by North Shore Child & Family Guidance Center | Sep 13, 2018 | In The Media, Press Releases
Did you know that every day more than 290 Americans die from suicide or a drug overdose?
With proper treatment, many of these tragedies could be prevented — but despite a law that guarantees coverage, people face enormous roadblocks when they seek care.
In 2008 President George W. Bush signed the landmark Mental Health Parity and Addiction Equity Act (Parity Act).
The Parity Act mandates equal insurance coverage for mental health and substance use disorders as compared to other medical/surgical benefits covered by the plan.
According to its new website parityat10.com, “Parity at 10 seeks to ensure that insurance carriers and state Medicaid programs comply with the law so that consumers can access the evidence-based health care they need and are entitled by law to receive.”
What does equal insurance coverage mean?
It means ending insurer discrimination against access to timely and affordable care including high out-of-pocket costs and shorter lengths of care for MH/SUD.
Parity — which is another word for equity — in this case means that MH/SUD coverage must be provided on par with coverage of medical and surgical care.
Notably, this legislation was the result of a bipartisan effort by Sens. Paul Wellstone, a liberal Democrat, and Pete Domenici, a conservative Republican. What the senators had in common were personal family experiences that motivated their tireless efforts to pass this law.
Parity saves lives. Parity law is a civil rights law that has not been vigorously enforced by the States, which have the primary responsibility for enforcement of private insurance and Medicaid.
One of the most pernicious violations and barriers to care is inadequate networks of MH/SUD providers.
North Shore Child & Family Guidance Center documented this in its 2018 Project Access Study which surveyed 650 Long Island consumers of MH/SUD care. Nearly 50 percent of respondents said that it was easier for them to access medical/surgical care than MH/SUD Care.
Nationally, patients responding to a National Alliance on Mental Illness survey reported being denied twice as often for mental health care as for medical-surgical care under the Affordable Care Act.
The actuarial firm Milliman reviewed claims data in New York and found that patients had to go out-of-network for MH/SUD care far more often than for medical/surgical care — a very expensive proposition that flies in the face of the Parity Act.
At North Shore Child & Family Guidance Center, we are a proud partner of the Parity at 10 Compliance Campaign. On August 10 I attended an inaugural Parity at 10 meeting in Albany with my fellow advocates and top officials in the Cuomo administration.
Some of the details in this column were included in the policy brief provided to Gov. Cuomo. The consensus among the advocates was that insurers do everything in their power to skirt parity.
Another staunch supporter of the original legislation was Patrick J. Kennedy, a former member of the U.S. House of Representatives. Kennedy struggled with mental illness and addiction for most of his life.
In his book “A Common Struggle,” Kennedy said the battle ahead is for the law to be enforced in the face of health insurers who stand to profit by denying the full range of coverage for people living with mental illness and addictions.
Kennedy rightly frames the inequities that people with mental illness and addictions face as a matter of civil rights.
Discriminatory insurance coverage for those with mental health and substance use disorders must end. When insurers do not comply with the law and enforcement is inadequate, millions of Americans are at risk.
Andrew Malekoff is the Executive Director of North Shore Child & Family Guidance Center, which provides comprehensive mental health services for children from birth through 24 and their families. To find out more, visit www.northshorechildguidance.org.
by North Shore Child & Family Guidance Center | Sep 13, 2018 | Anton Media, In The Media, Press Releases
In the aftermath of the 17th anniversary of September 11, I offer a remembrance of several groups of people—all Queens court personnel—whom I spent a day with in their courthouse, just three days after the 2001 terrorist attack.
The people I met with included individuals with missing relatives or friends, individuals with relatives or friends confirmed dead, individuals who were in the World Trade Center complex during the attack, individuals with family members who barely escaped, and individuals who witnessed the attack and collapse of the Twin Towers from courthouse windows. All were deeply affected. Most were in a state of shock and disbelief.
When I arrived at the courthouse, I learned that I would be meeting with three groups of 8 to 12 people each. I was called in by an official from an Employee Assistance Program to offer a supportive group experience. We met in a vacant courtroom. I arranged chairs around two adjacent prosecution and defense tables.
As I awaited the first group, a court officer said, “Today should be interesting.” I asked him what he meant. He said, “It’s foreclosure Friday.” He explained that every Friday they have an auction of foreclosed property and, typically, about 200 Arab-Americans participate in the auction, signaling a sense of mounting unease with people of Middle Eastern descent.
I greeted the first group, and one by one the participants revealed signs and symptoms of trauma and stress. These included numbness, shock, headaches, loss of appetite, aches and pains, frequent trips to the bathroom, sleeplessness, flashbacks, startle responses to loud noises (especially airplanes), helplessness, gruesome nightmares, anger, uncertainty, guilt and fear.
Fear was a powerful theme. Many felt that the courthouse was unsafe. During the final group meeting a female court officer walked in unannounced and searched for explosives, explaining there was a bomb threat.
At least one or two people wept openly in each group, women and men. In each group at least one person left the room to compose themselves and then came back. More than one person said, “I can’t stop crying.” And more than one said, “I can’t cry.”
Anger was a prevailing theme. There was anger at the government. “How could they let this happen?” they asked.
Many shared feelings of disbelief, saying how surreal it seems. One said, “I am in a semi-daze; I feel like I’m not even here.”
Guilt was prevalent, especially about going on with mundane day-to-day activities. A court officer said he felt insignificant, like “a grain of sand.” He said he felt helpless and wondered if he was going crazy.
One group participant’s son escaped from the 78th floor. He took the stairs. His co-workers waited for the elevator. They didn’t survive. The son’s story was retold by his mother through sobs. When he emerged from the building, she shared, he witnessed “flaming bodies falling from the sky.” Two others held her hands as she told the story.
In each group people reached out to comfort one another through physical touch and understanding words. In one group a woman who said she couldn’t understand why she hadn’t cried was brought to tears by another’s pain over a missing sister.
In closing, the participants in one group agreed that “it’s good to know you’re not alone,” and “it’s good to know you’re not going crazy.”
I found the intensity of that experience and the participants’ ability to reach out to one another moving. Although I was there to facilitate, my role was to bear witness. It confirmed for me what I was already feeling; when facing incomprehensible tragedy and overwhelming grief we must push ourselves to forgo isolation and reach out to one another.
Andrew Malekoff is the executive director of North Shore Child & Family Guidance Center.
by North Shore Child & Family Guidance Center | Sep 10, 2018 | Blog
On the days following the attacks of 9/11, North Shore Child & Family Guidance Center responded to the crisis by offering counselling and support to bereaved children and families all across Long Island and in New York City. Following is the reflection of Executive Director Andrew Malekoff on the memorial service at the World Trade Center on October 28, 2001, which he attended with a group of mental health workers who offered their support for the bereaved.
As I recall, at the end of the service there was a chill in the air as the sun disappeared behind the ruins of the World Trade Center. Renee Fleming, accompanied by the Orchestra of St. Luke’s, sang God Bless America.
Moments earlier I said goodbye to the family I stood beside during the memorial service. They sat in the back row of our section, one of scores of sections filled with thousands of folding chairs, each chair occupied by a grieving family member. I stood with my back against an iron gate so I would not block anyone’s view. The family had lost its father and husband, a decorated firefighter. The widow was a slight woman of Italian descent, probably in her late sixties.
Photos of her husband were pinned to her wool coat, and to the coats of her three children. He was handsome. He had a white moustache and a full head of silvery hair, combed straight back. When the memorial service started an hour earlier one of her sons, an off-duty police officer, asked if I would make sure that no one obstructed his mother’s view. He said, “You can see how short she is.”
The service began with a processional that included His Eminence Edward Cardinal Egan, Archbishop of New York. Then, police officer Daniel Rodriguez of the NYPD sang The Star Spangled Banner. He had become a national presence by appearing in his dress blues and singing the national anthem at Yankee Stadium before the 97th World Series that pitted the Yankees against the Arizona Diamondbacks.
Everyone was on his or her feet. A massive wall of mourners rose around the tiny figure to my right. When I saw her struggling to climb, I took her arm and helped her up onto a folding chair. I told her that she could grab on to me. “Hold on to my shoulders,” I said. She hesitated. I told her, “Don’t worry, you won’t knock me over.”
I could feel her trembling as she removed her right hand from my shoulder and fumbled for a tissue inside her coat pocket. I reached into my pocket and handed her a handkerchief.
When I was picking out my clothes earlier in the morning I had come across several unopened packets of white handkerchiefs. They belonged to my father who died seven years earlier. As I got dressed, I thought that today my father would want somebody who needed it to have one of his handkerchiefs. At first she refused my offer, not wanting to impose. I urged her, “Please, take it. It’s okay.”
Ten years later, my father’s handkerchiefs remain tucked into my dresser drawer – a daily reminder of when I joined a parade of broken hearts. Sometimes I close my eyes, think back and try to recall what things felt like before that sunny fall morning at ground zero.
Note: A version of this story originally appeared in Anton Media.
by North Shore Child & Family Guidance Center | Sep 6, 2018 | Anton Media, In The Media, Press Releases
Did you know that every day more than 290 Americans die from suicide or a drug overdose?
With proper treatment, many of these tragedies could be prevented — but despite a law that guarantees coverage, people face enormous roadblocks when they seek care.
In 2008 President George W. Bush signed the landmark Mental Health Parity and Addiction Equity Act (Parity Act).
The Parity Act mandates equal insurance coverage for mental health and substance use disorders as compared to other medical/surgical benefits covered by the plan.
According to its new website parityat10.com, “Parity at 10 seeks to ensure that insurance carriers and state Medicaid programs comply with the law so that consumers can access the evidence-based health care they need and are entitled by law to receive.”
What does equal insurance coverage mean?
It means ending insurer discrimination against access to timely and affordable care including high out-of-pocket costs and shorter lengths of care for MH/SUD.
Parity — which is another word for equity — in this case means that MH/SUD coverage must be provided on par with coverage of medical and surgical care.
Notably, this legislation was the result of a bipartisan effort by Sens. Paul Wellstone, a liberal Democrat, and Pete Domenici, a conservative Republican. What the senators had in common were personal family experiences that motivated their tireless efforts to pass this law.
Parity saves lives. Parity law is a civil rights law that has not been vigorously enforced by the States, which have the primary responsibility for enforcement of private insurance and Medicaid.
One of the most pernicious violations and barriers to care is inadequate networks of MH/SUD providers.
North Shore Child & Family Guidance Center documented this in its 2018 Project Access Study which surveyed 650 Long Island consumers of MH/SUD care. Nearly 50 percent of respondents said that it was easier for them to access medical/surgical care than MH/SUD Care.
Nationally, patients responding to a National Alliance on Mental Illness survey reported being denied twice as often for mental health care as for medical-surgical care under the Affordable Care Act.
The actuarial firm Milliman reviewed claims data in New York and found that patients had to go out-of-network for MH/SUD care far more often than for medical/surgical care — a very expensive proposition that flies in the face of the Parity Act.
At North Shore Child & Family Guidance Center, we are a proud partner of the Parity at 10 Compliance Campaign. On August 10 I attended an inaugural Parity at 10 meeting in Albany with my fellow advocates and top officials in the Cuomo administration.
Some of the details in this column were included in the policy brief provided to Gov. Cuomo. The consensus among the advocates was that insurers do everything in their power to skirt parity.
Another staunch supporter of the original legislation was Patrick J. Kennedy, a former member of the U.S. House of Representatives. Kennedy struggled with mental illness and addiction for most of his life.
In his book “A Common Struggle,” Kennedy said the battle ahead is for the law to be enforced in the face of health insurers who stand to profit by denying the full range of coverage for people living with mental illness and addictions.
Kennedy rightly frames the inequities that people with mental illness and addictions face as a matter of civil rights.
Discriminatory insurance coverage for those with mental health and substance use disorders must end. When insurers do not comply with the law and enforcement is inadequate, millions of Americans are at risk.
Andrew Malekoff is the Executive Director of North Shore Child & Family Guidance Center, which provides comprehensive mental health services for children from birth through 24 and their families. To find out more, visit www.northshorechildguidance.org.
by North Shore Child & Family Guidance Center | Sep 6, 2018 | Anton Media, In The Media, Press Releases
In recent years I have written about concussions in youth sports in this space, with a special focus on Chronic Traumatic Encephalopathy (CTE), a progressive degenerative disease of the brain that is the result of repetitive brain trauma. This was something I knew nothing about in my teenage years. As a high school and college football player in the 1960s and ’70s, using one’s head as a battering ram and shock absorber was expected.
Beyond the discovery of CTE and what it has generated in the way of much-improved player safety, August never fails to evoke memories of twice-daily summer practices when guys like me went to “training camp” before school started. Training camp lasted about two weeks. It was usually hot out. They were two weeks that felt like a year. Those were the make or break days of my youth. No one was cut from the team as long as they showed up, but many did not last.
The rawest depiction of a brutal summer football camp can be found in the book The Junction Boys by Jim Dent. The subtitle of the book is How Ten Days in Hell with Bear Bryant Forged a Championship Team. Although I never went through anything quite like the Junction Boys did, it seems that all high school and college football players have similar war stories about summer camp.
I’m not about to rehash what I’ve since learned since the discovery of CTE and the need for protective measures or share stories from my summer football camp days. However, at the risk of being cliché, there are some important lessons I learned from playing football.
As we round out another August, I thought I’d share a few of those lessons here. Most have served me well. Some have a downside.
1. Punctuality
As the saying goes, showing up is half the battle. But don’t just show up; be there on time. In football there were serious consequences for being late, but losing the respect of one’s peers eclipsed them all.
2. Hard work
Know that when you are working hard, there are others working just as hard and others who are not. Push yourself to surpass your opponents and inspire your teammates.
3. Stoicism
Keep your head up. Push through disappointment and injuries. This is mostly a good trait, but it can also prevent you from seeking the support you need when you really need it, physically and emotionally. Vulnerability is not a lesson I learned in football.
4. Dependability
It is essential that others who are pulling with you toward accomplishing a goal know that they can always count on you. There is a brotherhood that forms on a football team that demands dependability.
5. Humility
Enjoy success but don’t be boastful. Have gratitude for all those who helped to support your success.
6. Perseverance
Never give up. It is what your adversaries expect. By pushing through missteps and setbacks you learn what it takes to succeed and that your capacity to overcome failure is greater than you anticipated.
7. Resilience
As the legendary coach of the Green Bay Packers Vince Lombardi said, “It’s not whether you get knocked down; it’s whether you get up.” To survive playing football, resilience is essential.
Fortunately, these lessons can be learned in many places other than the football field. Any group activity that requires teamwork, sacrifice and shared goals generate important life lessons. Make sure the young people in your life put down their cellphones and other tech gadgets and take up a sport, join a club or get involved in the arts, to name a few possibilities. They’ll grow into better people—and with no head-butting required.
