceive things differently, and one way is not necessarily superior to the other." Which is an unexpected—and welcome—revelation to come out of the latest internet craze.View Comments | Add Comment
New York's First Lady Gets Real About Mental Health
Feb. 27, 2015 Caroline Miller
Chirlane McCray is one of the things New Yorkers liked about Bill DeBlasio when they elected him mayor of New York City in 2013. The family made such an unforgettable picture—the very tall white guy with the very short black wife and two quite colorful children. Bill and Chirlane seemed like real people who were comfortable being different and letting their kids be different.
Of course Bill and Chirlane also had a record of being fierce and fearless advocates. And we're thrilled that Chirlane has decided to use her role as New York's first lady to focus on mental health. She's speaking out about, and collecting data about, the disturbing number of New Yorkers who don't have access to good mental health care. And she's being real about it: She published a piece today in the New York Daily News in which she writes about her struggles to find the right care for their daughter Chiara, who has struggled with anxiety, depression, and addiction.
Like so many parents we hear from, she found it daunting to understand what Chiara needed and to respond effectively. "Our child was in terrible pain, but because it originated in her brain and not another part of her body, there wasn't an established series of steps to follow."
The DeBlasio family is lucky, she notes, because they had the resources to get good treatment for Chiara, who she reports is doing well in recovery. But she hasn't forgotten what it was like:
Even after our crisis ended, I couldn't forget how scared and helpless I felt during those first frantic weeks. So I continued my research, wanting to understand how other people manage in these situations, especially those who don't have the same advantages as us.
Read the rest of her piece to see what she learned, and what she plans to do to help New York City develop a more inclusive system—one that acknowledges the very real obstacles that prevent people from getting care. As she puts it, "When I say a 'more inclusive' system, I mean one that meets—and treats —people where they live."View Comments | Add Comment
Metta World Peace Coaches a Girls’ High School Basketball Team
Feb. 26, 2015 Rachel Ehmke
Metta World Peace, the NBA All-Star and member of the 2010 Lakers team that won the championship, is now an assistant basketball coach for Palisades Charter High School. He's been working with the girls' team since June, but Torino Johnson, the head coach, says they've been talking about him joining the staff ever since World Peace's daughter Sadie was playing for the team four years ago. He has started helping out on his son's team as well.
It would be an amazing opportunity for anyone to be coached by the NBA star, but the fact that he's taking his expertise to high school kids, and not only to high school kids but to high school girls, is pretty phenomenal. Women's athletics don't get a lot of respect, so knowing that an NBA champion takes girls' basketball seriously enough to sign on to coach must be a heady confidence boost for the players.
When a reporter from TMZ Sports recently asked World Peace what it's like coaching a girls' high school basketball team, he replied, "They do a great job and they're smart—smarter than the boys." He was also very modest when the reporter pointed out it must be surreal for the girls to be coached by the former Lakers star. "Everybody had a coach," World Peace said. "Everybody needs some type of coach on their way to pro or college. And I played for professional basketball players who coached. You know, Phil Jackson was a basketball player and he coached us, and that was nice."
There was a time when few people would have called World Peace a good role model. Back when the Queensbridge projects native went by Ron Artest, he made headlines for his anger issues, like the infamous 2004 "Malice at the Palace" brawl between players and fans. But he started going to counseling and changed his name to the Buddhist-inspired Metta World Peace, and since then he's been an outspoken advocate for mental health care. He thanked his psychiatrist after winning the 2010 NBA championship and even auctioned off his championship ring to raise money for mental health. He was already a favorite of ours, but hearing about his new coaching gig makes him even more of a hero.View Comments | Add Comment
Teen Suicide and the Oscars
Feb. 23, 2015 Caroline Miller
There were a couple of electrifying moments at the generally snoozy Academy Awards ceremony last night, and one of them was when screenwriter Graham Moore, who won for The Imitation Game, used his Oscar moment to acknowledge that he tried to kill himself when he was 16. He did it, he said, "because I felt weird and I felt different, and I felt like did not belong. And now I'm standing here, and so I would like this moment to be for that kid who's out there who feels weird or feels different or feels she doesn't fit in anywhere. Yes you do. I promise you do."
Moore's excellent shout-out to teenagers who have suicidal thoughts deserved the standing ovation it got. And it was especially welcome because just two days ago another teenager who was creative and clever and different also tried to kill himself—but Draven Rodriguez, unfortunately, succeeded.
Rodriguez was a smart, funny 17-year-old from Schenectady, New York, who had become something of an Internet sensation when he submitted a kitchy image of himself and his cat, against a background of colored lasers, for his high school yearbook picture. The picture was rejected—rules must be followed!—but his principal posed with Draven, his cat, and her Chihuahua for a separate page with a message about the importance of adopting pets from rescue organizations. And the original picture went viral.
Draven's parents haven't shared any more information about what might have been behind his suicide, but they noted his independent streak. At 9, he was allowed to have his hair dyed green, as long as he brought home good grades. His interests included guitar, computers, gaming, running, rowing, and grammar—including correcting his teachers, the Times-Union reports. We don't know if he struggled with depression or anxiety, but he was certainly different.
Moore, a successful novelist as well as a sought-after screenwriter, acknowledged to Dateline Hollywood backstage at the Oscars that he had been depressed as a teenager, and has continued to struggle with depression since then.
We couldn't admire more his decision to use his Oscar win to extend a hand to other struggling teenagers. He said backstage that it had been hard, but he thought, "I'm a writer, when am I ever going to be on television? I might as well use it to say something useful."
Teenage suicides are so often an utter surprise to the people who love them that helping kids who are struggling to be more open about their pain can be a life-saver.View Comments | Add Comment
A Salute to the Academy for Recognizing Mental Health in Film
Feb. 20, 2015 Harold Koplewicz
This year, Hollywood made major strides in recognizing the importance of mental health through the accurate portrayal of psychiatric disorders in film. Reese Witherspoon gave a riveting performance in Wild as a woman healing from the trauma of losing her mother by walking the Pacific Coast Trail and reconnecting with herself. Whiplash showed the stress that's an inevitable part of striving to be the best, and the strong impact teachers can have on their students—for better or worse. In The Imitation Game, Benedict Cumberbatch portrayed genius code breaker Alan Turing in a way that showed just how isolating genius can be. Meanwhile, The Theory of Everything showed not only how ALS has affected Stephen Hawking, but also the emotional burden on his wife and family. For many, movies are the first vehicle through which they see and begin to understand mental health issues, which is why it is so important that these films reflect reality.
More than 15 million American children live with a psychiatric or learning disorder. That's more than the number of children affected by leukemia, diabetes and AIDS combined. Yet historically, Hollywood has rarely told these stories, and when it has, they have often been painted as terrifying or laughable. Thankfully, this is changing.
I am thrilled to see Hollywood creating more and more films over the last five years that accurately portray different types of mental illness and hardship. From Silver Linings Playbook to The King's Speech, these films are making a real difference in how the public views and comprehends mental health.
Mental health is often misunderstood, but it doesn't have to be. Accurate portrayals of mental illnesses like autism or bipolar disorder in the media help the general public better understand the reality behind these diseases. One in five children copes with a psychiatric or learning disorder. Yet parents who notice signs of psychiatric or learning disorders in their children wait, on average, two years to get help for them. There are various reasons for this—parents are scared, they hope their son or daughter will outgrow it, or they think their child is just a late developer. But a major reason people hesitate to get help is because of the stigma attached to mental illness. The fact is, mental illness is real, common and treatable. That's where films like this year's Oscar nominees come in.
These films can change people's minds about mental health and learning disabilities. Though we still have a long way to go when it comes to ending stigma and raising awareness, these films provide a good start. My hope is that as more and more of these stories are told through notable and award-winning movies, parents will feel more comfortable talking to other parents, educators, or health professionals about their children's mental health issues.
It is vital that people be open and knowledgeable about mental health, and much of this begins with what we see in film, television, and the media around us.
I applaud the Academy for drawing attention to these important issues, and I look forward to seeing many more films that accurately portray the difficulties, triumphs, and overall journeys associated with mental health.
Originally published at the Hollywood Reporter.View Comments | Add Comment