Despite feeling blindsided, most of us now know that we are living in the midst of an unprecedented drug epidemic. According to the U.S. Department of Health and Human Services (HHS), since 1999, the rate of overdose deaths including prescription pain relievers, heroin and synthetic opioids such as fentanyl, nearly quadrupled.
Some of the steps taken to save lives include improving prescribing practices and expanding access to medication-assisted treatment and the use of Naloxone.
Medication-assisted treatment combines talk therapy and medications such as methadone or buprenorphine to treat opioid addiction. Through affordable, accessible and quality care people can recover and go on to live productive lives.
Naloxone is used to treat a narcotic overdose in an emergency situation by reversing the effects of opioids, including slowed breathing or loss of consciousness.
Notwithstanding the increased attention to lifesaving measures, there is less focus on the devastating impact of addiction on children living in families where a parent is addicted to drugs or alcohol.
Perhaps nothing drove home the reality of America’s opioid problem more than the recent photo taken in Ohio of two overdosed adults spread out in the front of a car, while one of their young grandsons looked on from the back seat.
There are more than 8 million children younger than 18 years of age that are growing up in homes with alcohol and other drug-abusing parents. These young people are likely to become alcohol or drug abusers themselves without intervention.
Parental alcoholism and drug addiction influence the use of alcohol and other drugs in several ways including increased stress and decreased parental monitoring.
Children who grow up with an addicted parent learn to distrust to survive. When unpredictability dominates a child’s life, he or she is likely to be wary, always sensing disappointment lurking nearby.
Children growing up with an addicted parent become uncomfortably accustomed to living with chaos, uncertainty and instability. When a child grows up under these conditions, they learn to guess at what normal is, with no roadmap to assist them.
Denial, secrecy, embarrassment and shame are common experiences of children who live with an addicted parent. Even seeking help outside of the family might in itself be seen as an act of betrayal, a step toward revealing the family secret.
Children who grow up with an addicted parent live with an unspoken, emotionally numbing mandate – don’t talk, don’t trust, don’t feel.
Growing up with an addicted family member leaves one with little hope that things will ever change; unless, we take steps to change it. I am reminded of a parable about the small village on the edge of a river.
One day a villager saw a baby floating down the river. He jumped in the river and saved the baby. The next day he saw two babies floating down the river. He and another villager dived in and saved them. Each day that followed, more babies were found floating down the river. The villagers organized themselves, training teams of swimmers to rescue the babies. They were soon working around the clock.
Although they could not save all the babies, the rescue squad members felt good and were lauded for saving as many babies as they could. However, one day, one of the villagers asked: “Where are all these babies coming from? Why don’t we organize a team to head upstream to find out who’s throwing the babies into the river in the first place!”
Mobilizing resources to pull babies from the river, while neglecting the one’s left behind makes no sense.
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.
As Election Day 2016 approaches I am wondering how first-time voters, especially young people, are faring. Even when my powers of concentration are sharpest after a full night’s sleep, I cannot fully trust that I can accurately differentiate substance from style, image from authenticity. As I watch and listen, I am reminded that we tend to place great emphasis on intellect, especially language skills and ability to reason and less emphasis on more personal intelligences.
Howard Gardner, author of Multiple Intelligences, identified key areas that we should look for in leaders that go beyond intellect. They include abilities to understand oneself and others, and to address profound human concerns, especially during times of crisis. These are abilities that we cannot possibly know about through scripted sound bytes and clever marketing.
We know that Donald Trump is a wealthy businessman, gifted salesman, media personality and, by all accounts, a celebrity. We know that Hillary Clinton is a lifelong public servant, former first lady, politician and advocate for many vulnerable groups; and, also a celebrated figure. Both are spouses, parents and grandparents.
We know that both lead candidates are far from perfect. Their character flaws, vulnerabilities and missteps have been revealed repeatedly in what is perhaps the bloodiest presidential campaign in memory. Let’s assume, just for the sake of argument, that the character issue is a wash. Does that make it any easier for young people placing their ballot for the first time? I think not.
We cannot forget about the fear factor – terrorism, homeland security, crime, illegal immigration, gangs, the drug trade – that the candidates and their surrogates aim at fence sitters – the independents that can be swayed one way or the other and whose collective votes can make all the difference. And, of course, there is the economy.
For the last 15 years, the income of the typical American family has been at a standstill, health outcomes for many children are poor, and globalization and technological change have made it most difficult for poorly educated Americans to achieve the peace of mind and self respect that a secure livelihood enables.
So when one checks off character, wades through media deceit and considers the fear factor and economic concerns, first-time voters are left only with faith about what they glean each candidate to really stand for in the areas that are most important to them.
Reverend Theodore Hesburgh, former president of Notre Dame University said, “Voting is a civic sacrament.”
As I consider my final decision about who to vote for, I am reminded of a line by Carlos Castaneda in his book, A Separate Reality: “Anything is one of a million paths. Look at every path closely and deliberately. Try it as many times as you think necessary. Then ask yourself, and yourself alone, one question: Does this path have a heart?”
I offer good wishes to first-time voters who have sacrificed their time and energy to make some sense out of who to support on November 8th. It is the soul searching and the struggling through that make you the true winners on Election Day. 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.
There were many reflections about the 2001 terrorist attack on America leading up to the 15th anniversary just a few weeks ago. Following is my reflection on the memorial service at the World Trade Center on October 28, 2001. I attended the service with a group of mental health workers who offered their support for the bereaved.
As I recall, at the end of the service there was a chill in the air as the sun disappeared behind the ruins of the World Trade Center. Renee Fleming, accompanied by the Orchestra of St. Luke’s, sang God Bless America.
Moments earlier I said goodbye to the family I stood beside during the memorial service. They sat in the back row of our section, one of scores of sections filled with thousands of folding chairs, each chair occupied by a grieving family member. I stood with my back against an iron gate so I would not block anyone’s view. The family had lost its father and husband, a decorated firefighter. The widow was a slight woman of Italian descent, probably in her late sixties.
Photos of her husband were pinned to her wool coat, and to the coats of her three children. He was handsome. He had a white moustache and a full head of silvery hair, combed straight back. When the memorial service started an hour earlier one of her sons, an off-duty police officer, asked if I would make sure that no one obstructed his mother’s view. He said, “You can see how short she is.”
The service began with a processional that included His Eminence Edward Cardinal Egan, Archbishop of New York. Then, police officer Daniel Rodriguez of the NYPD sang The Star Spangled Banner. He had become a national presence by appearing in his dress blues and singing the national anthem at Yankee Stadium before the 97th World Series that pitted the Yankees against the Arizona Diamondbacks.
Everyone was on his or her feet. A massive wall of mourners rose around the tiny figure to my right. When I saw her struggling to climb, I took her arm and helped her up onto a folding chair. I told her that she could grab on to me. “Hold on to my shoulders,” I said. She hesitated. I told her, “Don’t worry you won’t knock me over.”
I could feel her trembling as she removed her right hand from my shoulder and fumbled for a tissue inside her coat pocket. I reached into my pocket and handed her a handkerchief.
When I was picking out my clothes earlier in the morning I had come across several unopened packets of white handkerchiefs. They belonged to my father who died seven years earlier. As I got dressed, I thought that today my father would want somebody who needed it to have one of his handkerchiefs. At first she refused my offer, not wanting to impose. I urged her, “Please, take it. It’s okay.”
Ten years later, my father’s handkerchiefs remain tucked into my dresser drawer – a daily reminder of when I joined a parade of broken hearts. Sometimes I close my eyes, think back and try to recall what things felt like before that sunny fall morning at ground zero.
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.
Patrick J. Kennedy is a former member of the U.S. House of Representatives who has struggled with mental illness and addiction for most of his life. He has become a leading force in the passage of the Mental Health Parity and Addiction Equity Act of 2008, a U.S. law that states that it is illegal to treat diseases of the brain differently than those of any other part of the body. 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 suffering with mental illness and addictions.
In his 2015 book, A Common Struggle: A Personal Journey Through the Past and Future of Mental Illness and Addiction, Kennedy offers personal reflections on the impact of trauma, addiction and mental illness on the extended Kennedy clan. He talks about the rocky relationship he had with his dad, the late U.S. Senator Edward “Ted” Kennedy and about his mom Joan’s battle with alcoholism.
At the heart of the memoir are Kennedy’s own revelations about his co-occurring mental illness and prescription drug and alcohol addiction, his path to recovery, and his ascendance to becoming, arguably, the nation’s leading advocate for parity and equity in mental health and addiction care. Kennedy has fought hard to lift the veil of ignorance about mental illness and addiction and to expose the health insurance industry’s tradition of denying and restricting access to care for individuals with brain illness.
Kennedy radiates a fire for eradicating stigma and ending discrimination against people with brain illness. According to One Mind, a nonprofit organization he co-founded, that is dedicated to benefiting all affected by brain illness and injury, “One of the harmful effects of stigma is that it can lead to discrimination. It could be as obvious as someone making a negative remark about your mental illness or as subtle as someone avoiding you because they think you could be unstable, violent or dangerous.”
On their website, One Mind lists some of the ways that these attitudes can be damaging and even dangerous. For example:
Reluctance to seek help or treatment due to the labeling
Lack of understanding by family, friends, co-workers or others you know
Fewer opportunities for work, school or social activities or trouble finding housing
Bullying, physical violence or harassment
Health insurance that doesn’t adequately cover your mental illness treatment
The belief that you’ll never be able to succeed at certain challenges or that you can’t improve your situation
Kennedy rightly frames the inequities that people with mental illness and addictions face as a matter of civil rights.
What he has accomplished, which he freely acknowledges is the result of a collective effort, has already gone a long way to wiping out stigma and increasing people’s access to mental health and addictions care. His goal, he states, is to launch “a new civil rights movement, to finally force medical equality for diseases of the brain.”
Tens of millions of Americans owe Patrick Kennedy a debt of gratitude for leading the way. Now all of us must carry the ball forward by treating children and adults with brain illnesses with dignity; and demanding that government enforce parity and equity for all and put an end to discrimination.
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.
Violence—random, sudden, illogical, and lethal—has become a fact of life. Shootings and acts of terror, homegrown and imported, with or without racial or religious overtones, have become gruesome signposts along a seemingly endless path of public and private horrors. They are taking a toll on our children.
No child should have to wake up each day as if he or she was on 24-hour-a-day guard duty. But in the United States this is the reality.
We can no longer think of these as isolated incidents, aberrations or confined to urban settings. Denial, an emotional trap door, is not a viable escape in a world where a sense of imminent threat is ever present.
In the immediate aftermath of the September 11, 2001 attack, writer Jeph Loeb and artist J. Scott Campbell produced a nine-framed cartoon entitled “Please Stand By,” that featured a very young girl watching cartoons.
By the third and fourth frames, the image on the screen changed to a live feed of the Twin Towers ablaze. As the little girl stood transfixed, stuffed animal in hand, the commentator announced, “We interrupt this program to take you live…,” the little girl turned away and called, “Mommy…” The next three frames began with her mother dropping a basket of laundry. Then, with her face contorted in anguish, she embraced her daughter to shield her from the unrelenting images. The final frame is a close up of the little girl asking, “Mommy, when are the cartoons gonna come back on?”
Among those who are left in the wake of violent acts are the survivors – friends and family members of victims, who live with the emptiness, frustration, and rage of incomprehensible death by violence.
Earlier this month, as the mother of the oldest child of Alton Sterling, the black man fatally shot by Baton Rouge, Louisiana police, expressed sorrow and outrage at his death, Cameron Sterling, 15, the oldest of Sterling’s children wept inconsolably by her side, for the entire world to see and experience his heartbreak.
One day later a St. Paul, Minnesota Montessori school cafeteria supervisor Philando Castile met a similar fate. Just one day after his shooting, five police officers, protecting hundreds of people in Dallas, Texas, who were peacefully protesting the two shootings, were gunned down and murdered, ambush-style, by a lone shooter who was fueled by racial hatred and bent on misguided revenge.
Beyond those left in the direct wake of violence are growing numbers of young people who are fed a regular diet of horrific episodes of violence through graphic media accounts such as the live streaming of a bloodied and gasping Philando Castile, filmed by his girlfriend Diamond Reynolds who wanted the world to join her in bearing witness as he took his last breaths.
In the aftermath of trauma, children (and others) feel fearful, unprotected, hyper-vigilant, and hopeless and on their own; similar to orphans who feel they must take care themselves.
We are living in world gone mad, a place where the rich diversity of colors, shades, languages, orientations, beliefs and rituals should be shared and celebrated rather than drawn as battle lines. The answers do not lie in books of psychology or popular bromides, or in aspiring national leaders who have proven to be untrustworthy.
The answer lies in being mindful – paying attention on purpose, making connections with one another and building a sense of communality.
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.
Once upon a time there was widespread belief that the human brain was fully developed by the time a child reached five or six years old. We know, for example, that the amygdala, the part of the brain that is responsible for instinctual reactions such as fear and aggressive behavior, does fully develop early. However, thanks to new technologies such as magnetic resonance imaging (MRI), neuroscience researchers have discovered that, although 95 percent of the brain’s architecture is formed by the time a child is six-years-old, that there are significant changes that occur around the time of the onset of puberty, between 10 and 13 years of age.
Scientists have discovered that during adolescence there is a rapid increase in the connections between the brain cells and refinement of brain pathways and that these changes are critical for the development of coordinated thought and action. As my colleague Craig Haen put it, “In the teen years, young people are going through a software upgrade, neurologically, in which circuitry is being consolidated, networks are being reorganized, connections are being made stronger and more expedient and unused pathways are wearing away.”
Changes in the brain take place in the context of many other factors including early childhood experiences and environment. Scientists are continuing to look into the development of the brain and the relationship between the changes taking place, behavior, and health.
The stakes are great during the teenage years. There is a perplexing contradiction between adolescents reaching the peak of physical health, strength and mental capability and, at the same time, facing greater risks and hazards than ever before. Parents walk a fine line between supporting their children’s independence and protecting them from harm.
Child and adolescent brain studies affirm that the brain is hard-wired for social interaction and for attaching and bonding with caregivers. Despite all the scientific advances, according to leading brain researcher Jay Giedd, people might be disappointed to know that the “best advice we can give is things that our grandmother could have told us generations ago: to spend loving, quality time with our children.”
Teenagers hunger for significant relationships with adults who care about them. This belief has been validated by social scientist Ellen Galinsky, who interviewed more than a thousand children and found that teens longed for more time with their parents, even when they seemed to be pushing them away. Galinsky concluded , “Even though the public perception is about building bigger and better brains, what the research shows is that it’s the relationships, it’s the connections, it’s the people in children’s lives who make the biggest difference.”
If a child’s job is to explore and a parent’s job is to protect, understanding changes in adolescent brain development offers an opportunity to support and create environments that promote positive peer experiences, where teens can safely explore and experiment and avoid behavior that can harm themselves or others.
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.
May 27, 2016, Long Island Weekly, an Anton Media Publication
At North Shore Child & Family Guidance Center, the vast majority of our clients are from Nassau County communities, but we recently had the opportunity to work with a young girl who came to Long Island from Haiti.
Thirteen-year old Anabelle traveled to the United States to receive life-saving surgery for an advanced stage of scoliosis at Shriners Hospital for Children in Philadelphia. Her condition was so serious that she would not have survived in Haiti. She was placed with a generous and loving host family that lived in Nassau County—far from home for a frightened and ailing teenager.
After about two weeks in the U.S., Anabelle became very withdrawn and refused to communicate with the family in any way. They weren’t sure how to help Anabelle, who didn’t speak English. The family was desperate to figure out a way to ease her fears and draw her out.
During this period the host family’s son, a recent college graduate, was working as a volunteer tutor at North Shore Child & Family Guidance Center’s Westbury office, known as the Leeds Place. He shared with his mom the broad scope of the work that we do with a very diverse population. She decided to call the director of the Leeds Place, Dr. Nellie Taylor-Walthrust, to brainstorm about what could be done to help Anabelle.
The discussion led to a plan that included one of our Haitian Creole-speaking outreach workers, Marmeline Martin, who has extensive experience working with special needs children and in training foster parents. Nellie asked the host mom if Marmeline could make a home visit to meet her and Anabelle. She was so happy and said, “Absolutely!” Then she asked, with a look of surprise on her face, “You make home visits?”
She was assured that we do, and added that seeing Anabelle in the home environment would be better, at least to start, than bringing her to an unfamiliar setting.
Marmeline readily agreed and made her way to the home where she met Anabelle who was sitting in her wheelchair, head bowed, with a somber look on her face. Marmeline asked if she could speak with Anabelle alone, and the family agreed it was fine.
At first, Anabelle would not speak to Marmeline. But in a short period of time, she opened up and revealed feeling homesick and alone, sharing that she wished to see her mother and the rest of her family back in Haiti. As Marmeline continued to speak to Anabelle in Creole, Anabelle began to brighten up, feeling reassured because she could be understood and feel comfortable enough to express her feelings. Marmeline asked if it would make her feel better if she came back to visit with her and she nodded in agreement.
Marmeline then met with the host mom to reassure her that Anabelle wasn’t in need of psychotherapy but was feeling low due to the separation from her family. She promised that she would continue her visits and that Anabelle was going to be fine.
On the next visit Marmeline brought some Haitian music to listen to that reminded Anabelle of being home. As the weekly visits continued, Anabelle began to smile and became more engaged with the family.
We reassured the host mom that she was caring for Anabelle in a loving manner and that what she needed to understand was that Anabelle’s adjustment to a new culture, environment and language was naturally frightening to the teen.
Cultural competency and the flexibility of home visits are key components of providing community-based mental health care, whether preventive care as in the case of Anabelle, or more intensive treatment for children with serious emotional disturbances.
As Nellie said, reflecting back, “It’s the small things that often make a world of difference.” Andrew Malekoff is the executive director of North Shore Child & Family Guidance Center (www.northshorechildguidance.org), which provides comprehensive mental health services for children from birth through 24 and their families.
Jordan and mom Patty in Soho, New York Fashion District.
Jordan and mom Patty in Soho, New York Fashion District.Although I’ve written before about bullying in this column, none of my experiences or research prepared me for my friend Patty Underwood’s reflections about walking the streets of New York with her teenage daughter Jordan, an incredibly talented theater student from the Boston area. I had the pleasure to meet Jordan on a trip to Boston a few months before she departed for New York City to begin her freshman year at NYU. But this story is about more than bullying. It is about a mother’s love and a child’s resiliency.
Patty’s story, painstakingly recalled and beautifully reported, will surely touch many a raw nerve. Her story requires no editorial comment from me, which would only dilute an intimate experience that speaks for itself. Patty granted me permission to share her story with you, my readers. Patty told me, “Walking with Jordan allowed me to be in her shoes. I heard her talk about this experience before, but it was the first time I really experienced it.” She added, “Jordan is all for letting people hear her story.”
Patty Underwood: “As we walked to the MOMA, I glared at the middle-aged woman who was looking at my 19-year old daughter like she was the circus fat woman. The woman appeared to be with her own thin teenagers; as she glanced at them, her face seemed to be mixed with wonder and disgust. I could feel the judgment exuding from her eyeballs, and the anger in me surged back with fire in my eyes. On the next block a group of construction workers smirked and cat-called. Then the teenagers wearing tiny belly-revealing tank tops gawked at her tummy that also peaked out.
“Every New York City block we walked brought eyes that bore holes in my daughter’s body and I was feeling a mix of distress, rage, worry and pure exhaustion. How the hell does someone survive the unrelenting visual persecution and surging negative energy? By the end of the day, I wanted to crawl under a rock and it wasn’t even me that was at the receiving end of this attack. My daughter kept saying, ‘What’s wrong?’ ‘Do you not want to be here?’ ‘You seem distant.’ I told her I was just tired from the long day in the city.
“Truthfully, I was trying to swallow the impact of her walking out the door every day. How does she do it? Who is there to protect her? What is this doing to her brain? I felt paralyzed by witnessing humanity try to crush my daughter’s spirit. At one point I suggested that maybe she not show so much cleavage, and she railed back, ‘Oh, just because I have big boobs it’s okay to comment about them? As a social worker, mom, you should know better. What, are you now going to say that women who get raped asked for it!?’
“We continued to walk, her with her head high and mine stuck down, avoidant of the imminent look. My daughter, it seems, has come to terms with the battle she faces when she walks out the door. ‘Mom, if you weren’t here, I would respond, tell them to f*** off.’ I am reminded of the practice she has had at facing the bullying since middle school. And the barrier it created; and the friends who love her unconditionally. And the dance teachers who see the beauty in how her body moves. And the 10,000 likes she got on Tumbler after posting a video of her dancing.
“Plus-size models are walking the runways and appearing in fashion magazines and Ashley Tipton won Project Runway. [Tipton is a 24-year-old clothing designer.] Tipton is an amazing woman who is advocating for the underprivileged and the eradication of all types of discrimination. Yes, she’s a fighter, fiercely protective of those whose human rights are under attack, passionate, creative, funny, singer, actor, dancer, black belt carrying, plus-sized and beautiful. Jordan is all this and more.”
Thank you Patty and Jordan.
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. The views expressed in this column are not necessarily those of the publisher or Anton Media Group.
This column original appeared in Anton Media Group. Click here for Anton’s website.
Peer pressure can play a major role in the sending of texts, with parties being a major contributing factor.
A few years ago, in an effort to better understand where sex and social media intersect with respect to attitudes and behavior, The National Campaign to Prevent Teen and Unplanned Pregnancy conducted a survey of teens and young adults. The study measured the proportion of them who are posting sexually suggestive text and images. There were a total of 1,280 respondents—653 teens (ages 13 to 19) and 627 young adults (ages 20 to 26).
The survey found that a significant number of the 13 to 19 year olds have electronically sent, or posted online, nude or semi-nude pictures or video of themselves. Sexually suggestive messages via text, email or IM (instant message) were even more prevalent according to the survey. Seventy-five-percent of the teen respondents and 71 percent of young adults said sending sexually suggestive content “can have serious negative consequences,” yet they continue this behavior despite substantial personal safety and legal risks.
In the past few months on Long Island, sexting has been all over the news, including arrests and school suspensions of teens charged with sexting and viewing these messages. Parents, caregivers and other relevant people in kids’ lives need to be attuned to this behavior and be prepared to address it.
Despite the influence of peers, which is not all negative, this is only one part of a four-part community that includes family, larger community and media influences, all of which have demonstrable effects on adolescents’ sexual attitudes and behavior and all of which interact in a complex way. For example, beyond the peer group are information and images transmitted by the media that may typify values that are detrimental to young people’s self-image and health.
In families in which sexuality is not a taboo subject and related discussions occur quite naturally throughout childhood, pathways are forged for ongoing dialogue about all aspects of sexuality. If parental influence is strong enough—that is, if their relationships with their children are warm and close and their parenting style is authoritative—it can be a powerful protector against negative peer influence.
The American Academy of Pediatrics offers some good tips for talking to you kids about texting (go to www.aap.org and search for “sexting”):
• Talk to your kids, even if the issue hasn’t directly impacted your community. “Have you heard of sexting?” “Tell me what you think it is.” For the initial part of the conversation, it is important to first learn what your child’s understanding is of the issue and then add to it an age-appropriate explanation (see next bullet).
• Use examples suited to your child’s age. For younger children with cell phones who do not yet know about sex, alert them that text messages should never contain pictures of people—kids, teens or adults—without their clothes on, kissing or touching each other in ways that they’ve never seen before. For older children, use the term “sexting” and give more specifics about sex acts they may know about. For teens, be very specific that “sexting” often involves pictures of a sexual nature and is considered pornography.
• Make sure kids of all ages understand that sexting is serious and considered a crime in many jurisdictions. If they “sext,” there will be serious consequences, quite possibly involving the police, suspension from school, and notes on the texter’s permanent record that could hurt their chances of getting into college or getting a job.
• Experts have noted that peer pressure can play a major role in the sending of texts, with parties being a major contributing factor. Collecting cell phones at gatherings of tweens and teens is one way to reduce this temptation.
• Monitor headlines and the news for stories about sexting that illustrate the very real consequences for both senders and receivers of these images. “Have you seen this story?” “What did you think about it?” “What would you do if you were this child?” Rehearse ways they can respond if asked to participate in inappropriate texting.
• Encourage school and town assemblies to educate parents, teachers and students.
An important and related problem is that with social networking there is no respite. Social media has a 24-7 quality that leaves many teens feeling that there is nowhere to turn and no escape—not at home, not on vacation, no place.
Social media has opened the door to new avenues of sexual expression and new challenges for families, health educators and human services professionals. Don’t miss this opportunity to educate your youngster about its dangers.
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, visitwww.northshorechildguidance.org.
This column original appeared in Anton Media Group. Click here for Anton’s website.
The reprehensible act that wound up getting Deputy-School Resource Officer Ben Fields fired from the police department.Several weeks ago I read three letters to the editor in another newspaper that focused on the importance of classroom discipline and respect for authority, and I have not been able to get the incident out of my mind. The letters were written with regard to the high school girl in Spring Valley, SC who was thrown around like a rag doll and body-slammed by power-lifting Deputy-School Resource Officer Ben Fields. Her crime? Refusing to turn over her cell phone. The incident was captured on two cell phone videos.
Here’s how the violent arrest was described by CNN:
“The videos show the officer standing over a student, seated at her desk. He puts his arm near her neck, then yanks her backward. The desk tips over and the student crashes onto the floor. The uniformed officer doesn’t let go, sharply tugging the student toward the front of the classroom. She flies out of her desk and slides several feet across the floor.”
Although the letter writers were critical of the deputy’s actions, there was not a scintilla of sympathy for the victim expressed in their reflections or, seemingly, any wish to know or even wonder about her back story.
Maybe they didn’t know that her grandmother had become her caregiver for years because her own mother had lost custody of her due to criminal activity. Perhaps they were not aware that her grandmother died a week before the classroom incident. Or, that her cell phone was her only personal property, a comforting transitional object.
This information is sourced but isn’t “reportable” in the news because of her age and status in foster care. If the media “outs” her mother and grandmother she becomes identifiable. But surely the school must have known. And if they didn’t, they are negligent.
Did they do anything to comfort the grieving girl or just call the school resource officer to discipline her and bend to their authority? Why didn’t they call the guidance counselor or school social worker instead of a law enforcement officer? Did he know she was grieving? Did school authorities tell him? Would it have made any difference?
CNN also reported the following: “Curtis Lavarello, one of more than 46,000 people employed full time as school resource officers [across the country], has seen this kind of scenario ‘played out hundreds of times, … and it’s one that can be handled so simply.’ But he can’t explain why this one was handled as it was. ‘We saw a pretty routine discipline issue become a criminal issue in just a matter of minutes,’ said Lavarello, head of the School Safety Advocacy Council. ‘It escalated needlessly’.”
Discipline and respect for authority are completely beside the point in this case. Those issues are for another discussion. What this teenage girl who was grieving needed was some empathy and TLC and not physical abuse by school personnel and condemnation by judgmental outsiders. 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. The views expressed in this column are not necessarily those of the publisher or Anton Media Group.
Even though the chill of autumn is well upon us, it’s always a great time to enjoy the outdoors—and it’s also important for a youth’s development to keep their connection to our natural world.
With teens so immersed in texting and video games and other tech-focusedpursuits, they often lose both the connection to each other and to the world around them. That’s why North Shore Child & Family Guidance Center designed our Wilderness Respite Program, which provides a unique opportunity for at-risk adolescents to participate in nature activities that foster individual growth, leadership skills, self-esteem and friendships while also promoting environmental stewardship.
Following is a “slice of life” from the program:
During one of the planning meetings for an upcoming hike, a few of the boys tried to take control of the situation by dominating the other group members through physical posturingand verbal banter. That all changed once the teens drove to the state park and departed from the van. We found ourselves immersed in the forest, with no pavement, stores, traffic lights or any of the usual trappings of the home neighborhood—the kind of pure, natural environment many of the teens had rarely if ever experienced.
To our surprise, the boys did not volunteer to lead the way. Instead, they followed the girls, who became models of leadership. Little by little, all of the teens learned to work together, decoding the trail markers located on trees and rocks. Relying on their growing awareness of themselves and the direction of the staff, the teens gradually learned to hike at a controlled, measured pace, rather than starting out in a sprint and tiring as the day wore on. Although this was emphasized during preparation meetings, it was in the “doing” that this learning was integrated by the hikers, who soon learned how easy it was to get worn out.
The hike was a challenging one, lengthy and with rough terrain. It was an experience most of the teens felt was beyond their capabilities, but once they realized they could overcome these perceived limitations, they felt exhilarated. They also developed a noticeable respect, admiration and affection for each other. Tired and done-in, the group gathered around some rocks, leaning on one another for support, warmth and belonging.
Self-discovery took another turn on a canoeing trip by the same group. The teens were faced with strong winds and an unfriendly current as they attempted to learn basic canoeing skills on Long Island Sound. All of the teens experienced a great deal of frustration, disappointment and anger as they struggled in teams to control the direction and progress of their canoes. They learned that the elements and obstacles proved too formidable on that day for us to reach our destination, when after three hours of tiresome paddling, we needed to turn around and paddle back to our starting point, rather than continue to our original destination six miles away.
But the trip wasn’t by any means a failure, because learning how to handle disappointment is just as valuable as experiencing success. The group learned that when the challenges of the wilderness became tiring and weather conditions on the water became burdensome and oppressive, they had to reach inside themselves to summon up additional strength to overcome frustration, anger and fear. So, even though the trip had more than its share of disappointments, the teens were able to carry over the feeling that they could handle it when things don’t go smoothly.
These wilderness outings to excursions on both land and sea were successful because they all serve to prepare the teens for unknown challenges ahead.
For more information about the Wilderness Respite Program, contact Director Bruce Kaufstein at 516-626-1971, ext. 316.
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.
It wasn’t necessary for the slaughter of innocents at Sandy Hook to validate that there is evil in the world. But it did affirm that if the massacre of six-year-olds isn’t off limits, then nothing is. Sadly, we are reminded of this again after the senseless killings at Umpqua Community College in Roseburg, OR on Oct. 1.
As after Sandy Hook, mental health experts offered tips to speechless parents about how to soothe their children. Their advice: reassure safety, limit media exposure, offer distractions to prevent obsessive worry, watch for angry outbursts and depression and if symptoms persist, seek professional help.
I imagine if parents speak to their children from their guts instead of their heads and hearts, they’d say, “It’s a cruel world, evil is everywhere, watch your back and don’t trust anyone.”
Since Sandy Hook, there have been 142 school shootings. After some time passes, Umpqua Community College will become another tombstone in our collective psyche, alongside Columbine, Virginia Tech and many more.
The two major talking points will continue to be preventing gun violence and promoting mental health. On gun violence, the discussion is about maintaining the right to bear arms and taking steps to keep certain guns out of uncertain hands.
The gun lobby is formidable. On the other hand, it seems that children don’t have a voice until they are in the ground. Children die, grieving parents become tireless advocates and laws are passed named after their deceased children.
Yet, although the Sandy Hook tragedy ignited a national discussion on mental health, not much has changed. People with mental health problems often feel shame and suffer in silence, while major metropolitan newspapers exploit and discredit people suffering with mental illnesses with malicious name-calling that reinforces fear, mistrust and stigma.
Many people might be surprised by the fact that most violent acts are not committed by persons with mental illness. In fact, people with mental illness are disproportionately the victims of violence. New gun laws require that the names of individuals with severe mental illness who are designated as dangerous be recorded in a national database. Whether this will improve public safety or generate a witch hunt that further stigmatizes the mentally ill remains to be seen. In any case, what it doesn’t do is address the problem of better access to quality mental healthcare that takes into account an individual’s needs and social circumstances in a holistic manner.
Congressman Tim Murphy (R-PA)
According to a subcommittee on mental health chaired by U.S. Representative Tim Murphy, 75 percent of all serious mental illness occurs before the age of 24 and 50 percent before the age of 14. Yet, only one out of five children who have emotional disturbances receives treatment from a mental health specialist.
Early screening by schools and pediatricians is a promising development. But beyond screening, many states only assure continued access to mental healthcare to children and families with Medicaid coverage, which leaves a significant number of children and adults in the lurch. The government throws the underinsured middle class and working poor overboard with no life preserver.
And the health insurance industry is no better. Most private health insurers pay substandard rates that community-based agencies can no longer afford to accept. To add insult to injury, profit-driven insurance authorization denials kill people. For example, in 2001 Timmy O’Clair, a 12-year-old from upstate New York, committed suicide after his parents were unable to obtain mental health treatment for him due to health-insurance coverage limits.
Timmy’s death was the impetus for the passage of Timothy’s Law, which extended insurance coverage for mental health treatment in New York. Although the Affordable Care Act extends federal parity protections, profit-driven insurance companies have a very long way to go to meet their mandate for adequate networks of care. When they don’t meet the mandate, we must expose them and fight to have their licenses revoked.
Although this is a story about a school in rural Roseburg, OR, as it was in Sandy Hook a blink of an eye ago, it’s really a story about the thousands of children that community-based mental health agencies guide safely to shore every year, offering them the chance to see a brighter day. To do this we need to overcome stigma and fight for funding that allows for ready access to quality mental healthcare.
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, visitwww.northshorechildguidance.org.
In one week in September, soon after we commemorated the 14th anniversary of the Sept. 11, 2001 terrorist attack on our country, there were three widely publicized stories that revealed the ugliness of post-9/11 America.
At a town hall meeting in New Hampshire, Republican campaign front-runner Donald Trump was questioned by a man who said, “We’ve got a problem in this country; it’s called Muslims. You know our current president is one. You know he’s not even an American.” Obviously, the questioner felt comfortable asking this question of Mr. Trump, whose rhetoric about immigrants has been, to put it mildly, less than kind.
Mr. Trump tried to laugh it off. But instead of correcting the audience member’s false assertion about President Obama or challenging his bigoted smear of Muslims, he just let it stand.
Dr. Ben Carson
Shortly thereafter, Dr. Ben Carson, running close behind Mr. Trump in the campaign, asserted onMeet the Press that he would not be comfortable with a Muslim as President of the United States.
Just prior to these ugly interchanges, Ahmed Mohamed, a Muslim boy living in Irving, TX, was arrested for bringing a homemade clock to school. A teacher who thought it was a bomb reported Ahmed, a ninth grader, to the police, who then arrested him.
President Obama invited Ahmed to the White House, telling him, “Cool clock, Ahmed. Want to bring it to the White House? We should inspire more kids like you to like science. It’s what makes America great.”
Although these stories were well-publicized, they represent only the tip of the iceberg in post-9/11 America. In recent years I had an encounter that is probably more typical than you’d expect.
During a roundtable group forum on immigration and youth held at North Shore Child & Family Guidance Center’s Roslyn Heights headquarters, a 12-year-old boy named Muhammad, who was listening intently to others tell personal stories about leaving their homelands and struggling to fit in after arriving in the U.S., decided to speak up.
With a trembling voice, Muhammad revealed that there were kids in school who taunted him. “They’ve been calling me ‘terrorist’ for years because of my name.” Muhammad is an Arabic name that means praiseworthy. But, instead of feeling proud, Muhammad felt like an outcast.
Muhammad sat slumped in his chair and spoke softly and guardedly, but clearly and eloquently, and he was heard. By the end of the day he had received so much support from the group for having the courage to speak out that he was beaming.
During the lunch break I approached him to ask him how he was doing. He said, “Everybody is telling me that I talk good. I didn’t know that I could talk so good. Nobody ever told me that before.” Muhammad left the meeting feeling praiseworthy, a feeling befitting his name—a name he was given at birth that he should feel proud to have.
Sadly, stories of racism and hatred against Muslims are not rare—not surprising given the recent example of Ahmed Mohamed’s arrest for his innocent work on a school project. I recall that shortly after 9/11 one Muslim mother who came to us for help revealed that she dyed her children’s hair to a lighter color so that they wouldn’t be viewed as “kin of terrorists.” Those are the lengths that one mother felt were necessary to protect her children and they display a sad commentary on our culture.
As we remember the thousands who were lost on 9/11, along with other acts of terrorism, we should not lose sight of the fact that profiling people of Middle Eastern descent as terrorists or as sympathetic to terrorists must be confronted. Such widespread profiling is detrimental and devastating to thousands of innocent children and their families, many of whom were not even born until after Sept. 11, 2001. It’s time to let our voices be heard and, unlike Mr. Trump, take a stand against bias when we hear it.
When the staff at North Shore Child & Family Guidance Center noticed a trend of first–generation Latina teens coming to the center with depression, anxiety and even suicidal thoughts, they came up with a program that has been an enormous success: The Latina Girls Project, which uses not only individual, group and family therapy, but also organizes monthly outings, supported by a generous grant from the John and Janet Kornreich Charitable Foundation, to show the girls the world outside of their communities and provide them with hope for their future.
Many of the outings are designed to expose the girls to their heritage and to celebrate Hispanic culture. On one recent trip, the girls attended a performance by Segunda Quimbamba, a Jersey City-based percussion and dance ensemble that performs authentic bomba and plena, the drum music of Puerto Rico. The music was uplifting and joyful, and the girls were instantly drawn to the rhythmic expressions of the group, which features drums, wind instruments, guitarists, vocalists and dancers performing Latino songs. The musicians provided the girls with some interesting and important historical information—but the most important and impactful part of the experience was when the performers invited the teens to dance and drum. To watch as some of the most shy and withdrawn girls bravely and excitedly joined the group onstage was inspiring beyond words. The trip revealed how music and dance are terrific therapeutic tools which help teens heal by encouraging self-expression and self-awareness, and it also exposed the teens to positive messages about Hispanic culture, making them feel the richness of their heritage.
For another cultural event, the guidance center staff took 18 teens to see a play called La Gringa at the Repertorio Español in Manhattan. For most of the girls, it was their first exposure to a Manhattan theater. The play was an excellent choice for this age group due to their ability to identify with the protagonist. La Gringa depicts the struggles of a young Latina woman whose parents are Puerto Rican but who is born and raised in New York City. She visits her parents’ homeland as a young adult who is seeking out her cultural identity. She immediately falls in love with her country of origin, but is met with the reality that she is neither a “native” Puerto Rican nor a North “Americana,” as family members label her. The play uses humor and sensitivity to deal with the cultural conflicts related to the different values and their impact on relationships within their families. The girls especially enjoyed how the protagonist is able to assert herself and seek out her individualism.
A group from the Latina Girls Project at the Statue of Liberty in summer 2014.
Another trip this year was a spectacular evening at the Metropolitan Museum of Art to celebrate Women’s History Month. The teens, who were invited by the Met’s Multicultural Audience Development Initiative’s Advisory Committee, had never experienced such an elegant affair and the guidance center staff members who chaperoned the trip were so proud of the girls’ ability to conduct themselves with grace and maturity as they interacted with accomplished women of diverse social, racial and educational backgrounds. The teens confidently introduced themselves as young women from Long Island looking to expand their opportunities in their future careers. It impressed the girls so much that a few of them are saying that they’re now looking into college, their next milestone in life.
On Aug. 18, Rosie O’Donnell took to social media to ask her followers to help her find her 17-year-old daughter Chelsea, who had run away from home the week before. O’Donnell posted an alert on her website and Twitter account stating that Chelsea hadn’t been seen since Aug. 11.
O’Donnell also posted that her daughter had stopped taking her medication and “was in need of medical attention.” Her spokesperson added that “Chelsea, like millions of people, lives with mental illness. It has been a difficult road for Chelsea and her family and they just want her back safe.”
Thankfully, Chelsea was found unharmed. Apparently, alerts from her peers and the pinging on her cell phone led police to her location. O’Donnell tweeted her thanks, telling her followers, “Chelsea has been found and is safe in police custody—thank u all for the help and light #missingchildren.”
While no one outside of O’Donnell’s family knows the circumstances that led Chelsea to run away, one possible cause is clear. A quick search on social media revealed that there is no shortage of gossip about Chelsea’s family life, sarcasm about O’Donnell’s fitness as a mother, black humor suggesting she was kidnapped by Donald Trump and speculation about the missing girl’s mental status. There were also shaming commentaries as to how her mother’s impending divorce may have contributed to her daughter’s distress.
It’s more than likely that Chelsea O’Donnell had easy access to all of this. One can only imagine how a young person in turmoil was able to make sense out of it, and how much of the onslaught of cyberbullying against her family contributed to her demoralization before she made the dangerous choice to head to the home of a stranger, a 25-year-old who had a history of criminal offenses whom Chelsea met on an online dating app called Tinder.
All media—conventional and social—can be invaluable in helping to track down a missing child; that is a blessing. Almost anything in the way of messaging that might lead to the recovery of a runaway child is welcome.
But where’s the dividing line between offering assistance and adding to the emotional damage? What is the benefit in publicly revealing, among a population (that’s us, folks) that remains primitive in their understanding and acceptance of mental illness, that the runaway child has a history of mental health problems? While there should be no shame in having a mental illness, any more than with any other illness like diabetes, we still live in a culture that stigmatizes those who face these challenges. This story, and the subsequent cyberattacks joking about the condition, make that more clear than ever before.
Traditional media in recent decades has skewed more and more in the direction of sensationalism. It’s not unheard of for certain media outlets to use expressions such as “crazy” or “loony” to refer to those with mental illness; and social media, a 24-7 town meeting with minimal monitoring, is a runaway train that assumes more of the characteristics of chaos than order. The very tools we now have at our disposal that can be instrumental in the recovery of a missing child can also administer damage that the public ignores in the celebratory aftermath of the child’s recovery.
In the O’Donnell case, it seems likely that the family made a decision to discuss Chelsea’s mental health issues to help find their child, and one cannot imagine a more compelling reason to “go public” with her condition. But it’s also likely that, given the ignorance that is so widespread regarding mental illness, it wasn’t an easy decision for them to make.
If this incident sheds some light and sparks some intelligent discussions about media sensationalism, the role of social media both for good and ill, and the stigma surrounding mental illness, then that will at least result in some positive outcomes from what has been a sad, personal family story made public.
Have you ever sought mental health care for your child? What about care for a drug addiction? Have you made calls to multiple providers on your health insurer’s “list” and had the door slammed repeatedly in your face? Or were you fortunate enough to make a good connection and then unceremoniously have the rug pulled out from under you, with your insurer denying continued care?
Welcome to the club.
If you have a child with a mental health or addiction problem, you know how hard it is to make that first phone call. A parent with a child with cancer doesn’t hesitate to call for help. But when mental health is the problem, it can take weeks, months or even years because of the crippling effect of stigma. But what about the two situations I described above: You make that call, but you are denied continued care or you’re denied access to care in the first place?
The federal parity law, formerly known as the Mental Health Parity and Addiction Equity Act, is designed to prevent group health plans and health insurance companies from imposing less favorable benefits than they do for other medical conditions. The law is supposed to guarantee that people with mental illnesses have the same access to treatment as patients with diseases like diabetes, but some insurers have continued to limit treatment in subtle ways.
According to a recent report by NPR, since 2010, the United States Department of Labor, which is the main federal agency in charge of parity, has found 140 instances in which a patient’s parity rights were violated. Although all those issues were resolved voluntarily, no insurer has been fined and none of the results are public.
Regarding gaining access to care in the first place, network adequacy refers to a health plan’s ability to deliver the benefits promised by providing reasonable access to a sufficient number of in-network primary care and specialty physicians, as well as all health care services included under the terms of the contract. The reality is that, because private insurers pay substandard rates as compared to Medicaid, middle class families are finding it harder and harder to find providers to help their children. They look at their insurer’s list of providers, make phone calls and are repeatedly told, I’m sorry, I don’t accept your insurance. The lists are inadequate, outdated or just plain falsehoods.
On July 22, 2015, Assemblyman Todd Kaminsky authored a letter to the New York State Department of Financial Services (DFS) to express deep concern about the lack of commercial insurance coverage for mental health services for middle class families on Long Island. He requested that DFS launch an investigation to determine the scope of this pressing problem.
Assemblyman Kaminsky said, “After hearing from numerous constituents and closely studying this issue, it is clear that commercial insurance companies do not have adequate mental health service networks for hard-working families. This lack of access to care is alarming, and I hope DFS will immediately respond by commencing a thorough study of this issue.”
While Medicaid covers comprehensive mental and behavioral health services, commercial insurance frequently does not provide coverage, or if they do, the rates are miniscule compared with the cost of treatment. The reality today is that fewer community-based mental health clinics are accepting privately insured clients who earn too much to qualify for Medicaid, which leaves these families with nowhere to turn for affordable care. They have few options to access care for their children, even those experiencing life-threatening crisis situations.
By ignoring the enforcement of the federal parity law, the majority of representatives in government are turning their backs on the millions of Americans who are in need of essential mental health care services. We cannot trust insurance companies, whose eye is on their bottom lines, to do the right thing. It’s no exaggeration to say that lives have been and will continue to be lost unless we pressure our politicians to make this a top priority.
The church shootings of nine black parishioners in Charleston, SC, at the hands of 21-year old Dylann Roof, who has confessed to the crime, sends a sobering message to all those involved with adolescents. Although cries of “hate crime” ring out in this instance—and no doubt are true—we need to recognize that issues surrounding diversity and systemic racism are an issue for every teenager and young adult here on Long Island.
Those of us who have the privilege to work with youth in schools, community centers and other arenas face the unique challenge of helping them address diversity and racism openly and honestly. Although discussions about race during the last two presidential campaigns gave a number of people a chance to process their feelings, it doesn’t appear that we have come very far.
An open, nonjudgmental group experience can provide adolescents with a unique opportunity to explore the typically taboo areas of race and ethnicity, exposing deeply ingrained or loosely-formed beliefs and influencing their perceptions and behaviors in the world outside of the group.
When stories like the church shootings and the deaths of unarmed black citizens at the hands of the police dominate the media, young people’s tendency toward stereotyping and polarizing is too often reinforced. Within group settings, we can encourage discussion about ethnic identity, bias, prejudice and intergroup relations as a normal part of adolescent development. We can help young people to tune in to ethnically and racially-charged local, national and international events that affect them.
I vividly recall a meeting I had with a group of local teenagers in the immediate aftermath of the Columbine High School shootings in Littleton, CO. The group talked about their feelings regarding profiling and stepped-up security in schools and in the community. One group member, Carlos, recalled an incident when he was stopped by a police officer who asked to check his arms. “He was looking for gang tattoos. He thought I was MS-13,” Carlos explained as he slowly pulled his shirtsleeve back across his forearm, as if back in the moment. “I told the cop, ‘First of all, I’m Salvadorian and proud of it. Second, I’m not a gangbanger.’ ”
Carlos continued, “A week later, I saw the same cop at my restaurant job, where I work as a maître d’ and wear a tuxedo. He looked me over and seemed really confused. I smiled and said to him, ‘See, I’m the same person.’”
A healthy exchange of ideas and opinions about controversial subjects in a safe environment enables young people to test out their beliefs and attitudes, to practice listening to the views of others, to respectfully express differences and to discover common ground.
By advancing an understanding of differences, we can reach for commonalties experienced among young people across cultures to open pathways for relating among different ethnic groups.
Presently, we all face the sad possibility of seeing a dramatic erosion of empathy and loss of community as a result of the struggle for economic survival. We cannot afford to allow the development of empathy for others to slip away from our youth in the process. As adults, we must do all that we can to help young people confront the issues surrounding diversity openly, honestly and safely. Our survival and humanity depend upon 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, visit www.northshorechildguidance.org.
As parents, we naturally want to keep our children safe. But it’s important to remember that, while it’s a parent’s job to protect, it’s a child’s job to explore. But for mothers and fathers who came to the United States from countries in Central and South America that are rife with war, gang violence and poverty, allowing their children—and especially their daughters—to explore the world around them can be terrifying.
Regardless of their origins, it’s natural for all teens to want to be accepted by their peers and feel like they are part of American culture, but it’s understandable that the parents of first-generation Latinas are extremely overprotective. Many immigrated to America because they wanted their families to be safe, which results in a tendency to continually hover over their daughters. Many of them won’t let the girls participate in typical teen activities, such as sleepovers, dating or trips to the mall, which makes the girls feel trapped and isolated.
Even if the teens are allowed to go out with friends, they are required to have a chaperone, such as a parent or brother. In addition, they are often relegated to gender-biased roles, required to cook, clean and take care of their siblings, while their brothers are treated, as one girl said, “like princes.”
The result of these conflicts: An increasingly large number of teenage Latinas were coming to North Shore Child & Family Guidance Center with depression, self-harming behaviors and suicidal thoughts. Some had even attempted suicide.
Determined to help these girls and their families, Associate Executive Director Regina Barros-Rivera gathered a team of bilingual, multicultural counselors from the Guidance Center and created the Latina Girls Project, an innovative program that employs counseling, monthly outings and other activities designed to tackle issues such as hopelessness, poor self-esteem and school refusal (a disorder of a child who refuses to attend school or has problems staying in school).
Individual, group and family therapy are integral pieces of the program. Through therapy, the girls develop trust, learn healthy ways to deal with stress and depression and find better ways to communicate with their parents.
But the monthly outings are also a very important element of the Latina Girls Project. During one trip to Manhattan, the girls took part in a workshop led by female artists, dancers and poets, all accomplished and confident Latina women. This was a huge adventure for the teens, because they were so often stuck in their home communities—and also stuck in feelings of low self-esteem, shame and self-consciousness.
At first, the girls couldn’t say anything positive about themselves; they had no access to such self-affirming feelings. But they gradually spread their wings, bit by bit, and took part in art, dance and writing. The teens were uplifted by witnessing the confidence and compassion of these powerful role models, who told the girls to look in the mirror and see their own strength and beauty.
This workshop, along with other trips to historical sites, artistic venues and nature settings, help the girls shift from feelings of helplessness to hopefulness. Over time, they find their voices and discover the inner strengths that had eluded them.
By participating in family therapy and also witnessing the transformation their daughters experience, the girls’ parents become more compassionate and understand that they need to let their teens separate in healthy, age-appropriate ways. As one girl put it, “My parents learned that I just wanted them to be there for me and listen. They learned that it doesn’t help to question why I feel the way I do but to accept it and support me.”
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 ww.northshorechildguidance.org.
Finally, what seemed like the longest winter in memory is over. I’m grateful to spend time soaking up the sun, walking and biking along the boardwalk in my Long Beach neighborhood.
But during my excursions, it saddens me to see how many young people are isolated and clueless about the beauty of the world surrounding them. Most are staring down at their phones as they text or scroll through their Instagram feeds.
For other kids, their tech device of choice doesn’t even make it out of the house. It can be a perfect spring day and these youngsters prefer to stay indoors, playing video games or glued to some other electronic device. Regardless of their protestations otherwise, a number of these children and teens are not only lonely and miserable, they’re also at risk of a host of problems.
Here are just a few: We all know that obesity is an epidemic in our culture, and a big reason is that our kids’ addiction to gadgets means they’re not outside running around and playing. When kids spend all their time on Facebook instead of face-to-face with their peers, they feel isolated and alone. Research suggests that nature-deprived kids are prone to anxiety and depression.
Here at North Shore Child & Family Guidance Center, we’ve seen firsthand how children blossom when they “get back to the garden.” At our Roslyn Heights headquarters, groups of children and teens water, seed and weed our organic bed, and they are filled with joy when they see the vegetables grow. Moreover, since much of the produce they harvest is donated to local food pantries, they experience the pride that comes from helping others.
Through their work in the garden, kids who were shy and insecure developed self-confidence and made new friends. They learned leadership and team-building skills. Tending the garden and watching it grow intensified their sense of wonder and curiosity.
Gardening helps kids connect to the earth, to each other and, yes, even to their parents. Young children will be in awe as you show them the fruits (and vegetables) of your joint labor. If your teens are reluctant to work with you, expose them to tools that they can begin to master—and don’t be surprised if they end up joining you in the garden.
Another plus: Gardeners achieve a natural state of calm and focus called “mindfulness.” Though people often associate it with meditation, mindfulness doesn’t require hours of prayerful silence or chanting mantras. Mindfulness at its core is about staying in the present, moment by moment, to feelings, thoughts, bodily sensations and the surrounding environment.
Mindfulness is an inherent part of the experience of gardening; it gives kids new ground to stand on, both literally and figuratively, embracing their senses of sight, smell, sound, touch and taste. Mindfulness in nature calms the brain, allowing for reflection and healing and it’s also great for the body.
If gardening isn’t up your alley, not to worry. Being outdoors—whether hiking, biking or swimming—restores the spirit. There’s bound to be an activity your kids will enjoy.
So, whether you are 8 or 80, take advantage of the beautiful weather and find your bliss. It’s right outside your door.
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.
Members of a Wisconsin middle school basketball team are being lauded as heroes, and rightfully so. When the boys noticed some bullies making fun of one of their cheerleaders—a 14-year-old girl named Desiree who has Down’s Syndrome—they took action, walking over to the bleachers and telling the offenders to cut it out. As one of the boys told reporters, “They were pointing and laughing at her from the stands. It’s not funny to make fun of somebody by the way they look or act.” Another said, “This is not a one-time thing. You always have to stick up for kids that are bullied. It’s the right thing to do.”
Another group in New York City, Teen Pact, has taken steps to combat cyberbullying by producing public service announcements that are being used nationwide. One PSA depicts a boy texting an affectionate message about a classmate. His friends then pass it on and when it goes viral he becomes the target of unrelenting teasing and taunting. The PSA message is: “It’s not funny anymore, don’t be an accidental bully.”
Just how many kids are being tormented, either online, in school or both? Recent studies report some startling statistics:
83 percent of girls and 79 percent of boys report being bullied either in school or online.
75 percent of school shootings have been linked to harassment and bullying against the shooter.
About 160,000 teens skip school every day because they are bullied, and 1 in 10 teens drops out of school due to repeated bullying.
Kids who are bullies as young adults continue the trend of abuse and violence into adulthood. By the age of 30, about 40 percent of boys identified as bullies in middle and high school had been arrested three or more times.
The most frequent targets are kids seen as “different”—gay or transgender youth, those with special needs or who are overweight—but no kid is immune from being a victim.
While bullying isn’t a new phenomenon, cyberspace obliterates any sense of sanctuary that children once found when they were away from school and in their own homes.
One social media app that’s particularly alarming is Yik Yak, which allows users to send out posts—known as “yaks” — that can be seen by anyone within a 1.5-mile radius. What makes it worse than most other social media forums kids are using is the fact that the posters are anonymous. A user can “yak” out anything they want without fear of being identified. Perfectly acceptable posts: “Jane is an ugly cow,” “John is a fag,” and much more that would be unprintable in this newspaper. It’s devastating to imagine the damage this type of abuse can have on a child or teen.
Laws such as the Dignity for All Students Act , which took effect in July 2012, seeks to provide students with a safe and supportive environment free from discrimination, intimidation, taunting, harassment and bullying on school property, buses or at a school function.
The passage of the dignity act provides an opportunity for parents to talk to their children about how to protect themselves from bullying and offers them a context to discuss how to be sensitive to others who are different. This is, of course, providing that parents are able to engage their children in an accepting and nonjudgmental manner that opens communication.
But laws like the dignity act aren’t enough to tackle what is a social problem. No amount of legislation and no penalties for intimidating schoolyard behavior can guarantee that children will be safe at all times whether inside or outside of school.
These laws must be complemented by support at home, pro-social bonds among neighbors and consistent community standards against bullying, bias and harassment, including in cyberspace. Otherwise, the legislation will be little more than a paper tiger, another layer of bureaucracy with limited influence in the real world.
Despite the influence of some distinguished legislators with big hearts, big government has treated community-based mental health organizations with little respect. For example, at North Shore Child & Family Guidance Center, we have not received a net increase in government funding for our outpatient mental health services for more than 30 years.
Mental health agencies are disappearing all around us. In late January, the Federation of Employment and Guidance Services (FEGS), a $250 million, 81-year-old health and human services organization, announced it was closing. Last month, word came out that Catholic Charities is giving up their Freeport mental health clinic. In the last few years, 100-year-old Peninsula Counseling Center in Valley Stream and 57-year-old Pederson-Krag in Huntington gave up their mental health clinics; South Shore Child Guidance was taken over by the Epilepsy Foundation; and Long Island Consultation Center in West Hempstead and Roosevelt Counseling and Resource Center, which operated since 1958, shut their doors. More than likely, others will follow.
A key factor contributing to this tragic trend is a poorly regulated managed health care system that is more interested in managing costs than managing care, paying a substandard rate for critical services that save children’s lives.
To make up the difference in big government’s neglect and the insurance industry’s greed, mental health organizations have relied for decades on the compassion and generosity of community members who support the cause. But, despite the good that they do, these people are more than do-gooders. They are smart and selfish. They’re smart because they know that what community-based mental health centers do is cost-effective, saving tens of millions of taxpayer dollars by keeping troubled kids out of costly institutional settings. They are selfish because they know, as one of them stated, “If your child is not healthy, my child is not safe.”
Beyond these attributes, our supporters are empathetic. They look into the eyes of their own children, grandchildren, nieces and nephews and feel a deep connection to all children. Perhaps my greatest influence in joining the field of human services was observing the impact of the kindness of others during my youth.
The father of a close childhood friend died in the 1950s. My friend was six-years-old, decades before “grief counseling” entered our lexicon. I lost touch with him as we grew older, but when his mother died years later, I sent him a note. My old friend, who is a physician today, wrote back. I saved his letter, and each time I read it, it leaves a lump in my throat. He wrote: “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…”
As a child, I observed my parents and other adults in my family carrying out acts of profound kindness and generosity with no fanfare and no expectation of receiving anything in return. I married a woman who came from a similar family, one in which her parents took in their nieces after the death of their mother. Now I have found these people again among our board of directors and community supporters. What they have in common with my family is their empathy.
Government bureaucracies are by definition dispassionate and without empathy. They have rules and regulations. But only in tyrannies do they get to run things. One can only hope that the policies that guide their rules are based in values rooted in the needs of real people.
I know that we cannot rely exclusively on government to take care of us; we must rely on one another. If we allow empathy to slip away under the cover of economic survival, we’re in trouble. The demise of empathy would be the most perilous consequence of the fragile economy.
Let’s take care to preserve empathy. When all else fails, it’s all that 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.
Anton News, Long Island; Opinion – Andrew Malekoff
February 25 – March 3, 2015
When we hear that our neighbor’s teenage son has been diagnosed with cancer, or that our colleague’s newborn has a heart defect, we shed some tears—and then we move into action. We bring meals; we offer to take their other kids to soccer games or piano lessons; we raise money so the parents can stay home from work to care for their ailing children.
But when we learn that our daughter’s best friend has been hospitalized for depression, or that a boy on our son’s basketball team has stopped going to school because of severe anxiety, we’re often at a loss as to how to respond.
Here’s a fact that may surprise you: Although more children suffer from psychiatric illness than autism, leukemia, diabetes and AIDS combined, only one of five with an emotional disturbance gets help from a mental health specialist. Moreover, 50 percent of serious mental illness occurs before the age of 14.
People with mental health problems and addictions, along with their families, often suffer in silence, while people with physical health problems evoke the sympathy and support of others. Why do we continue to treat illnesses above the neck differently than illnesses below the neck?
The sad truth is that there’s still a widespread stigma when it comes to mental health. The result? Parents who need help often wait months and even years to make that first phone call. A parent whose child is diagnosed with cancer doesn’t wait to ask for help. Waiting only happens with mental illness and addiction.
Fortunately, more than 60 years after our founding, North Shore Child & Family Guidance Center is still here to fight that stigma and provide help to children in need. Let me share a few of their stories.
We met nine-year-old Joey 14 years ago, a few weeks after his father died in the World Trade Center. We soon discovered that he was calling his dad’s cell phone number every day. As Joey explained, “I call because, what if he is still alive? I don’t want him to be all alone.”
We met seven-year-old Jeremy two years ago. He came to us holding a large flashlight in his tiny hands. He said he needed it in case the lights went out again, like they did after Hurricane Sandy, when Jeremy lost his toys, his home, his daily routine. And, as Joey before him, he lost his belief that the world is a safe place.
While we do respond to headline stories, we more often are called upon to respond to personal dramas and private disasters that are hidden in plain sight.
For example, we met six-year-old Jerome soon after he attempted to jump out a window because, as he said, “Nobody loves me.” Fifteen-year-old Celeste said the reason that she cuts her arms until they bleed is not to take her life, but to lower her blood pressure. And 14-year-old Maria told us that she lives in a house with a revolving door welcoming men who touch her.
Depression, anxiety, fear, child abuse, school refusal, bullying, isolation, drug addiction, domestic violence . . . we receive more than 100 calls a week, and increasing numbers are emergencies.
All across Long Island, mental health agencies are shuttering their doors, or they’ve been acquired by corporate entities with no roots in the community. That’s tragic, because community-based mental health organizations are as essential to the health and well-being of our children as hospitals or schools.
What can you do? First, tell your representatives that you value the mental health organization that serves your community and would like their support to ensure its future. And if you know someone whose child is suffering from a mental health issue, don’t ignore them. Make that phone call. Let them know you care.
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.
Anton News, Long Island; Opinion – Andrew Malekoff
March 26 – April 1, 2014
The American reality today is 1 out of 10 children has a serious emotional disturbance and more children suffer from psychiatric illness than from autism, leukemia, diabetes and AIDS combined. Yet, we continue to treat illnesses above the neck differently than those below the neck. People with mental health problems, and their families, often feel a sense of shame and suffer in silence; while people with physical health problems evoke the sympathy, support and comfort of others.
In the past 25 years, the mental health system has seen many changes. From a system in New York State that consisted primarily of outpatient clinics, community hospitals, state hospitals, and residential treatment facilities, a continuum has evolved which now also includes a variety of additional services, originally funded with the reinvestment dollars saved from the 1990’s reduction in state hospital beds. The largest of these programs are Medicaid-driven.
Nevertheless, parents still find that there are major gaps in our service system. Even with the available community support services, children with mental illness and their families continue to need good, often intensive, outpatient clinical services. The onset of managed care resulted in hospitals discharging children earlier, often before they are sufficiently stabilized to return home. Mental health outpatient clinics are then left with the task of trying to provide adequate clinical care to these needy and often high-risk youths, but with highly inadequate rates of financial support from insurance companies and government.
Despite a growing demand for community-based children’s mental health care, right here in Nassau County there are outpatient mental health clinics that have closed their doors, have been taken over by larger corporate entities with no community roots, have transformed their operations into fee-for-service factories with little or no capacity for dealing with inevitable crisis situations, or have decided to turn away anyone who does not have Medicaid.
Commercial insurance companies are expected to demonstrate what is called “network adequacy.” Network adequacy refers to a health plan’s ability to deliver the benefits promised by providing reasonable access to a sufficient number of in-network primary care and specialty physicians, as well as all health care services included under the terms of the contract. Nevertheless, many insurers do not have adequate mental health care networks despite the many names on their rosters. When it comes to seeking mental health care, for many families, the process of finding help is a shell game.
Only quality community-based children’s mental health organizations are capable of providing the labor-intensive quality of care necessary to address the mental health needs of children with serious emotional disturbances. Yet, these vital organizations are being squeezed out of Nassau County because of substandard insurance reimbursement and government neglect. Furthermore, community-acute care hospitals, because of insurance limitations, are not able to keep kids long enough to stabilize them in many cases. And, so, kids are being discharged to a community with inadequate supports.
The NYS Office of Mental Health has established a multi-year vision for the future of New York State’s mental health care system that they refer to as Regional Centers of Excellence. The vision does not include community-based care for middle class and working poor families with commercial health insurance.
Sounds more like Regional Centers of Mediocrity to me.
Andrew Malekoff, North Shore Child and Family Guidance Center, 480 Old Westbury Road, Roslyn Heights, New York, 11577; E-mail:amalekoff@northshorechildguidance.org
Domestic minor sex trafficking (DMST) – the commercial sexual exploitation of children within U.S. borders – is a growing problem. Once involved in commercial sexual exploitation, according to group counselors Kristine Hickle and Dominique Roe-Sepowitz, “individuals are at increased risk for economic instability and poverty, as adolescents who begin selling or trading sex prior to any legitimate employment experience may lack skills necessary to obtain employment and achieve economic stability after escaping their trafficking situation.” In addition, they state, “adolescents who run away from home are at increased risk for being exploited and coerced by pimps-traffickers, and may engage in and become victim to violence, including sexual or physical assault.”
It is important to note that DMST is not prostitution. Legally, minors cannot consent to sex with an adult, so, as Forbes Magazine reporter Brooke Axtell observed, “the use of the term ‘child prostitution’ in the media is misleading. In any other context, this would be considered statutory rape. Force, fraud and coercion are used to control the victim’s behavior.”
There is a myth that sex-trafficking is only prevalent in poorer countries. It is widespread in developed nations as well. Because DSMT is hidden, statistics are hard to calculate; however, according to the US Department of Justice (DOJ), more than 250,000 American youths are at risk of becoming victims of commercial sexual exploitation. Human-trafficking, according to the DOJ, is the second leading criminal industry behind drug-trafficking, and half of all the victims are minors.
There is an alarming disconnect between the treatment of domestic-trafficked minors and their status as victims. Many do not receive shelter and treatment in a safe residential setting; rather, they are re-victimized in juvenile-detention facilities. Due to its covert nature, DMST is under the radar in suburbia, yet, a 2011 study by researchers from Hofstra University reported more than 11,000 victims of sex-trafficking on Long Island.
Hofstra Sociology Professor Dr. Gregory Maney, the lead investigator, reported that those victims who sought private help were only the tip of the iceberg. And that the number did not include victims that went to public-service providers, moved out of the area, have not been able to escape their captors or died in the process of being trafficked.
It probably seems unlikely that anyone close to you could be at risk of being sex trafficked. However, traffickers are proficient at seducing and disarming their marks, usually vulnerable young women. Two warning signs for spotting a sex-trafficker include premature promises of undying love that are aimed at cementing a quick emotional connection and a promise of employment.
Hopefully, greater public awareness of DMST will help bring about more humane treatment, better policies and improved access to resources, such as long-term housing and quality mental health care for victims. As Axtell wrote of taking steps to help children break free from sexual exploitation, “we [must] face the disturbing truth that the demand for girls’ bodies is happening in our own communities.”
This year marks the 60th anniversary of North Shore Child and Family Guidance Center. I wonder if its founders, a small group of parents, could have imagined in 1953 that six decades later the Guidance Center would be taking more than 100 calls a week from parents concerned about their children’s emotional well-being. The callers tell stories about children and teens who are troubled, in trouble or causing trouble. Handling their first call sensitively is a hallmark of the Guidance Center. That first person-to-person contact makes all the difference in whether a parent chooses to take the next step forward towards hope or retreats into a sense of despair…
The reprehensible act that wound up getting Deputy-School Resource Officer Ben Fields fired from the police department.Several weeks ago I read three letters to the editor in another newspaper that focused on the importance of classroom discipline and respect for authority, and I have not been able to get the incident out of my mind. The letters were written with regard to the high school girl in Spring Valley, SC who was thrown around like a rag doll and body-slammed by power-lifting Deputy-School Resource Officer Ben Fields. Her crime? Refusing to turn over her cell phone. The incident was captured on two cell phone videos.
With teens so immersed in texting and video games and other tech-focused
During one of the planning meetings for an upcoming hike, a few of the boys tried to take control of the situation by dominating the other group members through physical posturingand verbal banter. That all changed once the teens drove to the state park and departed from the van. We found ourselves immersed in the forest, with no pavement, stores, traffic lights or any of the usual trappings of the home neighborhood—the kind of pure, natural environment many of the teens had rarely if ever experienced.
The hike was a challenging one, lengthy and with rough terrain. It was an experience most of the teens felt was beyond their capabilities, but once they realized they could overcome these perceived limitations, they felt exhilarated. They also developed a noticeable respect, admiration and affection for each other. Tired and done-in, the group gathered around some rocks, leaning on one another for support, warmth and belonging.
But the trip wasn’t by any means a failure, because learning how to handle disappointment is just as valuable as experiencing success. The group learned that when the challenges of the wilderness became tiring and weather conditions on the water became burdensome and oppressive, they had to reach inside themselves to summon up additional strength to overcome frustration, anger and fear. So, even though the trip had more than its share of disappointments, the teens were able to carry over the feeling that they could handle it when things don’t go smoothly.
