As Ahmaud Arbery fell to the ground, the sound of the gunshot that took his life echoed loudly throughout his Georgia neighborhood.I rewound the video of his killing. Each time I viewed it, I was drawn first to the young black jogger’s seemingly carefree stride, which was halted by two white men in a white pickup truck.Then I peered at Gregory McMichael, 64, and his son Travis, 34, who confronted Arbery in their suburban community.I knew that the McMichaels told authorities that they suspected Arbery of robbing a nearby home in the neighborhood. They were performing a citizen’s arrest, they said.The video shows Arbery jogging down the street and the McMichaels blocking his path with their vehicle. First, a scuffle. Then, gunshots at point-blank range from Travis McMichael’s weapon.My eyes traveled to the towering trees onscreen, which might have been the last things that Arbery saw. How many of those same trees, I wondered, had witnessed similar lynchings? And how many of those lynchings had been photographed, to offer a final blow of humiliation to the dying?A series of modern lynchingsIt may be jarring to see that word – lynching – used to describe Arbery’s Feb. 23, 2020, killing. But many black people have shared with me that his death – followed in rapid succession by Breonna Taylor’s and now George Floyd’s officer-involved murders – hearkens back to a long tradition of killing black people without repercussion.Perhaps even more traumatizing is the ease with which some of these deaths can be viewed online. In my new book, “Bearing Witness While Black: African Americans, Smartphones and the New Protest #Journalism,” I call for Americans to stop viewing footage of black people dying so casually.Instead, cellphone videos of vigilante violence and fatal police encounters should be viewed like lynching photographs – with solemn reserve and careful circulation. To understand this shift in viewing context, I believe it is useful to explore how people became so comfortable viewing black people’s dying moments in the first place.Images of black people’s deaths pervasiveEvery major era of domestic terror against African Americans – slavery, lynching and police brutality – has an accompanying iconic photograph.The most familiar image of slavery is the 1863 picture of “Whipped Peter,” whose back bears an intricate cross-section of scars.Famous images of lynchings include the 1930 photograph of the mob who murdered Thomas Shipp and Abram Smith in Marion, Indiana. A wild-eyed white man appears at the bottom of the frame, pointing upward to the black men’s hanged bodies. The image inspired Abel Meeropol to write the poem “Strange Fruit,” which was later turned into a song that blues singer Billie Holiday sang around the world.Twenty-five years later, the 1955 photos of Emmett Till’s maimed body became a new generation’s cultural touchstone. The 14-year-old black boy was beaten, shot and thrown into a local river by white men after a white woman accused him of whistling at her. She later admitted that she lied.Throughout the 1900s, and until today, police brutality against black people has been immortalized by the media too. Americans have watched government officials open firehoses on young civil rights protesters, unleash German shepherds and wield billy clubs against peaceful marchers, and shoot and tase today’s black men, women and children – first on the televised evening news, and, eventually, on cellphones that could distribute the footage online.When I conducted the interviews for my book, many black people told me that they carry this historical reel of violence against their ancestors in their heads. That’s why, for them, watching modern versions of these hate crimes is too painful to bear.Still, there are other groups of black people who believe that the videos do serve a purpose, to educate the masses about race relations in the U.S. I believe these tragic videos can serve both purposes, but it will take effort.In 1922 the NAACP ran a series of full-page ads in The New York Times calling attention to lynchings. New York Times, Nov. 23, 1922/American Social History ProjectReviving the ‘shadow archive’In the early 1900s, when the news of a lynching was fresh, some of the nation’s first civil rights organizations circulated any available images of the lynching widely, to raise awareness of the atrocity. They did this by publishing the images in black magazines and newspapers.After that image reached peak circulation, it was typically removed from public view and placed into a “shadow archive,” within a newsroom, library or museum. Reducing the circulation of the image was intended to make the public’s gaze more somber and respectful.The National Association for the Advancement of Colored People, known popularly as the NAACP, often used this technique. In 1916, for example, the group published a horrific photograph of Jesse Washington, a 17-year-old boy who was hanged and burned in Waco, Texas, in its flagship magazine, “The Crisis.”Memberships in the civil rights organization skyrocketed as a result. Blacks and whites wanted to know how to help. The NAACP used the money to push for anti-lynching legislation. It purchased a series of costly full-page ads in The New York Times to lobby leading politicians.Though the NAACP endures today, neither its website nor its Instagram page bears casual images of lynching victims. Even when the organization issued a statement about the Arbery killing, it refrained from reposting the chilling video within its missive. That restraint shows a degree of respect that not all news outlets and social media users have used.A curious double standardCritics of the shadow archive may argue that once a photograph reaches the internet, it is very difficult to pull back from future news reports.This is, however, simply not true.Images of white people’s deaths are removed from news coverage all the time.It is difficult to find online, for example, imagery from any of the numerous mass shootings that have affected scores of white victims. Those murdered in the Sandy Hook Elementary School shooting of 2012, or at the Las Vegas music festival of 2017, are most often remembered in endearing portraits instead.In my view, cellphone videos of black people being killed should be given this same consideration. Just as past generations of activists used these images briefly – and only in the context of social justice efforts – so, too, should today’s imagery retreat from view quickly.The suspects in Arbery’s killing have been arrested. The Minneapolis police officers involved in Floyd’s death have been fired and placed under investigation. The videos of their deaths have served the purpose of attracting public outrage.To me, airing the tragic footage on TV, in auto-play videos on websites and social media is no longer serving its social justice purpose, and is now simply exploitative.Likening the fatal footage of Ahmaud Arbery and George Floyd to lynching photographs invites us to treat them more thoughtfully. We can respect these images. We can handle them with care. In the quiet, final frames, we can share their last moments with them, if we choose to. We do not let them die alone. We do not let them disappear into the hush of knowing trees.[Insight, in your inbox each day.You can get it with The Conversation’s email newsletter.]Allissa V. Richardson, Assistant Professor of Journalism, University of Southern California, Annenberg School for Communication and JournalismThis article is republished from The Conversation under a Creative Commons license. Read the original article.
Wednesday, August 19, 2020
Sunday, August 16, 2020
In Hard-Hit Areas, COVID’s Ripple Effects Strain Mental Health Care Systems
In late March, Marcell’s girlfriend took him to the emergency room at Henry Ford Wyandotte Hospital, about 11 miles south of Detroit.“I had [acute] paranoia and depression off the roof,” said Marcell, 46, who asked to be identified only by his first name because he wanted to maintain confidentiality about some aspects of his illness.Marcell’s depression was so profound, he said, he didn’t want to move and was considering suicide.“Things were getting overwhelming and really rough. I wanted to end it,” he said.Marcell, diagnosed with schizoaffective disorder seven years ago, had been this route before but never during a pandemic. The Detroit area was a coronavirus hot spot, slamming hospitals, attracting concerns from federal public health officials and recording more than 1,000 deaths in Wayne County as of May 28. Michigan ranks fourth among states for deaths from COVID-19.The crisis enveloping the hospitals had a ripple effect on mental health programs and facilities. The emergency room was trying to get non-COVID patients out as soon as possible because the risk of infection in the hospital was high, said Jaime White, director of clinical development and crisis services for Hegira Health, a nonprofit group offering mental health and substance abuse treatment programs. But the options were limited.Still, the number of people waiting for beds at Detroit’s crisis centers swelled. Twenty-three people in crisis had to instead be cared for in a hospital.This situation was hardly unique. Although mental health services continued largely uninterrupted in areas with low levels of the coronavirus, behavioral health care workers in areas hit hard by COVID-19 were overburdened. Mobile crisis teams, residential programs and call centers, especially in pandemic hot spots, had to reduce or close services. Some programs were plagued by shortages of staff and protective supplies for workers.At the same time, people battling mental health disorders became more stressed and anxious.“For people with preexisting mental health conditions, their routines and ability to access support is super important. Whenever additional barriers are placed on them, it could be challenging and can contribute to an increase in symptoms,” said White.After eight hours in the emergency room, Marcell was transferred to COPE, a community outreach program for psychiatric emergencies for Wayne County Medicaid patients.“We try to get patients like him into the lowest care possible with the least restrictive environment,” White said. “The quicker we could get him out, the better.”Marcell was stabilized at COPE over the next three days, but his behavioral health care team couldn’t get him a bed in one of two local residential crisis centers operated by Hegira. Social distancing orders had reduced the beds from 20 to 14, so Marcell was discharged home with a series of scheduled services and assigned a service provider to check on him.However, Marcell’s symptoms ― suicidal thoughts, depression, anxiety, auditory hallucinations, poor impulse control and judgment ― persisted. He was not able to meet face-to-face with his scheduled psychiatrist due to the pandemic and lack of telehealth access. So, he returned to COPE three days later. This time, the staff was able to find him a bed immediately at a Hegira residential treatment program, Boulevard Crisis Residential in Detroit.Residents typically stay for six to eight days. Once they are stabilized, they are referred elsewhere for more treatment, if needed.Marcell ended up staying for more than 30 days. “He got caught in the pandemic here along with a few other people,” said Sherron Powers, program manager. “It was a huge problem. There was nowhere for him to go.”Marcell couldn’t live with his girlfriend anymore. Homeless shelters were closed and substance abuse programs had no available beds.“The big problem here is that all crisis services are connected to each other. If any part of that system is disrupted you can’t divert a patient properly,” said Travis Atkinson, a behavioral consultant with TBD Solutions, which collaborated on a survey of providers with the American Association of Suicidology, the Crisis Residential Association and the National Association of Crisis Organization Directors.White said the crisis took a big toll on her operations. She stopped her mobile crisis team on March 14 because, she said, “we wanted to make sure that we were keeping our staff safe and our community safe.”Her staff assessed hospital patients, including Marcell, by telephone with the help of a social worker from the emergency room.People like Marcell have struggled during the coronavirus crisis and continue to face hurdles because emergency preparedness measures didn’t provide enough training, funds or thought about the acute mental health issues that could develop during a pandemic and its aftermath, said experts.“The system isn’t set up to accommodate that kind of demand,” said Dr. Brian Hepburn, a psychiatrist and executive director of the National Association of State Mental Health Program Directors.“In Detroit and other hard-hit states, if you didn’t have enough protective equipment you can’t expect people to take a risk. People going to work can’t be thinking ‘I’m going to die,’” said Hepburn.For Marcell, “it was bad timing to have a mental health crisis,” said White, the director at Hegira.At one time Marcell, an African American man with a huge grin and a carefully trimmed goatee and mustache, had a family and a “pretty good job,” Marcell said. Then “it got rough.” He made some bad decisions and choices. He lost his job and got divorced. Then he began self-medicating with cocaine, marijuana and alcohol.By the time he reached the residential center in Detroit on April 1, he was at a low point. “Schizoaffective disorder comes out more when you’re kicked out of the house and it increases depression,” said Powers, the program manager who along with White was authorized by Marcell to talk about his care. Marcell didn’t always take his medications and his use of illicit drugs magnified his hallucinations, she said.While in the crisis center voluntarily, Marcell restarted his prescription medications and went to group and individual therapy. “It is a really good program,” he said while at the center in early May. “It’s been one of the best 30 days.”Hepburn said the best mental health programs are flexible, which allows them more opportunities to respond to problems such as the pandemic. Not all programs would have been able to authorize such a long stay in residential care.Marcell was finally discharged on May 8 to a substance abuse addiction program. “I felt good about having him do better and better. He had improved self-esteem to get the help he needed to get back to his regular life,” Powers said.But Marcell left the addiction program after only four days.“The [recovery] process is so individualized and, oftentimes, we only see them at one point in their journey. But, recovering from mental health and substance use disorders is possible. It can just be a winding and difficult path for some,” said White.Seeking HelpIf you or someone you know is in immediate danger, call 911. Below are other resources for those needing help:— National Helpline: 1-800-662-HELP (4357) or https://findtreatment.samhsa.gov.— National Suicide Prevention Lifeline: 1-800-273-TALK (8255).— Disaster Distress Helpline: 1-800-985-5990 or text TalkWithUs to 66746.
Thursday, August 13, 2020
Pandemic Presents New Hurdles, and Hope, for People Struggling with Addiction
Before Philadelphia shut down to slow the spread of the coronavirus, Ed had a routine: most mornings he would head to a nearby McDonald’s to brush his teeth, wash his face and — when he had the money — buy a cup of coffee. He would bounce between homeless shelters and try to get a shower. But since businesses closed and many shelters stopped taking new admissions, Ed has been mostly shut off from that routine.He’s still living on the streets.“I’ll be honest, I don’t really sleep too much,” said Ed, who’s 51 and struggling with addiction. “Every four or five days I get a couple hours.”KHN agreed not to use his last name because he uses illegal drugs.Philadelphia has the highest overdose rate of any big city in America — in 2019, more than three people a day died of drug overdoses there, on average. Before the coronavirus began spreading across the United States, the opioid overdose epidemic was the biggest health crisis on the minds of many city officials and public health experts. The coronavirus pandemic has largely eclipsed the conversation around the opioid crisis. But the crisis still rages on despite business closures, the cancellation of in-person treatment appointments and the strain on many addiction resources in the city.When his usual shelter wasn’t an option anymore, Ed tried to get into residential drug treatment. He figured that would be a good way to try to get back on his feet and, if nothing else, get a few good nights of rest. But he had contracted pinkeye, a symptom thought to be associated with the virus that leads to COVID-19, so the evaluation center didn’t want to place him in an inpatient facility until he’d gotten the pinkeye checked out. But he couldn’t see a doctor because he didn’t have a phone for a telehealth appointment.“I got myself stuck, and I’m trying to pull everything back together before it totally blows up,” he said.Rosalind Pichardo wants to help people in Ed’s situation. Before the pandemic, Pichardo would hit the streets of her neighborhood, Kensington, which has the highest drug overdose rate in Philadelphia. She’d head out with a bag full of snack bars, cookies and Narcan, the opioid overdose reversal drug.She’d hand Narcan out to people using drugs, and people selling drugs — anyone who wanted it. Pichardo started her own organization, Operation Save Our City, which initially set out to work with survivors of gun violence in the neighborhood. When she realized that overdoses were killing people too, she began getting more involved with the harm reduction movement and started handing out Narcan through the city’s syringe exchange.When Pennsylvania’s stay-at-home order went into effect, Pichardo and others worried that more people might start using drugs alone, and that fewer first responders would be patrolling the streets or nearby and able to revive them if they overdosed.So, Pichardo and other harm reduction activists gave out even more Narcan. A representative for Prevention Point Philadelphia, the group that operates a large syringe exchange program in the city, said that during the first month of the city’s stay-at-home order, they handed out almost twice as much Narcan as usual.After the lockdowns and social distancing began, Pichardo worried that more people would be using drugs alone, leading to more overdoses. But Philadelphia’s fatal overdose rate during the pandemic remains about the same as it was this time last year. Pichardo said she thinks that’s evidence that flooding the streets with Narcan is working — that people are continuing to use drugs, and maybe even using more drugs, but that users are utilizing Narcan more often and administering it to one another.That is the hope. But Pichardo said users don’t always have a buddy to keep watch, and during the pandemic first responders have seemed much more hesitant to intervene. For example, she recently administered Narcan to three people in Kensington who overdosed near a subway station, while two police officers stood by and watched. Before the pandemic, they would often be right there with her, helping.To reverse the overdoses, Pichardo crouched over the people who she said had started turning blue as their oxygen levels dropped. She injected the Narcan into their noses, using a disposable plastic applicator. Normally, she would perform rescue breathing, too, but since the pandemic began she has started carrying an Ambu bag, which pumps air into a person’s lungs and avoids mouth-to-mouth resuscitation. Among the three people, she said, it took six doses of Narcan to revive them. The police officers didn’t step in to help but did toss several overdose-reversal doses toward Pichardo as she worked.“I don’t expect ’em to give ’em rescue breaths if they don’t want to, but at least administer the lifesaving drug,” Pichardo said.In her work as a volunteer, she has reversed almost 400 overdoses, she estimated.“There’s social distancing — to a limit,” Pichardo said, “I think when someone’s life is in jeopardy, they’re worth saving. You just can’t watch people die.”Even before Philadelphia officially issued its stay-at-home order, city police announced they would stop making low-level arrests, including for narcotics. The idea was to reduce contact overall, help keep the jail population low and reduce the risk of the virus getting passed around inside. But Pichardo and other community activists said the decreased law enforcement emboldened drug dealers in the Kensington neighborhood, where open-air drug sales and use are common.“You can tell they have everything down pat, from the lookout to the corner boys to the one actually holding the product — the one holding the product’s got some good PPE gear,” said Pichardo.More dealers working openly on the street has led to more fights over territory, she added, which in turn has meant more violence. While overall crime in Philadelphia and other major cities has declined during the pandemic, gun violence has spiked.Police resumed arrests at the beginning of May.Now when she goes out to offer relief and hand out Narcan, Pichardo packs a few extra things in her bag of supplies: face masks, gloves and gun locks.“It’s like the survival kit of the ’hood,” she said.For those struggling with addiction who are ready to start recovery, newly relaxed federal restrictions have made it easier to get medications that curb opioid cravings and stem withdrawal. Several efforts are underway among Philadelphia-based public health groups and criminal justice advocacy organizations to give cellphones to people who are homeless or coming out of jail, so they can make a telehealth appointment and get quicker access to a prescription for those medicines.During the pandemic, people taking medication-assisted treatment can renew their prescription every month instead of every week, which helps decrease trips to the pharmacy. It is too soon to know if more people are taking advantage of the new rules, and accessing medication-assisted treatment via telehealth, but if that turns out to be the case, many addiction medicine specialists argue the new rules should become permanent, even after the pandemic ends.“If we find that these relaxed restrictions are bringing more people to the table, that presents enormous ethical questions about whether or not the DEA should reinstate these restrictive policies that they had going in the first place,” said Dr. Ben Cocchiaro, a physician who treats people with substance-use disorder.Cocchiaro said the whole point of addiction treatment is to facilitate help as soon as someone is ready for it. He hopes if access to recovery can be made simpler during a pandemic, it can remain that way afterward.This story is part of a partnership that includes WHYY, NPR and Kaiser Health News.
Monday, August 10, 2020
Avoiding Family Drama During the Covid-19 Pandemic
Several times since the Covid-19 pandemic broke out, I have wondered whether my brothers were safe. Knowing whether John*, my middle brother, was okay was easy. Although we’ve not talked to each other in 12 years, I found out through two of our mutual childhood friends that he was not one of the more than 350,000 people in his state who have contracted the virus.Finding out whether Marco* was okay took several weeks. Nobody in our family and none of my childhood friends can deal with him. He has bipolar disorder, and since his diagnosis 39 years ago, he has consistently refused meds. He’s verbally and physically abusive to most people he comes in contact with, especially women, which he came by honestly as the saying goes.I never needed a diagnosis to know something was seriously off with Marco. Looking back, he exhibited all the signs: stretches of mania followed by equally long bouts of depression, calculated and well-thought-out verbal and physical assaults, and rage that seemed to come from nowhere.When I was 10 (Marco is four years older than I) he planned out his first of two attempts to kill one of the neighbors in our Manhattan apartment building. He tied a thin wire across the top of the staircase. He then rang the doorbell and tried to lure this woman out of her apartment and down those marble stairs, where she would surely have fallen to her death. She saw the wire just in the nick of time and held onto the banister. Marco was hiding out of sight, snickering.He told our parents he did it because the neighbor wouldn’t let him play with her daughter. Laughing as he retold the story was creepy as hell.A few days later while staring out the window, Marco noticed the same neighbor climbing out of a cab. He had a 10-gallon garbage bag already filled with water, waiting beside the window. As she closed the car door, Marco dropped that 85-pound “water balloon” down 10 flights. It missed our neighbor by a hair and she did as anyone would do: she looked up and saw Marco looking out the window. He not only didn’t duck inside (as most people would have done), he yelled out to her, “Better luck next time!” Although none of us saw this happen, his version of events was identical to hers.With me Marco had a trigger hand, like our father. If our father didn’t like something I said or did, I would get knocked across the room. Our father beat all three of us whenever he felt like it, which was probably three to four times a week, as did his father to him growing up. When I was 14, I paid $25.00 from my babysitting money to a neighborhood kid to install a lock on my bedroom door. I couldn’t control the world outside my bedroom, but I could protect myself in my own room.And what was John doing as Marco was abusing his sister and trying to kill the neighbor? John has always been good at taking care of John and ignoring everyone else. Give him a substance and the world ceases to exist.Forgive and Forget Because Nothing is More Important Than FamilyThose who don’t know my family or think I’m exaggerating when I describe what it was like growing up usually say things to me like, “Nothing is more important than family,” “Whatever happened, just forgive him and move on” or “You’ll regret it when you get older.”The last comment has some merit. We are all in our 50s, and I’m acutely aware there are fewer years in front of us than behind. Our parents are now deceased, so they’re non-issues in the forgive and forget department. But for the living, reconciliation isn’t always so easy.It involves real work my brothers are too stuck to do. The apple rarely falls far from the tree, although the real mystery isn’t how one brother has bipolar and the other is an alcoholic. The question I’ve had my whole life is, why didn’t I become an alcoholic, have bipolar or both?Depression, bipolar disorder and alcoholism run on both sides of my family. My mother struggled with depression and used alcohol to self-medicate. She was a functional alcoholic—so functional that she was an editor at a prominent New York publication for years. While she rarely hit me, my mother was the queen of belittling. To give you an idea how biting her tongue could be, when I hit adolescence and my body started changing, she told me, “I don’t know what I did in life to deserve a mother, a best friend, a husband and a daughter who are all fat.”My father was a different variety of excrement. He just shit on everyone he knew and claimed to love. When he wasn’t confessing his mortal marital sins to my mother on a near-weekly basis, he was beating the crap out of us. He used whatever was handy: a book, a shoe, a belt, his fist, his legs to kick us, and when he was really frustrated, he’d throw things at us.My mother used to say, “Parents give their children unspoken commands their children learn to implicitly obey.” Marco and John learned at a young age to throw weapons instead of using their words. Their weapons of choice included a skateboard, a frying pan, scissors, lamps, glass bottles and a hammer. It amazes me they’re both still alive.Shorter and less muscular than Marco, John took up martial arts when he was 11. By the time he was 15, John was a black belt in three styles of Kung Fu. He was still shorter than Marco, but now his weapons became sharper, his hands and arms stronger, and he could inflict serious, life-altering damage. I lost count of how often I had to call the police because I wasn’t about to get in the middle of a fight between two rabid dogs.I used to pray for my parents and brothers to get arrested, so I could raise myself.Aleutian Islands: Same Name, Not ConnectedAfter I graduated from high school at 16, I rented a furnished room in the apartment of a different neighbor. By 17, I was in therapy, where I was diagnosed with PTSD and a panic disorder. I would end up spending seven years with Barbara, working through the damage of my childhood. Together, we dismantled me so we could put me back together. I was 24 when Barbara and I decided I was ready to go out into the world without an attendant.The first few years after I left home—especially while I was still in therapy—I hardly spoke with my parents or my brothers. I honestly didn’t know what Marco was doing, but I knew from various people he was fine and living with a woman in another state. Periodically, I’d run into John on the street. On those occasions we were cordial, but there was nothing to talk about. It was like seeing someone from my childhood I had nothing in common with now. We’d promise to catch up, knowing full well neither of us would make that call.Weeks turned into months and eventually years between check-ins with my brothers. I spoke with my parents every so often because, no matter how much work I’d done on myself, I was also raised with a sense of obligation, and daughters aren’t supposed to just cut off their parents. While they were still alive, I controlled the direction of the conversations to keep them from touching on areas that could trigger me.I once told Barbara in therapy that I felt like we were the Aleutian Islands. They were people I knew but had no connection to. I didn’t hate them; I felt nothing for them. My mother used to say, “The opposite of love isn’t hate. It’s indifference.” She was right.I met my husband in 1996 and we were married in 2001 while living in Southern California. Although all of my girlfriends who had previously gotten married and who were getting married opted to keep their maiden names, I couldn’t wait to change mine. Despite being every bit as feminist as my friends, for them the decision to keep their maiden name was about maintaining their identity. For me, the act of changing my last name meant adopting a new one.As important as leaving my home the first chance I got and staying in therapy for seven years (no matter how uncomfortable things got sometimes), changing my name allowed me to reinvent myself.The beauty of having a different last name is that, unless I tell people my maiden name, nobody knows I have any association with those people. It helps that I have an amazing relationship with my husband’s family, who have been my tribe for 23 years.Today, my husband and I live in Puerto Rico on an organic farm. We have rich relationships with people both in Puerto Rico and the States. When I think about the stark contrast between my life then and now, I’m reminded of a quote by Maya Angelou: "Family isn't always blood, it's the people in your life who want you in theirs: the ones who accept you for who you are, the ones who would do anything to see you smile and who love you no matter what.” Separate Lives in the Time of Covid-19My husband and I have talked with my brothers a handful of times over the last 24 years we’ve been together. My mother died in 1994 and, after my father’s death in 2002, I was named executor of my parents’ estate. I had to periodically be in touch with both brothers for signatures on this or that document required to sell our parents’ home, which we did in 2008. Between then and now, I had no desire to contact them.When the pandemic broke out, for the first time since I left home, I felt conflicted between the need to learn they’re safe and my need to maintain a drama-free life. Once I found John was alive, I felt I was halfway to feeling I wouldn’t need to expose myself.It took several weeks, but I was finally able to confirm Marco is also safe from Covid-19. I remembered a nickname he used to refer to himself when we were younger and during times he was manic. I started googling versions of the nickname and eventually came across his Twitter profile.He’s on his fourth wife, living somewhere in the Midwest. What I read were 75 tweets in rapid fire succession about everything that angers him that nobody reacted to or commented on. Based on my accelerated heart rate while reading them, I deduced he still isn’t treating his bipolar disorder. I got what I came for: I know he’s alive. Now that I know both my brothers are safe from Covid-19, and that I can continue to confirm it without reaching out to them, I no longer have to wonder and I can continue living my life.
Friday, August 7, 2020
Flattening the mental health curve is the next big coronavirus challenge
The mental health crisis triggered by COVID-19 is escalating rapidly. One example: When compared to a 2018 survey, U.S. adults are now eight times more likely to meet the criteria for serious mental distress. One-third of Americans report clinically significant symptoms of anxiety or clinical depression, according to a late May 2020 release of Census Bureau data.While all population groups are affected, this crisis is especially difficult for students, particularly those pushed off college campuses and now facing economic uncertainty; adults with children at home, struggling to juggle work and home-schooling; and front-line health care workers, risking their lives to save others.We know the virus has a deadly impact on the human body. But its impact on our mental health may be deadly too. Some recent projections suggest that deaths stemming from mental health issues could rival deaths directly due to the virus itself. The latest study from the Well Being Trust, a nonprofit foundation, estimates that COVID-19 may lead to anywhere from 27,644 to 154,037 additional U.S. deaths of despair, as mass unemployment, social isolation, depression and anxiety drive increases in suicides and drug overdoses.But there are ways to help flatten the rising mental health curve. Our experience as psychologists investigating the depression epidemic and the nature of positive emotions tells us we can. With a concerted effort, clinical psychology can meet this challenge.Reimagining mental health careOur field has accumulated long lists of evidence-based approaches to treat and prevent anxiety, depression and suicide. But these existing tools are inadequate for the task at hand. Our shining examples of successful in-person psychotherapies – such as cognitive behavioral therapy for depression, or dialectical behavioral therapy for suicidal patients – were already underserving the population before the pandemic.Now, these therapies are largely not available to patients in person, due to physical distancing mandates and continuing anxieties about virus exposure in public places. A further complication: Physical distancing interferes with support networks of friends and family. These networks ordinarily allow people to cope with major shocks. Now they are, if not completely severed, surely diminished.What will help patients now? Clinical scientists and mental health practitioners must reimagine our care. This includes action on four interconnected fronts.First, the traditional model of how and where a person receives mental health care must change. Clinicians and policymakers must deliver evidence-based care that clients can access remotely. Traditional “in-person” approaches – like individual or group face-to-face sessions with a mental health professional – will never be able to meet the current need.Telehealth therapy sessions can fill a small part of the remaining gap. Forms of nontraditional mental health care delivery must fill the rest. These alternatives do not require reinvention of the wheel; in fact, these resources are already readily accessible. Among available options: web-based courses on the science of happiness, open-source web-based tools and podcasts. There are also self-paced, web-based interventions – mindfulness-based cognitive therapy is one – which are accessible for free or at reduced rates.Democratizing mental healthSecond, mental health care must be democratized. That means abandoning the notion that the only path to treatment is through a therapist or psychiatrist who dispenses wisdom or medications. Instead, we need other kinds of collaborative and community-based partnerships.For example, given the known benefits of social support as a buffer against mental distress, we should enhance peer-delivered or peer-supported interventions – like peer-led mental health support groups, where information is communicated between people of similar social status or with common mental health problems. Peer programs have great flexibility; after orientation and training, peer leaders are capable of helping individual clients or groups, in person, online or via the phone. Initial data shows these approaches can successfully treat severe mental illness and depression. But they are not yet widely used.Taking a proactive approachThird, clinical scientists must promote mental health at the population level, with initiatives that try to benefit everyone rather than focusing exclusively on those who seek treatment. Some of these promotion strategies already have clear-cut scientific support. In fact, the best-supported population interventions, such as exercise, sleep hygiene and spending time outdoors, lend themselves perfectly to the needs of the moment: stress-relieving, mental illness-blocking and cost-free.Finally, we must track mental health on the population level, just as intensely as COVID-19 is tracked and modeled. We must collect much more mental health outcome data than we do now. This data should include evaluations from mental health professionals as well as reports from everyday citizens who share their daily experiences in real time via remote-based survey platforms.Monitoring population-level mental health requires a team effort. Data must be collected, then analyzed; findings must be shared across disciplines – psychiatry, psychology, epidemiology, sociology and public health, to name a few. Sustained funding from key institutions, like the NIH, are essential. To those who say this is too tall an order, we ask, “What’s the alternative?” Before flattening the mental health curve, the curve must be visible.COVID-19 has revealed the inadequacies of the old mental health order. A vaccine will not solve these problems. Changes to mental health paradigms are needed now. In fact, the revolution is overdue. [You need to understand the coronavirus pandemic, and we can help.Read The Conversation’s newsletter.]This article is republished from The Conversation under a Creative Commons license. Read the original article.
Tuesday, August 4, 2020
Opioid Addiction and COVID-19
The global coronavirus pandemic has likely just begun. People across the globe need to prepare for the fact that our lives will probably be changed for the foreseeable future. With that in mind, people struggling with opioid use disorder mustn't delay their treatment while the pandemic is ongoing.Waismann Method® Opioid Treatment Specialists have adapted their protocols to offer safe, effective opioid detox during the pandemic. Here is what you should know about medically assisted detoxification, and how the Waismann Method® Opioid Treatment Specialists are keeping patients safe during this time.What is Rapid Detox or Medically Assisted Opioid Detoxification?For over 21 years, Waismann Method® has offered medically assisted solutions to treat withdrawal symptoms of opioid and alcohol dependency. Medical treatments are provided within a private room of a full-service accredited hospital.The goal of the treatment is to provide patients suffering from opioid use disorder a safe, effective, and much more pleasant way to successfully get through withdrawal. In other words, instead of forcing people to endure unnecessary pain and health risks related to an opioid detox, withdrawal symptoms are medically managed, and vitals adequately controlled."We offer patients a humane and effective solution to a physiological condition that has the potential to harm all aspects of someone's life," says Clare Waismann, founder of the Waismann Method. "Our approach to the treatment of opioid use disorder is based on science, compassion, and results."Detox treatments are under the supervision of a quadruple board-certified medical director, Michael H. Lowenstein, M.D. Dr. Lowenstein has successfully treated thousands of patients suffering from opioid use disorder (OUD) for over two decades. He is also world-renowned as one of the most experienced rapid detox physicians in the world.Waismann Method team has worked diligently for over 21 years in providing the most advanced and successful opioid detox protocols. Rapid detox was just the beginning of a myriad of medically assisted protocols based on each patient's overall health needs."We believe patients should have the right to become opioid-free so they can be emotionally present to work with whatever emotional issues they have," Waismann says. "Often, long-term opioid maintenance drugs don't fix the real problem; instead, they just delay it."Opioid addiction is a consequence of untreated pain, either physical or emotional, and in most cases, both. Successfully treating the physical dependence allows people the stability to focus entirely on addressing their pain, and moving forward without substance abuse."This newfound freedom from drug dependence, combined with non-addictive forms of craving management, allows people to be emotionally present to adhere to whatever type of emotional support is necessary to sustain recovery," Waismann says.Getting through detox with sedation and other supportive medications is terrific but not enough. A short amount of care throughout the regulation period is crucial for patients to regain some physical and emotional strength before returning home. For that reason, Waismann Method provides patients with a few days at Domus Retreat - a safe haven for those seeking compassionate and professional assistance in this first part of recovery. Also, at Domus Retreat, treatment professionals can help clients identify underlying mental health issues, and guide them toward the resources that can support their emotional and physical health.Adjusting safety protocols in response to COVIDAs a science-based medical provider, Waismann Method pays close attention to the latest medical guidance. It has implemented new measures in order to continue to provide detox during the pandemic while keeping everyone safe.Waismann Method and Domus Retreat Enhanced Safety Precautions During Covid-19As concerns about the Coronavirus (COVID-19) consume our nation, the Waismann Method and Domus Retreat team step up to protect the health and safety of our patients and employees by adopting additional protocols.Family visits have been suspended at this time.Those seeking admission will be screened with questions concerning current health, recent travel, and interactions with others before arriving. When in the hospital, out-of-state patients or those with suspicious symptoms will be tested for COVID. Individuals who fail to meet medical criteria will be denied admission.Patients and staff are instructed to practice aggressive hand washing; avoid touching face; masks and gloves are provided and, in some areas, enforced.Maintaining Domus with 3 to 4 clients at one time.Housekeep staff are spending additional time disinfecting and cleaning all areas of Domus RetreatWe continue to monitor CDC and state health department recommendations and adapt as needed.The time for detox is now.Currently, some people are concerned about seeking substance abuse care. But the truth is that opioid use disorder is a medical condition that gets worse with time. Delaying detox and treatment can pose an irreversible risk to people.Addiction does not discriminate, and the need for treatment certainly does not wait for "a convenient time." Times of crisis lead to heightened stress and anxiety amongst every living being, and especially for that suffering from addiction. There is no better time to seek help than now. The Waismann and Domus Team is fully prepared to help patients get the help they deserve when they need it the most.
Saturday, August 1, 2020
Police officers accused of brutal violence often have a history of complaints by citizens
As protests against police violence and racism continue in cities throughout the U.S., the public is learning that several of the officers involved in the killing of George Floyd in Minneapolis and Breonna Taylor in Louisville share a history of complaints by citizens of brutality or misconduct.Decades of research on police shootings and brutality reveal that officers with a history of shooting civilians, for example, are much more likely to do so in the future compared to other officers.A similar pattern holds for misconduct complaints. Officers who are the subject of previous civilian complaints – regardless of whether those complaints are for excessive force, verbal abuse or unlawful searches – pose a higher risk of engaging in serious misconduct in the future.A study published in the American Economic Journal reviewed 50,000 allegations of officer misconduct in Chicago and found that officers with extensive complaint histories were disproportionately more likely to be named subjects in civil rights lawsuits with extensive claims and large settlement payouts.In spite of this research, many law enforcement agencies not only fail to adequately investigate misconduct allegations, they rarely sustain citizen complaints. Disciplinary sanctions are few and reserved for the most egregious cases.Protesters went to the home of the Minneapolis police officer, Derek Chauvin, who is now charged with George Floyd’s death.Complaints, lawsuits – but few consequencesDerek Chauvin, the ex-officer who has been charged with third-degree murder and second-degree manslaughter for killing Floyd, is no stranger to situations in which deadly force has been deployed.During a 2006 roadside stop, Chauvin was among six officers who, in just four seconds, fired 43 rounds into a truck driven by a man wanted for questioning in a domestic assault. The man, Wayne Reyes, who police said aimed a sawed-off shotgun at them, died at the scene. The police department never acknowledged which officers had fired their guns and a grand jury convened by prosecutors did not indict any of the officers.Chauvin is also the subject of at least 18 separate misconduct complaints and was involved in two additional shooting incidents. According to The Associated Press, 16 of the complaints were “closed with no discipline” and two letters of reprimand were issued for Chauvin related to the other cases.Tou Thao, one of three Minneapolis officers at the scene as Floyd pleaded for his life, is named in a 2017 civil rights lawsuit against the department. Lamar Ferguson, the plaintiff, said he was walking home with his pregnant girlfriend when Thao and another officer stopped him without cause, handcuffed him and proceeded to kick, punch and knee him with such force that his teeth shattered.The case was settled by the city for US$25,000, with the officers and the city declaring no liability, but it is not known if Thao was disciplined by the department.In Louisville, Kentucky, at least three of the officers involved in the shooting death of Breonna Taylor while serving a no-knock warrant at her home – allowing them to use a battering ram to open her door – had previously been sanctioned for violating department policies.One of the officers, Brett Hankison, is the subject of an ongoing lawsuit alleging, according to news reports, harassing suspects and planting drugs on them. He has denied the charges in a response to the lawsuit.Another officer in the Taylor case, Myles Cosgrove, was sued for excessive force in 2006 by a man whom he shot seven times in the course of a routine traffic stop. The judge dismissed the case. Cosgrove had been put on paid administrative leave as his role in the shooting was investigated by his department, and returned to the department after the investigation closed.Patterns of misconduct and abuseI am a scholar of law and the criminal justice system. In my work on wrongful conviction cases in Philadelphia, I regularly encounter patterns of police misconduct including witness intimidation, evidence tampering and coercion. It is often the same officers engaging in the same kinds of misconduct and abuse across multiple cases.The Bureau of Justice Statistics reports that across the nation fewer than one in 12 complaints of police misconduct result in any kind of disciplinary action.And then there is the problem of “gypsy cops” – a derogatory ethnic slur used in law enforcement circles to refer to officers who are fired for serious misconduct from one department only to be rehired by another one.Timothy Loehmann, the Cleveland officer who shot and killed 12-year-old Tamir Rice, resigned before he was fired from his previous department after they deemed him unfit to serve. A grand jury did not indict Loehmann for the killing, but he was fired by the Cleveland Division of Police after they found he had not disclosed the reason for leaving his previous job.In the largest study of police hiring, researchers concluded that rehired officers, who make up roughly 3% of the police force, present a serious threat to communities because of their propensity to re-offend, if they had engaged in misconduct before.These officers, wrote the study’s authors, “are more likely … to be fired from their next job or to receive a complaint for a ‘moral character violation.’”The Newark modelThe Obama administration’s Task Force on 21st Century Policing recommended the creation of a national database to identify officers whose law enforcement licenses were revoked due to misconduct. The database that currently exists, the National Decertification Index, is limited, given state level variation in reporting requirements and decertification processes.Analysts agree that this is a useful step, but it does not address underlying organizational and institutional sources of violence, discrimination and misconduct.For example, in the aftermath of the police shooting of Michael Brown in Ferguson, Missouri, the Department of Justice found that the department had a lengthy history of excessive force, unconstitutional stop and searches, racial discrimination and racial bias.The report noted that the use of force was often punitive and retaliatory and that “the overwhelming majority of force – almost 90% – is used against African Americans.”One promising solution might be the creation of independent civilian review boards that are able to conduct their own investigations and impose disciplinary measures.In Newark, New Jersey, the board can issue subpoenas, hold hearings and investigate misconduct.Research at the national level suggests that jurisdictions with citizen review boards uphold more excessive force complaints than jurisdictions that rely on internal mechanisms.But historically, the work of civilian review boards has been undercut by limitations on resources and authority. Promising models, including the one in Newark, are frequently the target of lawsuits and harassment by police unions, who say that such boards undermine the police department’s internal disciplinary procedures.In the case of civilian review board in the Newark, the board largely prevailed in the aftermath of the police union lawsuit. The court ruling restored the board’s ability to investigate police misconduct – but it made the board’s disciplinary recommendations nonbinding. [Deep knowledge, daily.Sign up for The Conversation’s newsletter.]Jill McCorkel, Professor of Sociology and Criminology, Villanova UniversityThis article is republished from The Conversation under a Creative Commons license. Read the original article.
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