Powering Through an Outage, Parenting Plus, by Sue Cohen, August 17, 2020

Powering Through an Outage, Parenting Plus, by Sue Cohen, August 17, 2020

On Tuesday, Aug.p 4, heavy wind and rain from Tropical Storm Isaias hit much of the east coast. More than 2 million customers in New York, New Jersey and Connecticut lost power as a result of the storm’s impact. One week later, some are still in the dark.

While power outages are always frustrating, the situation was made much more difficult with the ongoing COVID-19 pandemic. A large number of people are working from home and are dependent on their power, WiFi and phone services to be able to do so. With the cancellation of many summer programs and activities, lots of kids are bored at home already, and without power, they lose much of the entertainment they rely on so heavily.

As Director of Early Childhood and Psychological Services at North Shore Child & Family Guidance Center, I’ve seen how COVID-19 and social distancing protocols have reduced or even eliminated many opportunities for respite, such as staying at the home of a friend or relative who has power. All your usual options that can help in an outage aren’t necessarily there.

It is crucial that parents do their best to remain calm, as your children will model their own behavior from you. When you lose it, they will do the same—and, fortunately, the opposite is true, too.

Before the next outage hits, take preventative actions by creating power outage kits for the entire family. These should include necessities such as flashlights, batteries, nonperishable food and water, but also off-the-grid activities for the family to participate in together. In our digital world, it is especially important for children to find engaging activities that do not take place on a screen. Power outages provide an opportunity to introduce these experiences to your children and remind them of the need to disconnect every so often.

Though it can be hard to find anything positive that has come from the COVID-19 pandemic, parents have mastered the act of improvisation. For months, they’ve learned how to entertain anxious children and navigate uncertainty. While power outages can be difficult, they offer yet another opportunity to spend quality time with your children and to explore new activities.

Parents need to take a step back and try to think outside of the box. Power outages have provided the foundation for some of my most treasured memories. One time, my daughter wanted to bake cookies, but due to the power outage, she attempted to make them on a pancake griddle. Though the cookies may not have turned out as good as usual, the memory is one that always brings a smile.

Parents should also attempt to find the positive in this situation. Just as your children should try different, off-the-grid activities, you should do the same. It’s easy to slip back into the

smartphone-focused world we usually live in. Use this opportunity to establish small habits such as daily reading or writing time or meditation exercises that can bring calm to your day.

Younger children may enjoy hands-on activities such as making crafts, going on a scavenger hunt, putting on a puppet show or playing dress up. Older children can get lost in a book, engage in healthy competition in a board game or learn card games.

No matter the season, power outages are difficult for families to deal with, but when they occur alongside a pandemic and a heat wave, they are even more challenging. However, this experience may serve as a teaching moment for parents and kids to learn the benefits of unplugging and finding enjoyment in the simple things in life.

Dr. Sue Cohen is the Director of Early Childhood and Psychological Services at North Shore Child & Family Guidance Center, the leading children’s mental health agency on Long Island. The Guidance Center is seeing new and existing clients via telephone and video during the COVID-19 crisis. To make an appointment, call (516) 626-1971.

Guidance Center Grant Supports Children’s Mental Health, Anton Media, August 18, 2020

Guidance Center Grant Supports Children’s Mental Health, Anton Media, August 18, 2020

The North Shore Child and Family Guidance Center is pleased to announce that the nonprofit organization received a Community Development Block Grant (CDBG) from Nassau County for $147,500 to support its work serving Long Island’s communities during the pandemic crisis.

“During this most troubling and stressful time for so many families of all backgrounds, we are grateful to Nassau County for awarding us a Community Development Block Grant COVID grant,” Andrew Malekoff, executive director of the Guidance Center, said. “It could not have come at a better time. We are seeing an increase in young people who are experiencing depression and anxiety, are at risk for suicide and other self-harming behaviors, and cannot afford to be placed on a waiting list. This funding supports our ability to offer a rapid response and quality mental health care for all families who need us regardless of their ability to pay.”

Nassau County distributed nearly $2.5 million in federal CDBG-COVID funding to 12 nonprofit partners and nine municipalities across Nassau County to provide mental health and substance abuse services, youth and senior services, and health, safety, and accessibility upgrades for local community centers.

North Shore Child and Family Guidance Center, the leading children’s mental health agency on Long Island, is seeing new and existing clients via telephone and video during the COVID-19 crisis. To make an appointment, call 516-626-1971. Visit www.northshorechildguidance.org for more information.

Powering Through an Outage, By Dr. Sue Cohen, Anton Media, August 17, 2020

Powering Through an Outage, By Dr. Sue Cohen, Anton Media, August 17, 2020

On Tuesday, August 4, heavy wind and rain from Tropical Storm Isaias hit much of the east coast. More than 2 million customers in New York, New Jersey and Connecticut lost power as a result of the storm’s impact. One week later, some are still in the dark.

While power outages are always frustrating, the situation was made much more difficult with the ongoing COVID-19 pandemic. A large number of people are working from home and are dependent on their power, WiFi and phone services to be able to do so. With the cancellation of many summer programs and activities, lots of kids are bored at home already, and without power, they lose much of the entertainment they rely on so heavily.

As Director of Early Childhood and Psychological Services at North Shore Child & Family Guidance Center, I’ve seen how COVID-19 and social distancing protocols have reduced or even eliminated many opportunities for respite, such as staying at the home of a friend or relative who has power. All your usual options that can help in an outage aren’t necessarily there.

It is crucial that parents do their best to remain calm, as your children will model their own behavior from you. When you lose it, they will do the same—and, fortunately, the opposite is true, too.

Before the next outage hits, take preventative actions by creating power outage kits for the entire family. These should include necessities such as flashlights, batteries, nonperishable food and water, but also off-the-grid activities for the family to participate in together. In our digital world, it is especially important for children to find engaging activities that do not take place on a screen. Power outages provide an opportunity to introduce these experiences to your children and remind them of the need to disconnect every so often.

Though it can be hard to find anything positive that has come from the COVID-19 pandemic, parents have mastered the act of improvisation. For months, they’ve learned how to entertain anxious children and navigate uncertainty. While power outages can be difficult, they offer yet another opportunity to spend quality time with your children and to explore new activities.

Parents need to take a step back and try to think outside of the box. Power outages have provided the foundation for some of my most treasured memories. One time, my daughter wanted to bake cookies, but due to the power outage, she attempted to make them on a pancake griddle. Though the cookies may not have turned out as good as usual, the memory is one that always brings a smile.

Parents should also attempt to find the positive in this situation. Just as your children should try different, off-the-grid activities, you should do the same. It’s easy to slip back into the smartphone-focused world we usually live in. Use this opportunity to establish small habits such as daily reading or writing time or meditation exercises that can bring calm to your day.

Younger children may enjoy hands-on activities such as making crafts, going on a scavenger hunt, putting on a puppet show or playing dress up. Older children can get lost in a book, engage in healthy competition in a board game or learn card games.

No matter the season, power outages are difficult for families to deal with, but when they occur alongside a pandemic and a heat wave, they are even more challenging. However, this experience may serve as a teaching moment for parents and kids to learn the benefits of unplugging and finding enjoyment in the simple things in life.

Dr. Sue Cohen is the Director of Early Childhood and Psychological Services at North Shore Child & Family Guidance Center, the leading children’s mental health agency on Long Island. The Guidance Center is seeing new and existing clients via telephone and video during the COVID-19 crisis. To make an appointment, call (516) 626-1971.

Greentblatt, Zitelli Join Guidance Center Board, Anton Media, June 19, 2020

Greentblatt, Zitelli Join Guidance Center Board, Anton Media, June 19, 2020

North Shore Child & Family Guidance Center has two new members on its Board of Directors: Nassau County residents Jeffrey Greenblatt and Jacklyn A. Zitelli.

Jeffrey Greenblatt, who co-chaired the Guidance Center’s Trivia Night fundraiser this year, is Assistant Regulatory Counsel at PSEG Long Island. He received his J.D. from St. John’s and his B.A. from the University of Michigan. 

“Long Island is a special place,” said Greenblatt, who lives in Syosset with his wife Jaclyn and three daughters, Hayley, Harper and Taylor. “It’s where I grew up, work and raise my family. I always feel good anytime I’m able to give back to the local community. That’s why it’s such an easy decision to join during tough times like these and support an agency like the Guidance Center now and in the future.”

Zitelli, counsel in Farrell Fritz’s real estate practice group, is a resident of Jericho, where she lives with her husband Michael and two children. She earned her J.D. from St. John’s University School of Law and her B.A. from Syracuse University. 

“It is an honor to join such a great organization and to support its important mission,” said Zitelli. “I believe that children and families gain invaluable experiences from North Shore Child & Family Guidance Center throughout every stage of life. I’ve been appreciative of the services and programs offered through the Guidance Center for many years and am enthusiastic about now being able to directly contribute to its initiatives as a board member.”

Board President Paul Vitale is excited to welcome Greenblatt and Zitelli to the Guidance Center team. “Jeffrey did a great job getting a big crowd out for a fun experience at Trivia Night, and both his and Jacklyn’s energy and passion for our mission will be a huge asset as we navigate these challenging times.”

To learn more about North Shore Child & Family Guidance Center, Long Island’s preeminent children’s mental health agency, please call (516) 626-1971 or visit www.northshorechildguidance.org.

Lesson from the Past Can Help Us Now, by Andrew Malekoff, Anton Media, May 27, 2020

Lesson from the Past Can Help Us Now, by Andrew Malekoff, Anton Media, May 27, 2020

When I was 10 years old, I discovered a thick folder in a box at my home in New Jersey. I twirled the string that held the flap secure and pulled out the contents—a cache of newspaper articles dating back to the mid-1930s. The articles were from the Newark Star Ledger and the Newark Evening News

As I sifted through the news clippings, they all had one thing in common: They were about my father and his days as a high school athlete in Newark. 

When I asked him where they came from, he replied, “Oh, your grandmother cut them out of the newspaper.” My grandmother Jennie was an immigrant from the part of Russia now known as Belarus. She and my grandfather Joseph came to the U.S. sometime around the early 1900s. Neither one spoke English at the time, only Yiddish. 

I’m sure my grandparents knew next to nothing about American sports, but somehow my grandmother knew that her son was doing something noteworthy if his name was always in the newspaper. 

To attest to their lack of knowledge about football, years later I learned that when my grandfather—a carpenter whom I called Pop—went to his first game and saw my father’s youngest brother get gang tackled, he ran onto the field and started throwing the opposing team’s players off the pile to free his son. 

I had known that my father was an athlete in his younger years, but I knew none of the details that the treasure trove of news clips revealed. One in particular came to mind almost as soon as the Coronavirus pandemic led to “sheltering-in.”

Back when I first found the articles, I spent months carefully trimming them and using Elmer’s glue to paste them into a scrapbook that I’ve kept until this day. Today, talk of quarantine led me to dig it up. 

As I flipped through the pages, I found an article with this long headline: Test Guard After Brother Gets Scarlet Fever. Streaks Minus Star, Meet St. Benedict Prep’s Gray Bee. Ace’s Return Hinges On Condition. My father Izzy was a guard on the basketball team. 

The article, written by someone named Frank J. Fagan, went on to state: “The chances of South Side High School’s Sun Streaks in the state basketball tournament grew dimmer today when it became known that Izzy Malekoff, star guard, may be lost to the squad for the remainder of the season. Albert Malekoff, the South Side player’s younger brother, was taken down with Scarlet Fever on Saturday. Izzy immediately took up quarters with a teammate who lives near him.”

Fagan went on to write, “The Board of Health, however, has quarantined Izzy, who is to take a test today to discover if the fever germs have invaded his system . . . If it is found that the schoolboy athlete has contracted the germ, he will not be allowed to return to school for a month.”

Back in those days, signs were posted on homes of those who were infected that read:  “Quarantine Scarlet Fever. No one shall enter or leave these premises except as provided by the State Department of Health or Local Board of Health.”

Although I have not done an exhaustive study on scarlet fever, what I learned is that there is no vaccine; recommended prevention includes frequent handwashing, not sharing personal items and staying away from other people when infected. I couldn’t find anything about six feet or wearing masks.

In the early 1900s, before antibiotics were available, it was a leading cause of death in children. Can you imagine if that was true in today’s Covid-19 pandemic? Perhaps some of our fellow Americans who appear to think older people are expendable would think twice. 

In case you’re wondering, for some reason at the time I never asked my father how it all turned out. The story left my mind after first reading it. 

Until now. 

Andrew Malekoff is the Executive Director of North Shore Child & Family Guidance Center, the leading children’s mental health agency on Long Island. The Guidance Center is seeing new and existing clients via telephone and video during the COVID-19 crisis. To make an appointment, call (516) 626-1971. Visit www.northshorechildguidance.org for more information.

A Quarantine Trendsetter, By Andrew Malekoff, Anton Media, April 13, 2020

A Quarantine Trendsetter, By Andrew Malekoff, Anton Media, April 13, 2020

In my February column, I wrote about the fact that I had a stem cell transplant in early December 2019, about a month before I heard for the first time about the coronavirus.

The transplant entailed getting an unrelated donor’s stem cells to replace mine; then, if all went according to plan, these cells would grow into a new immune system to seek and destroy my cancer cells.

As a result of the transplant, all of my childhood vaccinations became ineffective. I was instructed to stay in isolation for at least four months in order to avoid infectious and possibly deadly diseases like influenza. Consequently, I have been quarantined since December. 

Just a day before writing this, a friend told me that I’m a “trendsetter.”

I knew very little about viruses before the coronavirus came along—only that they were microscopic infectious organisms that invade living cells and then reproduce. In an effort to review what I had been (mostly unconsciously) protected from before transplant, I Googled the Centers for Disease Control and Prevention (CDC) and found a piece entitled, “Vaccines for children: Diseases you almost forgot about.”

I was reminded that most of us had vaccines as children for some of the nastiest viruses, including polio, which invades the brain and spinal cord and leads to paralysis; tetanus, a potentially fatal disease that causes lockjaw; whooping cough, which can lead to violent coughing that makes it difficult to breathe; and many more.

Most older adults are familiar with chicken pox, mumps and measles. I had two of them as a young teenager. One that I forgot about is diphtheria, which affects breathing or swallowing and can lead to heart failure, paralysis and death. There are several more.

I imagined the panic that parents must have felt and the pain that young children must have experienced before vaccines were discovered to prevent these horrible infectious diseases.

For the time being, I cannot replace my old vaccines. I must wait for at least one year while my new immune system gets stronger.

The idea of being in isolation and maintaining a safe social distance for a few months post-transplant made sense to me. I was well prepared by doctors and nurses and I knew my wife would be a great caregiver, so I thought I could do the time.

And then, the coronavirus came along. 

For me, being quarantined was an old hat by the time a national emergency was declared and everything started to shut down. I learned that this new virus’ main target was the lungs and people older than 60 years with underlying health conditions were its primary targets.

I fit the bill and knew that I’d have to do more time: at least another three months, my transplant doctor told me. The only difference is that this time, hundreds of millions of people would be joining me.

I was well-prepared before and after my transplant. I knew why I had to self-isolate and for how long. No one, including me, was prepared for COVID-19 and the mass quarantine that it now requires—not only to protect oneself and one’s family, but also to protect strangers. Mostly older strangers like me.

Scientists and other health professionals were the heroes of viral epidemics gone by. I do believe we will get through this, with people like immunologist Dr. Anthony Fauci leading the way.

Still, the unknown is what is most frightening. We all want answers, yet some remain illusive at the moment. This is an opportunity for all of us to strengthen our tolerance for ambiguity.

When will this end? No clue. Will it come back? No idea.

Although my new immune system needs more time to protect me, I just found out after a PET scan that I’m in complete remission from my cancer.

Will it come back? No idea.

We are all in the same boat, living in uncertainty, whether young or old, healthy or unwell. As Plato said, “Be kind, for everyone you meet is fighting a harder battle.”

Andrew Malekoff is the executive director of North Shore Child and Family Guidance Center. To find out more, call 516-626-1971 or visit www.northshorechildguidance.org.

Strength In Diversity, By Andrew Malekoff, Anton Media, February 16, 2020

Strength In Diversity, By Andrew Malekoff, Anton Media, February 16, 2020

In my August 2019 column titled “Thank You,” I expressed my gratitude for the cancer researchers and practitioners who have been instrumental in getting me through the last 10 years of my life. As I explained, my cancer was responsive to treatment, but it was persistent and kept reemerging.

Since that piece was published, it was determined by my “team” that I was eligible for an allogeneic stem cell transplant, which meant getting someone else’s stem cells to help rebuild my immune system. Although this is a risky treatment, it does offer the possibility of a cure, which routine chemotherapy and immunotherapy do not, at least not for my type of blood cancer.

The team thought that given my age and overall good health and fitness, this was the best window within which to proceed. After considering all of the information with my family, I agreed.

The transplant was scheduled for December and required that the hospital find a non-related donor. I was fortunate enough that a stranger was discovered through the donor registry.

I spent three mostly difficult weeks in the hospital. The first phase was “conditioning,” in which I received high doses of chemotherapy and total body irradiation. Next came the transplant. The final and longest phase, which I am in now, is recovery. There is the risk of “graft versus host disease”– the possibility of the new cells not only attacking the cancer, but other organs in my body—which is part of what recovery aims to prevent.

Currently, I am vulnerable to many ailments and illnesses as I have the immune system of a newborn baby. It will become stronger over time, and eventually I will receive all of the childhood immunizations, which are now rendered useless.

This is all background that leads to what I really want to talk to you about: my experience with the personnel involved in the transplant.

The three nurses depicted in the photo, along with an attending physician (not pictured), presided over my stem cell transplant on Dec. 12, 2019, at Memorial Sloan Kettering Cancer Center in New York City. Some consider transplant day to be a new birthday. So now, I have two. I don’t know the identity of my donor, although there is a process in which I can communicate with that person to thank him or her directly if I so choose, in due time.

Obviously, as the photo reveals, the nurses are a diverse group. At the time of transplant, I asked them a little about themselves. Among the three nurses are a Muslim, Christian and Buddhist. The attending physician is Hindu. I am Jewish. There are racial and ethnic differences as well.

I teared when I said, “With all that is happening in the world, all of the hate, you represent the truth about the value of diversity.”

With their permission, I snapped this photo with my cell phone from my hospital bed. Amid the rampant and unrelenting stories of hate, this is a graphic reminder that diversity is our strength.

We cannot afford to squander it.

Andrew Malekoff is the executive director of North Shore Child and 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.

Guidance Center Responds to Coronavirus Crisis, By Andrew Malekoff, Anton Media, April 22, 2020

As the Coronavirus pandemic has come to dominate a good deal of our daily lives, are we, as Dr. Suzan Song suggests in U.S. News and World Report, “on the brink of a mental health pandemic that our current system is not equipped to handle?”

Recent polling by the Kaiser Family Foundation found that almost half of U.S. adults said the pandemic has affected their mental health, while more than half believed that they would be exposed to COVID-19 because they could not afford to stay at home financially.

At North Shore Child & Family Guidance Center, where we work with children, teens and their families, we’ve made the transition from face-to-face office, home and school-based visits to remote video conferencing sessions. Although we didn’t formally poll the families we work with, judging by feedback from our therapists, the mental health impacts of COVID-19 are pervasive.

Most of the children we see haven’t come to us because of COVID-19 fears, although we are starting to get referrals specifically related to the pandemic. Nevertheless, everyone we see is impacted by it. The problems that they came to us for in the first place—most often depression and anxiety—are exacerbated by the fear and uncertainty that the Coronavirus brings.

Many of our recent referrals come to us from urgent care or as the result of hospital  discharges. Along with depression and anxiety, some are also experiencing panic attacks, crying spells, passive suicidal thoughts and urges to self-harm.

As one of our therapists reported:  “Using Zoom video conferencing sessions to navigate family therapy has given me the opportunity to remain connected with the family while working with them virtually to discuss ways they can practice and implement better communication skills. Zoom sessions have also allowed me to work with my client individually to review and practice coping skills she can utilize when experiencing low moods.”

The challenges brought on by the pandemic are significant. Kids don’t know when they will return to school and, for many, when their moms and dads will return to work. Being in close quarters with their family 24/7 can feel like a pressure cooker, particularly when the stress of isolation from friends, economic worries at home and terror about  the possibility of a loved one becoming ill and dying are constantly at play. 

It’s fairly common knowledge that as many as one in five Americans experiences some form of mental illness, and the pandemic has greatly escalated their symptoms. As Dr. Song stated, “In my psychiatry practice, some of my college-aged patients who were previously able to manage their depression and anxiety are crippled in paralyzing fear of going outside, or depressed about the loss of their year and uncertain of their future.”

The Guidance Center’s seamless transition from in-person to virtual practice has made a significant difference for our families. When all feels like it is being lost with the limits that the shutdown has exacted, being able to maintain the routine of mental health counseling was a great relief. Parents have expressed gratitude for the continuity and for knowing that we have not abandoned them. 

Of course, we can only do what we are doing  because we have the technology to do so. And, as Dr. Song affirmed, “Prior to the pandemic, telehealth was not always covered by insurance; restrictions have temporarily been lifted for many, but need to continue post-pandemic.”

At the same time the nation’s mental health is declining due to the pandemic, the number of mental health professionals accepting insurance—and particularly psychiatrists—remains low due to the substandard rates of reimbursement that health insurers pay. 

Federal mental health parity law demands universal access to care, yet health insurers rarely comply by providing adequate networks of providers, and government does not adequately enforce this law. 

During this uncertain time, now more than ever we need to ensure universal access to care in order to flatten the mental health curve for our children and families.  

Andrew Malekoff is the executive director of North Shore Child & Family Guidance Center, the leading children’s mental health agency on Long Island. The Guidance Center is seeing new and existing clients via telephone and video during the COVID-19 crisis. To make an appointment, call (516) 626-1971. Visit www.northshorechildguidance.org for more information.

“A Visit with Rusty,” by Andrew Malekoff, Anton Media, December 19, 2019

From time to time, North Shore Child and Family Guidance Center has used animal assisted therapy (AAT) in its mental health treatment programs with children and teens, working in partnership with local canine and equine organizations.

In animal assisted groups, the therapist works closely with the animal handler or trainer. Think of the handler as an interpreter who teaches about the animal. The handler loves to talk about the personality of the animal and its unique qualities. They can humanize how the animals “speak” and keep appropriate boundaries.

Although using dogs is a little easier to arrange logistically speaking, there are a growing number of settings that offer equine facilitated therapy. Following is an illustration of animal assisted therapy using horses that helped build social skills and self confidence in a group of young teenagers who were identified as painfully shy or socially awkward.

After they arrived at the stables, the girls and boys sat around a table. Group work with horses mostly entails ground activities. Sitting on or riding the horses is the exception.
The horses were led outside and the group members were asked, “How do the horses welcome each other? How did they say hi?” Or “Look at Rusty: he looks like he is trying to get away from the others. Why do you think that is?” This opened the door for humor, as one of the more quiet boys said, “Maybe he has B.O. or bad breath.”

The handler then said, “Oh, did you see that? Rusty tried to kick that horse. Why do you think he did that?” This led the way to some discussions about anger and aggression.

In time the process became a little more sophisticated—for example, when the teens were asked, “How do the horses communicate?” The group could see that horses are powerful animals. The handler taught them that horses are prey animals that are always on the lookout. They learned that these majestic animals are instinctual and that they don’t see straight ahead but side to side, thus the rule to always stay on their side. (And, similarly, when a group is working with canine therapy, they learn not to look a dog in the eye because he can take it as aggression.)

The handler said, “See, you stay on their side because horses look side to side to scan the horizon.” Later, they learned that approaching and petting animals is a lesson in respecting one’s boundaries.

It was all about observation and metaphor, helping the young people build their observational muscles and reflect on what they saw and sensed. The activities were both direct and yet metaphorical in nature.

After a while the group members were asked, “Which horse do you want to spend some time with and why?” One group member said, “I’ll take Rusty; he’s a little shy but I think he is a tough horse and nobody’s gonna mess with him.”

Some of the teens we work with are immigrants from Central America, who escaped treacherous circumstances, and being with the horses brought back fond memories and staked a little claim to fame for them in the group. For example, Maria shared, “I know something about this. My family has horses. That one over there looks sad.”

The handler then talked about the “sad” horse’s history. Many of the horses were adopted and/or donated. This piqued the kids’ interest as the horse’s experience became a metaphor for their own dislocations and transitions. These issues were explored in a subtle, sensitive manner whereby the participants could project their feelings and experiences on the horses in an emotionally safe way.

By working with horses or dogs, children and teens learn many lessons, among them the importance of expressing their emotions, the ability to bond (both with the animal and with the other kids) and ways to keep calm and decrease stress. It’s a profound experience that can have lasting positive effects.

Andrew Malekoff is the executive director of North Shore Child and Family Guidance Center, which provides comprehensive mental health services for children from birth through 24 and their families. To learn more about the Guidance Center’s innovative programs, call 516-626-1971 or visit www.northshorechildguidance.org.

“Ask the Question,” By Andrew Malekoff, Anton Media, November 11, 2019

“Ask the Question,” By Andrew Malekoff, Anton Media, November 11, 2019

If my count is accurate, I was one of just three men (aside from the tech guy) who attended the Maternal Mental Health Conference on Oct. 2, at the Morrelly Conference Center in Bethpage. Yet the message of this conference was as germane for men—fathers, brothers, grandfathers and coworkers—as it was for mothers.

The conference was led by a terrific panel of health professionals, health educators and advocates. In the comments to follow, I will not cite any one in particular but I credit all five—Pauline Walfisch, Dr. Ariela Frieder, Vanessa McMullan, Sonia Murdoch and Phyllis Kaufman—who are all champions for pregnant and parenting moms.

We must begin with understanding the false ideal imposed upon many new moms. The ideal is that when a woman becomes pregnant, delivers a child and becomes a mother who cares for that child, everything is supposed to perfect.

Undoubtedly, some moms are able to acknowledge that being a mother is messy. They can adjust their sights, recognize that the ideal of perfection is a fantasy and adjust to the new reality of their lives. Naturally, it helps enormously to have the consistent support and understanding of their partner, family members and friends.

For some moms, though, messiness is harder to tolerate, especially when they experience what used to be known exclusively as postpartum depression and is now known as perinatal mood or anxiety disorders (PMADs for short). The latter term broadens the focus by recognizing that depression can occur during pregnancy as well as after giving birth, and that anxiety may also be a part of the picture. In other words, postpartum depression, the term most well-known by the lay public, is just one type of PMAD.

It is important here to pause and explain the difference between baby blues and clinical depression. The term baby blues represents the normal and characteristically mild ups and downs that new moms might experience for a few weeks after giving birth. Postpartum depression, on the other hand, can be the result of a confluence of stressors including the shifting of reproductive hormones following the delivery, sleep deprivation, poor nutrition, isolation, inadequate partner support, poverty and health issues of mom or baby, for example.

When you couple all this with the myth of perfect maternal bliss, the result is that many moms living with PMADs suffer in silence. Anything other than 100 percent perfection evokes feelings of stigma and shame.

Some mothers who are clinically depressed live with the belief that they should just “suck it up.” Others are advised to “pray it away.” Moms are very hard on themselves; they can begin to feel hopeless and harbor the feeling that things will never get better.

The good news is that there is help. The better news is that you can help. As one of the panelists advised, just ask the question. In other words, ask how mom is doing. The focus is most often on how the baby is doing, totally disregarding the mom, which just reinforces the idea that moms should be happy, holding their own and thrilled to be a new mother.

Whether you are a partner, parent, friend or colleague—female or male—asking the question is the first step toward eliminating stigma and shame. It can make all the difference in the world for a new mom who is suffering in silence. Ask the question.

Andrew Malekoff is the executive director of North Shore Child & Family Guidance Center. To find out more, including information about the Guidance Center’s Diane Goldberg Maternal Depression Program, call 516-626-1971 or visit www.northshorechildguidance.org.

“Make Your Voice Heard,” by Andrew Malekoff, Anton Media, Oct 16-22, 2019

“Make Your Voice Heard,” by Andrew Malekoff, Anton Media, Oct 16-22, 2019

As young people all across the U.S. reach their 18th birthdays, they will become eligible to vote in their first presidential election in 2020. It’s shaping up to be a record turnout ever since the vote went to 18-year-olds in 1972, after the 26th Amendment to the Constitution was ratified.

Although the law was written to prevent government from denying a citizen who is at least 18 years old the right to vote, a number of state governments have found a way to do just that—and not only to 18-year-olds, but anyone who they think might vote against a favored candidate or proposition.

In a June 13, 2019, report for The Atlantic, writer Ron Brownstein cited Michael McDonald, a University of Florida political scientist who specializes in voting behavior. McDonald stated that the greatest increase in eligible voters comes from “young people who turn 18 and immigrants who become citizens.”

The increase in eligible voters doesn’t necessarily determine how many of them vote. Who shows up to vote does. And who is turned away doesn’t.

In recent years, there has been a fair amount of political bluster about rampant voter fraud, which has not been substantiated except in a miniscule number of individual instances. What has been well-documented historically, however, is voter suppression to prevent or discourage particular groups of people from voting. Many tactics are used to disenfranchise voters from casting ballots that range from inconveniencing voters to physically intimidating them.

For example, Jim Crow laws were passed in southern states after the Civil War to suppress poor and racial minority voters. Such laws were made illegal after the enactment of the Voting Rights Act of 1965. Nevertheless, in 2013 the Supreme Court decided to eliminate Section 4 of the Voting Rights Act; the loss of Section 4, it has been argued, results in voter suppression among African-Americans. In the intervening years more than 1,000 polling places were closed that were in close proximity to where many African-American eligible voters live.

In 2014, attorneys for seven college students argued in a North Carolina case that a voter ID law suppresses the youth vote. According to an ABA Journal report by Debra Cassens Weiss on July 18, 2014, “The North Carolina law at issue eliminated same-day registration, shortened the period for early voting, and eliminated a program that allowed teens to fill out registration forms that took effect on their 18th birthday. A photo ID [would be required] but student IDs won’t be accepted and neither will out-of-state driver’s licenses, in most cases.”

The next presidential election will be held Nov. 3, 2020. If you are a teenager who has or will become eligible to vote before that time, it is important that you register to vote and know your rights.

Depending on where you live, you can become eligible to cast a ballot in all state and federal elections when you reach 18. Check out www.usa.gov/voter-registration-age-requirements for age requirements by state. Another good resource regarding voting rights is the League of Women Voters (www.lwv.org) whose mission is: Empowering voters. Defending democracy.

Your vote counts. Get registered and use it.

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, call 516-626-1971 or visit www.northshorechildguidance.org.

“Greta,” by Andrew Malekoff, Anton/Long Island Weekly, October 1, 2019

“Greta,” by Andrew Malekoff, Anton/Long Island Weekly, October 1, 2019

16-year-old Swedish climate activist Greta Thunberg (Photo source: Greta Thunberg Facebook)

On Sept. 18, I listened to Greta Thunberg, the 16-year-old Swedish climate activist who testified before a U.S. Congressional hearing on climate change. Her message was brief and then she answered questions along with a number of fellow youth climate activists.

She told the congressional members that she had no prepared remarks and, instead, was leaving them with written testimony. She said, “I am submitting this report as my testimony because I don’t want you to listen to me, I want you to listen to the scientists. And I want you to unite behind the science. And then I want you to take real action.”

Nevertheless, four months earlier she did offer more extensive remarks to the British Parliament. Here, in part, is what she said:

“My name is Greta Thunberg. I am 16 years old. I come from Sweden. And I speak on behalf of future generations. I know many of you don’t want to listen to us—you say we are just children. But we’re only repeating the message of the united climate science.

“Many of you appear concerned that we are wasting valuable lesson time, but I assure you we will go back to school the moment you start listening to science and give us a future. Is that really too much to ask?

“In the year 2030, I will be 26 years old. My little sister Beata will be 23. Just like many of your own children or grandchildren. That is a great age, we have been told. When you have all of your life ahead of you. But I am not so sure it will be that great for us.

“I was fortunate to be born in a time and place where everyone told us to dream big; I could become whatever I wanted to. I could live wherever I wanted to. People like me had everything we needed and more. Things our grandparents could not even dream of. We had everything we could ever wish for and yet now we may have nothing.

“Now we probably don’t even have a future any more.

“Because that future was sold so that a small number of people could make unimaginable amounts of money. It was stolen from us every time you said that the sky was the limit and that you only live once.

“You lied to us. You gave us false hope. You told us that the future was something to look forward to. And the saddest thing is that most children are not even aware of the fate that awaits us. We will not understand it until it’s too late. And yet we are the lucky ones. Those who will be affected the hardest are already suffering the consequences. But their voices are not heard.”

Greta went on to offer more specific information about reductions in greenhouse gases including methane gas escaping from rapidly thawing arctic permafrost. A note of clarification: When methane leaks into the air before being used it absorbs the sun’s heat, warming the atmosphere. If you would like more scientific detail you can read Greta’s full remarks to Parliament by clicking the link provided at the bottom of this column.

Greta concluded her remarks by stating, “We children are not sacrificing our education and our childhood for you to tell us what you consider is politically possible in the society that you have created. We have not taken to the streets for you to take selfies with us, and tell us that you really admire what we do.

“We children are doing this to wake the adults up. We children are doing this for you to put your differences aside and start acting as you would in a crisis. We children are doing this because we want our hopes and dreams back.

“I hope my microphone was on. I hope you could all hear me.”
Just as Greta wanted Congress to listen to the scientists, I would like you to listen to her.

To read Greta Thunberg’s full testimony to Parliament, visit www.theguardian.com/environment/2019/apr/23/greta-thunberg-full-speech-to-mps-you-did-not-act-in-time.

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 learn more about the Guidance Center’s innovative programs, call 516-626-1971 or visit www.northshorechildguidance.org.

“Tapping the Power of Youth,” by Andrew Malekoff, Anton Media

“Tapping the Power of Youth,” by Andrew Malekoff, Anton Media

The headline read: “Student activists prevail.” It was a story by Joie Tyrell published earlier this year that told the tale of a group of high school students who were researching the international issue of access to feminine hygiene products.

In their research, the teenage girls found that New York State legislation called for the provision of feminine hygiene products in the restrooms of all school buildings at no charge to students. Yet the Lindenhurst High School girls found that in their school such products were only available in the nurse’s office.

The girls addressed the issue with a school administrator and district officials. The authorities responded to the girls’ advocacy and the situation was remedied.

Some years ago, I worked in a high school where I encountered a situation that also involved a high school bathroom. In this case the problem was the fact that there were no doors on the stalls in the boy’s bathroom.

A group of boys, who were members of a school-based mental health counseling group, raised the issue. As one of them said, “Do you think they have any idea how humiliating it is to go to the bathroom with no doors on the stalls? There’s no privacy; it’s embarrassing.”
The group decided to present their concern to school authorities. During a group meeting they rehearsed what they would say. Soon after they requested a meeting with the principal, and sometime after that their “demand” was met.

What these two stories have in common is young people identifying problems, having a vision, organizing and taking steps to ensure they receive the respect and dignity that they deserve.

As we approach the beginning of another school year, it is worth noting that young people have power and, when they exercise it and receive support, they can make a difference.
Roger A. Hart, a professor of environmental psychology, has devoted much of his life’s research to children’s development in relationship to the physical environment. To that end he created a “ladder of participation” that differentiates the degrees to which young people might initiate change.

Following is an elaboration of the ladder of participation by Adam Fletcher, an internationally recognized expert on youth and community engagement. Fletcher starts with the top rung of the ladder.

  • Young people-initiated, shared decisions with adults: Projects or programs are initiated by young people and decision-making is shared between young people and adults.
  • Young people-initiated and directed: Young people initiate and direct a project or program. Adults are involved only in a supportive role.
  • Adult-initiated, shared decisions with young people: Projects or programs are initiated by adults but the decision-making is shared with the young people.
  • Consulted and informed. Young people give advice on projects or programs designed and run by adults. The young people are informed about how their input will be used and the outcomes of the decisions are made by adults.
  • Assigned but informed. Young people are assigned a specific role and informed about how and why they are being involved.
  • Tokenism. Young people appear to be given a voice, but in fact have little or no choice about what they do or how they participate.
  • Decoration. Young people are used to help or “bolster” a cause in a relatively indirect way, although adults do not pretend that the cause is inspired by young people.
  • Manipulation. Adults use young people to support causes and pretend that the causes are inspired by young people.

Understanding the ladder of participation can help those of us who care about kids to know when to lead, follow or get out of the way. In any case, making decisions that support young people becoming active participants in community affairs is a win-win, particularly when it supports them in blazing a path and making a difference in areas where we have failed.

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.

“Thank You,” by Andrew Malekoff, Anton/Long Island Weekly, August 24, 2019

“Thank You,” by Andrew Malekoff, Anton/Long Island Weekly, August 24, 2019

I know that I am not alone. When I write about the fact that I have cancer, it is not my intention to suggest that I am in any way unique. Although when I was first diagnosed in 2010, I did feel special, and not in a good way.

At first, I thought I had a hernia. But the surgeon said no. It took almost two months for the biopsy of the lymph node that he extracted from my body to be definitively identified. I don’t know why it took so long. They said it was a good sample. They sent it to Bethesda for further analysis. Still no answer. I then had a second biopsy.

I received the phone call from the oncologist while I was at work on a Friday afternoon nine years ago. Hearing the words was surreal. What does this mean?

In the intervening years I’ve had radiation and several rounds of combined immunotherapy and chemotherapy, all aimed at killing the bad cells and stimulating my immune system. That is how I understand it.

I was fortunate enough to stay active—I exercised normally and hardly took a sick day, except when I had an all-day infusion. I had side effects: fatigue, constipation, rashes, neuropathy, alopecia and more. Of course, there is an emotional impact as well, particularly when death and dying are closer to consciousness than ever before.

When I was diagnosed, the first question I asked my doctor was, “Am I dead man walking?” She told me no. I was a bit self-obsessed for a period of time. I soon realized that my diagnosis had a profound impact on my family as well. Although they didn’t have to deal with the physical aspects of treatment or contend with immediate thoughts of their own mortality, caretakers and loved ones bear a burden that cannot be underestimated or ignored.

My father had cancer. He eventually died as the result of his spreading cancer invading his vital organs. My cancer is different than my father’s, but both are in the blood disease family. When he died, he was 74 years old. I slept in his hospital room for several days and watched him take his last breath.

I asked my doctor how long I could expect to live. I threw out a number and asked if I would make it that far. She said, we have lots of really good treatments.

In the intervening years, after several treatments, I learned that my cancer is not resistant to treatment, but it is persistent. In other words, it comes back much faster after treatment than they would like to see.

When I decided to write this, I didn’t want it to come across as self-indulgent. And, as I said at the top, I am not unique. When I read obituaries, I have noticed a common expression, so-and-so died after a long battle with cancer. Will my obituary say that?

Why am I writing this? It is to thank the researchers, the scientists who are hard at work discovering new treatments and cures every day—lots of really good treatments.

What I know today is that I owe the last nine years of my life to you and the health professionals who diagnose and administer care.

Thank you, one and all.

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.

“A Sad Anniversary,” by Andrew Malekoff, Anton Media, May 29-June 4, 2019

“A Sad Anniversary,” by Andrew Malekoff, Anton Media, May 29-June 4, 2019

Just the other day I was reminded that May marks the anniversary of one of the saddest trending tweets in Twitter history. The reminder was a photo posted on Instagram of a girl holding a cardboard sign. The girl looked to be 13 or 14 years old. The sign read: If I die in a school shooting, leave my body on the steps of Congress.

#IfIDieInASchoolShooting was first tweeted a year ago, after 22 school shootings up to that point in 2018. Number 22 happened at Santa Fe High School in Texas on May 18, 2018, just a few months after the shooting at Marjory Stoneman Douglas High School in Parkland, FL, when a gunman killed 17 students and staff members and injured 17 others.

At Santa Fe, 10 people—eight students and two teachers—were fatally shot. Thirteen more were wounded.

As we mark the first anniversary of #IfIDieInASchoolShooting, the “statistics” have climbed. Eight school shootings have taken place on high school or college campuses in 2019 through the month of May. So far.

In a piece on the trending hashtag written by India Pougher for ELLE Magazine four days after the Santa Fe shooting, she wrote, “Students began tweeting…and sharing the things they would miss out on if their lives were taken too soon. The answers range from leaving their loved ones behind to never graduating college and never getting married.”
Here are some of the tweets:

#IfIDieInASchoolShooting:

Prop up my casket in front of the White House — @scottf6f

I want to be buried next to my best friend — @2muchisntenough

Make sure I am the last to do so — @ardenneastonn

Is a sad reality for America — @tiatameraa

Please make school shootings die with me — @madhavids

Don’t release pictures of my smiling face. Release pictures of my bloody dead corpse to show what school shootings really are. Politicize my death — @hmc823

I’ll never get to publish my book, celebrate my sweet 16, get married, or see my children grow to be wonderful people — @casforachange

Then my parents would have outlived their only child — @estef4change

Protect my little sister so she can stop “learning to hide from the bad guy” — @robinisme16

My 8 younger siblings will have to grow up without their oldest sister, i’ll never graduate high school or college, i’ll never get to work in dc like i’ve wanted to since i was young, i’ll never get to create change — @jaxonomara

My dogs would be left wondering why I never came home. My internet friends would be clueless. I wouldn’t achieve my dream. If I die in a school-shooting the government won’t do anything to prevent another — @TAKENBYDEMA

I will never become a nurse and fulfill my dream of helping children, teenagers, and young adults. My passion for wanting to save lives will die with me — @beachwonders

One adult saved me the trouble of writing a conclusion, when he tweeted:

If I Die In A School Shooting is the saddest hashtag I’ve ever read — @StevenBeschloss

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 or call 516-626-1971.

“Guidance Center to Host 23rd Annual Jonathan Krevat Memorial Golf & Tennis Classic,” Anton Media, May 20, 2019

“Guidance Center to Host 23rd Annual Jonathan Krevat Memorial Golf & Tennis Classic,” Anton Media, May 20, 2019

From left: Michael Mullman, Ed Geller, Jeff Krevat and Peter Braverman

North Shore Child & Family Guidance Center will hold its 23rd annual Jonathan Krevat Memorial Golf & Tennis Classic on Monday, June 3, at the North Hempstead Country Club in Port Washington, one of the region’s premier courses.

Co-chairs Mike Mondiello, Michael Schnepper and Troy Slade are once again working together to create a stellar event filled with friendly competition, delicious dining and wonderful auction prizes. This year, the event is celebrating the dedicated mental health professionals at the Guidance Center—the people who are at the heart of the many success stories of moving families from hurting to healing.

“The reason the Guidance Center changes so many lives for the better is because the staff is composed of caring, compassionate and highly trained individuals,” said Slade, who is a member of the board of directors. “I’m thrilled that we are celebrating them at this year’s Krevat Cup.”

“This is going to be a phenomenal event,” said Mondiello, also a member of the Guidance Center’s Board of Directors. “The North Hempstead Country is a beautiful course, and we are excited to hold the Krevat Cup at this elegant location for the first time!”

 

Troy Slade, Mike Mondiello, Dan Donnelly and Michael Schnepper



Established on Long Island’s beautiful and serene Gold Coast in 1916, the North Hempstead Country Club features a tree-lined, superiorly manicured golf course designed by renowned architect A. W. Tillinghast, one of the most creative and productive golf course designers ever.

In addition to golf, the event will feature round robin tennis (for the non-golfers among the attendees), a delicious brunch and a gourmet dinner after the day’s games conclude. It will also feature a silent and live auction, with prizes ranging from club seats for a Yankee game to exciting vacation packages and much more.

Dan Donnelly, one of the Guidance Center’s most ardent supporters, as well as a former Krevat Cup honoree, will be serving again as the emcee and auctioneer. “I’m so pleased that this year’s event is celebrating the Guidance Center’s amazing staff,” said Donnelly. “The people working here are such caring souls who are truly devoted to saving lives.”

 

A tennis player readies her serve.



The other auctioneer for the evening portion of the event is Andrew Marcell, a Guidance Center Board Member. “The Krevat Cup is one of the most enjoyable events of the season,” Marcell said. “It’s a win-win: Everyone has a terrific time while supporting the lifesaving mission of the Guidance Center.”

Executive Director Andrew Malekoff said, “The event is crucial to our fundraising efforts, and will help us continue to help thousands of children each year who are struggling with issues such as bullying, depression, anxiety and substance abuse.”

Fifth Avenue of LI Realty/Americana Manhasset has signed on as a Diamond Sponsor.
For those interested in joining a team, attending the dinner, becoming a sponsor or placing a journal ad, contact Patrick Madden at pmadden@northshorechildguidance.org or 516-626-1971, ext. 309.

North Shore Child & Family Guidance Center is the preeminent nonprofit, children’s mental health agency on Long Island, dedicated to restoring and strengthening the emotional well-being of children (from birth to age 24) and their families. For more than 65 years, the Guidance Center has been a place of hope and healing, providing innovative and compassionate treatment to all regardless of their ability to pay.

For more information about the Guidance Center, visit www.northshorechildguidance.org
 or call 516-626-1971.
“Taking the Fight Out of Food,” By Andrew Malekoff, Anton Media/Long Island Weekly, May 13, 2019

“Taking the Fight Out of Food,” By Andrew Malekoff, Anton Media/Long Island Weekly, May 13, 2019

Is your child a picky eater? Does her or his eating create tension in your home? What was your experience in being fed growing up? Were your parents overly involved?

These are a few questions to consider if you are concerned with your child’s eating habits. Donna Fish, a licensed clinical social worker, offers parents and kids guidance in how to take the fight out of food.

I met Ms. Fish at her workshop that focused on learning how to prevent and solve childhood and teen eating problems. She advised that two questions to ask up front are: What is the problem? And whose problem is it?

These two questions are critical to understanding whether your child’s eating is problematic from a medical/developmental perspective.

If a medical problem has been ruled out, the child is not nutritionally compromised and there are no body image issues the child is experiencing, then there needs to be some better understanding about how their picky eating is affecting dynamics in the family. For example, does it lead to parents frequently fighting or to tension on vacations?

Basic parent education on nutrition and development go a long way in helping a parent to understand that their child is on a normal growth curve and that how they eat from a nutritional perspective is nothing to be worried about. Consulting with your pediatrician or finding a nutritionist is a good place to begin.

If education doesn’t do the trick, then it is helpful to understand a bit more about whose problem it is. This necessitates an understanding about the meaning of food in the family.

In many cultures food and feeding represent love, nurturing and bonding. If a child’s picky eating denies a parent a sense of nurturing it can lead to a battle of wills. In that case, a child quickly learns how their eating represents an ability to take control, which can lead to power struggles in the family.

For parents, understanding their own experiences eating when growing up can offer them some insight. For example, if their parents were overly involved with their eating it might suggest some difficulty trusting your own body signals regarding when you’re hungry or full and satiated.

If a parent makes this historical connection, it may help them to better understand the value in allowing their child to have more autonomy with eating. For example, they can be allowed to control their own meal portions. For a toddler that might mean putting finger foods on their tray so they can help themselves as opposed to being spoon fed.

In her work with children who are struggling with eating, Fish advises “You are the expert on your body. You need to be the best body detective possible. It’s your job, not your parents’ job.” This is important work that helps the child to separate emotions from feelings of fullness and comfort.

Ms. Fish sees “all food as good,” as having some value, and talks to kids about nutrition in a way that generates interest and curiosity.

Still, if your child appears to continually make poor choices, it is important that you set reasonable limits. As Fish puts it, “Parents think their job is to protect their child from disappointment, anxiety and hurt,” but it is okay for children to experience the disappointment of your setting limits on occasion. It’s just another of the many areas where parents can help their kids learn a valuable life lesson.

To learn more about Donna Fish, visit www.donnafish.com. Take the Fight Out of Food can be found on Amazon.

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 or call 516-626-1971.

“Seeking Humane Solutions for Young Refugees,” by Andrew Makekoff, Anton/Long Island Weekly, December 14, 2018

“Seeking Humane Solutions for Young Refugees,” by Andrew Makekoff, Anton/Long Island Weekly, December 14, 2018

In a recent story in the Albany Times Union, reporter Mallory Moench paints a different picture about juvenile asylum seekers as compared to recent stories about caravans purportedly composed of gang members and Middle Eastern terrorists.

In the report we meet Rosa, who left El Salvador as a young adolescent after being targeted by a gang intending to prostitute her. To prevent becoming sexually exploited, she left her parents and crossed the border. She has been living in the Capital Region of New York for the past two years.

Rosa, now 17, is undocumented and is seeking special immigrant juvenile status that would enable her to apply for a green card which permits a foreign national to live and work permanently in the U.S.

Rosa understands that she could be denied and deported. More than 12,500 undocumented young people have participated in immigration court this year alone. For those without a lawyer, the odds of deportation are much greater.

According to the Albany Times Union report, “If juveniles [under the age of 21] have a relative who is a U.S. citizen or green card holder, they can apply for a family-based petition. If they are victims of trafficking, domestic violence or another crime they can apply for crime victim visas. If they’re fleeing persecution like Rosa, they can apply for asylum. If they’re missing one or more parents they’re eligible for special immigrant juvenile status.”

Former Attorney General Jeff Sessions had taken measures to fast-track deportations. Consequently, many juveniles may be sent back to their homelands—and the dangers and threats that await them—before legal proceedings are implemented.

Many of the young people living in New York’s Capital Region, ages 12 to 19, came from El Salvador, Guatemala, Honduras or Mexico after being confronted with gang violence. The profile and numbers of refugees on Long Island is similar. It is ironic that with the incendiary political rhetoric of the day, many asylum seekers have been labeled gang members, when it is gangs that they are trying to escape from.

Many young migrants endured trauma in their passage to the U.S. They faced starvation, violence and abandonment.

There are only two immigration courts in all of New York. One is located in New York City and the other is in Buffalo. For many asylum seekers, the cost for transportation to court hearings prevents them from following through. For example, for those living in the Capital Region, a bus ride can be as much as $100 and more than $500 for private transportation.

This is especially daunting when they are living in poverty.

Furthermore, there is a cap on the number of visas given each year and also each month. This contributes to inordinate delays in court.

For most of these juveniles the fear and anxiety of being deported as they await a final legal determination can be unbearable and impacts their ability to heal from the traumatic journey to the U.S.

Immigration laws do need to be enforced as open borders with endless flow of refugees is unsustainable.

The challenge is how to enforce the law, dial down the divisive and hateful rhetoric, demonstrate compassion and seek humane solutions for young migrants simply looking to live without fear. We’ve strayed from that ideal. I hope we can find our way back.

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.

“Flint Revisited,” by Andrew Malekoff, Anton Media Group, April 12, 2019

“Flint Revisited,” by Andrew Malekoff, Anton Media Group, April 12, 2019


(Image by Rudy and Peter Skitterians from Pixabay)

I have protested or testified before government bodies for issues including separating children at the border, school shootings and insurance parity for mental health and substance use disorders. I participated in a number of relief efforts after large-scale disasters such as 9/11 and Hurricane Sandy. Yet nothing haunts me as much as the poisoning of an American city.

The water crisis in Flint, MI, began in April 2014 when, in a cost-cutting measure, the drinking water supply from Detroit’s system was switched to the Flint River. When essential treatment and testing of the water did not follow, health issues ensued.

Government officials turned their backs on the residents of Flint by ignoring the problem that was signaled by foul smelling and discolored water being piped into people’s homes for nearly two years.

Five years later, in January 2019, Gov. Gretchen Whitmer assured Flint residents that they will continue getting free bottled water until all of the pipes are replaced. According to a Jan. 23, 2019 report in The Detroit News, “As of December, the city had replaced nearly 7,000 out of 18,300 lead or galvanized steel water pipes it had identified.”

Beyond the local community, where is the sustained outrage about this unfathomable crime against the children and families of Flint?

I’ve seen a lot in seven decades beginning in the early 1950s, and although I never attempted to rank the horrors over those years, I find the poisoning of Flint, MI, to be among the most troubling. Although there has been backlash, I find it to be muted in comparison to other disasters.

The poisoning of an American city and all of its children, mostly children of color, was a government cost-cutting measure that would have been considered ethnic cleansing by our government leaders if it happened in any other country but our own, according to filmmaker Michael Moore.

To be clear: The residents of an entire American city were poisoned for 19 months. There were warning signs—off-tasting water, body rashes, itchy skin, hair loss—yet government officials told the residents that the water was just fine. It took almost two years of poisoning for the government to wake up after researchers pointed to elevated levels of lead in children.

Corruption in New York State and the country at large is so common that clean government has become an oxymoron. Have we become so inured to it that our attention cannot focus on the latest scandal for very long? Has our capacity for empathy become drained by serial horrors?

If my children were among the poisoned I would likely have to contain feelings of murderous rage, because acting on such impulses would do nothing to help my children.

Yet how do the parents of Flint cope with the knowledge that their children, with still-developing brains, may sustain cognitive impairments that will last a lifetime?

Gov. Whitmer reflected, “Trust was not broken overnight, and it’s not something you can earn overnight.”

The Detroit News reported that “many residents remain wary of the water amid fears that pipe replacement efforts could dislodge lead flakes.” They likely remember that state regulators did not make sure that the city used corrosion control chemicals when it made the switch to the Flint River for its water supply in April 2014.

Will trust ever be restored by parents who understand that their children’s intellectual potential has been compromised by bureaucrats looking for a shortcut to balance the budget? What can one do or say to offer some relief? I cannot think of a thing. Can you?

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.

“Giving Hearts,” Anton’s Long Island Weekly, February 6-12, 2019, by Andrew Malekoff

By Andrew Malekoff

Why do people choose to support certain causes, while others look away?

Sometimes it’s personal. A family member dies in hospice where their dignity was preserved in their final days. Other times it’s not as close to home. A television spot features a child with a cleft palette, a shivering dog or a malnourished baby.

Certain causes seem easier to sell. For example, the school you attended or a research center that is making advances in treating cancer.

Other causes may be tarnished by misunderstanding. For example, I’ve worked in the mental health and addiction fields since the early 1970s. It is in this arena that some believe that one’s ailments “above the neck” are self-inflicted, failures of character or poor parenting or lack of will power. Consequently, they deem them unworthy of philanthropy.

Nevertheless, I must recognize the compassion and generosity of those who do understand and support the work we do at North Shore Child and Family Guidance Center and many of our sister agencies. It is important to acknowledge that these givers are more than do-gooders, despite the good that they do.

They are smart and empathetic. They know that what we do is cost-effective, saving tens of millions of dollars by keeping troubled kids at home and out of costly institutional settings. They look into the eyes of their own children or grandchildren and feel a deep connection to all children.

Family members and friends have asked me what led to my choosing a career in human services, intimating that it’s not a financially lucrative path. My greatest influence was observing the profound impact of the kindness of others during my childhood and youth.
The father of my closest childhood friend died in the 1950s when we were little kids. We lost touch as we grew older. When his mom died, I sent him a sympathy card.

Some weeks later my friend wrote back to me. His words brought a lump to my throat.

“Dear Andy: What a surprise to hear from you! My mom’s death has caused me to spend hours thinking about my childhood. Some of my most fond recollections involve you and your family. Your father was the dad I didn’t have…”

Throughout my childhood, my parents, as well as other adults in my family, performed acts of profound kindness and generosity without fanfare or any expectation of anything in return. I married a woman who came from a similar family. Her parents took in their nieces after the untimely death of their mother.

Now I have found these people with giving hearts again among our board of directors and community supporters. What they have in common with my family is their empathy.

Government bureaucracies have no empathy. They have rules and regulations. One can only hope that legislation they enact is guided by values rooted in the felt needs of real people.

We cannot rely exclusively on government to take care of us. We must rely on one another. We cannot allow empathy to slip away, as it sometimes seems it is. The demise of empathy is perhaps the most perilous consequence in today’s divided America.

When all else fails, empathy is all we have to maintain a humane society.

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.

“New Law Aims to Strengthen Access to Mental Health Care,” Anton Media, January 9-15, 2019

“New Law Aims to Strengthen Access to Mental Health Care,” Anton Media, January 9-15, 2019

By Andrew Malekoff

Thanks to a strong advocacy push by a broad array of consumer and provider representatives of behavioral health services, the Mental Health and Substance Use Disorder Parity Report Act was enacted into law by Governor Cuomo on Dec. 21, 2018, as Chapter 455 of the Laws of 2018.

The historic new law is a huge victory for North Shore Child & Family Guidance Center and the broader mental health and substance use care community as it will compel insurers to submit key information to the NYS Department of Financial Services (DFS) for analysis and evaluation of compliance with federal and state parity laws, culminating in the publication of a report on the DFS website that will provide much needed accountability and transparency.

Until now, existing parity laws, which demand that coverage and treatment for mental health and substance use disorders are on par with the coverage and treatment of physical illnesses, have been widely ignored, putting lives at risk. The failure to enforce parity laws was made clear in January 2018, when North Shore Child & Family Guidance Center released Project Access, a Long Island-wide study on the difficulty or ease in which families were able to access healthcare for mental illness and addiction.

This new legislation—which was passed one year after the release of Project Access—is a shared success and would not have been possible without strong grassroots support that included the generation of an enormous volume of letters, calls and tweets from consumer and provider advocates.

The enactment of the law at this time is especially symbolic as New York marks the twelfth anniversary of the passage of Timothy’s Law (the name of New York’s parity law), which Governor Cuomo recognized in his approval message: “Ensuring New Yorkers have access to care and treatment for mental illness and substance abuse disorders is critical and is the reason New York enacted one of the strongest mental health parity laws in the nation [Timothy’s Law] in 2006.”

2018 also marked the 10th anniversary of the federal Mental Health Parity and Addiction Equity Act. The new Mental Health and Substance Use Disorder Parity Report Act puts New York on a path to achieving full compliance and transparency with the state and federal parity laws, which are critical components in maintaining and enhancing access to care for those experiencing mental health and substance use disorders.

The challenge ahead will be to hold the NYS Department of Financial Services accountable, to be sure that they are taking adequate steps to verify the data and information that will be provided to them by health insurers.

Verification is essential to determining, for example, that the networks of providers on a health insurer’s rolls are in fact real as opposed to deceased, retired or no longer accepting insurance. They must also verify and report when waiting lists of valid providers are so long that access is delayed beyond a reasonable time with respect to the urgency of the need.

The reason why there is a paucity of mental health and drug treatment providers is due to the substandard rates of reimbursement that health insurers pay for mental health and addiction care as compared to what they pay physical health care providers. This must be exposed and corrected if found to be the case for denied access.

Access delayed is access denied.

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.

Kids First: Words Really Do Matter,” by Andrew Malekoff, Blank Slate Media, November 5, 2018

By Andrew Malekoff

Words matter. Today, this is no more evident than in the incendiary rhetoric spoken – and tweeted – that has contributed to American citizens being pitted against one another.

There is a growing sentiment that the mass shooting in a Pittsburgh synagogue that took the lives of 11 congregants was fueled by hate speech that ignited the shooter’s growing rage.

Although that subject is being abundantly covered in the media, it is the words associated with another kind of shocking death that I wish to draw attention to here. 

When someone takes their life, they are most frequently reported to have “committed suicide.” Commit is a word that connotes a criminal act. Yet, suicide is not a crime.

Desiree Woodland, a mom who lost her son to suicide shared her experience in a National Alliance on Mental Illness publication. “My son did not commit a crime. He believed the only way to end the unbearable pain was to end his life. He died because he didn’t have the words to express the deep psychological/biological turmoil he was experiencing.”

If not a crime, is suicide an immoral, depraved or sinful act? It isn’t if it is the consequence of mental illness, unbearable stress, or trauma.

Nonetheless, family members who are survivors of suicide loss report the experience of others speaking in hushed tones around them. Some people refer to suicide as a selfish act, the result of poor parenting, a deficit in the family or all of the above.

At the same time that there is a growing demand to tone down divisive and hateful rhetoric in order to prevent interpersonal violence, there needs to be discussion about mental illness and suicide. 

According to Denver psychotherapist Dr. Stacy Freedenthall, “If changing our language can help suicidal people to feel safer asking for help, then changing language can save lives.” 

In academic journals there appears to be an inclination to use the term “completed suicide.” However, committed and completed are terms that advance the stigma and shame related to suicide and should be avoided.

Increasingly there is preference to the expression “died by suicide,” which avoids the judgmental undertone of “committed suicide.” 

Perhaps a contributor to The Mighty, a digital health community created to empower and connect people facing health challenges and disabilities, said it best: “By shifting our language around suicide, we have the power to reduce some of the massive shame carried by survivors of suicide. If you feel scared or helpless about what to say to someone who’s lost someone to suicide, take comfort in knowing that, by changing your language about suicide, you’re offering an act of kindness.”

“Beyond Words: Trauma and the Arts,” by Andrew Malekoff, Anton Media Group, Oct 17-23, 2018

Powerful images that depict disturbing events in ways that literature alone cannot can be illuminating and healing. Following are three descriptions of different media that capture recent man-made disasters, still very close to the surface for many of us.

The first, Please Stand By, is an example of cartoon art in the aftermath of 9/11. The second, The Last Lockdown, is about a sculpture created after the mass school shooting in Parkland, FL. Both illustrate the fear-inducing paralysis of traumatic events. The last, Memorial Rock Garden, describes bereaved children painting stones to memorialize their deceased dads.

Please Stand By

In the immediate aftermath of the September 11, 2001, terrorist attack on America, several artists joined together to produce a soft cover book titled 9/11: Artists Respond. It is a collection of art, sequenced to showcase the artists’ response to the terror that befell the world.

One nine-frame piece entitled “Please Stand By…,” by Jeph Loeb and J. Scott Campbell, features a girl of about 8 years old watching cartoons on television. By the third and fourth frames, the image on the screen changes to a live feed of the Twin Towers ablaze.

As the little girl stands transfixed, stuffed animal in hand and her face less than 12 inches from the screen, the commentator announces, “We interrupt this program to take you live…”

The little girl turns away and cries out, “Mommy!” The next three frames begin with her mother dropping a basket of laundry. Then, with her face contorted in anguish, she embraces her daughter to shield her from the unrelenting televised images.

The final frame is a close up of the little girl asking, “Mommy, when are the cartoons gonna come back on?”

The Last Lockdown

The next image is a haunting statue, as described by journalist Josh Hafner, of a “small girl cowering beneath an open school desk, clutching a leg as she gazes into the distance with a look of fear in her eyes.”

The sculpture was created by Manuel Oliver, an artist who lost his 17-year-old son Joaquin in the Parkland, FL, mass shooting earlier this year.

As Oliver said, “It’s too late for us to save Joaquin from gun violence, but through art, my family and I are making sure that we protect the rest of the kids out there.”

“Talking about the trauma is rarely if ever enough,” advises noted trauma expert Bessel van der Kolk. He points to the Holocaust Memorial in Jerusalem and the Vietnam War Memorial in Washington, D.C., “as good examples of symbols that enable survivors to mourn the dead and establish the historical and cultural meaning of the traumatic events to remind survivors of the ongoing potential for communality and sharing.”

Memorial Rock Garden

In 2002 at North Shore Child & Family Guidance Center, a group of boys and girls who lost fathers in the attack on the World Trade Center decorated stones to be placed in a memorial rock garden.

The kids in the bereavement group sat together around a table covered with newspaper. In front of each of them was a large smooth oval-shaped stone. They decorated the stones with unique designs of paint and glitter, each one a personal remembrance of their fathers.
“Mine is painted gold,” beamed Mack. “I painted it gold because my dad is like gold to me.”
A heart framed Jenny’s design, “because my dad will always be in my heart.”

On Seth’s stone were two intertwined hands, a small one and a larger one that showed “me and my dad were best friends.”

Victoria painted a fire hat and said, “My dad is my hero.”

We might do well to remember that when funding cuts threaten to decimate arts programs in schools there is more at stake then we might imagine. The impact of the arts is not measured by standardized tests and its value is incalculable.

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. 

“Reach Out and Remember,” By Andrew Malekoff, Anton Media Group, September 12, 2018

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.

“Kids First: Look at Where We Have Come,” by Andrew Malekoff, Blank Slate Media, August 31, 2018

“Kids First: Look at Where We Have Come,” by Andrew Malekoff, Blank Slate Media, August 31, 2018

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.