TREATMENT LAWS AREN'T BEING ENFORCED

Tucked into the heartbreaking story by Newsday about a young women’s lack of access to lifesaving healthcare to treat her addiction (“A daughter lost to heroin,” Editorial, May 15, 2016) is the fact that Bridgette Kurtzke was diagnosed with bipolar disorder as a teenager.

A 2014 study by the U.S. Substance Abuse and Mental Health Services Administration, 7.9 million people had both a mental health disorder and substance use disorder.

Newsday’s editorial stated that Gov. Andrew M. Cuomo has created a task force on opioid addiction that will propose new legislation. The fact is, we already have federal legislation; namely, the Mental Health Parity and Addiction Equity Act and the Obama Patient Protection and Affordable Care Act. Both state that it is illegal to treat diseases of the brain differently than those of any other part of the body.

Before proposing bills, the governor and his task force should know that these laws aren't being adequately enforced in New York, especially as it relates to having an adequate network of services. Insurers must provide enrollees with timely access to a sufficient number of providers included in the benefit contract.

Andrew Malekoff is executive director for the nonprofit children’s mental health agency North Shore Child and Family Guidance Center in Roslyn Heights, NY

THE ADOLESCENT BRAIN AND A GRANDMOTHER'S WISDOM

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.

https://longislandweekly.com/adolescent-brain-grandmothers-wisdom/

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. 

HELPING HAITIAN GIRL FEEL AT HOME

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.”

https://longislandweekly.com/helping-girl-feel-home/

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. 

"ONE PERSON CAN IGNITE A FIRE THAT CAN LIGHT THE ENTIRE FOREST"

On March 30, 2016 I had the pleasure of meeting a true hero - Dr. Bennet Omalu. He was the keynoter at the Head Injury Association's Awareness Sports Forum at the Hyatt Regency Long Island.

In 2002 Dr. Omalu discovered the presence of degenerative disease in the brain of National Football League (NFL) player Mike Webster. He named the brain disease chronic traumatic encephalopathy, known as CTE. His discovery has proven to be a powerful pebble that has generated waves throughout the troubled waters of youth, college and professional football, as well as other contact sports.

Dr. Omalu was portrayed by Will Smith in the 2015 film Concussion, based on his book of the same name. Prior to that, he was prominently featured in the public affairs television program Frontline and in the book, League of Denial: The NFL, Concussions and the Battle for Truth.

Although the focus of the head injury forum was to raise awareness to protect school-aged athletes from concussions, Dr. Omalu transcended his role as a forensic scientist, inspiring an audience of several hundred people with his deep faith and fortitude.

He began his remarks by recalling that he was born in war-torn Nigeria and describing how he suffered as a child from malnutrition. He revealed that, "Because of the consequences of war, I became a weakling and introvert who was ridiculed."

The turning point in his life came, he remembered, when he realized that "with knowledge you can do all things." This realization ignited what became a lifetime thirst for learning and quest for truth. In fact, he has earned eight degrees and certifications.

Omalu explained that both science and faith seek truth. The role of faith, he said, "is the manifestation of things we do not see," which was the case with Mike Webster and the rest of the world. Dr. Omalu said that it was his deep faith in humanity that led him to wonder about the cause of Webster's destitution, deterioration and death, and, to "speak" to Webster's spirit during the autopsy.

"Whatever happens to the least of us happens to all of us," he told the rapt audience in Hauppauge; and, "what we do for the least of us, we do for all of us." And, so began his spiritual relationship with the deceased Mike Webster.

Omalu has faced enormous obstacles as a scientist. He shared that he was smeared by National Institute of Health which said he was not a reputable doctor. And he was also defamed by the NFL that did all they could to stonewall his discovery and disassociate the notion that repeated blows to the head were the cause of a degenerative brain disease that led to the premature deaths, including suicides, of scores of former players and counting.

Dr. Omalu spoke to the challenge of working in a context of "conformational intelligence" which he explained as when one's "mind conforms to the expectations of society" and not necessarily truth. "How does conformational intelligence hold down a society?" he asked.

Omalu—who portrayed himself as an "outlier," someone who operates outside of the box—concluded his remarks by stating, "One person can ignite a fire that can light the entire forest."

We owe Dr. Omalu a debt of gratitude for his discovery and for his quest for truth, against all odds.

We must demand that those in power in youth, interscholastic and intercollegiate sports protect our children; and we must help our children, from an early age, to think critically and to develop the good sense and courage, without shame, to speak the truth and break the silence.

https://longislandweekly.com/one-person-can-ignite-fire-can-light-entire-forest/

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.

PATTY AND JORDAN ON THE STREETS OF MANHATTAN

Although I’ve written before about bullying, in this space, 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.  

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 contaminate 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 judgement 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 NYC 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 no 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 10k likes she got on Tumbler after posting a video of her dancing.

And Ashley won project runway and plus-size models are walking the runways and appearing in fashion magazines and Ashley won Project Runway. [Ashley Tipton is a 24-year-old clothing designer.] She 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.

https://longislandweekly.com/patty-and-jordan-on-the-streets-of-manhattan/

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. 

PRAISEWORTHY

In one week in September, soon after we commemorated the 14th anniversary of the September 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.

Shortly thereafter, Dr. Ben Carson, running close behind Mr. Trump in the campaign, asserted on Meet 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, Texas, 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 September 11, 2001. It’s time to let our voices be heard and, unlike Mr. Trump, take a stand against bias when we hear it.

https://longislandweekly.com/praiseworthy/

Andrew Malekoff is executive director of North Shore Child & Family Guidance Center, a nonprofit children’s mental health center in Roslyn Heights, NY.

RUNAWAY TRAIN

On August 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 August 11.

One can only imagine the terror O’Donnell felt. Not only was her daughter missing, but Chelsea also had a medical condition that needed treatment. O’Donnell posted that her daughter had stopped taking her medication and “was in need of medical attention.” A spokesperson for the comedienne 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 in Barnegat, New Jersey. Apparently, alerts from her peers and the pinging on her cell phone led police to her location and recovery. O’Donnell tweeted her thanks later that day, telling her followers "Chelsea has been found and is safe in police custody - thank u all for the help and light #missingchildren.”

While none of us outside of O’Donnell’s family knows the circumstances that led Chelsea to run away, at least one possible cause is clear. A quick search on social media on the subject of the missing teen 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 idle chatter among strangers about this incident, including speculation about the missing girl’s mental status. There were also reports citing her mother’s pending divorce and shaming commentaries as to how that may have contributed to her daughter’s distress.

It’s more than likely that Chelsea O’Donnell had easy access to all of this, as do most of today’s teens and even children. One can only imagine how a young person in turmoil and on the run was able to make sense out of any of it, and how much of the onslaught of cyberbullying against her family contributed to her distress and 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.

Cyberspace obliterates any sense of sanctuary that children once found when they were away from school and in their own homes. What happens when a teenager who is stressed or overwhelmed with her life and doesn’t have the coping skills to weather the storms of adolescence decides to run and is able to follow the story by simply scrolling through her phone?

All media – conventional and social – can be invaluable in helping to track down a missing child, as was clear in this case. That is a blessing.  Almost anything in the way of messaging that might lead to the recovery of a runaway child is welcome, even if it becomes a bit sensational.

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.

Conventional 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 “looney” to refer to those with mental illness. And social media, a 24-7 town meeting with minimal monitoring of any consequence, is a runaway train that assumes more of the characteristics of chaos than order.

It’s clear that the very tools we now have at our immediate 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 recovery of a child on the run.

And we must, as always, continue to fight the stigma that still plagues the 20% to 25% of people in this country facing mental illness. There should be no shame in such a diagnosis, any more than a diagnosis of diabetes or cancer.

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.

Andrew Malekoff is executive director of North Shore Child & Family Guidance Center, a nonprofit children’s mental health center in Roslyn Heights, NY. He can be reached directly at AMalekoff@Northshorechildguidance.org