IN THE WAKE OF SANDY HOOK - SIX MONTHS LATER

In the Wake of Sandy Hook - Six Months Later

by Andrew Malekoff

On June 3, 2013, at a White House conference on mental health, President Obama urged Americans to “help bring mental illness out of the shadows” and pledged that his administration will provide new resources to support the effort. He called for an open dialogue on mental illness. He said a lack of public understanding about mental illness leads to a lack of treatment. These are timely and encouraging words.

On April 3, 2013, I participated as a panelist in a National Public Health Week event, organized by Hofstra University School Health Sciences and Human Services, on mental health issues in the wake of Sandy Hook. My emphasis was on eradicating stigma and improving access to quality mental health care and child care.

The American reality today is one out of five 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. It is shameful that the editors of major metropolitan newspapers exploit and discredit people suffering with mental illnesses with malicious name-calling that reinforces fear, mistrust and stigma, causing labeled persons to lose status and experience discrimination.

We know that the most violent acts are not committed by people with mental illness. In fact, people with mental illness are disproportionately the victims of violence. New gun laws require that the names of designated individuals with severe mental illness be recorded in a national data-base. 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 does not do is address the problem of better access to quality mental health care.

Here are the facts: seventy-five percent of all serious mental illness occurs before the age of 24; and 50% before the age of 14. Yet, only one out of five children who have emotional disturbances receive treatment from a mental health specialist. We must do more to identify mental health problems early and then, when indicated, provide ready access to quality community-based mental health care.

Early screening by schools and pediatricians is a promising development. Yet, New York State has implemented a "clinic reform" plan that assures continued access to care only to children and families with Medicaid insurance coverage. This leaves a significant number of children and adults in the lurch. 

What’s more, New York State does not support universal access to quality child care, which is critical to a child’s healthy emotional development. By lowering income-eligibility levels for child-care subsidies, thousands of Long Island children are now being denied quality child care, leaving parents to either curtail work or leave their children in unlicensed child-care settings.

When elected representatives and appointed officials champion early mental health screening in schools and pediatrician’s offices, while denying universal access to child care and community-based mental health care, there is only the illusion of caring, political sleight of hand and insult to the children and adults who died at Sandy Hook.

 

EXPRESSWAY: YOUNG PEOPLE NEED CONNECTIONS

Expressway: Young people need connections

published in NEWSDAY on November 17, 2011

by Andrew Malekoff ©

There are times that I feel as if I am being buried alive, one tablespoon of tabloid dirt at a time. To name names here would be redundant. Besides, they all blur together in blaring headlines like the latest scandal, complements of Happy Valley, Pennsylvania.

I wonder what young people think of the endless parade of public figures – government officials, businessmen, entertainers, professional athletes, college coaches and administrators - crashing and burning before their eyes. Perhaps F. Scott Fitgerald said it best when he wrote: “Show me a hero and I will write you a tragedy.”

A few years ago in a survey conducted by North Shore Child and Family Guidance Center, we asked 1200 high school students from all across Long Island to tell us their concerns now and for the future.

One of them wrote: “I don’t think this world is ever going to get better. To live in this world you have to be very very strong, because if you’re not, the system will walk all over you…you really cannot trust anybody but your family, and not even them half the time.”

Relationships, illness, divorce and death weighed heavily on their minds. One wrote about the dissolution of his parents’ marriage, “My parents are getting a divorce and now there is talk about my mother being forced to move out of the house and my father move in and I have no say. I have lost faith in the court system. I thought we had the right to freedom of speech, but I guess actually being heard is another story.”

Another talked about his fears: “I am afraid of a lot of things; mainly dying too young and not getting to live to my greatest expectations.”
We asked, “When you’re confused about life who helps you sort things out?” Almost three-quarters said their parents, and their friends fill that role. Far from rejecting parents in favor of peers, family is part of the solution, not the problem.

In an all-day gathering of teens and adults that followed the release of the survey results, the young people talked about well-meaning parents who are overwhelmed with trying to make ends meet, with little or no time for substantive discussion with them; and they talked about teachers who they admire but who are too preoccupied with preparations for standardized testing.

In one small group discussion that day a parent commented: “What stood out for me the most was the observation by several of the kids that they need support from adults to tackle the challenging issues they face. Often, adults complain that kids are apathetic, lazy, unmotivated or apolitical. Maybe it is our own apathy and fears that prevent us as adults from helping.”

And, a teacher said: “Listening to the depths of emotion and world concerns from the students, I came away feeling that we are missing the boat with our kids. I know this is a generalization but, so many young people are walking around with such powerful feelings that we as adults are not helping them with. Our schools appear to be more interested in control, assessments and achievement scores than the life events that affect our children.”

As I reflect on the voices of young people living all across Long Island I am reminded a simple truth – connections count. It is the good connections in their lives that enable our children to bounce back from private crises such as illness, divorce, drug addiction, child abuse and death; and to keep them from being weighed down by the daily drumbeat and demoralizing impact of public scandal and corruption that beset us.

Andrew Malekoff is executive director and chief executive of North Shore Child and Family Guidance Center.

When a Child Refuses to Go to School

When a Child Refuses to Go to School
Andrew Malekoff © 2011

Twenty-eight percent of children across the United States refuse to go to school at some time during their school years. In a recent survey of new applications at North Shore Child and Family Guidance Center, we found increasing numbers of children who refused to go to school. This was further validated at a meeting that the Guidance Center hosted for counselors, social workers and psychologists from public and private schools throughout Nassau County.

School-refusal behavior is identified, according to the NYU Child Study Center, in boys and girls from 5-17 who: (1) are entirely absent from school, and/or; (2) attend school initially, but leave during the course of the school day, and/or; (3) go to school following crying, clinging, tantrums or other intense behavior problems, and/or (4) exhibit unusual distress during school days and then plead for future absenteeism.

Naturally, the meeting with local school personnel led to speculation on what causes children to refuse to go to school. To no one’s surprise, bullying topped the list. Nevertheless, although bullying is one cause, other issues such as a transition from one school to another; an illness or death in the family; or school-performance problems, also trigger school refusal.

A few things to consider when school-refusal is a problem in your home:

1. Do your best to get your child to school every day. The more a child is allowed to stay home, the harder it will be to get him or her out of the house;
2. You may think that your child is not being honest about feeling poorly in the morning. Try to remember that anxiety can lead to physical symptoms like aches and pains or nausea;
3. Talk to your child and school personnel to see if you can discover what is leading to his or her avoidance of school. It could be bullying or academic problems or social isolation and trouble making friends;
4. Consider consulting with a school guidance, social work or community-based mental health counselor, especially if every morning is a battle; and
5. If there are troubles at home, like a divorce, death in the family, new sibling, or a recent relocation, don’t ignore them. Family therapy can help to sort things out and increase your child’s ability to cope with difficult changes in his or her life.

School-refusal is an issue that we deal with frequently at North Shore Child and Family Guidance Center. Adults – parents, teachers, counselors, coaches – must work together in trying to understand the underlying causes and triggers for a child’s school-avoidance behavior.

By working together – school, community and family - we can be successful in helping fearful or anxious young people to overcome of school-avoidance problems and help them to and return to school and learn, socialize and move forward in their lives.

This column was printed in the Long Island Anton chain of newspapers in April 2011.

PLEASE DO FIGHT WITH YOUR TEEN-AGERS

PLEASE DO FIGHT WITH YOUR TEEN-AGERS

By Andrew Malekoff© 2011

Teen-agers enjoy a good “fight” with adults who do not feel a need to dominate and are willing to listen. As children progress from the “earthbound” quality of concrete thinking to the “intergalactic” quality of complex thinking, they become capable of formulating contrary-to-fact-hypotheses, of leaping with their minds here, there and everywhere. Herein lays the source of teen-agers’ growing ability and fervor for challenging others’ ideas, beliefs and values and for engaging in furious debate, often to the dismay of parents, teachers and other adults.

One day when my son Jamie was 14, he told me that he was thrown out of class. He had argued with his Spanish teacher about how she had graded a test. One of the questions had a visual component. The class was asked to write, in Spanish, a sentence describing what they had observed in a drawing that depicted two women who were simultaneously holding a gift-wrapped package. Jamie told me that his answer was, “Una mujer está recibiendo un regalo” (A woman is receiving a gift). When the test was returned his answer was marked wrong and points were deducted. The correct answer, the teacher said, was, “A woman is giving a gift.”

He argued that the drawing could be interpreted both ways, giving or receiving. The debate was heated. The teacher was flustered. Jamie pressed on, continuing to argue his point until he was silenced by the teacher

He told me that he then raised his hand. The teacher ignored him at first. Nevertheless, his long outstretched arm became an exclamation point, punctuating the space in the classroom.

“JAMIE WHAT IS IT?” she shouted. He responded, “I just like to hear the sound of my voice.” His enraged teacher then banished him.

British educator Janet Batsleer has spoken eloquently about the hostilities and complicities that young people have experienced in schools. She refers to “Those people who have ‘spoken out of turn,’ or who have not spoken ‘properly,’ or who have learned carefully exactly when to speak in order to please the teacher, or who have become afraid to speak for fear of being spoken about as a problem or in even more hostile ways.”

We should welcome debate from young people. Reasoned arguments gradually replace simple reliance on authoritative pronouncements by grown-ups.

As a child’s brain develops, opposites such as good and bad, or black and white, or yes and no, can be held in one’s mind simultaneously, enabling an individual to examine subtle shadings of disparate ideas and to tolerate the ambiguities that are generated by thoughtful debate. This “quantum leap” in thinking enables one to consider many viewpoints at once, use inductive and deductive thinking to reason and test reality by challenging contradictions and inconsistencies.

Young adolescents find that they can begin to argue for argument’s sake—for the fun of it. When we engage with them in spirited debate we help them to cultivate critical thinking, which is essential in order for a young person to become an active citizen in community affairs; to learn when to stand up and speak out.

So, please do fight with the teen-agers in your life. Fight with them to help them to flex their cognitive muscles and fight with them for fun. If you can avoid becoming defensive or intimidated, you might be pleased to discover that from the same source of adolescent combativeness and intellectual intransigence spring the seeds of inspiration and idealism.

To be published in the Long Island, NY Anton Newspapers in November, 2011.

LET THEM EAT CAKE

LET THEM EAT CAKE

By Andy Malekoff © 2007

I recently learned that some schools have banned parents from bringing cupcakes into school for their children’s birthdays in an effort to decrease childhood obesity. Some parents agree and some object. Those who agree are encouraged by reports that the children don’t miss the sweet treats when they are replaced with healthy snacks and fun activities. Those who object to substitute foods and activities see an end to an age old childhood ritual.

What’s the big deal anyway? Cupcakes can be replaced with healthy snacks like rice cakes. I tried to stick a candle into a rice cake and the rice cake split in half. I tried it again and the candle wouldn’t hold. So I bought a container of low fat Jell-O, scooped it out and put it on top of the rice cake. I stuck the candle into the Jell-O and it stayed, although it did jiggle.

Some think that fun activities are good alternatives to cupcakes. I would steer clear of pin the tail on the donkey and bashing a piñata with stick, particularly if the piñata is an animal figure. I think pin the tail on the eggplant might work. Just think how things might have turned out for Michael Vick if he pinned the tail on an eggplant when he was a child.

I am in favor of anything that will help children to grow up healthy, physically and emotionally; anything that will help them to fit in socially and gain a real sense of belonging. Some call this latest movement to reduce childhood obesity “culinary correctness.” It is fun to joke around about this, just as it was fun when Ronald Reagan declared ketchup a vegetable some years ago when he and his budget director David Stockman took on school lunches during Reagan’s budget cutting days in the early 1980’s.

If depriving kids a couple trays of cupcakes each year will really help to keep them fit and trim I am all for it. And, of course I know that this is just one part of a grander plan for improving kids’ healthy development and an easy target to poke fun at. The reality, according to national studies is that between 5-25 percent of children and teenagers in the United States are obese and, according to some reports, on the increase.

According to experts, obesity is easier to prevent than to treat. Prevention focuses in large part on parent education that includes encouraging proper nutrition, selection of low-fat snacks, good exercise/activity habits, and monitoring of television viewing.

Specialists at the Mayo Clinic advise parents to, “Keep in mind that many overweight children grow into their extra pounds as they get taller. Realize, too, that an intense focus on your child's eating habits and weight can easily backfire, leading a child to overeat even more, or possibly making him or her more prone to developing an eating disorder.”

In the final analysis and if I had to take a stand, I say give the kids an extra lap or two during gym class on birthdays. And, let them eat cake.

This article was originally published in the Anton Community Newspapers, Long Island, NY.