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.
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.
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.”
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.
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.
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.
In recent years I have written about concussions in youth sports in this space, with a special focus on Chronic Traumatic Encephalopathy (CTE), a progressive degenerative disease of the brain that is the result of repetitive brain trauma. This was something I knew nothing about in my teenage years. As a high school and college football player in the 1960s and ’70s, using one’s head as a battering ram and shock absorber was expected.
Beyond the discovery of CTE and what it has generated in the way of much-improved player safety, August never fails to evoke memories of twice-daily summer practices when guys like me went to “training camp” before school started. Training camp lasted about two weeks. It was usually hot out. They were two weeks that felt like a year. Those were the make or break days of my youth. No one was cut from the team as long as they showed up, but many did not last.
The rawest depiction of a brutal summer football camp can be found in the book The Junction Boys by Jim Dent. The subtitle of the book is How Ten Days in Hell with Bear Bryant Forged a Championship Team. Although I never went through anything quite like the Junction Boys did, it seems that all high school and college football players have similar war stories about summer camp.
I’m not about to rehash what I’ve since learned since the discovery of CTE and the need for protective measures or share stories from my summer football camp days. However, at the risk of being cliché, there are some important lessons I learned from playing football.
As we round out another August, I thought I’d share a few of those lessons here. Most have served me well. Some have a downside.
1. Punctuality
As the saying goes, showing up is half the battle. But don’t just show up; be there on time. In football there were serious consequences for being late, but losing the respect of one’s peers eclipsed them all.
2. Hard work
Know that when you are working hard, there are others working just as hard and others who are not. Push yourself to surpass your opponents and inspire your teammates.
3. Stoicism
Keep your head up. Push through disappointment and injuries. This is mostly a good trait, but it can also prevent you from seeking the support you need when you really need it, physically and emotionally. Vulnerability is not a lesson I learned in football.
4. Dependability
It is essential that others who are pulling with you toward accomplishing a goal know that they can always count on you. There is a brotherhood that forms on a football team that demands dependability.
5. Humility
Enjoy success but don’t be boastful. Have gratitude for all those who helped to support your success.
6. Perseverance
Never give up. It is what your adversaries expect. By pushing through missteps and setbacks you learn what it takes to succeed and that your capacity to overcome failure is greater than you anticipated.
7. Resilience
As the legendary coach of the Green Bay Packers Vince Lombardi said, “It’s not whether you get knocked down; it’s whether you get up.” To survive playing football, resilience is essential.
Fortunately, these lessons can be learned in many places other than the football field. Any group activity that requires teamwork, sacrifice and shared goals generate important life lessons. Make sure the young people in your life put down their cellphones and other tech gadgets and take up a sport, join a club or get involved in the arts, to name a few possibilities. They’ll grow into better people—and with no head-butting required.
Roslyn Heights, NY, August 2, 2018 — North Shore Child & Family Guidance Center held its 5th Annual Ladies’ Night Out event on Thursday evening, July 19th, at the beautiful Neiman Marcus Garden City store. This marked the second year in a row that the Guidance Center partnered with Neiman Marcus in an event that offered exceptional beauty services and raffle opportunities to the women of our local communities and also raised awareness of the programs and services offered by the Guidance Center.
All proceeds from the event will support the Guidance Center’s mission to provide help and healing to children and families dealing with mental health issues and to combat stigma and discrimination. Guests savored delicious small bites from NM Cafe and sipped unique bubbly libations while they were treated to brow shaping and makeovers by Neiman Marcus makeup artists, along with blow-outs and hair styling from Manhasset salon nuBest.
Carol Marcell, a member of the Guidance Center’s Board of Directors, brought her mother Joyce Bruno and two of Bruno’s friends. “This was the second time my mom and I attended Ladies’ Night Out, and she didn’t hesitate to accept my invitation once again and to bring along her friends,” says Marcell. “We got our hair blown out by a charming young man from nuBest. And all of us loved looking at the clothes, jewelry and shoes at wonderful Neiman Marcus!”
“Neiman Marcus Garden City is very proud to be a supporter of the North Shore Child & Family Guidance Center,” says Doris Wilshere, Vice President, General Manager at Neiman Marcus, Roosevelt Field. “It is our corporate philosophy to support and give back to our local community, particularly with organizations that are centered on children and family. Since our opening in 2016, we have been an ongoing partner with the Guidance Center and will be for the future. We look forward to a growing partnership.”
“The Guidance Center is grateful to the philanthropic team at Neiman Marcus,” says Nancy Lane, Board President. “The events we hold at the store are very special.”
About Us:
As the preeminent not-for-profit children’s mental health agency on Long Island, North Shore Child & Family Guidance Center is dedicated to restoring and strengthening the emotional well-being of children (from birth – age 24) and their families. Our highly trained staff of psychiatrists, psychologists, social workers, vocational rehabilitation counselors and other mental health professionals lead the way in diagnosis, treatment, prevention, training, parent education, research and advocacy. The Guidance Center helps children and families address issues such as depression and anxiety; developmental delays; bullying; teen pregnancy; sexual abuse; teen drug and alcohol abuse; and family crises stemming from illness, death, trauma and divorce. For 65years, the Guidance Center has been a place of hope and healing, providing innovative and compassionate treatment to all who enter our doors, regardless of their ability to pay. For more information about the Guidance Center, visit www.northshorechildguidance.org or call (516) 626-1971.
Children, like chickens, need a few minutes to settle down. Above: Ethel, Margaret, Betty and Tori make the lawn furniture their perch. (Photo by Christy Hinko)
It’s a common refrain heard in classrooms and at dinner tables all across the country:
“Why won’t you just sit still?” Sometimes, with kids who seem especially hyperactive, there is an all-too-quick leap to giving the “problem” a psychiatric label and pulling out a prescription pad.
Although I’m a clinical social worker by training, I find that alternative sources of knowledge (what some may refer to as old-fashioned common sense) sometimes fit best. Here’s an example:
I recall a meeting with my colleagues regarding a newly formed after-school program for teenagers.
A shared frustration was getting things started on time. After some conversation, it became clear that the kids eventually settled down, but it always took more time than the
adults deemed necessary.
One of the women, my longtime colleague Dr. Nellie Taylor-Walthrust, an alcohol and substance abuse counselor and pastor, asked her colleagues, “Did any of you ever live on a farm?” They all signaled that they hadn’t. She smiled knowingly and responded, “Well, I did. And when you grow up on a farm you notice certain things.”
She went on to explain, “I’ve been watching closely, and in the afterschool program I’ve noticed certain behavior by a number of the youngsters each time they come to the group.
Whether they arrive early or after the group has already begun, they perform a certain ritual before connecting more consciously with what is going on in the group. It goes something like this: They move the chairs several times, place certain objects—coat, sweater, book bag—in a certain position on or near the chair, collect objects from their pockets or begin to crumple paper and place it in the waste basket, and so on. When confronted about their distracting behavior, they often reply, ‘OK, just one minute,’ meaning that they hadn’t quite completed their settling-in process.
“After weeks of observation, I was reminded that I had seen chickens perform similar rituals before laying eggs. I often wondered why they didn’t simply walk in, lay their eggs, and walk out. But instead, they would survey the nest, scratch and peck some more and sit down again. This behavior continued until they felt settled in. When the process was interrupted, I observed, they would start the ritual all over again. Now, I’m not suggesting that some youngsters are like chickens, but there seems to be a similarity in their need to release a certain amount of energy in order to focus on the task before them.”
Nellie’s “down home” observations captured the essence of the young people’s waking moments. The milling process seemed to be a normal resistance brought on by the daily residue of feelings either about home or school, perhaps intended to sidestep the work at hand.
For most kids, milling is a natural and normal process to be respected and left alone, as opposed to a manifestation of a disorder or some form of pathology. The kids eventually settled down and attended to task, as did the chickens.
This tale of the chickens had a soothing effect on Nellie’s colleagues, whose patience increased as a result.
What does this story about restless kids and chickens preparing to lay eggs mean? Sometime a kid is just a kid. That’s not to say that, for some, careful examination, diagnosis and specialized care are necessary and should be sought.
But for the others? Well, sometime they’re just being chickens. I mean kids.
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.
In a report issued by Nassau County’s Department of Health—Community Health Assessment and Community Health Improvement Plan (2016-18)—there is no mention of maternal mortality or information on social and environmental risk factors for women and infants of color. Consequently, no initiatives to address maternal and infant mortality disparities are recommended, yet overall Nassau County health data indicates that it ranks at the top of all counties in New York State.
To address this “invisible injustice,” maternal and child health advocates convened at Hofstra University on March 23 for a Birth Equity Breakfast organized by the Nassau County Perinatal Services Network.
Birth equity refers to the assurance that all human beings have the best possible births, buttressed by careful attention to racial and social disparities.
Keynoter Dr. Martine Hackett, assistant professor at Hofstra University’s School of Health Professions and Human Services, presented data from the state Department of Health that showed the disparate outcomes for black mothers and babies as compared with their white counterparts.
Infant mortality refers to the death of children before their first birthdays, which is a key indicator of the overall health of a population. According to the United Nations International Children’s Fund (UNICEF), Japan is the number one ranked country for newborn survival, while the United States ranks only 22nd in the world.
Among the eye-opening data that Hackett cited are the differences between the infant mortality rates in contiguous communities in Nassau County. For example, in Roosevelt there were 11.1 infant deaths per 1,000 births from 2012-14, while neighboring Merrick had zero deaths. Overall, in Nassau County the black infant mortality rate is more than four times that of the White infant mortality rate and even higher than in New York City.
Dr. Joia Creer-Perry, president of the National Birth Equity Collaborative, spoke about the perception of black mothers and the barriers to receiving holistic care by the health care system. If a woman is living under great stress she will have trouble carrying her baby to term. Premature birth to underweight babies is a leading cause of infant mortality.
Social justice activist and attorney Fred Brewington condemned the institutional racism prevalent in healthcare that has resulted in infant mortality figures today that are no different than they were almost a century ago.
Just weeks after the Birth Equity Breakfast, Tasha Portley, a nurse living in Tyler, TX, spoke at a similar forum halfway across the U.S. In a report published in the April 16 edition of the Tyler Morning Telegraph, Portley stated that “Pregnant black women often experience casually degrading remarks from white people when they seek maternal health care.”
Portley shared the story of a black woman who had some difficulty acquiring a breast pump from a local social services agency and, in the process, was the target of demeaning remarks by an employee. Portley went on to say, “We are dying because we are black and we are living in a country where there is inherent racism. It is systemic. It is the thread; it is the fiber of everything that exists.”
Hackett highlighted what needs to happen in order to turn the corner on disparities in Nassau County. Among her recommendations were to inform women after childbirth of warning signs for hemorrhage, embolism or infection, especially when there are preexisting conditions; to enhance service integration for women and infants; and to treat women of color with dignity, respect and culturally relevant care.
Bringing birth inequities to light is an important step forward. When this issue is not identified in Nassau County health data, people don’t know about it and it cannot be addressed. The breakfast concluded with the unveiling of the Birth Justice Warriors, an initiative envisioned by Hackett, to train birth advocates with the hope of ameliorating the birth inequities in Nassau County.
Imagine being American in every way except on paper and knowing that if you are the victim of violent crime you cannot report it out of fear of being deported. This is the sad reality for nearly 800,000 young immigrants who found hope in DACA.
If you’ve heard the acronym but are not familiar with DACA, it refers to Deferred Action for Childhood Arrivals, a federal program that began in 2012 permitting any person who was brought into the U.S. before the age of 16 the temporary right to live, study and work legally in America, providing they meet certain criteria including no criminal record and attending in high school or college, or serving in the military.
According to the Pew Research Center, two-thirds of current DACA recipients are 25 or younger, many of whom were brought to the U.S. as children so they might escape persecution, violence and poverty for the promise of a better life.
One young immigrant, Rodrigo Trejo, shared his story with United We Dream, the largest immigrant youth-led organization in the country: “When I was in the 11th grade my step dad was deported to Mexico, but he had a conversation with me before he was sent back. He told me that I was going to have to be the man of the house because he didn’t think he was ever coming back. I didn’t know what he was trying to say at the time, until he passed away crossing the U.S border. He couldn’t bear to be away from his family.”
Although Rodrigo became depressed and dropped out of school he bounced back. He reenrolled and graduated at the age of 20. Soon thereafter he applied for DACA in order to continue his education. “I plan to continue my studies and want to help others who have the potential of becoming someone great but because of similar life circumstances, don’t believe in themselves,” he said.
On September 5, 2017, U.S. Attorney General (AG) Jeff Sessions pronounced, “I am here today to announce that the program known as DACA that was effectuated under the Obama administration is being rescinded [effective March 5, 2018].”
On January 9, 2018, four months after AG Session’s announcement, a U.S. District Judge temporarily blocked the Trump administration from ending DACA, thus allowing recipients to renew their protected status for two years, re-affirming their legal legitimacy to remain in the U.S. A subsequent appeal of the judge’s ruling to keep DACA going failed.
If DACA were to be permanently rescinded it would prevent young immigrants like Rodrigo from applying for deportation protections and work permits, exacerbating the isolation, uncertainty, hopelessness and terror that preceded DACA becoming law.
If you follow national news, there is a cat-and-mouse game being played with DACA recipients in our nation’s capital. Let’s not lose sight of the fact that what is at stake is the physical and emotional well-being of young people like Rodrigo who came to the U.S. as children by no fault of their own.
In addition to the shifting sentiments expressed by the president, there is an organized anti-immigrant movement underway in the U.S. led by groups such as the Federation for American Immigrant Reform (FAIR), Center for Immigration Studies and Numbers USA. These nativist groups advocate for white European power and political control, and paint undocumented immigrants with a broad criminalized brush.
The issue of immigration in the U.S. is much broader than DACA. Nevertheless, we need to stand up to protect these young people from being rounded up and sent away. If you believe in human rights, doing nothing is not an option.
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.
This article was first published in Long Island Weekly of the Anton Media Group, April 18-24, 2018
From Anton Media: Andrew Malekoff discusses the Struggle for Access to Mental Health Care
It’s a heartbreaking scenario that is far too common: someone makes the difficult decision to seek out professional help for a mental health or substance abuse problem for themselves or their loved one and is faced with a myriad of roadblocks. They start calling providers on their insurance plan and find that they are not taking new patients, or they no longer accept insurance and only want cash. And the cost of paying out of pocket is too much for many to afford.
Here is the reality: Health insurers are required by law to offer an adequate network of providers for their beneficiaries to choose from, and not just for physical illnesses. This requirement is known in the health insurance industry as network adequacy.
Along with the difficulty of finding a provider who will accept your insurance, the problem is often complicated by a family’s reluctance to seek help for a mental health or drug problem, as opposed to physical illnesses like cancer or diabetes. Despite progress in public education, stigma still looms large.
Once someone takes the leap of faith to ask for help, he or she is too often told, “I’m sorry, I don’t accept your insurance any longer.” When this happens there is a chance they will give up.
It is this reality that spurred North Shore Child & Family Guidance Center to launch a research initiative called Project Access. This entailed creating a survey that was completed by almost 650 people across Long Island. Here is some of what we found:
• Almost 50 percent of the participants said that it was more difficult finding help for mental health or drug problems than finding help for physical illnesses, especially when they were in crisis.
• Nearly 40 percent said that their insurance company did not have an adequate number of providers.
• 66 percent reported that their insurance company was not helpful in finding a suitable provider for themselves or a loved one.
One survey respondent wrote: “A family member within my household required therapy and we had difficulty finding a provider; when we did, scheduling was a nightmare because so many patients were trying to see him. I believe it was because he was one of the few willing to accept multiple insurance policies.” This was a familiar refrain.
Health insurers reimburse mental health and addictions care providers at such low rates that they flee health insurers in droves. This is a civil rights issue and a situation that puts lives at risk.
The NY State agency that Governor Cuomo has charged with monitoring and enforcing network adequacy is the Department of Financial Services. We are using the Project Access data to demand that Governor Cuomo and the Department of Financial Services launch a full scale investigation of access to care in New York State and to hold commercial health insurers’ feet to the fire.
If you agree, print this column, add a note saying “I agree” and include your name and address. You can write to the governor at: The Honorable Andrew M. Cuomo, Governor of New York State, NYS State Capitol Building, Albany, NY 12224; email him at Press.Office@exec.ny.gov; or call him at 518-474-8418.
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.
Remembering without awareness is a phrase I really like. It suggests the retrieval of a memory that escapes conscious awareness.
Recently, I passed the 20-year mark without either parent, and many more years without grandparents. One grandmother, Annie, died before I was born. I was named after her. The other, Jenny, died when I was too young to remember her. My grandfathers, Harry and Joseph, died a few years later, still during my childhood years, but I have memories of both of them.
Each had disabilities and prostheses. Both of Grandpa Harry’s legs were amputated as the result of diabetes. Grandpa Joe lost his eye as the result of a carpentry accident. Their disabilities were never hidden from me. I went with my dad and Grandpa Harry when he had his prosthetic legs fitted. Grandpa Joe regularly took his eye out and showed it to me on request. I used to wonder if I would have artificial parts when I got older.
In my first year of graduate school in 1976, I was assigned to intern in a program called “Aged in Distress.” It was a crisis intervention program for older people. I made home visits to people with physical and mental disabilities, as well as one woman who was bedridden and terminally ill.
Although my primary interest in becoming a social worker was to work with children and teenagers, I was surprised at how much I liked working with older people. I was 25 at the time. Thinking back, it shouldn’t have come as such a surprise to me. Sometime after the internship, I realized that I was remembering without awareness the short time I had with my grandfathers.
Now I know that my early memories and recollections, whether I am consciously aware of them or not, influence how I feel about and relate to others in the present. As a child who experienced my grandfathers’ lives and deaths, I wasn’t conscious of the fact back then that one day I would be dealing with my parents’ aging, illnesses and deaths.
My father had cancer and my mother had heart and kidney problems. I traveled often from my home on Long Island to New Jersey to help care for them, some of that time at the same hospital in Newark where I was born in 1951.
One memorable evening—which also happens to have involved artificial body parts—was the time my mother fell and was taken to the hospital. She called me at 2 a.m. and said, “Andy, will you bring my Polident to the hospital?” Broken arm and bruised face, all she could think about was what she needed to keep her dentures in place so that she would look good.
I took the 90-minute drive from Long Beach to Newark at 2:30 am, retrieved her tooth powder from the medicine cabinet in her home, headed to Beth Israel hospital, spent a few hours with her and drove back to Long Island with enough time to make it to my office for work.
Although the trip was inconvenient, I was aware all along that one good turn deserves another. Both my mother and father took time caring for their parents when they aged while also caring for me and my brother. It is these kinds of life lessons that seep into your unconscious and define the person you become, with many generations to thank.
By Andrew Malekoff, Executive Director of North Shore Child & Family Guidance Center, which provides comprehensive mental health services for children from birth through 24 and their families.
Published in the Anton Media Group papers, Feb. 7, 2018.
North Shore Child & Family Guidance Center recently hosted psychotherapist, author and parenting expert Sean Grover for a workshop titled “When Your Child Relates Better to Screens than Human Beings.” We were pleased to offer this program to help fortify parents during these difficult times.
As tech-dependence increases, many kids move through the world in a self-centered bubble, separated from their own thoughts and feelings, as well as the thoughts and feelings of others. As conversation skills and positive interactions crumble, technology even starts to change kids’ sense of humanity; they are less compassionate and sensitive to others. The workshop explored these vital issues and offered advice about what parents can do to help.
“Everywhere you look, children are staring into cell phones, screens, computer screens, tablets, iPads and more,” said Grover, who has appeared on the Today Show, in the New York Times and in many other media outlets. “While some kids use technology as a pastime, others are absorbed by it. Technology devours their lives. They can’t put it down or turn it off. These kids tend to be more isolated and anxious, have poor people skills, difficulty maintaining friendships or an unstable sense of self.”
In his workshop, Grover gave parents guidelines on how to take back control and help their offspring wean off their technology addiction. Here are some of his tips:
Tech Blackouts
Set aside specific times at home when no one (parents included) uses technology. Cell phones, computers, iPad…everything is off. If you want your kid to be less tech-addicted, you must lead the way. Tech-free time can be spent reading, talking, playing games, cooking, making art…anything creative or social will do.
Tech Hours
Kids resist structure—but fall apart without it. Technology needs limits. For instance, I often recommend that families establish tech hours; time for homework, gaming or surfing the Internet. Scheduling tech time will help to limit battles by setting clear guidelines. For instance, when it comes to gaming, many parents may allow thirty minutes a day during the school week and two hours a day on the weekends.
Tech Spaces
When possible, keep all technology in a common space like the living room — not in a child’s bedroom. Establish communal places for tech time; try to avoid allowing your kid to disappear for hours behind a closed door.
Tech Limits
There are plenty of online services that can filter out inappropriate or violent material. These services can also limit Internet access by scheduling times that the Internet is available and times when it is not. One example of such a service is Net Nanny.
If you haven’t already read between the lines, you should know that how you use tech devices influences your ability to effectively guide your kids. Although your example is not the sole factor, keep in mind that as distant as some kids become from adults as they are moving through their teen years, they continue to observe you, and more closely than you know.
As the lyrics from the 1970s-80s new wave rock band the Police advise: “Every breath you take, Every move you make, Every bond you break, Every step you take, I’ll be watching you.”
Andrew Malekoff is the executive director of North Shore Child & Family Guidance Center, which provides comprehensive mental health services for children and their families. Visit www.northshorechildguidance.org for more.
Anton Media’s Long Island Weekly, Parenthood Plus by Andrew Malekoff
In New York it is illegal to use a handheld cellphone while driving. Although drivers have the option to use hands-free devices, studies show that talking or texting on any cellphone while driving is so mentally distracting as to suggest it is a serious safety hazard. Nevertheless, not a day goes by that I do not see drivers talking on both hand-held and hands-free devices. Safety aside, what does all this chatter in the car portend about one’s ability to be alone?
More than 50 years ago Clark Moustakas, a psychologist and the author of the existential study Loneliness, wrote, “Being alone, for me, usually means an opportunity to think, imagine, plan. I choose to be alone because I desire to be quiet for awhile to consider aspects of my life. It is usually a tranquil time of self-expression and self-renewal.”
Can you remember a time when a solitary ride in the car offered such an opportunity, to simply be alone with your thoughts, feelings and sensations—maybe with your favorite soundtrack playing in the background?
We now live in an era when, because we are plugged in 24-7, the simple pleasure of being alone is something that we avoid. For many people, young and old, aloneness is a source of discontent. Why? Are we afraid that it might lead to loneliness?
Loneliness is not just about a lack of companionship but an inner sense of being alone, regardless of the external circumstances—of feeling lonely even when with friends or family.
I believe that the recent popularity of mindfulness—a mental state achieved by directing one’s awareness on the present moment, while calmly noticing and accepting one’s feelings, thoughts and bodily sensations—is a counterforce to the busy-ness of our perpetually plugged-in lives.
As if to foreshadow the current era of mindfulness, Moustakas said, “Loneliness anxiety is a widespread condition in contemporary society. The individual no longer has an intimate sense of relatedness to the food he eats, the clothing he wears, the shelter which houses him.”
According to Maria Gonzalez, an author and corporate executive whose most recent book is Mindful Leadership, 9 Ways to Self-Awareness, Transforming Yourself, and Inspiring Others, “The daily commute is a great opportunity to train the mind.” She recommends practicing simple techniques, repeatedly, to train the mind in three areas:
1. To be more focused and better able to concentrate;
2. To experience more clarity in our thinking and decision-making; and
3. To approach all of life with a sense of balance, whereby we can “go with the flow” when a situation cannot be changed in the moment.
“The idea,” Gonzalez says, “is that you are continuously aware of three things: your body, what you see and what you hear. This is what it is to be mindfully present as you drive. Do your best to stay present for the entire commute.”
Although it seems elementary, it’s not as easy it sounds. As your mind wanders you may have the impulse to check your phone, or give in to some other distraction. When that happens, intentionally pull yourself back.
Like all things worth mastering, being mindful takes practice. As you do this you are preparing yourself to be present, to be at ease in your own company and, at the same time, you’re making the road a safer place for us 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. Visit www.northshorechildguidance.org to find out more.
In New York it is illegal to use a hand-held cell phone while driving. Although drivers have the option to use hands-free devices, studies show that talking or texting on any cell phone while driving is so mentally distracting as to suggest it is a serious safety hazard. Nevertheless, not a day goes by that I do not see drivers talking on both hand-held and hands-free devices. Safety aside, what does all this chatter in the car portend about one’s ability to be alone?
More than 50 years ago Clark Moustakas, a psychologist and the author of the existential study Loneliness, wrote, “Being alone, for me, usually means an opportunity to think, imagine, plan. I choose to be alone because I desire to be quiet for awhile to consider aspects of my life. It is usually a tranquil time of self-expression and self-renewal.”
Can you remember a time when a solitary ride in the car offered such an opportunity, to simply be alone with your thoughts, feelings and sensations—maybe with your favorite soundtrack playing in the background?
We now live in an era when, because we are plugged in 24-7, the simple pleasure of being alone is something that we avoid. For many people, young and old, aloneness is a source of discontent. Why? Are we afraid that it might lead to loneliness?
Loneliness is not just about a lack of companionship but an inner sense of being alone, regardless of the external circumstances—of feeling lonely even when with friends or family.
I believe that the recent popularity of mindfulness—a mental state achieved by directing one’s awareness on the present moment, while calmly noticing and accepting one’s feelings, thoughts and bodily sensations—is a counterforce to the busy-ness of our perpetually plugged-in lives.
As if to foreshadow the current era of mindfulness, Moustakas said, “Loneliness anxiety is a widespread condition in contemporary society. The individual no longer has an intimate sense of relatedness to the food he eats, the clothing he wears, the shelter which houses him.”
According to Maria Gonzalez, an author and corporate executive whose most recent book is Mindful Leadership,9 Ways to Self-Awareness, Transforming Yourself, and Inspiring Others, “The daily commute is a great opportunity to train the mind.” She recommends practicing simple techniques, repeatedly, to train the mind in three areas:
1. To be more focused and better able to concentrate;
2. To experience more clarity in our thinking and decision-making; and
3. To approach all of life with a sense of balance, whereby we can “go with the flow” when a situation cannot be changed in the moment.
“The idea,” Gonzalez says, “is that you are continuously aware of three things: your body, what you see and what you hear. This is what it is to be mindfully present as you drive. Do your best to stay present for the entire commute.”
Although it seems elementary, it’s not as easy it sounds. As your mind wanders you may have the impulse to check your phone, or give in to some other distraction. When that happens, intentionally pull yourself back.
Like all things worth mastering, being mindful takes practice. As you do this you are preparing yourself to be present, to be at ease in your own company and, at the same time, you’re making the road a safer place for us 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
New legislation signed by Governor Cuomo in 2016 requires that public schools in New York State begin providing instruction in mental health on or after July 1, 2018. The legislation was co-sponsored by Senator Carl Marcellino (R-Nassau) and Assemblywoman Kathy Nolan (D-Queens).
The new legislation adds mental health education to areas of learning that were already required by law, including education on the use and misuse of alcohol, tobacco and other substances and the early detection of cancer.
According to Glen Liebman, CEO of the Mental Health Association in New York State, “By ensuring that young people are educated about mental health, we increase the likelihood that they will be able to recognize signs in themselves and others that indicate when help is needed and how to get help.”
Why is this legislation so important? One in five adolescents ages 13-18 is diagnosed with a mental health problem, yet only 40% get help. The average time from onset to seeking help is eight to 10 years.According to Centers for Disease Control and Prevention, one in 12 high school students attempt suicide, the third leading cause of death for 10 to 24 year olds.
Teaching about mental health in schools and educating to reduce stigma is long overdue. There is great misunderstanding and fear among many who have erroneous ideas about people with mental illness. Consequently, young people suffering with mental illness walk around school feeling isolated, believing that there’s something inherently wrong with them that will never change.
These children and teens often feel shunned, unlike their peers who have a physical health problem and who have others rally around them. I can vividly recall a news report and photo of a middle school boy afflicted with cancer who was receiving chemotherapy. In the photo he was surrounded by his teacher and a smiling group of his classmates, all of whom shaved their heads in solidarity with him.Imagine if instead of cancer he was depressed and suicidal. There would be no such image of public support, only one of isolation, shame and despair.
A caring school community can offer a young person a safety net of meaningful and helpful connections. It is not unusual for a teenager to feel defective when struggling alone with a mental illness. Mental health education in schools can begin with mental wellness practices for children as early as four or five years old, for example, by teaching social skills and how to manage angry feelings.
As children grow they can learn about the concept of wellness including self-care and personal responsibility. They can learn to recognize the signs and symptoms of developing mental health problems, how to manage crises such as the risk of suicide and self-harm and how to identify appropriate services and supports for treating and maintaining recovery from mental illness.
I can already hear those voices that will decry using educational resources for addressing the emotional needs of kids. If that is your view, I ask you to consider that approximately 50% of students age 14 and older who are living with a mental illness drop out of high school. Youngsters’ mental health and their ability to learn and become productive citizens in the community and workplace go hand-in-hand.
We owe it to our children to support this vital new legislation by encouraging schools to incorporate meaningful education into the curriculum that reinforces the idea that mental health is an integral part of wellbeing. Our children need to learn that there is help that can lead to recovery.
Bio: Andrew Malekoff is the Executive Director and CEO 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.
September marks the start of another new school year and, for football diehards, it’s also the kickoff to a new season. The flowing together of the two brings to mind the moving story of former Florida State University (FSU) wide receiver Travis Rudolph and Bo Paske, a sixth grade boy with autism.
At the start of the school year in 2016, Rudolph and several teammates visited Montford Middle School in Tallahassee, located near the FSU campus. When Travis spotted 11-year-old Bo sitting alone in the cafeteria, he walked over with his slice of pizza, joined him, and struck up a conversation.
Travis’ simple act of kindness drew national attention when a photo of the two sitting across from one another went viral. Bo described the lunch as “kind of like me sitting on a rainbow.” Travis remarked: “A lot of people give me credit for doing what I did, even though I just see it as that is me.”
Bo told Travis that he was a big FSU fan. The two of them stayed in touch after their first encounter.
Leah Paske, Bo’s mom, wrote about it on Facebook: “Several times lately I have tried to remember my time in middle school. Did I have many friends? Did I sit with anyone at lunch? Just how mean were kids really? Now that I have a child starting middle school, I have feelings of anxiety for him, and they can be overwhelming. Sometimes I’m grateful for his autism. That may sound like a terrible thing to say, but in some ways I think, I hope, it shields him. He doesn’t seem to notice when people stare at him when he flaps his hands. He doesn’t seem to notice that he doesn’t get invited to birthday parties anymore. And he doesn’t seem to mind if he eats lunch alone.”
She went on to say, “A friend of mine sent this beautiful picture to me today and when I saw it with the caption ‘Travis Rudolph is eating lunch with your son’ I replied ‘Who is that?’ He said ‘FSU football player,’ then I had tears streaming down my face. I’m not sure what exactly made this incredibly kind man share a lunch table with my son, but I’m happy to say that it will not soon be forgotten. This is one day I didn’t have to worry if my sweet boy ate lunch alone, because he sat across from someone who is a hero in many eyes.”
Difference and inclusion are terms that are increasingly in vogue in today’s public schools. Growing numbers of children who were previously separated in special education classes and schools are being integrated into the “mainstream” in order to reduce costs and provide less restrictive environments for learning and social-emotional development.
Labeled children, particularly as they approach adolescence, are often objectified, devalued, isolated and ridiculed by their peers. Objectification robs individuals of their humanity. In such relationships the different child simply becomes “the other,” the one too often left out in the cold.
In an era when there seems to be no shortage of awful stories generating from college campuses, the story and photo of Travis and Bo is a breath of fresh air. Henry James said that “a good story is both a picture and idea, and that the picture and the idea should try to be interfused.”
The picture of Travis joining Bo at the lunch table tells us that a simple act of kindness can go a long way to making a difference in someone’s life. We learned from Travis that what it takes is just a little effort—and an abundance of heart.
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.
In a four year span during the mid to late 1990s my now-grown children lost three of their grandparents and their dog. My boys were 10 and 6 when my father died in 1994. Three years later there were three more losses. My mom died in 1997.A little more than one year later my father-in-law and dog Kirby, a cairn terrier, died on the same day in August 1998. My wife and I were in Quebec City at a music festival, at the time, on our first extended vacation away from our children when we received the news in two heartbreaking telephone calls just six hours apart.
As a mental health professional who has spent time with bereaved children and adults over many years, I had extensive knowledge about how children process death at different ages. Over the years I developed good skills in listening and gently encouraging the expression of feelings through talk and play. But I also knew that addressing the death of strangers was not the same thing as coping with one’s own losses.
Like so much that I have struggled with as a parent, I knew I had to put my credentials aside and simply do the best I could to support my family and take care of myself, as I was bereaved as well.
Soon thereafter my family and I experiencedanother death—this timewith an impact I had not expected and effects that linger to this day. In our yard was an old pine tree that had to be felled after it contracted a disease. None of the tree “experts” that I employed could bring it back to health.
It was a splendid tree of great character, oddly shaped, home to a squirrel’s nest and countless birds, and with branches sitting low enough for swinging and climbing. Its trunk was thick enough to run around to evade contact during games of tag. It was free enough of branches in one high spot to support a backboard and hoop.
It wasn’t easy to dribble on the grass but it was just perfect for endless games of H-O-R-S-E. On the warmest summer days its shade offered respite from the oppressive sun. Each fall I was left with the unpleasant task of raking pine needles. But our tree also bore pine cones that I threw into the winter fireplace for extra snap, crackle and pop that rivaled Rice Krispies.
It was our family tree, a tree for all seasons.
Today, when I look outside or sit in the yard I am flooded with memories of my old friend and the times we had together. We’ve planted a few new trees around the perimeter of the yard in the intervening years, but the hole in the center remains.
Henry David Thoreau wrote, “I frequently tramped eight or ten miles through the deepest snow to keep an appointment with a beech-tree, or a yellow birch, or an old acquaintance among the pines.”
Life is full of surprises, and it came as a surprise to me to think that I would one day be thinking about how much I really loved that old tree.
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.
Have you heard of godwinks? A godwink is an experience where you’d say, “What are the chances of that!” It’s been described by some as a spiritual message of reassurance, especially in times of uncertainty, maybe the impetus for restored faith during difficult times. Some see it as divine intervention, others as pure coincidence.
Although I was not familiar with the term, it reminded me of something that happened to me that I thought was astonishing. In 2005 I lost a very good friend and colleague named Roselle. We had become business partners in 1990. The longtime editors of a popular professional journal decided to step down and asked the two of us, strangers at the time, to become their successors.
Years later we both revealed that we were, at first, wary of each other. After all, we’d never met, and so we had no idea what it would be like working together as co-editors of an esteemed quarterly publication. Roselle was a university professor and I was a frontline mental health practitioner. What we shared in common was that we were both published authors.
After a relatively short period of testing and unease we not only became great collaborators but fast friends. The relationship ended in June of 2005 when I received a call that Roselle had died. It was sudden, unexpected and heartbreaking.
Shortly thereafter, in December 2005, I organized a meeting with two of Roselle’s fellow professors and friends. Together we decided to develop a special publication in Roselle’s honor. We were to meet in Manhattan at their university. Normally, I would have just taken the LIRR into the city them morning of our meeting, but, as luck would have it, at the time there was a transit strike. So I decided to play it safe and get in the night before and stay in a hotel while the trains were still running.
That night I took a walk and stopped in a bar to get a glass of wine. I walked to the end of the bar and there was my cousin Amy whom I had not seen in years. Unbeknownst to me, she lived across the street from the bar and was working as a real estate broker. It was great catching up with her.
Fast forward some months later. I was back in Manhattan to take care of some business regarding my partnership with Roselle at a local university. Having reconnected, I called Amy to see if she was free for lunch. She was and so we got together. She asked me why I was in the city. I told her I had to go to Hunter College School of Social Work to take care of some business related to a partnership I had with a professor there. I explained that she died last June. She asked me, “What was name?” I told her, “Roselle Kurland.” She gasped and said, “Oh my God, I just sold her apartment!”
Was this a godwink? Was it a tangible signpost giving me hope and faith that someone is watching over me and everything is going to be alright? Or was it pure coincidence, a fluke? I choose to think that it was more than that. During these uncertain times, a source of faith, however unusual, is a welcome reminder that we are not alone and that there is hope.
On March 9, 2017 I had the honor of introducing Darryl “DMC” McDaniels, a founding member of the early hip hop group Run-D.M.C. Young and old of all backgrounds gathered together at the Leeds Place of North Shore Child & Family Guidance Center in Westbury for a community forum.
If you don’t already know, DMC is a hip hop pioneer, a rap poet and an inspiring prophet. The packed house at the Leeds Place got to experience all three in a two hour tour-de-force in which Darryl taught us about the history of hip hop, delighted us with rap lyrics and moved us with intimate stories of resiliency.
When I introduced Darryl, I told the audience that I learned that his favorite things to do as a child were to read comic books and pretend to be a superhero. In fact, I told them, he now produces comic books under the DMC – Darryl Makes Comics – label.
Darryl’s comics are not about traditional superheroes like Batman, Superman, Spiderman or the Incredible Hulk. Darryl, I learned, believes that there are heroes in everyday life with powerful stories to tell. Just like everyone in the room tonight, I said.
Darryl is 52 years old, six feet tall and solidly built, with muscular arms bulging from his tight black t-shirt. He spoke for two hours without a break, moving about energetically without breaking a sweat.
He inspired the crowd with the story of when he was a young boy growing up in Hollis, Queens, and he was a self-described Catholic School nerd who wore thick-framed glasses and read comic books all the time. He said he liked school.
He gave a great history lesson about the birth and meaning of hip hop. He described how neighborhood kids who had little in the way of physical resources brought music and art to the parks and streets by pluggingturntables and speakers into light poles, making dance floors out of cardboard boxes and creating street art by painting and drawing on walls.
In his talk, Darryl encouraged the young people in the room with transcendent and core messages of hip hop: “Always be open to do something different. It could change your life.”
Darryl spoke about his unexpected rise to fame and fortune, exhorting the young people to develop what they like to do, try new things, take chances and, most important, to know that “no matter what you’re going through, you’re worth something.”
He went on to say that despite his early rise to fame and fortune, at the age of 35 he discovered that he was adopted and was a foster child. Around the same time he went through a period of suicidal depression and became addicted to alcohol.
When he finally sought professional help, he discovered that he had been suppressing powerful feelings his whole life, especially things that angered him. Despite the powerful lyrics in his raps, he said that he never wanted to make waves in his personal relationships.
Some of the lessons he learned were: “You have to express your truth. It’s normal to feel. Release what you’re going through. Your situation doesn’t define who you are.”
In time, with the help of his adoptive parents, Darryl met his biological mom who told him that she gave him up so that he could have a better life.
In the end, before Darryl patiently signed autographs, posed for photos and chatted with kids and parents, I closed the meeting by saying, “DMC gave his music to the world. And, tonight Darryl gave us his heart.”
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.
On Feb. 8, I was invited to participate in a program for parents and their teen and pre-teen children at East Woods School in Oyster Bay. The focus was on raising awareness about the struggles and danger our youth face today in connection with improper and inappropriate use of social media, cyber-bullying and gaming addictions. The program included a viewing of the documentary film Screenagers: Growing Up in the Digital Age, and featured a live panel discussion afterwards. I was one of four panelists.
Before seeing the film, I read some anonymous reviews written by adults and kids. Many of them sounded like this one: “Spot on Fantastic!” A few others were more critical. For example, a 16-year-old wrote, “It focuses on the downsides of electronics and never positives.” A 12-year-old wrote, “The message of Screenagers is that kids just exist for their parents to boss around and children’s opinions don’t matter.”
The film was well done and did spend a good deal of time presenting the risks in the digital world. The strength of the film was the interaction it stimulated, a positive step toward reducing isolation and building community.
The audience of kids and adults was asked, “Are you more fearful after having seen the film?” Easily more than half the parents raised their hands. A 13-year-old boy, when asked what he thought, said that he hadn’t realized how the overuse of digital technology impacts the brain and learning.
I shared the insight that, “Most parents are immigrants to the digital world, while our kids are digital natives.” A mom responded by saying that she never thought about it that way, like actual immigration and the misunderstandings it can create between the generations. Another parent spoke to the analogy by citing the challenge of trying to negotiate traditional and modern values with her kids, and how to preserve their cultural heritage without preventing them from adapting and growing.
“The digital world is an evolving landscape that parents have to learn to navigate,” said Kathleen Clark-Pearson, M.D., in a report she co-authored for the American Academy of Pediatrics.
The digital world is a great place for kids to connect socially, share photos with family, learn and have fun. As “immigrants” to this high-tech arena, parents would do well to immerse themselves in the digital world of their children and learn as much as possible in order to build common ground for communicating effectively with their kids.
If a child’s job is to explore and a parent’s job is to protect, becoming more knowledgeable and proficient in digital technology is essential for parents to help their children navigate the many risks and dangers of the digital world including online grooming, cyber-bullying, sexting, gaming addiction and sleep deprivation. Of course, adults are also susceptible to risks and, we have to be careful not to fall victim to “distracted parent syndrome,” when we use our own hand-held devices, for example.
I shared the story of observing a mother and her pre-teen son sitting across from one another at a local diner. She did not get off of her mobile phone the entire time. The boy did not have such a device. He just fidgeted most of the meal. It was so sad. What was he learning from her example?
Social media and digital technology are here to stay. The benefits far outweigh the dangers, but with the average kid spending 6.5 hours a day looking at screens, it’s imperative that parents learn the ins and outs, growing with their kids as we all get accustomed to this new world.
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. Visit www.northshorechildguidance.org to find out more.
I recently read rock star Bruce Springsteen’s 2016 autobiography Born to Run. I have to admit: I started the book a virtual stranger. Of course I was familiar with Springsteen’s music, but mostly as background. I wasn’t a faithful fan. My only obscure connection is that I attended junior high and high school in South Orange and Maplewood, NJ with his drummer Max Weinberg.
Max and I weren’t close friends but, I would say, friendly acquaintances. I remember him telling me one day in the early 1960s that he was going to be playing drums on a UHF television show hosted by John Zacherle. On the night of the broadcast, I set up the UHF antenna on my parent’s black-and-white TV and was proud to see someone I personally knew performing on the tube. It was almost as exciting as the build up to the Beatles on Ed Sullivan.
Although I had no intention of reading Springsteen’s book, I decided to pick it up on the recommendation of a friend who knew I worked in the field of children’s mental health. At the same time I read the book, I turned my dial to E Street radio to add a sound track to my reading experience. By listening to the music I thought I could better get to know the author, who wrote extensively about his personal life in his songs.
Born to Run blends many elements of Springsteen’s life, from early family experiences to first steps as a musician to forming a band to becoming a rock star, husband and parent—and much more. But the core of the book is the enduring and troubling impact of his relationship with his father Doug. Near the end of Born to Run, Springsteen reveals a dream in which he is performing on stage. His then deceased father is sitting in the audience. Bruce approaches him in the dream and says: “Look dad…that guy on stage…that’s you, that’s how I see you.” You’ll have to read the book to have a more complete understanding what the dream represents.
As I worked my way through the book and his music, I was struck with the overwhelming feeling that it was written in its entirety in the voice of vulnerable young boy, as opposed to world-renowned rock icon. The boy has been fighting the isolation and loneliness of living with mental illness in the family his whole life and, at the same time, he has been seeking enduring and healthy relationships. And, he found them.
As much as it is a book about rising to music stardom, Born to Run is a story about debilitating depression, mental illness and adverse childhood experiences. But it’s also a story of hope. Springsteen shows that despite his most troubling childhood experiences, resilience and healing are possible. Readers owe him a debt of gratitude, not only for the decades of socially conscious and uplifting music, but for stepping beyond stigma to, in his own words, “show the reader his mind.”
I started the book a stranger; now I’m a fan.
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.
If you are a sentient being you’re well aware of the alarming degree of divisiveness that has been generated as a result of the presidential campaign. Given the growing incidence of hateful speech and action, there is a desperate need for open dialogue with young people.
I can vividly recall meeting with a therapy group for troubled teens some 25 years ago. They raised the subject of race and racism after having been exposed repeatedly to the videotaped TV footage of the Rodney King beating, which foreshadowed the current era of cell phone videos and body cams.
Rodney King was an African-American man who became widely known after being beaten by Los Angelespolice officers after a high-speed car chase on March 3, 1991. A local resident witnessed the beating and videotaped it from his nearby apartment. The officers were tried in court but were found not guilty.
The two minority members of the group spoke about their own fear and “paranoia.” I listened and then told them “just because you’re paranoid doesn’t mean they aren’t out to get you.”
In 1968, psychiatrists William Greir and Price Cobbs noted in their book Black Rage that, for some people, a suspiciousness of one’s environment is necessary for survival.
Indeed, the phenomenon of adaptive paranoia—which recognizes real threats, not imaginary ones—is not at all uncommon to minority groups who have experienced profound prejudice historically and who now, after the brutal 2016 campaign, are more concerned than ever.
Here’s what we know for sure: Reports of hateful intimidation and harassment are on the rise since the election. According to the Southern Poverty Law Center, there were more than 850 accounts of racism, Islamophobia and xenophobia between November 9 and the morning of November 14.
Recently, I posed these questions on social media: What is the emotional impact of the trickle-down divisive campaign rhetoric on the nation’s children? What signs are you seeing? What can you do? Here are two responses:
“Hispanic students are afraid to go to school because classmates bully them and tell them they are being deported.”
“Immigrant children are terrified! They are afraid their parents are going to be sent away. I think it is important to allow a space for dialogue.”
Now, more than ever, rather than squash discussion on these sensitive matters, we owe it to the young people in our lives to foster open dialogue. Noted family therapist Harry Aponte’s reflection on diversity might serve us well as a guideline. He said,
“Diversity is not about us-versus-them. And neither is it about easy agreement among different cultural, ethnic and racial groups… It is a bold, rich and complex tapestry. It has to do with being different in values, traditions and speech, and the same in human need, suffering and love. It has to do with living in separate neighborhoods, and together in the larger common community of nation. Diversity of culture, ethnicity and race gets its significance and specialness in the context of our universal identification as human beings.”
Although a better understanding and respect for cultural differences is important, we owe it to our children to reach for commonalties experienced across cultures. That is the way we will open new pathways for connection.
Bio: 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 find them on Facebook.
Living or working with teenagers can be unsettling and disorienting even when you think you have it all figured out. Teenagers will spare no time reminding you that, as an adult, you are not a part of their world.
I am reminded of a quip attributed to Mark Twain: “When I was a boy of 14, my father was so ignorant I could hardly stand to have the old man around. But when I got to be 21, I was astonished at how much the old man had learned in seven years.”
Having worked with countless teenagers for more than forty years, and having raised two of them, I discovered early on that whatever world I occupied outside of their presence with my professional reputation and credentials, these meant little to the kids I worked with or for that matter, to my own kids.
Decades ago I found something that one of my sons, then about 10-years-old, wrote about me in school. The heading on the page was, “My Dad.” Naturally I read on with great anticipation and a swelling sense of self-importance. Underneath the title he wrote, “My dad is 6’1”, bald, wears glasses, and busts my chops. He likes dogs. My dad has brown eyes and brown hair, at least what’s left of it. He’s a social worker.”
The kids I’ve worked and lived with invariably drew their conclusions about me as they got to know me. In turn, I drew my conclusions about them as I got to know them, despite what might be called their credentials, that is – the often-negative labels assigned to them. It is important to recognize the difference between the way in which young people are viewed and classified by others, and their own experiences and perceptions.
Assuming a stance of uncertainty is one way of saying how important it is for us to be open and reflective, to listen intently to the kids we see only then can we think more deeply and see outside the box.
One of my colleagues, Camille Roman, tells a story about growing up in an economically deprived and chaotic family and how desperately she struggled as a teenager to be heard, and how no one was ever listening. During one particularly troubling and heated exchange at a holiday gathering Camille, whose family is from Puerto Rico, recalled, “My face apparently betrayed my fear and confusion to an elderly aunt who was secretly thought to be a witch. Tia Mercedes turned to me with her soft face and wise eyes and whispered, ‘when your tongue is silent only then can you hear.’”
Camille said, “My Tia was telling me that something else was going on here and if I didn’t get caught up in the noise then maybe I could understand and make sense of the chaos and it would be less frightening and I would not feel so powerless.” And so this powerful bit of homespun advice became a life lesson for her in her work as a social worker and, I think, a powerful insight for all of us.
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.
Imagine being American in every way except on paper and knowing that if you are the victim of violent crime you cannot report it out of fear of being deported. This is the sad reality for nearly 800,000 young immigrants who found hope in DACA.
