mental health

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Mental health cuts slash through safety net

Sadly, it's often a high-profile crime committed by someone with untreated or inadequately treated mental illness that puts the issue of spending for mental health care back in front of the public. But as headlines fade, so does public willingness to face the consequences of cutbacks on mental health spending. InvestigateWest, together with 10 other reporting centers around the country, drilled down to see what state budget cuts were doing to the mental health safety net.

What we found was disturbing: Beds closing at hospitals, short-term treatment centers, and group homes. Caseloads rising for already over-taxed mental healthcare workers. The population of people with mental illness in jails, emergency rooms and on the street escalating.

The way these stories make the news also frustrates those who have worked hard to erase the stigma of mental illness in society. A huge number of people live with mental illness, and almost none of them commit crimes. The vast majority are not violent. Many, however, do need help and support to stay in school, get jobs, and maintain healthy relationships.

In short, the cuts are quickly dismantling many of the gains that mental health advocates have fought for decades to establish -- access to treatment, support and housing that helps people with mental illness stay well and able to function in their families and communities. As many of those we interviewed in our story pointed out, the short-term cost savings of the budget cuts likely will wind up costing taxpayers more over the long run.  You can see the national picture in this story from Amy Biegelsen at the Center for Public Integrity.


Early homelessness sets stage for school, mental health problems


The truest victims of homelessness are young children, who have no control over the decisions that put them there, and no power to change their circumstances.

The typical homeless families in the country are headed by young women in their 20s, typically with two children. Nearly half those kids are under age five.

The consequences of homelessness can be devastating and long-lasting for young children. By age eight, one in three homeless children has a mental health problem that affects their functioning, said Karen Hudson, social worker with Children’s Hospital of Philadelphia and a national expert on homeless children.

More than three-quarters of homeless children under age five have developmental delays. And nearly 40 percent exhibit emotional and behavioral problems, she said.  These early problems can set the stage for problems, including homelessness, later in life. Surveys have noted that more than one-quarter of homeless adults experienced homelessness when they were young.

Children who lack stable housing face a host of challenges that stress their developing systems, including lack of sleep, hunger, fear, and increased levels of stress hormones such as cortisol, which can wreak havoc on young brains.

Sleep deprivation or disruption can make a child look and behave as though they have severe behavioral problems such as oppositional defiant disorder, said Dr. Ben Danielson, medical director of the Odessa Brown Children’s Clinic of Children’s Hospital and Medical Center in Seattle.

The symptoms that result from the stress of homelessness, can include anxiety, depression, extreme withdrawal, poor concentration or various forms of “acting out,” such as tantrums.

“We see attachment disorders, big time,” said Danielson.

Serious mental problems can go untreated because they are difficult to diagnose.

“Depression can look a lot different in kids,” said Danielson. “A child might not say,

The Communal Impact of Homelessness

Last week, I sat down with LaKesha Knatt, program development manager at First Place, an elementary and middle school designed especially for homeless children. First Place has been recognized for excellence in curriculum development, and relief services. It  can boast of successful graduates who have made names for themselves in local business and community activism. With a team of dedicated and highly qualified staff, First Place is more than equipped to care for the needs, educationally, emotionally, and psychologically, of its students. 

But as the daughter of a woman who works in education, and a peer of many local community volunteers and activists, I wondered if programs such as First Place offer anything in the way of psychological support for the very people who are assisting those in need—teachers, administrators, case managers, counselors, volunteers. I asked Knatt if her peers were offered, or required to take, on-site emotional-social counseling to ensure they can cope with hearing and witnessing daily tales of violence, neglect and abuse, given that such fields often see a high turnover rate.

Knatt smiled and replied, “You know, we don’t. That’s something I should really talk to the team about.” First Place requires intensive and innovative training for their teachers, both at the beginning of the school year and at mid-year to help teachers and staff respond best to crisis situations, and has an on-site physchologist for emotional support.

After being in First Place for only an hour, the training’s impact is clear—all staff speak with students with the utmost of care and sensitivity, ensuring them they are in a safe place where they are expected to succeed. Because First Place is entirely privately funded, their limited resources naturally and rightly go to places of highest need—providing education, food, clothing, and housing assistance for homeless families.

Carol Smith's picture

Military teens suffer emotional costs of war

carol_smithwebThe adjustment issues, mental health problems, and stress-related disorders experienced by deployed and returning servicemen and women have been widely documented. Less has been said about the children, especially teens, who suffer the secondary effects of a parent’s deployment. The Oregonian’s Julie Sullivan reports on a new study that shows military teens, especially girls, suffer lingering emotional effects and behavioral problems – even after a parent returns from deployment. 

The study, sponsored by the National Military Family Association and reported today in the journal Pediatrics, found that 34 percent of military kids deal with such issues, compared with 19 percent of children in civilian families.

As a culture, we like to focus on the picture-perfect moment when the soldier comes home. You-tube abounds with videos of returning dads surprising their children, an ecstatic moment to be sure. But then the cameras shut off, and the children have to deal with the aftermath of a parent’s absence as well as the parent’s own fallout from war.

Oregon has about 7,000 families with a member in the National Guard. Washington, too, has thousands of Guard families.

The children of deployment experience difficulties in school, anxiety over their parents’ marriages, worry about redeployments, difficulty relating to other kids and fighting. The longer a parent’s deployment, the more trouble they have.

Clearly, issues facing returning veterans are complex. Family trouble only makes them harder to deal with, which in turn only makes it harder on families.

--Carol Smith