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.

 

SIXTY YEARS OF INSTILLING HOPE, RESTORING MORALE AND MORE

Sixty Years of Instilling Hope, Restoring Morale and More

Andrew Malekoff© March 2013

This year marks the 60th anniversary of North Shore Child and Family Guidance Center. I wonder if its founders, a small group of parents, could have imagined in 1953 that six decades later the Guidance Center would be taking more than 100 calls a week from parents concerned about their children’s emotional well-being. The callers tell stories about children and teens who are troubled, in trouble or causing trouble. Handling their first call sensitively is a hallmark of the Guidance Center. That first person-to-person contact makes all the difference in whether a parent chooses to take the next step forward towards hope or retreats into a sense of despair.

In the early 1950’s, the north shore communities of Long Island were experiencing rapid change. What was once a bucolic landscape peppered with small villages and large estates was being converted into a vast array of suburban developments. The last remaining farms were leveled as roads. Housing developments and schools suddenly popped up, many clustered near the most prominent new roadway, the Long Island Expressway.

According to Bob Smith, who penned a reflection on the first 50 years of the Guidance Center, “In the beginning there were the parents; a generation of mostly young professionals and middle-class workers who had come of age in the great depression, been tempered by the crucible of war, and then came marching home to an increasingly troubled urban environment. These young men and women came to the suburbs in search of a safer, healthier place to raise their children.” The new residents had come with little children or the expectation of children. They came as a single generation, not as an extended family. The priority of the suburbs became raising children.

The Guidance Center’s beginnings were rooted in a community-based model, where progressive-minded suburban activists organized to establish a children’s mental health clinic for members of the community in need of such services. The message to new suburbanites was that, despite their relocation into more affluent communities, mental health problems were not confined to the underprivileged and poor.

Smith recalled that the founders, “made it understood that the oft repeated remark – ‘wherever you go – there YOU are’ was, in fact, true; that the need for services crossed financial, educational, ethnic and class barriers. And that the suburban environment, because of its isolation, might even be more stressful for these young families than the urban environment might have been, with its close-knit neighborhoods and extended families for support.” This remains true today, despite dramatic changes in the intervening years.

Sixty years later, we are blessed to have modern technological innovations such as the Internet and cell phones that provide us with the capacity to make connections anywhere and anytime. Yet, instant access and social media are no replacements for more intimate face-to-face interaction, the essential medium of a community-based agency.

The 100-plus calls we receive every week tell different stories, yet are similar with characteristics of demoralization such as a sense of helplessness and hopelessness, inability to cope, self-blame, feelings of worthlessness and a sense of alienation. Perhaps the most enduring quality of the Guidance Center, over 60 years, is its ability to connect with struggling families of all backgrounds, up close and personal, and to instill hope and restore morale.

Happy 60th Anniversary North Shore Child and Family Guidance Center!

SHORTSIGHTED CUTS TO DRUG TREATMENT

http://www.newsday.com/opinion/letters/letter-shortsighted-cuts-to-drug-treatment-1.4809203

Shortsighted cuts to drug treatment

Andrew Malekoff

March 14, 2013

Regarding the escalating drug problem on Long Island ["Deadly turn to heroin," News, March 11], six months ago, County Executive Edward Mangano held a news conference on the growing heroin and prescription pill problem in Nassau County. He stood with the mothers of children who died from drug overdoses.

To remedy this he announced that Nassau had been certified by the New York State Department of Health to train its employees, as well as families of at-risk individuals, in administering the overdose-reversal agent Narcan to anyone who has ingested large amounts of opioids like heroin.

Any step to save lives is welcome. However, at the news conference there was no mention of $7.3 million in human services funding that was cut on July 5, 2012, which included $1.75 million for outpatient drug treatment.

I am reminded of the parable about the small village on the edge of a river. One day a villager saw a baby floating down the river. He jumped in the river and saved the baby. The next day he saw two babies floating down the river. He and another villager dived in and saved them. Each day that followed, more babies were found floating down the river. The villagers organized themselves, training teams of swimmers to rescue the babies. They were soon working around the clock.

Although they could not save all the babies, the rescue squad members felt good and were lauded for saving as many babies as they could. However, one day, one of the villagers asked: "Where are all these babies coming from? Why don't we organize a team to head upstream to find out who's throwing the babies into the river in the first place!"

Mobilizing county resources to pull babies from the river while simultaneously cutting back on activities to prevent the babies from being tossed into the river in the first place makes no sense.

Andrew Malekoff

Editor's note: The writer is the executive director of the nonprofit North Shore Child and Family Guidance Center in Roslyn Heights.

THEY LOBBY FROM THEIR GRAVES

THEY LOBBY FROM THEIR GRAVES

by Andrew Malekoff © 2013

It was not necessary for the slaughter of innocents at Sandy Hook Elementary School to validate what we are reminded of daily - that there is evil in the world. But what it did do is to affirm that if the massacre of six- and seven-year-old children is not off limits, then nothing is.

Immediately after the murderous rampage in Newtown, CT, mental health experts offered tips to speechless parents about how to soothe their children. The advice sounded like this: Be available emotionally, be compassionate, limit media exposure, reassure safety, offer distractions to prevent obsessive worry, monitor for angry outbursts and depression and, if symptoms persist, seek professional help.

Can you imagine how the advice might have sounded if parents spoke from their guts instead of their heads and hearts? The advice might have sounded like this: It’s a cruel world, evil is everywhere, toughen up, watch your back, be vigilant, don’t trust anyone and (for older children) just because you’re paranoid doesn’t mean that they’re not out to get you.

In the last 30 years, America has mourned at least 61 mass murders. After some time passes, the latest homegrown massacre will become another tombstone in our collective psyche, alongside Columbine, the World Trade Center, the Long Island Railroad, Virginia Tech, Oak Creek, Aurora and more.

We seem always to move forward believing that we have seen the last and worst of it; until the next time. Denial is a healthy defense when the alternative is all-consuming, paralyzing and debilitating fear. We do all we can to protect our children emotionally, as well as physically. And, so we support their denial, using psychological bromides to seal their emotional scars.

The two major talking points since Newtown are preventing gun violence and promoting mental health. On the issue of gun violence, I wholeheartedly support the right to bear arms and taking steps to get certain guns out of uncertain hands. On the issue of mental health care, the chronic under-funding of children's outpatient community-based mental health services in Nassau County and New York State, is a disgrace.

New York State has ensured easy access to community-based mental health care for Medicaid recipients and neglected the needs of underinsured middle class and working poor families. Their answer is always that the marketplace will take care of it. It won’t. They know full well that private practitioners often do not accept private insurance and will not provide the labor-intensive services that licensed community-based mental health agencies do.

The gun lobby is formidable and well-heeled. Children, on the other hand, don’t have a voice until they are in the ground. Children are killed, grieving parents become tireless advocates and laws are passed. Timothy’s Law (mental health parity), Megan’s Law (making information available to the public regarding registered sex offenders) and Katie’s Law (making aggravated vehicular homicide a crime) come to mind.

Think about it. After the Newtown shootings there was not one parent in the United States who was able to escape the tyranny of imagining their child being murdered in their neighborhood school. How many more children will be taken from us before lawmakers devote the same energy and resources it takes to launch their re-election campaigns, to safeguarding our children?

Wake up lawmakers, elected and appointed officials, and government bureaucrats. Our children are suffering and dying, families are struggling and desperate. Support the constitutional right to bear arms, take steps to prevent gun violence and provide adequate funding for community-based mental health centers to support the emotional well-being of all of our children.

AN OPEN LETTER TO A HOUSE DIVIDED

An Open Letter to a House Divided


Andrew Malekoff © October 2012
To the Nassau County Legislature and County Executive: I attended every Nassau County legislative meeting since May 2012 when funding cuts to human services were first addressed. I testified at four of the meetings. I presented illustrations of troubled children and working families and asked what the County’s backup plan was to help them after $7.3 million of tax-free, dedicated red-light camera revenues were shifted to the general fund. You offered no answers.

I provided facts and figures about the astronomical cost for incarceration in the Nassau County Correctional Facility and compared it to the relatively modest cost of preventive community-based services. I asked you where the money would come from if more kids are incarcerated or institutionalized as a result of depleted services. You offered no answers.

More than testifying, though, I listened and watched you interacting with one another and the public. To your credit, although you routinely pointed fingers at one another across the aisle, not one of you questioned the value of the services that have been held hostage for almost four months since the red-light camera funds were rescinded. If your sense of duty forbids these devastating cuts to human services, to paraphrase Abraham Lincoln, then I ask you to stand by your duty, fearlessly and effectively.

In his Cooper Union address, Lincoln famously declared that, "A house divided against itself cannot stand." We know that he was referring to a troubled nation. And, although what is at stake today is vastly different than what was at stake in 1860, what is unmistakable to me, after attending the legislative meetings, is that Nassau County is a house divided against itself. And what was true 150 years ago is still true today: a house divided against itself cannot stand.

I was invited, as a guest, to a meeting of the Federalist Society in September. Although I am not a member, I was very interested in what the guest speaker, NIFA Director George Marlin, had to say. I was hopeful that his remarks might shed additional light on Nassau County’s draconian cuts to vital human services. I did not expect Mr. Marlin to be sympathetic to youth services, for example, but I thought he might help me to better understand the fiscal context and what it would take for positive change to occur.

I was left with a distinct impression that Mr. Marlin, who described himself as a “street-corner conservative,” was not pleased with the fiscal trajectory of Nassau County. Yet, referring to New York State’s challenges, he lauded Governor Andrew Cuomo’s leadership and ability to find common ground, to work capably with members of both sides of the aisle and to effectively negotiate differences in balancing the state budget.

What a novel idea, I thought: cooperation, negotiation and integrated solutions. I implore you, our Nassau County elected representatives and County Executive, to provide leadership by finding ways to work together for the benefit of all of the people of Nassau County; and, in the process, to find a way to restore the tax-free essential human services funding; and, to do it soon.

ASSAULT ON HUMAN SERVICES

Anton Community Newspapers • 132 East 2nd Street • Mineola, NY 11501

ASSAULT ON HUMAN SERVICES
by Andrew Malekoff© September 20, 2012

September 5, 2012 marked two months since 7.3 million dollars, earmarked to support human services, were shifted to the general fund. We were told that this was due to the Nassau County legislature’s failure to pass $41 million in bonding for property tax refunds. But, it is not that simple.

How did all of this get started? In 2009, then-County Executive Tom Suozzi "enlisted" the county's most vulnerable citizens as unpaid lobbyists to advocate for red-light cameras, cigarette taxes and traffic-violation reform. Mr. Suozzi threatened scores of agencies serving tens of thousands of youths and families that they would be closed down or crippled unless the revenue enhancers were passed through Albany.

Red-light camera legislation passed and local agencies were assured, by unanimous vote of the full Nassau County legislature, that related revenues would become a sustainable source funding for these services. Three years later, that agreement is null and void. Our young people are now the collateral damage in a political war over bonding and redistricting.

More than two months have passed since the July 5, 2012 cuts to human services, which included $1.75 million of chemical dependency treatment funding. Despite extensive testimony, protests and media coverage, not a thing has changed. Advocates, young and old, have held press conferences, prayer vigils and a symbolic funeral for youth services. On August 6, several young people and adults attended a legislative meeting symbolically bound, gagged and blindfolded to point out that youth services were being held hostage.

What is the outcome of all of this activity and attention? Democrat and Republican legislators continue to point fingers and holler at one another in front of hundreds of disbelieving youths and family members who have become regular attendees at legislative meetings as well as activists in addressing this issue.

Youth services organizations that depend almost exclusively on County funds will close in a short time. Agencies with more diversified funding may not go out of business, but will have to shutter critical services such as after-school and summer programs as well as suicide, pregnancy, gang and drug-prevention programs that keep kids safe, provide enriching activities and offer a sense of belonging and relationships with caring adults during the non-school hours.

The developmental tasks necessary for adolescents in our culture to become healthy, functioning adults require great effort and time and more than parent and school support alone. These tasks include forging relationships with peers and adults that lead to the achievement of emotional independence from parents, developing a healthy sexual identity, building a capacity for greater intimacy with peers, learning skills and selecting an economic career; also developing a moral value and an ethical system to guide one’s behavior as well as desiring and employing socially responsible behavior.

Adolescence today is an age of particular vulnerability, a time in which youngsters are experiencing the sexual awakenings of puberty earlier than ever while facing increasing social and educational demands, and experimenting with more freedom, autonomy and choice than ever before. The politically-motivated de-funding of youth services is therefore an attack on the family.

Nassau County’s broken promises and its propensity to use vulnerable young people as pawns in promoting partisan political interests represents a moral failing and a lack of leadership. Our elected representatives on both sides of the aisle should be ashamed of themselves for putting our most vulnerable young people in the political crosshairs. Who among them will stand and deliver to put an end to this madness?

**Andrew Malekoff is Executive Director / CEO, North Shore Child and Family Guidance Center

Roslyn Heights, New York 11577 and author of Group Work with Adolescents: Principles and Practice (Guilford Press), now in its second edtion. E-mail: amalekoff@northshorechildguidance.org

PARENTS, STUDENT ATHLETES AND THE PENN STATE SCANDAL

Parenthood Plus: August 30, 2012


Written by Andrew Malekoff, Executive Director North Shore Child and Family Guidance Center Friday, 31 August 2012 00:00

Parents, Student Athletes And The Penn State Scandal

Bob, my younger brother, was a die-hard Penn State football fan going back to the early 1960s. In later years he became a college coach and athletic director. Presently, he is Chair of the Sports Studies Department at Guilford College. He has written and researched extensively on maximizing the educational value of sports participation for youths, middle and high school, and college athletes. I thought there was no one better to ask about the Penn State mess and what lessons parents could take from it? Here is what he told me:

“For the past few months, we have been inundated with news about what is now commonly known as the ‘Penn State Scandal.’ Although the focus has been on the horrific acts of Jerry Sandusky and decrying the actions – or lack thereof – of Penn State administrators and others, it may be helpful to consider what the parents of young athletes can learn from this tragic affair.

“Many parents have paused and asked themselves, ‘What do I really know about the people coaching my children?’ First, the overwhelming majority of youth and high school coaches are solid citizens who have the best interests of your child in mind. But it would be naïve to think that there are not exceptions. Many states have laws requiring youth sport organizations and public schools to run background checks on coaches. Whether or not this is the case for your community, you can speak to the appropriate authorities about conducting these checks and implementing training programs that address how coaches can help young athletes to have a positive and safe experience.

“Parents need to understand that it is the coach’s job to manage the team and, for the most part, you should not interfere. However, you should be aware of the kind of experience that your child is having and you should feel free to ask questions. We sometimes tend to assign positive personal characteristics to coaches, whether deserved or not. This is particularly so in the case of winning programs; even at youth, and middle and high school levels. But winning championships doesn’t necessarily make someone a good person or role model. And, there is no question that it is difficult to challenge the coach who is competitively successful and has strong support from team parents and in the community. With unconditional support, less sensitive coaches can feel empowered to do as they please, especially if they are oblivious to how youngsters might be adversely impacted by their actions.

“Finally, you should strive to help your children keep sports in perspective. This starts with you, as a parent, doing the same.

“An appropriate level of perspective doesn’t mean that your child should not be competitive or do his or her best to excel on the field or court, or should not show respect for coaches and teammates. It does mean that when faced with a coach who behaves inappropriately or a teammate who bullies other children, your child should be encouraged to share what is going on, as opposed to subscribing to the idea that a good team member never questions a coach’s authority, even if it is used to exploit or harm others.

“The great majority of coaches care deeply about the long-term development of the children under their supervision, but parents of young athletes are wise to bear in mind an adage that was lost on a number of people involved in the Penn State tragedy: ‘Power corrupts. Absolute power corrupts absolutely.’”