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Tag: iab-mental health

  • Lawmakers who struggle and have struggled with mental health see power in ‘telling the story’ | CNN Politics

    Lawmakers who struggle and have struggled with mental health see power in ‘telling the story’ | CNN Politics

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    Editor’s Note: If you or a loved one are facing mental health issues or substance abuse disorders, call The Substance Abuse and Mental Health Services Administration National Helpline at 1-800-662-4357 or visit SAMHSA’s website for treatment referral and information services.



    CNN
     — 

    In the spring of 2019, Democratic Sen. Tina Smith of Minnesota was busy putting the finishing touches on a bill that sought to expand mental health care access for kids in schools.

    But she couldn’t shake the feeling she was being less than honest about just how personal the issue of mental health was for her.

    Smith was on the precipice of an election. She had no obligation to open up about her own depression that she says happened twice – once in college and once as a young mom. But in May 2019, on the floor of the US Senate, Smith, delivered a speech about mental health and admitted, “The other reason I want to focus on mental health care while I’m here is that I’m one of them.”

    “I remember being nervous,” Smith recalled of delivering the speech. “I was concerned that people would think that I was trying to like make it be about myself, but once I got beyond that, and I realized that there was power in me telling the story – me particularly being a United States senator, somebody who supposedly has everything all together all the time, then it started to feel really interesting, and I could see right away the value of it.”

    The National Alliance on Mental Illness estimates that one in five adults in the US – nearly 53 million Americans – experience mental illness every year. The Centers for Disease Control and Prevention reports more than 50% of Americans will experience mental illness in their lifetime. But for politicians – often far away from home, under high levels of stress and pressure, all risk factors for mental illnesses like depression and anxiety – talking about their own mental health is still a relatively rare admission.

    It’s why in February when Pennsylvania Sen. John Fetterman announced he was seeking inpatient treatment for clinical depression, lawmakers on both sides of the aisle celebrated not only his decision, but his transparency.

    “It’s tough in politics, there’s a lot of scrutiny, you’re clearly in the public eye a lot. There are consequences to the things you say and talk about, but I think in a circumstance like this, it helps the conversation,” Senate Republican Whip John Thune said. “It helps people realize and understand the impact that this disease has on people across the country.”

    Years after coming forward with her own experience, Smith said she doesn’t have any regrets. In light of the Fetterman news, she feels even more the importance to share.

    “I think that every time a somebody like John or me is open about their own experiences with mental illness or you know, mental health challenges, it just breaks down that wall a little bit more about people saying, ‘Oh, it’s possible to be open and honest and not have the whole world come crashing down on you,’” Smith said.

    It’s been decades since Smith experienced depression, but she said she still remembers so much about that time.

    “I thought I was just off,” Smith said. “Something is wrong with me. I’m not with it. I’m not doing well enough and then you start to sort of blame yourself, and I was sort of in that cycle,” Smith said.

    It was her roommate in college who first suggested she talk to someone. Reluctantly, Smith took herself over to student health services and started talking to a counselor. She said she started to feel better and eventually noticed her depression abated.

    But as Smith tells it, mental health is a continuum and about a decade later, as a young mom with two kids, she found herself experiencing depression once again. At the time, she said she was caught completely off guard.

    “This is the thing that’s so treacherous about depression in particular. You think that the thing that is wrong with you is you,” Smith said. “I’ll never forget my therapist telling me, she said ‘You’re clinically depressed. That’s my diagnosis. I think that you’d benefit from medication to help you.’”

    Smith said she initially resisted. But, after a continued conversation, she agreed to start medication as part of her treatment. She remembers it took time to work, but eventually she noticed a major improvement.

    When she emerged from her depression, Smith was in her early 30s. She said she hasn’t had a resurgence of depression since then, but that she does pay very close attention to her mental health now.

    There are 535 members of Congress and just a handful of them have shared personal stories related to mental illness. Most of those who have talked about their experiences publicly are Democrats. Most of the men who have shared their stories talk about them in the context of military service. In part, it’s a risk for lawmakers to get too personal. The history of reactions to politicians being open about their mental illness has been checkered in the last several decades.

    “People still remember Tom Eagleton,” Smith told CNN.

    In 1972, Eagleton was newly selected to be the running mate for Democratic presidential nominee George McGovern. He admitted to being treated for clinical depression and receiving electroshock therapy. Days later, he withdrew from the ticket even as he continued to serve for years in the Senate.

    Memories of those kinds of episodes impact members in how they approach talking about mental health, even in recent memory.

    “When I was in Congress, I did everything I could to keep everybody from finding out that I needed help,” former Rep. Patrick Kennedy told CNN.

    Kennedy represented Rhode Island in Congress from 1995 to 2011. He suffered from addiction and bipolar disorder. While he was there in 2006, he crashed his green Mustang convertible into a barrier outside the Capitol in the early morning. Following the crash, he pointed to sleeping pills as the culprit and checked himself into the Mayo Clinic for treatment.

    “And is the case with anybody with these illnesses is it is the worst kept secret in town and you are often the last one to realize in what bad shape you are. People won’t tell it to your face because you are a member of Congress, your staff is walking around on eggshells,” Kennedy said.

    “When I did go to treatment. I kind of did it after I had been revealed to be in trouble like I’d gotten in a car accident.”

    But when he got back, Kennedy heard from many colleagues about their own struggles with issues related to mental health.

    Kennedy predicts when Fetterman returns to the Senate, that might also happen to him.

    “I think he is going to have our colleagues from both the House and the Senate look for him in order to tell him what is going on with them. He’s the only one they know,” Kennedy said. “While stigma is going away, there is a less forgiving attitude toward people who suffer from mental illness and addiction.”

    The aftermath of January 6, 2021, was another moment where the conversation around mental health started to shift on the Hill. Suddenly, members and their staff had undergone a traumatic and shared experience in the workplace.

    Democratic Rep. Sara Jacobs of California was just four days into being a new member of Congress on January 6th when she was trapped in the gallery above the House floor with several other members of her party. The experience – the sound of gas masks being deployed, the frenzy to escape, the echo of a gunshot – left her reeling. Jacobs said she considered herself well positioned to seek help. She already had a therapist. But, she noticed some of her older colleagues didn’t have the same tools.

    “I remember actually, after January 6, talking to some of my colleagues here who were a bit older and encouraging them to seek therapy and to get help because it was just something that that wasn’t as accustomed for them,” she said.

    The group of lawmakers who were trapped in the gallery also sought therapy together via Zoom and kept in touch via a text chain.

    For Jacobs, the trauma of January 6 manifested itself in unexpected ways. Suddenly, fireworks – something she once loved – were triggering. Loud people chanting or gathering somewhere made her tense up. She said a lot of her colleagues also dealt with anger, “lots of anger toward colleagues who went back that night and continued to deny the election.”

    When her brother got married in the fall and had fireworks, she had to excuse herself to another room because “it was stressing my body, my nervous system so much.”

    Rep. Dan Kildee, a Democrat from Michigan, also came forward after January 6 to talk about his battle with post-traumatic stress disorder after that day.

    It wasn’t easy.

    “There is still a stigma. People still make their own judgments and that was one of the reasons I decided to talk about it so that people would see that it can happen to anybody. You just have to get the care that you need.”

    “Not everybody was accepting when I sought treatment. My former opponent ridiculed it,” Kildee said.

    For Jacobs, who has been taking medication for anxiety and depression since 2013, stories like Fetterman’s are a sign that maybe the discussions around mental health are beginning to change on the Hill and maybe even in the rest of the country.

    “I think there’s absolutely a generational divide. And there’s also a gender divide and that’s why I think it’s so incredibly brave that Fetterman not only got the treatment needed, but talk about it,” Jacobs told CNN. “I think for me as a young woman, I spent a lot of time with my friends and peers talking about mental health, talking about therapists and what we’re learning in therapy, but I know that that is not something that other generations really have felt open to do.”

    It’s not clear, ultimately, how Fetterman’s openness around his mental health will impact the Hill going forward. It’s not clear what resonance it will have in the rest of the country or even back home for voters. But for lawmakers who’ve taken steps already to share their stories, there is some hope that it could make a major difference.

    “It doesn’t take a statistician to tell you that of the 100 of us in the United States Senate, mental health issues are going to have touched every single one of us in one way or another,” Smith said. “I think it gives people some permission to maybe speak a little bit more openly about it.”

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  • Why is it difficult for children to get a bed at pediatric hospitals? It’s more complicated than you think | CNN

    Why is it difficult for children to get a bed at pediatric hospitals? It’s more complicated than you think | CNN

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    CNN
     — 

    Effie Schnacky was wheezy and lethargic instead of being her normal, rambunctious self one February afternoon. When her parents checked her blood oxygen level, it was hovering around 80% – dangerously low for the 7-year-old.

    Her mother, Jaimie, rushed Effie, who has asthma, to a local emergency room in Hudson, Wisconsin. She was quickly diagnosed with pneumonia. After a couple of hours on oxygen, steroids and nebulizer treatments with little improvement, a physician told Schnacky that her daughter needed to be transferred to a children’s hospital to receive a higher level of care.

    What they didn’t expect was that it would take hours to find a bed for her.

    Even though the respiratory surge that overwhelmed doctor’s offices and hospitals last fall is over, some parents like Schnacky are still having trouble getting their children beds in a pediatric hospital or a pediatric unit.

    The physical and mental burnout that occurred during the height of the Covid-19 pandemic has not gone away for overworked health care workers. Shortages of doctors and technicians are growing, experts say, but especially in skilled nursing. That, plus a shortage of people to train new nurses and the rising costs of hiring are leaving hospitals with unstaffed pediatric beds.

    But a host of reasons building since well before the pandemic are also contributing. Children may be the future, but we aren’t investing in their health care in that way. With Medicaid reimbursing doctors at a lower rate for children, hospitals in tough situations sometimes put adults in those pediatric beds for financial reasons. And since 2019, children with mental health crises are increasingly staying in emergency departments for sometimes weeks to months, filling beds that children with other illnesses may need.

    “There might or might not be a bed open right when you need one. I so naively just thought there was plenty,” Schnacky told CNN.

    The number of pediatric beds decreasing has been an issue for at least a decade, said Dr. Daniel Rauch, chair of the Committee on Hospital Care for the American Academy of Pediatrics.

    By 2018, almost a quarter of children in America had to travel farther for pediatric beds as compared to 2009, according to a 2021 paper in the journal Pediatrics by lead author Dr. Anna Cushing, co-authored by Rauch.

    “This was predictable,” said Rauch, who has studied the issue for more than 10 years. “This isn’t shocking to people who’ve been looking at the data of the loss in bed capacity.”

    The number of children needing care was shrinking before the Covid-19 pandemic – a credit to improvements in pediatric care. There were about 200,000 fewer pediatric discharges in 2019 than there were in 2017, according to data from the US Department of Health and Human Services.

    “In pediatrics, we have been improving the ability we have to take care of kids with chronic conditions, like sickle cell and cystic fibrosis, and we’ve also been preventing previously very common problems like pneumonia and meningitis with vaccination programs,” said Dr. Matthew Davis, the pediatrics department chair at Ann & Robert H. Lurie Children’s Hospital of Chicago.

    Pediatrics is also seasonal, with a typical drop in patients in the summer and a sharp uptick in the winter during respiratory virus season. When the pandemic hit, schools and day cares closed, which slowed the transmission of Covid and other infectious diseases in children, Davis said. Less demand meant there was less need for beds. Hospitals overwhelmed with Covid cases in adults switched pediatric beds to beds for grownups.

    As Covid-19 tore through Southern California, small hospitals in rural towns like Apple Valley were overwhelmed, with coronavirus patients crammed into hallways, makeshift ICU beds and even the pediatric ward.

    Only 37% of hospitals in the US now offer pediatric services, down from 42% about a decade ago, according to the American Hospital Association.

    While pediatric hospital beds exist at local facilities, the only pediatric emergency department in Baltimore County is Greater Baltimore Medical Center in Towson, Maryland, according to Dr. Theresa Nguyen, the center’s chair of pediatrics. All the others in the county, which has almost 850,000 residents, closed in recent years, she said.

    The nearby MedStar Franklin Square Medical Center consolidated its pediatric ER with the main ER in 2018, citing a 40% drop in pediatric ER visits in five years, MedStar Health told CNN affiliate WBAL.

    In the six months leading up to Franklin Square’s pediatric ER closing, GBMC admitted an average of 889 pediatric emergency department patients each month. By the next year, that monthly average jumped by 21 additional patients.

    “Now we’re seeing the majority of any pediatric ED patients that would normally go to one of the surrounding community hospitals,” Nguyen said.

    In July, Tufts Medical Center in Boston converted its 41 pediatric beds to treat adult ICU and medical/surgical patients, citing the need to care for critically ill adults, the health system said.

    In other cases, it’s the hospitals that have only 10 or so pediatric beds that started asking the tough questions, Davis said.

    “Those hospitals have said, ‘You know what? We have an average of one patient a day or two patients a day. This doesn’t make sense anymore. We can’t sustain that nursing staff with specialized pediatric training for that. We’re going to close it down,’” Davis said.

    Registered nurses at Tufts Medical Center hold a

    Saint Alphonsus Regional Medical Center in Boise closed its pediatric inpatient unit in July because of financial reasons, the center told CNN affiliate KBOI. That closure means patients are now overwhelming nearby St. Luke’s Children’s Hospital, which is the only children’s hospital in the state of Idaho, administrator for St. Luke’s Children’s Katie Schimmelpfennig told CNN. Idaho ranks last for the number of pediatricians per 100,000 children, according to the American Board of Pediatrics in 2023.

    The Saint Alphonsus closure came just months before the fall, when RSV, influenza and a cadre of respiratory viruses caused a surge of pediatric patients needing hospital care, with the season starting earlier than normal.

    The changing tide of demand engulfed the already dwindling supply of pediatric beds, leaving fewer beds available for children coming in for all the common reasons, like asthma, pneumonia and other ailments. Additional challenges have made it particularly tough to recover.

    Another factor chipping away at bed capacity over time: Caring for children pays less than caring for adults. Lower insurance reimbursement rates mean some hospitals can’t afford to keep these beds – especially when care for adults is in demand.

    Medicaid, which provides health care coverage to people with limited income, is a big part of the story, according to Joshua Gottlieb, an associate professor at the University of Chicago Harris School of Public Policy.

    “Medicaid is an extremely important payer for pediatrics, and it is the least generous payer,” he said. “Medicaid is responsible for insuring a large share of pediatric patients. And then on top of its low payment rates, it is often very cumbersome to deal with.”

    Pediatric gastroenterologist Dr. Howard Baron visits with a patient in 2020 in Las Vegas. A large portion of his patients are on Medicaid with reimbursement rates that are far below private insurers.

    Medicaid reimburses children’s hospitals an average of 80% of the cost of the care, including supplemental payments, according to the Children’s Hospital Association, a national organization which represents 220 children’s hospitals. The rate is far below what private insurers reimburse.

    More than 41 million children are enrolled in Medicaid and the Children’s Health Insurance Program, according to Kaiser Family Foundation data from October. That’s more than half the children in the US, according to Census data.

    At Children’s National Hospital in Washington, DC, about 55% of patients use Medicaid, according to Dr. David Wessel, the hospital’s executive vice president.

    “Children’s National is higher Medicaid than most other children’s hospitals, but that’s because there’s no safety net hospital other than Children’s National in this town,” said Wessel, who is also the chief medical officer and physician-in-chief.

    And it just costs more to care for a child than an adult, Wessel said. Specialty equipment sized for smaller people is often necessary. And a routine test or exam for an adult is approached differently for a child. An adult can lie still for a CT scan or an MRI, but a child may need to be sedated for the same thing. A child life specialist is often there to explain what’s going on and calm the child.

    “There’s a whole cadre of services that come into play, most of which are not reimbursed,” he said. “There’s no child life expert that ever sent a bill for seeing a patient.”

    Low insurance reimbursement rates also factor into how hospital administrations make financial decisions.

    “When insurance pays more, people build more health care facilities, hire more workers and treat more patients,” Gottlieb said.

    “Everyone might be squeezed, but it’s not surprising that pediatric hospitals, which face [a] lower, more difficult payment environment in general, are going to find it especially hard.”

    Dr. Benson Hsu is a pediatric critical care provider who has served rural South Dakota for more than 10 years. Rural communities face distinct challenges in health care, something he has seen firsthand.

    A lot of rural communities don’t have pediatricians, according to the American Board of Pediatrics. It’s family practice doctors who treat children in their own communities, with the goal of keeping them out of the hospital, Hsu said. Getting hospital care often means traveling outside the community.

    Hsu’s patients come from parts of Nebraska, Iowa and Minnesota, as well as across South Dakota, he said. It’s a predominantly rural patient base, which also covers those on Native American reservations.

    “These kids are traveling 100, 200 miles within their own state to see a subspecialist,” Hsu said, referring to patients coming to hospitals in Sioux Falls. “If we are transferring them out, which we do, they’re looking at travels of 200 to 400 miles to hit Omaha, Minneapolis, Denver.”

    Inpatient pediatric beds in rural areas decreased by 26% between 2008 and 2018, while the number of rural pediatric units decreased by 24% during the same time, according to the 2021 paper in Pediatrics.

    Steve Inglish, left, and registered nurse Nikole Hoggarth, middle, help a father with his daughter, who fell and required stiches, inside the emergency department at Jamestown Regional Medical Center in rural North Dakota in 2020.

    “It’s bad, and it’s getting worse. Those safety net hospitals are the ones that are most at risk for closure,” Rauch said.

    In major cities, the idea is that a critically ill child would get the care they need within an hour, something clinicians call the golden hour, said Hsu, who is the critical care section chair at the American Academy of Pediatrics.

    “That golden hour doesn’t exist in the rural population,” he said. “It’s the golden five hours because I have to dispatch a plane to land, to drive, to pick up, stabilize, to drive back, to fly back.”

    When his patients come from far away, it uproots the whole family, he said. He described families who camp out at a child’s bedside for weeks at a time. Sometimes they are hundreds of miles from home, unlike when a patient is in their own community and parents can take turns at the hospital.

    “I have farmers who miss harvest season and that as you can imagine is devastating,” Hsu said. “These aren’t office workers who are taking their computer with them. … These are individuals who have to live and work in their communities.”

    Back at GBMC in Maryland, an adolescent patient with depression, suicidal ideation and an eating disorder was in the pediatric emergency department for 79 days, according to Nguyen. For months, no facility had a pediatric psychiatric bed or said it could take someone who needed that level of care, as the patient had a feeding tube.

    “My team of physicians, social workers and nurses spend a significant amount of time every day trying to reach out across the state of Maryland, as well as across the country now to find placements for this adolescent,” Nguyen said before the patient was transferred in mid-March. “I need help.”

    Nguyen’s patient is just one of the many examples of children and teens with mental health issues who are staying in emergency rooms and sometimes inpatient beds across the country because they need help, but there isn’t immediately a psychiatric bed or a facility that can care for them.

    It’s a problem that began before 2020 and grew worse during the pandemic, when the rate of children coming to emergency rooms with mental health issues soared, studies show.

    Now, a nationwide shortage of beds exists for children who need mental health help. A 2020 federal survey revealed that the number of residential treatment facilities for children fell 30% from 2012.

    “There are children on average waiting for two weeks for placement, sometimes longer,” Nguyen said of the patients at GBMC. The pediatric emergency department there had an average of 42 behavioral health patients each month from July 2021 through December 2022, up 13.5% from the same period in 2017 to 2018, before the pandemic, according to hospital data.

    When there are mental health patients staying in the emergency department, that can back up the beds in other parts of the hospital, creating a downstream effect, Hsu said.

    “For example, if a child can’t be transferred from a general pediatric bed to a specialized mental health center, this prevents a pediatric ICU patient from transferring to the general bed, which prevents an [emergency department] from admitting a child to the ICU. Health care is often interconnected in this fashion,” Hsu said.

    “If we don’t address the surging pediatric mental health crisis, it will directly impact how we can care for other pediatric illnesses in the community.”

    Dr. Susan Wu, right, chats with a child who got her first dose of the Pfizer-BioNtech Covid-19 vaccine at Children's Hospital Arcadia Speciality Care Center in Arcadia, California, in 2022.

    So, what can be done to improve access to pediatric care? Much like the reasons behind the difficulties parents and caregivers are experiencing, the solutions are complex:

    • A lot of it comes down to money

    Funding for children’s hospitals is already tight, Rauch said, and more money is needed not only to make up for low insurance reimbursement rates but to competitively hire and train new staff and to keep hospitals running.

    “People are going to have to decide it’s worth investing in kids,” Rauch said. “We’re going to have to pay so that hospitals don’t lose money on it and we’re going to have to pay to have staff.”

    Virtual visits, used in the right situations, could ease some of the problems straining the pediatric system, Rauch said. Extending the reach of providers would prevent transferring a child outside of their community when there isn’t the provider with the right expertise locally.

    • Increased access to children’s mental health services

    With the ongoing mental health crisis, there’s more work to be done upstream, said Amy Wimpey Knight, the president of CHA.

    “How do we work with our school partners in the community to make sure that we’re not creating this crisis and that we’re heading it off up there?” she said.

    There’s also a greater need for services within children’s hospitals, which are seeing an increase in children being admitted with behavioral health needs.

    “If you take a look at the reasons why kids are hospitalized, meaning infections, diabetes, seizures and mental health concerns, over the last decade or so, only one of those categories has been increasing – and that is mental health,” Davis said. “At the same time, we haven’t seen an increase in the number of mental health hospital resources dedicated to children and adolescents in a way that meets the increasing need.”

    Most experts CNN spoke to agreed: Seek care for your child early.

    “Whoever is in your community is doing everything possible to get the care that your child needs,” Hsu said. “Reach out to us. We will figure out a way around the constraints around the system. Our number one concern is taking care of your kids, and we will do everything possible.”

    Nguyen from GBMC and Schimmelpfennig from St. Luke’s agreed with contacting your primary care doctor and trying to keep your child out of the emergency room.

    “Anything they can do to stay out of the hospital or the emergency room is both financially better for them and better for their family,” Schimmelpfennig said.

    Knowing which emergency room or urgent care center is staffed by pediatricians is also imperative, Rauch said. Most children visit a non-pediatric ER due to availability.

    “A parent with a child should know where they’re going to take their kid in an emergency. That’s not something you decide when your child has the emergency,” he said.

    Jaimie and Effie Schnacky now have an asthma action plan after the 7-year-old's hospitalization in February.

    After Effie’s first ambulance ride and hospitalization last month, the Schnacky family received an asthma action plan from the pulmonologist in the ER.

    It breaks down the symptoms into green, yellow and red zones with ways Effie can describe how she’s feeling and the next steps for adults. The family added more supplies to their toolkit, like a daily steroid inhaler and a rescue inhaler.

    “We have everything an ER can give her, besides for an oxygen tank, at home,” Schnacky said. “The hope is that we are preventing even needing medical care.”

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  • Parents of sailor who died by suicide urge Pentagon to implement mental health measure named in his honor that became law over a year ago | CNN Politics

    Parents of sailor who died by suicide urge Pentagon to implement mental health measure named in his honor that became law over a year ago | CNN Politics

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    CNN
     — 

    More than a year after Congress signed into law a bill meant to help service members struggling with severe mental health problems, the Pentagon still has not issued guidance to the services to put the bill into practice.

    “We hear the rhetoric all the time, but we need action,” said Democratic Rep. Seth Moulton, who co-sponsored the Brandon Act. “They’ve been sitting on their hands and more Americans die every day as a result.”

    The Brandon Act is named after Brandon Caserta, a young sailor whose parents described him as a “very charismatic and upbeat young man” who “always helped everyone he could.”

    But in June 2018, Caserta took his own life at Naval Air Station Norfolk, Virginia. In letters to his parents and to his friends, Caserta said he was constantly hazed and bullied in the Navy, and he saw no other way out.

    He notified his commanders he was depressed but they took no action and showed no sympathy, according to Brandon Caserta’s father Patrick, who served 22 years in the Navy.

    “They said, ‘Suck it up and get back to work,’” Patrick Caserta told CNN. “You can’t have that. That’s now how you deal with it.”

    The Brandon Act was included in the 2022 National Defense Authorization Act. If a service member seeks mental health services or self-reports a problem, the Act requires a mental health evaluation. It also allows service members to seek confidential help outside the chain of command.

    “His letter led us to this,” Teri Caserta, Brandon’s mother, told CNN. “He wanted us to do something about suicide and the toxicity that happens in our military system. That’s why we created the Brandon Act.”

    But 15 months after it was passed the law has not been implemented and the Defense Department hasn’t followed through its requirements and issued guidance for the military. Therefore, the mental health evaluations and the confidential reporting required by the law are still not available to service members.

    In 2021, the latest year for which numbers are available, 519 US service members died by suicide. Though a slight decrease from the previous year’s 582 suicides, the trend over the last decade and more has been increasing.

    Last year, three sailors assigned to the USS George Washington died by suicide in a single week. Then, in December, four sailors at a faculty in Norfolk, Virginia died by suicide in one month.

    “DoD needs to do this,” said Moulton bluntly. “Active-duty service members don’t have a way to report mental health issues outside the chain of command because DoD just hasn’t gotten out of their own bureaucratic way to implement this act. It just requires the Secretary of Defense and his department to do their job.”

    The issue of military suicides has plagued the Department of Defense for decades. According to a 2021 study from Brown University, more than 30,000 active-duty personnel and veterans died by suicide during the 20-year War on Terror, which is more than four times the number of combat deaths in Iraq and Afghanistan combined.

    The Defense Department is currently working on implementing the requirements of the Brandon Act, according to a spokesperson.

    “Due to the complexity of the requirement, publication of policy to establish self-initiated referrals for a mental health evaluation via a commander or supervisor is currently in development,” said Cmdr. Nicole Schwegman, who stressed that there are mental health services available for members of the military seeking help or an evaluation.

    “A full continuum of mental health and wellness support is available worldwide to ensure access to care,” Schwegman said, including specialty and primary care clinics, as well as virtual health platforms.

    Last month, the Pentagon’s Suicide Prevention and Response Independent Review Committee unveiled 127 recommendations to combat military suicides, including a waiting period for gun purchases on base and raising the minimum age for buying firearms on base.

    The Pentagon said it would review the recommendations closely.

    “Even one suicide is too many, and we will exhaust every effort to promote the wellness, health, and morale of our total force,” said Pentagon press secretary Brig. Gen. Pat Ryder after the release of the recommendations.

    But for the parents of Brandon Caserta, the committee’s recommendations and the Pentagon’s promises to review its report smack of more waiting and less action.

    “As painful as this has been, had someone else done this before us, our son would still be alive,” said Patrick Caserta. “We want to be that person that saves lives later on.”

    Editor’s Note: If you or a loved one have contemplated suicide, call The National Suicide and Crisis Lifeline at 988 or 1-800-273-TALK (8255) to connect with a trained counselor.

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  • Mental health startup exposes the personal data of more than 3 million people | CNN Politics

    Mental health startup exposes the personal data of more than 3 million people | CNN Politics

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    Washington
    CNN
     — 

    A mental health startup exposed the personal data of as many as 3.1 million people online. In some cases, possibly sensitive information on mental health treatment was leaked, according to a company statement and a Department of Health and Human services filing.

    Cerebral, a California-based firm that connects people suffering from anxiety and depression with mental health professionals via video calls, said it discovered the “inadvertent” data exposure more than three years after it started using “pixels” – a common method that companies and advertisers use to track user behavior for marketing purposes.

    The company determined in January that tracking pixels had been sharing client and user data to “third-party platforms” and “subcontractors” that it didn’t name, according to a privacy notice near the bottom of its website.

    Cerebral said it was unaware of any misuse of the protected health information that was disclosed. But privacy advocates have for years warned that such data troves can be used to aggressively market products at consumers and infringe on their privacy.

    Some of the data potentially exposed in the Cerebral breach includes answers to online “self-assessments” about mental health that Cerebral asks prospective clients to fill out. That can include questions on whether someone is experiencing panic attacks, abusing alcohol or has a personality disorder, CNN’s review of the online assessments found.

    Cerebral said in a statement to CNN on Friday that it was “committed to correcting historical errors and leading the industry in privacy standards moving forward.”

    Cerebral notified the Department of Health and Human Services (HHS), which said in a filing this month that the breach affects over 3.1 million users. The department investigates potential violations of the Health Insurance Portability and Accountability Act (HIPAA), a law that requires medical providers to safeguard patient data.

    Rachel Seeger, a spokesperson for the HHS Office for Civil Rights, said the office typically “does not comment on open or potential investigations.”

    Cerebral said in its public statement that it had disabled the tracking pixels on its platforms and stopped sharing data with subcontractors “not able to meet all HIPAA [Health Insurance Portability and Accountability Act] requirements.”

    “It is important to note that Cerebral never impermissibly transmitted clinician generated notes or clinician communications,” the company told CNN.

    Cerebral spokesperson Chris Savarese did not respond to emailed questions about which and how many platforms and contractors to which the company disclosed the client health information.

    Some analysts argue that the broader market for data tracking tools is out of control. A group of conservative Catholics has spent millions of dollars to buy mobile data that identified priests who used gay dating and hookup apps, the Washington Post reported this week.

    Andrea Downing, who has done extensive research on pixel tracking and privacy, said patients are often unaware of how much personal data health care startups collect and potentially transmit to other parties.

    “What is in the fine print or the details of how data is being shared for advertising is not apparent to us when we’re going through the trauma of a diagnosis and seeking knowledge,” said Downing, who is co-founder of Light Collective, a digital rights nonprofit.

    “The only thing that is incentivizing change right now is the threat of liability,” Downing told CNN.

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  • NFL star Aaron Rodgers went to a darkness retreat to contemplate his future. What is that and how does it work? | CNN

    NFL star Aaron Rodgers went to a darkness retreat to contemplate his future. What is that and how does it work? | CNN

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    CNN
     — 

    For four days this week, home for Green Bay Packers quarterback Aaron Rodgers was a pitch-black room. There were no phones, no television, no lights or distractions. Just Rodgers, alone with his thoughts, in a cabin built specifically for prolonged isolation in the dark.

    When the four-time NFL MVP announced plans earlier this month to contemplate his NFL future in isolation at a “darkness retreat,” many were left scratching their heads.

    “It’s just sitting in isolation, meditation, dealing with your thoughts,” Rodgers said earlier this month. “We rarely even turn our phone off or put the blinds down to sleep in darkness. I’m really looking forward to it.”

    Rodgers is no stranger to alternative therapies. He credits psychedelics like psilocybin and ayahuasca for helping to alleviate his fear of death and deepening a sense of self-love. The football star said he has done “many meditation and yoga retreats” in the past and defended his decision to try darkness therapy as one of several practices “that have stimulated my mind and helped me get in a better headspace and have a greater peace in my life.”

    But what exactly happens in a darkness retreat? And is it just another new-age fad or perhaps something that could benefit the rest of us?

    A darkness retreat is exactly what it sounds like: a prolonged stay in a space completely devoid of light. One of the centers offering the practice is Sky Cave Retreats, nestled in the Cascade-Siskiyou wilderness, in Southern Oregon, near Klamath Falls.

    “The reasons for doing this range from people wanting to know themselves more, to people who want to rest, reset and relax, to those who want to explore consciousness and deepen their meditation practice,” said Scott Berman, who owns Sky Cave Retreats along with his wife Jill, adding the darkness helps illuminate what really matters by stripping away the constant bombardment of sensory input and stimulation many people experience in their hectic modern lives.

    “When someone goes into the darkness, all these things that were important to them like money, fame, power, status, being worthy – they all become insignificant and meaningless in the dark,” Berman said. “In the dark, all you have is the present moment which reveals what is truly meaningful – whether it’s love, forgiveness, peace – and it begins to transform you as you truly authentically touch what is most important to you.”

    The center currently operates three stand-alone cabins built specifically for prolonged isolation in the dark – earth-sheltered caves, which on the outside are somewhat reminiscent of a Hobbit home. Each space contains a bed, a toilet, sink and a bathtub, as well as a low table for eating and a carpeted area for yoga and meditation. Participants can leave at any time – the doors are never locked – and there is a light switch for emergencies which is protected by a childproof guard so it isn’t flipped on by accident.

    The cost includes three meals a day, which Berman delivers personally all at once in the evening (through a lightproof double-sided food box) to minimize the disturbance. This is when participants have an opportunity for a conversation, which could be 10 seconds or 30 minutes, according to Berman, depending on the person’s needs.

    Participants typically spend three to four days in the darkness at a cost of $250 a night and are encouraged to take an extra day before and after to integrate the experience.

    Each space contains a bed, a toilet, sink and a bathtub, as well as a low table for eating and a carpeted area for yoga and meditation.

    Burak Dalcik, a 27-year-old salesman from Arlington, Virginia, said the four days he spent in the dark at Sky Caves Retreats in January gave him clarity about his priorities. He found he no longer labeled experiences as positive or negative, but rather allowed them to come and to go, which led to less stress and anxiety at work and in his personal life. He also said he started calling his mom, who lives back in Turkey, more frequently.

    “It just really trims all the unnecessary fat and allows you to focus on some of the most important things and really allows you to understand who you are,” said Dalcik. “There’s nothing New Age about this – it boils down to can you just sit by yourself with yourself? And if you can’t, you should probably get pretty curious about why.”

    Berman cautions the retreat isn’t for everyone, nor should it be seen as a quick fix to one’s troubles.

    “It’s not like this magical, mind-blowing, amazing experience – it can be extremely difficult and uncomfortable,” Berman said. “But in the darkness, discomfort is the door to transformation. There’s an acceptance and a profound love that people start to experience when they’re no longer resisting that part of themselves.”

    For now, there is limited research on how darkness retreats impact the human brain and body. Some centers claim the experience can help heal traumas or activate the pineal glad, another claim is darkness therapy increases melatonin production in the brain.

    “That’s totally false,” said Dr. David Blask, the head of the Laboratory of Chrono-Neuroendocrine Oncology at Tulane University School of Medicine. “There may be some psychological benefits that people derive from a darkness retreat that they feel are important for them, but certainly not from a strict endocrine neuroendocrine or biochemical physiological standpoint.”

    Dr. Marek Malůš, a psychologist at the University of Ostrava in the Czech Republic who has been studying darkness therapies since 2010, sees the technique as a promising therapeutic tool.

    “Your thoughts, memories, emotions, inner world and mental processes become much more balanced and integrated,” Malůš said.

    While he and his colleagues are working to secure funding for additional studies, Malůš said preliminary research showed just four days in a darkness chamber was enough to help increase mindfulness and self-esteem, lower symptoms of depression and anxiety, while improving parasympathetic nervous system functions, which helps with stress management and lowering burnout symptoms. Subjects reported feeling the benefits three weeks after the experience.

    Berman said he hopes to see more scientific research into the benefits of darkness retreats, but cautions against anyone seeking to use the retreat for some sort of natural high.

    “If somebody’s coming here because they want to have a so-called DMT experience, you’ve come into the wrong place,” he said. “But there is a lot of benefit in not looking outside of ourselves for confirmation of our worth and using the darkness to illuminate our true nature.”

    For those who aren’t able to commit the time or money for a darkness retreat but want a taste of some of the benefits, Berman suggests starting small at home.

    “It’s about becoming accustomed to authentically slowing down, putting the phone away, turning out the lights, closing the blinds and just resting,” he said. “Not to get somewhere, not to heal but just to be curious about what’s actually happening within yourself.”

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  • Pentagon’s suicide prevention committee recommends age limit and waiting period for on-base gun purchases | CNN Politics

    Pentagon’s suicide prevention committee recommends age limit and waiting period for on-base gun purchases | CNN Politics

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    CNN
     — 

    A suicide prevention committee that was established by the Pentagon last year is recommending instituting a waiting period for gun purchases on bases and raising the minimum age for buying firearms in an attempt to reduce the number of suicides among service members.

    The Suicide Prevention and Response Independent Review Committee (SPRIRC) announced the suggested measures as part of a broader set of 127 recommendations to reverse the current trend of suicides in the military, which has steadily increased over the last 15 years.

    The committee recommended putting in place a seven day waiting period for gun purchases on Defense Department facilities and a four day waiting period for ammunition purchases.

    The committee was created by Defense Secretary Lloyd Austin in May 2022 to review the Department of Defense’s ongoing suicide prevention efforts. The committee submitted a first set of 10 recommendations to Austin in December before submitting its latest report.

    Dr. Craig Bryan, one of the members of the committee, said a high percentage of suicides on base involved guns purchased at base military exchanges.

    “There’s a very strong scientific basis showing that waiting period, even as short as seven days, significantly reduce suicide rates,” said Bryan, a lethal means safety expert, in urging the Defense Department to “follow the science.”

    The committee also recommended raising the minimum age to purchase weapons on base to 25 years old.

    “There’s arguably only one thing that all researchers agree on,” said Bryan, “and that one thing is that taking steps to slow down convenient access to highly lethal methods like firearms is the single most effective strategy for saving lives.”

    According to the Defense Department’s annual report, 519 service members died by suicide in 2021, the most recent number for which numbers are available. Though the latest figure is a slight decrease from the previous year’s 582 suicides, the overall number has still been trending upward.

    “We will review those closely,” said Pentagon press secretary Brig. Gen. Pat Ryder of the latest recommendations. “I don’t have anything to announce today in terms of what steps we may take, but again this is a very important topic to the Secretary and to the entire Department of Defense.”

    However, Dr. Rajeev Ramchand, an epidemiologist with the RAND corporation and another member of the SPRIRC, told reporters on Friday that service members the committee spoke with said they felt the Defense Department’s “current approach … was more of a check-the-block approach” and that suicide prevention was “not discussed frequently.”

    Ramchand gave an example of a series of required suicide prevention trainings that took place over a course of several days, saying service members sat in a dark auditorium where many of them fell asleep or “were on their phones.”

    “It’s hard to think this is having an effect,” Ramchand said.

    In addition to gun safety regulations, the committee also urged the Defense Department to address the lack of mental health services available for service members, including hiring psychologists and other mental health specialists quickly.

    “When service members were getting into care, they might not be seen for their second visit for about 6 weeks,” said Rebecca Blais, a sexual assault and suicide expert who is on the committee.

    Often, when job openings in mental health services were posted, the hiring process could drag out over a year, at which point the psychologist or other professional was no longer available, Blais said.

    In cases where mental health services were not available or already booked, the committee urged the Defense Department to increase insurance payments so service members could seek mental health experts outside of the military’s healthcare system.

    Editor’s Note: If you or a loved one have contemplated suicide, call The National Suicide and Crisis Lifeline at 988 or 1-800-273-TALK (8255) to connect with a trained counselor.

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  • Fetterman checked himself into hospital ‘to receive treatment for clinical depression,’ office says | CNN Politics

    Fetterman checked himself into hospital ‘to receive treatment for clinical depression,’ office says | CNN Politics

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    Editor’s Note: If you or someone you know is struggling with mental health, please call the Suicide & Crisis Lifeline at 988 to connect with a trained counselor or visit 988lifeline.org.



    CNN
     — 

    Democratic Sen. John Fetterman of Pennsylvania checked himself into Walter Reed National Military Medical Center “to receive treatment for clinical depression,” his chief of staff announced on Thursday.

    “On Monday, John was evaluated by Dr. Brian P. Monahan, the Attending Physician of the United States Congress. Yesterday, Dr. Monahan recommended inpatient care at Walter Reed. John agreed, and he is receiving treatment on a voluntary basis,” Chief of Staff Adam Jentleson said in a statement.

    Fetterman is a freshman senator and was elected in November after suffering a stroke in May of last year.

    Senate candidate who had a stroke gives interview. Hear what Dr. Gupta noticed

    Fetterman’s wife, Gisele, said on Thursday that she is “so proud of him for asking for help.”

    “After what he’s been through in the past year, there’s probably no one who wanted to talk about his own health less than John. I’m so proud of him for asking for help and getting the care he needs,” she tweeted.

    She went on to say, “This is a difficult time for our family, so please respect our privacy.”

    The statement from Fetterman’s chief of staff announcing the news said, “After examining John, the doctors at Walter Reed told us that John is getting the care he needs, and will soon be back to himself.”

    it also stated that Fetterman has experienced depression “off and on” over the course of his life, the issue “only became severe in recent weeks.”

    Last week, Fetterman’s office announced that after feeling lightheaded, Fetterman went to the George Washington University hospital. He was discharged two days later, and his office said that test results had been able to “rule out a new stroke.”

    Lawmakers on both sides of the aisle expressed support for Fetterman on Thursday.

    Senate Majority Leader Chuck Schumer said he is happy to hear the senator is “getting the help he needs.”

    “Millions of Americans, like John, struggle with depression each day. I am looking forward to seeing him return to the Senate soon. Sending love and support to John, Gisele, and their family,” Schumer tweeted.

    This story has been updated with additional developments.

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  • New York City directive to potentially involuntarily commit someone suffering a mental health crisis can proceed, court rules | CNN

    New York City directive to potentially involuntarily commit someone suffering a mental health crisis can proceed, court rules | CNN

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    CNN
     — 

    A New York City directive allowing first responders to enforce a state law that allows them to potentially involuntarily commit people experiencing a mental health crisis can proceed after facing legal challenges by mental health advocates, a judge has ruled.

    The ruling, issued Monday by U.S. District Judge Paul Crotty in the Southern District of New York, denied a motion brought by individuals and mental health organizations in December. The legal challenge asked a judge to issue a temporary restraining order and preliminary injunction against the city’s implementation of the policy.

    The motion was filed on December 8 as part of an existing lawsuit that alleges New York City has consistently failed to provide safe and appropriate care to New Yorkers experiencing mental health crises. The plaintiffs argued the city’s plan is unconstitutional and violates an individual’s “freedom to live without unlawful seizures and excessive force by law enforcement.”

    New York City Mayor Eric Adams first announced the directive in November as part of an attempt to address concerns about homelessness and crime.

    Adams said it was a myth that first responders can only involuntarily commit those who displayed an “overt act” showing they may be suicidal, violent or a danger to others, CNN previously reported. Instead, he said the law allowed first responders to involuntarily commit those who cannot meet their own “basic human needs” – a lower bar.

    Nicholas Paolucci, the director of public affairs at the New York City Law Department, said in a statement to CNN that the defendants are “pleased the court agreed plaintiffs have no legal standing to halt the Mayor’s sound and compassionate plan.”

    As part of the city’s plan, New York Police Department officers and first responders will get additional training to help them make such evaluations and a team of mental health technicians will be available, either via a hotline or video chat, to help them determine whether a person needs to be taken to a hospital for further evaluation, CNN previously reported.

    The city also plans to develop specialized intervention teams to work side by side with NYPD officers.

    Adams said first responders weren’t consistently enforcing the law because they were unsure of its scope, reserving it only for cases that appeared the most serious.

    New York state enacted a law in 2021 to allow first responders to involuntarily commit a person with mental illness who needs immediate care. The directive led to a mixed response from officials, who acknowledged the challenges of properly and humanely treating mentally ill people.

    “This is a longstanding and very complex issue,” NYPD Commissioner Keechant Sewell said in a statement. “We will continue to work closely with our many partners to ensure that everyone has access to the services they require. This deserves the full support and attention of our collective efforts.”

    Mental health advocates argued in their legal challenge that the city’s policy will authorize officers with “little to no expertise in dealing with individuals with mental disabilities…to determine whether an individual should be forcefully – often violently – detained against their will.”

    “If the Involuntary Removal Policy is permitted to continue to be implemented, Plaintiffs and countless other New Yorkers will suffer irreparable harm, including a substantially increased likelihood that they will be subjected to unlawful detention and involuntary hospitalization just for exhibiting behavior perceived by a police officer to be unusual – whether the individual has a mental disability or not,” the advocates’ December motion stated.

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  • What experts say about exercising when you’re tired | CNN

    What experts say about exercising when you’re tired | CNN

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    Editor’s Note: Seek advice from a health care provider if you have chronic sleep loss and also prior to starting a workout program.



    CNN
     — 

    It’s the end of another long day at the office after a poor night’s sleep. As usual, you’re exhausted, yet you want to stop at the gym on the way home to get the exercise you need to stay healthy.

    Should you work out when you are suffering from chronic sleep loss?

    This conundrum is a widespread problem, considering 1 in 3 Americans are sleep deprived, according to the US Centers for Disease Control and Prevention.

    “It is definitely a bidirectional relationship, not one or the other,” said Dr. Phyllis Zee, director of the Center for Circadian and Sleep Medicine at Northwestern University’s Feinberg School of Medicine in Chicago.

    “First, there is clear data to show that regular exercise improves sleep quality — moderate exercise in the morning, afternoon or very early evening can improve deep sleep,” Zee said.

    Deep sleep is the healing stage in which your body repairs and restores itself. Also called “slow wave” sleep, it can only be achieved if your sleep quality is good, with few to no nighttime interruptions.

    “Research also shows that if you sleep better, you’re more likely to be able to engage in exercise and your physical activity levels are going to be higher,” Zee said.

    “So I would say that even if you have had a bad night’s sleep, you should maintain your physical activity.”

    To be healthy, the body needs to move through four stages of sleep several times each night. During the first and second stages, the body starts to decrease its rhythms. Doing so prepares us for the third stage — a deep, slow-wave sleep where the body is literally restoring itself on a cellular level, fixing damage from the day’s wear and tear and consolidating memories into long-term storage.

    Rapid eye movement sleep, called REM, is the final stage in which we dream. Studies have shown that missing REM sleep may lead to memory deficit and poor cognitive outcomes as well as heart and other chronic diseases and an early death.

    On the flip side, years of research has found sleep, especially the deepest, most healing kind, boosts immune functioning.

    Since each sleep cycle is roughly 90 minutes long, most adults need seven to eight hours of relatively uninterrupted slumber to achieve restorative sleep and be healthy, according to the CDC. Sleep debt, along with irregular sleep duration, has been linked to an increased risk of obesity, heart disease, dementia and mood disorders such as anxiety and depression.

    One night of poor sleep shouldn’t have to impact your workout routine, but chronic sleep deprivation leading to multiple days of exhaustion is another matter, experts say.

    It may not be wise to hit the gym or play a sport when you’re barely putting one foot in front of the other, said sleep specialist Dr. Raj Dasgupta, an associate professor of clinical medicine at the University of Southern California’s Keck School of Medicine.

    “Without sleep, your muscles can’t recover from the stress you put them through during workouts. It doesn’t do you much good to keep breaking down your muscles without giving them time to recover and grow stronger,” Dasgupta said.

    In addition, you’re more likely to suffer an injury when you’re exhausted, he explained, due to slowed reaction times from your tired brain working to make decisions during the workout or sport.

    “Poor sleep can also affect your motivation to exercise in the first place. You might find yourself dreading your normal workouts and hating every minute in the gym, which is not good for long-term adherence to a fitness plan,” Dasgupta said.

    In addition, sleep deprivation can lead you to make poor food choices, which affect your fitness and physical performance, he said.

    So it’s not a good idea to work out while extremely tired, but you will also sleep better and get more out of exercise if you do. What’s the answer?

    Use common sense, Zee said. “If you’re not sleeping well, don’t go for that intense workout, right? Walk or do yoga instead, but certainly maintain an exercise or physical activity regimen at the regular time of the day that you normally would be doing it.”

    If you’re pressed for time, consider fitting in several short bouts of exercise throughout your day.

    “Everything counts,” Dasgupta said. “Do anything that makes you feel happy and refreshed. This is about hitting the reset button for yourself, not doing some form of exercise because you feel obligated to.”

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  • New 988 mental health crisis line sees ‘eye-opening’ rise in calls, texts, chats in first 6 months, data shows | CNN

    New 988 mental health crisis line sees ‘eye-opening’ rise in calls, texts, chats in first 6 months, data shows | CNN

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    CNN
     — 

    Since the summer launch of the 988 Suicide and Crisis Lifeline, the new three-digit number has seen a significant rise in call volume – routing more than 2 million calls, texts and chat messages to call centers, with the majority being answered in under a minute.

    “The average speed to answer year-over-year was about three minutes in 2021. It’s now 44 seconds in December of 2022,” said Dr. John Palmieri, a senior medical advisor at the US Department of Health and Human Services’ Substance Abuse and Mental Health Services Administration, who serves as 988’s deputy director.

    The 988 Suicide and Crisis Lifeline, formerly known as the National Suicide Prevention Lifeline, launched last July, transitioning the former 1-800-273-TALK phone number to the three digits of 988. The new number is intended to be easy to remember, similar to how people can dial 911 for medical emergencies.

    Since that transition, in the past six months, about 2.1 million calls, texts and chats to the new 988 number have been routed to a response center and, of those, around 89% were answered by a counselor, according to a CNN analysis of data from SAMHSA, which oversees 988. Many of the calls that went unanswered were due to callers hanging up before reaching a counselor.

    “We know that there are many individuals in this country who are struggling with suicidal concerns, with mental health or substance use concerns, who aren’t able to access the care that they need. And in many respects, historically, because of funding limitations or other limitations, the system has let them down,” Palmieri said. “So, this is truly an opportunity with 988 – as a catalytic moment – to be able to transform the crisis care system to better meet those needs in a less restrictive, more person-centered, more treatment- and recovery-oriented way.”

    Since the summer launch of 988, more than 300,000 calls, texts and chats have come in each month. SAMHSA data on the new lifeline show that in December 2022 versus December 2021, calls answered increased by 48%, chats answered increased by 263% and texts answered increased by 1,445%.

    “We see the uptick in volume as an indicator that more people are aware of the service and able to access it,” Kimberly Williams, CEO and president of Vibrant Emotional Health, the nonprofit administrator and operator of the 988 lifeline, said in an email Thursday.

    She added that Vibrant was “not surprised” by the increase in volume and has been “working strategically” with the more than 200 call centers in the 988 network to respond.

    “In December of 2022 compared to December of 2021, over 172,000 more contacts were answered as part of the lifeline system,” Palmieri said.

    The average amount of time counselors spent talking, chatting or texting with contacts was about 21 minutes and 55 seconds.

    “It’s really eye-opening to see the increase in the texts, chats and calls that are coming in. But to see that more states have a more than 90% answer rate for contacts coming from their state – and that average speed of answering is down, so people are getting help more quickly,” said Hannah Wesolowski, the chief advocacy officer for the National Alliance on Mental Illness.

    She added that before the launch of 988, there were likely many people seeking mental health support but didn’t feel like there was a call service available for them.

    “With the National Suicide Prevention Lifeline, even though they did answer a range of crises, it was billed as the ‘National Suicide Prevention Lifeline.’ So a lot of people who are not feeling suicidal but were in distress didn’t feel like that was a resource for them,” Wesolowski said.

    “I think awareness of 988 continues to grow each month,” she said. “This country is in a mental health crisis at large. I believe that many more people are feeling that they’re approaching a crisis situation or are in crisis.”

    The 988 lifeline also has been testing a pilot program specifically for the LGBTQ+ community, in partnership with the Trevor Project, in which calls, texts or chats from LGBTQ+ youth have the option of being connected with counselors specially trained in LGBTQ-inclusive crisis care services.

    The pilot program began around the end of September, and “there has been a lot of demand and a lot of utilization of that service,” Palmieri said. He added that LGBTQ+ youth are at a higher risk of suicide.

    “With that pilot program, it is so important that particularly a young person who’s feeling alone, who’s feeling isolated, is able to connect to somebody that they feel can share their experience and that comes from a similar place of understanding,” Wesolowski said. “I’m very anxious to see what the data shows when the pilot ends in March, but I feel very encouraged by my conversations with the Trevor Project and others involved in this.”

    Since its launch, the 988 lifeline also has increased the number of call centers taking Spanish calls from a total of three to seven. Spanish language options will increase for text and chat messaging as well, Palmieri said.

    “We are also implementing video phone capabilities for people who are deaf and hard of hearing,” he said.”In addition to that, in Washington state, there’s a pilot currently providing specialized care access for individuals who are American Indian/Alaskan Natives to be able to be connected to an organization that’s focused more specifically on their needs.”

    HHS announced in December that through SAMHSA, more than $130 million has been awarded in grants to support the 988 Suicide and Crisis Lifeline. The funding comes from the Bipartisan Safer Communities Act. The federal spending omnibus bill includes about $500 million for the 988 Suicide & Crisis Lifeline, according to SAMHSA.

    In total, the Biden administration has invested nearly $1 billion in the 988 lifeline.

    “Our country is facing unprecedented mental health and substance use crises among people of all ages and backgrounds,” HHS Secretary Xavier Becerra said in the announcement last month.

    “Although rates of depression and anxiety were rising before the pandemic, the grief, trauma, and physical and social isolation that many people experienced during the pandemic exacerbated these issues. Drug overdose deaths have also reached a historic high, devastating individuals, families, and communities,” he said. “The significant additional funding provided by the Bipartisan Safer Communities Act will have a direct positive impact on strengthening the behavioral health of individuals and communities across the country.”

    The 988 lifeline is just one tool in the ongoing effort to improve our nation’s mental health, which Lori Tremmel Freeman, chief executive officer of the National Association of County and City Health Officials, calls “a key concern of public health” right now.

    “It is also one of the root causes of substance abuse and misuse, which is fueling the national epidemic that we have. We’re also concerned about, of course, rates of suicide and what we can do to alleviate and lower those rates,” Freeman said.

    “This is very much also a primary public health crisis of concern and leads to many other public health issues that need to be addressed: homelessness, food insecurity, substance misuse, and poor health outcomes,” she said. “We need to get people healthy and well, and connected to the right resources and professionals that can help them overcome their mental health crises.”

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  • Why experts worry TikTok could add to mental health crisis among US teens | CNN Business

    Why experts worry TikTok could add to mental health crisis among US teens | CNN Business

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    New York
    CNN
     — 

    Jermone Yankey said he used to pull all-nighters when he was in college – not studying or partying, but scrolling on TikTok until the sun came up.

    “I saw me not putting the effort into my own life, rather just trying to live vicariously through what I’m seeing,” said 23-year old Yankey. He said he lost sleep, his grades suffered, and he fell out of touch with friends and himself.

    In 2021, he deleted the app. The positive impact, he said, was obvious. “It’s so great to be able to be sleeping again starting at midnight,” he said. “It’s great to be able to be up early and be more productive with the sun.”

    In recent months, TikTok has faced growing pressure from state and federal lawmakers over concerns about its ties to China through its parent company, ByteDance. But some lawmakers and researchers have also been scrutinizing the impact that the short-form video app may have on its youngest users.

    GOP Rep. Mike Gallagher, the incoming chairman of a new House select committee on China, recently called TikTok “digital fentanyl” for allegedly having a “corrosive impact of constant social media use, particularly on young men and women here in America.” Indiana’s attorney general filed two suits against TikTok last month, including one alleging that the platform lures children onto the platform by falsely claiming it is friendly for users between 13 to 17 years old. And one study from a non-profit group claimed TikTok may surface potentially harmful content related to suicide and eating disorders to teenagers within minutes of them creating an account.

    TikTok is far from the only social platform to be scrutinized by lawmakers and mental health experts for its impact on teens. Top execs from several companies, including TikTok, have been grilled in Congress on the matter. And this week, Seattle Public Schools sued social media companies like Facebook, Instagram, TikTok, Snapchat and YouTube alleging the platforms have been “causing a youth mental health crisis,” making it hard for the school system “to fulfill its educational mission.”

    But psychologist Dr. Jean Twenge said TikTok’s algorithm in particular is “very sophisticated” and “very sticky,” which keeps teens engaged on the platform longer. TikTok has amassed more than one billion global users. Those users spent an average of an hour and a half per day on the app in last year, more than any other social media platform, according to the digital analytics platform SensorTower.

    “A lot of teens describe the experience of going on TikTok and intending to spend 15 minutes and then they spend two hours and or more. That’s problematic because the more time a teen spends on social media, the more likely he or she is to be depressed. And that’s particularly true for at the extremes of use,” said Twenge.

    That may only compound a longer-term rise in mental health issues, partly fueled by technology. Psychologists say as smartphones and social media grew around 2012, so did the rate of depression among teens. Between 2004 and 2019 the rate of teen depression nearly doubled, according to the Substance Abuse and Mental Health Services Administration. And for teen girls its worse. By 2019, one in four US girls have experienced clinical depression, according to Twenge.

    TikTok said it has tools to help users set limits for how long they spend on the app each day. TikTok also continues to roll out other safeguards for its users, including ways to filter out mature or “potentially problematic” videos and more parental controls.

    “One of our most important commitments is supporting the safety and well-being of teens, and we recognize this work is never finished. We continue to focus on robust safety protections for our community while also empowering parents with additional controls for their teen’s account through TikTok Family Pairing,” TikTok said in a statement to CNN.

    The company said between April and June of 2022 it removed 93.4% of videos on self-harm and suicide from the app before they were ever viewed. But teens say it’s not the most egregious videos that keep them engaged. It’s the content programmed to them in the “For You” section of the app.

    “It’s so curated to you,” said Angelica Faustino, an 18-year-old sophomore at the University at Buffalo, who says she spends 3 to 4 hours a day on TikTok.

    “There is a lot of body checking on TikTok – a lot of people showing off things about themselves that are maybe unachievable. You see if enough times you are like maybe I should be that way,” said Faustino.

    For all the concerns, however, there are signs that TikTok and other social networks can have a positive impact on younger users, too.

    The majority of teens say social media can be a space for connection and creativity, according to Pew Research. Eight in 10 teens ages 13-17 say social media makes them feel more connected to what’s going on in their friends lives and 71% say social media is a place they can be creative, according to Pew.

    And some in Gen Z, the generation that has been raised on TikTok, have found unique opportunities on the platform.

    Hannah Williams spends her time on TikTok running her business, Salary Transparent Street. She interviews everyday Americans about the salary they make at their jobs, providing pay transparency to her nearly 1 million followers.

    “I quit my job in May of 2022 to work on my social media page on Tik Tok full time because I saw a great opportunity to do something with my career,” said 26 year-old Williams.

    “I think it’s interesting that we can try to use social media to really impact the world for good,” she said, “and I’m hoping that’s what happens.”

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  • Seattle public schools sue social media companies for allegedly harming students’ mental health | CNN Business

    Seattle public schools sue social media companies for allegedly harming students’ mental health | CNN Business

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    CNN
     — 

    Seattle’s public school system on Friday filed a lawsuit against several Big Tech companies alleging their platforms have a negative impact on students’ mental health and claiming that has impeded the ability of its schools “to fulfill its educational mission.”

    The lawsuit was filed against the parent companies of some of the most popular social media platforms, including Facebook, Instagram, TikTok, Snapchat and YouTube.

    The school district, which is the largest in the state of Washington with nearly 50,000 students, alleges in the suit that the companies “have successfully exploited the vulnerable brains of youth” to maximize how much time users spend on their platforms in order to boost profits. The actions taken by the platforms, according to the suit, have “been a substantial factor in causing a youth mental health crisis, which has been marked by higher and higher proportions of youth struggling with anxiety, depression, thoughts of self-harm, and suicidal ideation.”

    The school district said students experiencing anxiety, depression, and other mental health issues perform worse in school, are less likely to attend school, more likely to engage in substance use, and to act out. The district said it continues to take additional steps to train teachers and screen students for mental health symptoms who may need further support but it needs a comprehensive, long-term plan and funding amid the growing mental health crisis today’s “youth are experiencing at [the companies’] hands.”

    The school district is seeking unspecified monetary damages.

    The lawsuit comes more than a year after executives from social media platforms faced tough questions from lawmakers during a series of congressional hearings over how their platforms may direct younger users – and particularly teenage girls – to harmful content, damaging their mental health and body image. While a growing number of families have filed lawsuits against social media companies for their alleged impact on the mental health of their children, it’s unusual to see a school district take such a step.

    In a statement sent to CNN on Monday, Antigone Davis, Meta’s global head of safety, said it continues to pour resources into ensuring its young users are safe online. She said the platforms have more than 30 tools to support teens and families, including supervision tools that let parents limit the amount of time their teens spend on Instagram, and age verification technology that helps teens have age-appropriate experiences.

    “We’ll continue to work closely with experts, policymakers and parents on these important issues,” she said.

    The other companies did not immediately respond to requests for comment.

    In the past year, a number of prominent social media platforms have introduced more tools and parental control options aimed at better protecting younger users amid mounting scrutiny.

    TikTok, which has faced pressure from lawmaker both for its potential impact on younger users and its ties to China, announced in July that it would introduce new ways to filter out mature or “potentially problematic” videos. The added safeguards allocate a “maturity score” to videos detected as potentially containing mature or complex themes. TikTok also rolled out a tool that aims to help people decide how much time they want to spend on the app.

    Snapchat, meanwhile, has introduced a parent guide and hub aimed at giving guardians more insight into how their teens use the app. That includes more information about who their kids have been talking to over the last week, without divulging the content of those conversations.

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  • Opinion: A New Year’s resolution we all need to embrace | CNN

    Opinion: A New Year’s resolution we all need to embrace | CNN

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    Editor’s Note: Sophia A. Nelson is a journalist and author of the book “Be the One You Need: 21 Life Lessons I Learned Taking Care of Everyone but Me.” The views expressed in this commentary are her own. View more opinion on CNN.



    CNN
     — 

    It’s the start of another year, and we are still working our way through a once-in-a-generation, life-changing pandemic almost three years after it began. We’ve all been affected by Covid-19’s scourge of sickness, hospitalization, death, loneliness, isolation, work dislocation and family disruption. Perhaps, like me, you even got sick with the coronavirus and are living with its long-term effects.

    When Covid-19 hit, workers in teaching, nursing, hospitality and retail — occupations where women predominate — bore a fair part of the burden associated with the disease. And no group felt this more acutely than Black and brown women.

    Women struggle to balance self-care against filling the needs of their families. But for Black women, juggling those competing needs often comes against a backdrop of intergenerational trauma and suppression of their emotions.

    In the Black community, women have perfected obsessive selflessness to an art form. We end up exhausted, emotionally drained — and in many cases, unhealthy — because we are conditioned to serve the needs of others and display superhuman strength — to our own detriment. I have lost friends, sorority sisters and mentors to hypertension-induced strokes, heart attacks, diabetes complications and plain old exhaustion from a lack of meaningful self-care.

    The effects of environmental stress on Black women are severe. One study found that by the time a Black woman reaches her 50s, the toll of stress on her body has resulted in an additional seven years of biological aging compared with White women. Black women are more likely to die from breast cancer, heart disease and diabetes, too.

    Northwestern University clinical psychologist Inger Burnett-Zeigler addressed the downside of viewing the strong Black woman as a “cultural icon” in her book, “Nobody Knows the Trouble I’ve Seen: The Emotional Lives of Black Women.”

    “Some Black women do not have the necessary tools to cope with their feelings in a healthy way and, as a result, may engage in unhealthy coping strategies such as eating unhealthy foods, drinking alcohol, using illicit drugs, being sedentary or a workaholic. While these behaviors may offer a Band-aid to the problem, they are not a long-term solution,” she said in an interview discussing the work that was published last year.

    In short, for Black and brown women, focusing on self-care is a matter of survival. But some of us needed the additional wake-up call that came from confronting the pandemic.

    My own Covid-19 journey started in February 2020 when I came down with an early case before we had testing or vaccines. I contracted the disease while speaking at a conference in Louisiana. I was sick for a week with a high fever, respiratory distress and other complications.

    I got a second, milder case in August 2021 after being vaccinated and boosted. I was lucky enough not to have to be hospitalized during either episode, but I still suffer the effects of long Covid-19, including some heart valve damage and residual issues with my right lung. Living with these infirmities means prioritizing the vital self-care I might otherwise have ignored.

    By self-care, I don’t mean going to the beach or taking a vacation. That is respite.

    The kind of self-care I want to see Black women practice is the kind that liberates the soul. The kind that allows us to be our authentic selves. The kind that frees us to wear our hair how we want, to speak our truths, to seek healthier romantic partners and build better friends. And it’s the kind of self-care that lasts a lifetime.

    The good news is that despite the heaviness of our times, we see examples of prominent Black women saying enough is enough — it’s time to put our wellness first. Women such as Olympic gymnast Simone Biles, tennis star Naomi Osaka and actress Taraji P. Henson have spoken openly about the importance of their mental health to their overall well-being.

    As a Black woman now in her 50s, it took me years to learn that although my family and friends matter, I matter most of all. I’ve learned that I have a right to joy, to peace and to self-care, too. I wrote about those hard-knock lessons in my fourth book, “Be the One You Need.”

    My hope was that by sharing just a few of my own life experiences, I can help educate and inspire a new generation of Black girls and women to embrace lives filled with self-care, hope, joy, physical and emotional wellness.

    But even if you’re neither Black nor a woman, these lessons can benefit you as well. Start by asking yourself three important questions: What do I want? What do I need? How am I really feeling? Your inner voice will provide the answers. Trust that you will find the courage to follow through on the wisdom you already possess.

    Here are three more things to bear in mind as you focus on your emotional wellness this new year:

    1. Self-care is a life strategy for success. It’s about setting healthy boundaries and ensuring that those boundaries are respected by others. It requires that you change you first and that you accept you can never change others.

    2. Prioritize your mental and emotional health above all else. You’re no good to anyone if you’re not good to yourself. Your mental and emotional well-being is one of the many “health verticals” you must tend to, just as you might regularly monitor your weight, heart health or blood pressure.

    3. “No” is a complete sentence. This one has really saved me a lot of heartache, unspoken resentment and time. I no longer do the things I do not want to do, to please others. I reserve my energy for only those things and people that are worth my energy.

    Women in general, and Black women specifically, often find it hard to say no. But it’s what you sometimes must do, even when your kids have endless requests, your boss has demands, and friends who have supported you in the past are in a crisis. And the reason for centering your own needs is implied in the subtitle of my book “Life Lessons I Learned Taking Care of Everyone but Me.” It’s simply not sustainable.

    Generations of Black women have watched our mothers, grandmothers and aunts do, give, run, lift, build up, sacrifice, protect and offer up themselves to anyone and everyone in need. This new year, we all have an opportunity to do better for ourselves.

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  • This year’s top health-related Google searches are in, and Covid-19 is nowhere to be found | CNN

    This year’s top health-related Google searches are in, and Covid-19 is nowhere to be found | CNN

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    Editor’s Note: Sign up for CNN’s Stress, But Less newsletter. Our six-part mindfulness guide will inform and inspire you to reduce stress while learning how to harness it.



    CNN
     — 

    You can learn a lot from a search history.

    This month, Google released its annual “Year in Search” list to show which terms saw the highest spikes over the past year. The roundup offers some insight into what internet users around the world cared about, were curious about and concerned about in 2022.

    One big topic is noticeably absent this year: Covid-19. Last year, vaccination and preventing infection were of great interest, but this year saw no mention of coronavirus in the top health and wellness searches.

    Instead, this year’s searches focused on physical and mental recovery — how to get stronger physically and how to cope with issues like anxiety, depression, attention deficit hyperactivity disorder and obsessive-compulsive disorder.

    Here’s a breakdown of 2022 in Google searches and some ways to address these topics going into 2023.

    Workouts were a big focus of conversation this year: “Body weight workouts,” “weekly workouts,” “exercising for mental health,” and “core workouts at the gym” all were among the popular health searches.

    Body-weight workouts are a good access point for exercise because you don’t need expensive equipment, and you can build a foundation for eventual weight training, said Dana Santas, CNN fitness expert and a mind-body coach in pro sports, in a previous story.

    She laid out a 10-minute workout to get started.

    Try this 10-minute body-weight workout


    10:46

    – Source:
    CNN

    If you are looking to go further and build a regular exercise routine, a 2021 megastudy found that the keys are to make a plan, build in reminders and reward yourself for sticking to it.

    Google users asked “how to handle stress,” “how to stop a panic attack,” “how to cure depression” and “focus with ADHD.” They also looked up good mental health practices for little ones, with searches for breathing exercises for kids.

    It might not be surprising that many people were focused on coping and stress, especially in light of an ongoing global pandemic, economic concerns, and the adjustments associated with returning to school and workplaces.

    While stress is a normal physiological reaction that all people experience, it can slide into a severe condition like anxiety or depression if left unchecked. One thing to look for is whether the feeling goes away after a stressful event has ended, said Dr. Gail Saltz, clinical associate professor of psychiatry at the NewYork-Presbyterian Hospital in New York City.

    Stress can also exacerbate mental conditions like depression and obsessive-compulsive disorder, Saltz said in a 2021 interview with CNN.

    If you suspect you might have chronic stress or another mental health disorder, you should talk to a trusted friend or family member to see whether they have noticed differences and reach out to a mental health professional, said Dr. Alfiee Breland-Noble, psychologist and founder of the AAKOMA Project, a youth mental health nonprofit, in a 2021 story.

    The quest for better mental and physical health didn’t stop at a quick internet search, according to the data.

    Among the popular terms were searches for more resources on mental health, like books, podcasts and journaling techniques aimed at improving wellness.

    “Expressive writing works for a number of reasons,” said James Pennebaker, a psychologist, researcher and professor at the University of Texas at Austin. Acknowledging an upsetting event has value, he added in a previous CNN story. “And writing about it also helps the person find meaning or understand it.”

    There are also guided and formatted journals to help keep you going.

    One significant change this year was the addition of the National Suicide Prevention Lifeline for mental health crises. The number is as simple as three digits: 988.

    Those numerals were among the health-related searches that saw a surge this year.

    The dialing code is available across the United States and is meant to be easier to access for people in mental health crises, similar to 911.

    “One of the goals of 988 is to ensure that people get the help they need when they need it, where they need it. And so, when a person calls 988, they can expect to have a conversation with a trained, compassionate crisis counselor who will talk with them about what they’re experiencing,” said Dr. Miriam Delphin-Rittmon, the administrator of the US Department of Health and Human Services’ Substance Abuse and Mental Health Services Administration in an interview with CNN in July.

    “If it’s the case that they need further intervention, then likely the crisis counselor will connect them with a local mobile crisis team,” she added.

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  • Prince Harry says William ‘screamed’ at him over royal split with Meghan, in final episodes of Netflix documentary | CNN

    Prince Harry says William ‘screamed’ at him over royal split with Meghan, in final episodes of Netflix documentary | CNN

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    CNN
     — 

    Prince Harry said it was “terrifying” to have his brother, Prince William, scream at him during his bitter split from the royal family, in the final installments of the Duke and Duchess of Sussex’s controversial Netflix documentary that were released Thursday.

    The fourth, fifth and sixth episodes of “Harry & Meghan” cover the pair’s challenges since their 2018 wedding, Meghan’s deteriorating mental health and her 2020 miscarriage, and ultimately their decision to quit as working members of the family.

    Harry said he initially asked for a “half in, half out” arrangement, where Harry and Meghan would have their own jobs but still work in support of the Queen, during a crunch family meeting. “But it became very clear very quickly that that goal was not up for discussion or debate,” Harry said.

    “It was terrifying to have my brother scream and shout at me, and my father say things that just simply weren’t true, and my grandmother quietly sit there and take it all in,” he said, recalling the conversations with Prince William, then-Prince Charles, and Queen Elizabeth II.

    “But you have to understand that from the family’s perspectives, especially from hers, there are ways of doing things. And her ultimate mission and goal, responsibility, is the institution … she’s going to go on the advice that she’s given,” Harry said.

    The pair describe throughout the new episodes how, in their view, their position within the royal family became untenable after constant hounding from Britain’s media and repeated disregard for the couple’s wellbeing inside palace walls.

    Buckingham Palace reiterated it will not comment on the documentary on Thursday. Royal engagements are meanwhile continuing, with King Charles and Camilla, the Queen Consort, set to visit a community kitchen in London and attend a carol service with the Prince and Princess of Wales and other members of the family.

    Harry hinted that there was jealousy from other royals towards Meghan given the amount of media attention she was initially receiving. “The issue is when someone who is marrying in, who should be a supporting act, is then stealing the limelight or is doing the job better than the person who is born to do this,” he said.

    “That upsets people. It upsets the balance. Because you have been led to believe that the only way that your charities can succeed and your mission can grow is if you are on the front pages of those newspapers.”

    The series also touches on Meghan’s deteriorating mental health and her miscarriage in July 2020. “I was pregnant. I really wasn’t sleeping. The first morning that we woke up in our new home is when I miscarried,” Meghan said.

    She described experiencing suicidal ideation, telling the filmmakers she believed “all of this will stop if I’m not here. And that was the scariest thing about it, it was such clear thinking.”

    “The lies, that’s one thing. You kind of get used to that when you live within this family,” Harry added. “But what they were doing to her, and the effect it was having on her… enough. Enough of the pain, enough of the suffering.”

    “I just did everything I could to make them proud, and to really be a part of the family,” Meghan said in the fifth episode, speaking of her relationship with the other royals. “And then the bubble burst.”

    “I realized that I wasn’t just being thrown to the wolves, I was being fed to the wolves,” she said.

    The highly anticipated Netflix documentary marks the Sussexes’ latest attempt to reclaim the narrative surrounding their departure from royal life.

    It features details on the increasingly tense relationships between Harry and his brother, WIlliam, and his father, King Charles III. And it emphasizes the suggestion that the royals wanted to sideline and isolate the couple, often through the planting of negative media reporting, rather than have them dwarf more senior royals in popularity.

    “My dad said to me: ‘Darling boy, you can’t take on the media. The media will always be the media,” Harry said, describing the palace’s relationship with news outlets as a “dirty game.”

    The culmination of the breakdown between the royal institution and Harry and Meghan, who were once touted by parts of the media as the modernizing force the monarchy needed, was their historic and controversial decision in early 2020 to quit as working royals and leave the UK.

    Harry said he spoke to Queen Elizabeth II and arranged to meet her, with Meghan, before that split was finalized.

    “She knew that we were finding things hard. I’d spoken to her many times about it,” Harry said. But as the meeting approached, Meghan said they received a message from an aide telling them they were not allowed to see the monarch.

    “I’ve actually been told that I’m busy all week,” the Queen then told Harry, according to his recollection. “I was like, wow,” Harry said. “This is when a family and a family business are in direct conflict … really what they’re doing is blocking a grandson from seeing his grandmother,” added Meghan.

    The couple were critical of the Queen’s aides but again were again complimentary of the late monarch herself, who died aged 96 in September, shortly after filming concluded for the series.

    Their documentary, and Harry’s upcoming memoir, focus more attention on the difficult relationship between the prince and his father, King Charles.

    Thursday’s release follows last week’s batch of episodes, in which Prince Harry criticized “unconscious bias” inside the family.

    It remains to be seen whether the venture will enhance the reputation of the couple as they look to sculpt their post-royalty personas.

    Six in 10 Brits believe it was a bad idea for the duke and duchess to release the Netflix documentary, according to a Savanta poll of 2,250 British adults carried out online between December 9 and 11, between the release of the first and second parts of the series.

    The same poll found that Harry and Meghan both have negative approval ratings among the British public – -3 and -19 respectively, when subtracting those with a negative opinion from those with a positive one – unlike the high popularity of Prince William (+60) and Charles III (+36).

    If you or someone you know is struggling with suicidal thoughts or mental health matters, please call the National Suicide Prevention Lifeline at 800-273-8255 to connect with a trained counselor or visit the NSPL site. The International Association for Suicide Prevention and Befrienders Worldwide also provide contact information for crisis centers around the world.

    Sign up for CNN’s Royal News, a weekly dispatch bringing you the inside track on the royal family, what they are up to in public and what’s happening behind palace walls.

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  • A hard look at New York’s controversial new approach to the homeless | CNN Politics

    A hard look at New York’s controversial new approach to the homeless | CNN Politics

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    A version of this story appeared in CNN’s What Matters newsletter. To get it in your inbox, sign up for free here.



    CNN
     — 

    New York City Mayor Eric Adams gave the city’s first responders, including its police force, a controversial new task this week – to enforce a state law that allows them to involuntarily commit people experiencing a mental health crisis.

    From CNN’s report by Mark Morales:

    Adams said it was a myth that first responders can only involuntarily commit those who displayed an “overt act” that they may be suicidal, violent or a danger to others. Instead, he said the law allowed first responders to involuntarily commit those who cannot meet their own “basic human needs” – a lower bar.

    The police department is still formulating a plan and Adams, a former cop, said officers will get additional training and real-time support from mental health professionals.

    The move follows a raft of violence in New York City and also increasingly visible homeless encampments in New York and cities around the country.

    Adams framed the policy as a way to help people who need it.

    “It is not acceptable for us to see someone who clearly needs help and walk past,” he said.

    Advocates for the homeless oppose this. “The city really needs to approach this more from a health and housing lens, rather than focusing on involuntary removals and policing,” Jacquelyn Simone from the Coalition for the Homeless told CNN’s Brynn Gingras for her report that aired this week on “AC360°.”

    Mental health professionals are questioning it. “We are defaulting to an extreme that takes away basic human rights,” Matt Kudish, CEO of the New York chapter of the National Alliance on Mental Illness, said in a statement after Adams’ announcement.

    Kudish said New York should do more to help people before they need intervention: “The City has the power to provide onsite treatment, as well as treatment in homeless shelters or supported housing, but has chosen not to.”

    Police are worried it puts them in a precarious position. “As soon as they want to resist, now where does the liability form – on the uniformed officer,” retired NYPD detective Andrew Bershad told Gingras.

    I talked to Ryan McBain, a policy researcher at the RAND Corporation who studies how government policies can reach vulnerable populations, including those experiencing both mental illness and housing insecurity.

    McBain argued Adams’ move is “well-intentioned but misguided,” first of all because police interactions with people experiencing serious mental health issues is “fuel for escalation.”

    “It’s something like 1 in 4 people who are shot by a police officer are people with significant mental health issues,” McBain said. When I looked to confirm that 25% figure, I found this in a 2015 Washington Post investigation.

    “If you stop and think about it, it makes sense, right? People who are disoriented or having atypical thoughts, they’re not in a position oftentimes to comply collaboratively with a police officer,” he said. “And given the fact that police officers are carrying weapons, you have sort of a recipe for bad outcomes.”

    There’s evidence, he said, that actually deploying trained mental health professionals alongside police officers would be more effective. In New York, first responders will get additional training and have access to a hotline with mental health professionals.

    Another issue is more systemic and has to do with how the US deals with chronic and serious mental illness, from a system of large institutional asylums that were shuttered in the ’60s and ‘70s to a flawed system focused on private insurance and community-based mental health centers.

    Currently, there aren’t enough beds for psychiatric patients.

    “We don’t need giant asylums where the conditions are inappropriate, but we do need larger facilities with more beds that can provide the type of care that the patients really need when they have more serious mental health issues,” McBain said.

    More permanent supportive housing is required for people who experience both mental health issues and homelessness. But that kind of solution – the public providing housing alternatives for people who cannot provide for themselves – can be expensive and politically difficult.

    RELATED: How one Minnesota county has been rapidly housing the homeless since the pandemic

    It’s a sentiment echoed by Dennis Culhane, a professor of social policy at the University of Pennsylvania, who appeared on “AC360°” on Thursday. “That is the fundamental problem here,” Culhane said. “You cannot actively and effectively treat people without having them in a place where they can take care of themselves.”

    McBain said that in the US health system, which is geared around insurance paying for services, mental health is not treated on par with physical health.

    “In the best of all possible worlds, you’d have a continuum of care for addressing people’s mental health needs,” he said.

    “And that continuum would begin with high-quality outpatient services that private insurers pay for at parity with physical health conditions. … I think until you see the system try to address these issues in a holistic way, these issues are going to continue to persist,” he said, arguing, “Mayor Adams is proposing putting a Band-Aid on something for which you really need sutures.”

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  • Former first lady Rosalynn Carter has dementia, Carter Center says | CNN Politics

    Former first lady Rosalynn Carter has dementia, Carter Center says | CNN Politics

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    Washington
    CNN
     — 

    Rosalynn Carter, the former first lady of the United States and wife of former President Jimmy Carter, has dementia, the Carter Center announced on Tuesday.

    “The Carter family is sharing that former First Lady Rosalynn Carter has dementia. She continues to live happily at home with her husband, enjoying spring in Plains and visits with loved ones,” the center announced. Additional details about Carter, 95, were not immediately provided and the Center said it did not expect to comment further.

    The Center said that, in sharing news of Carter’s diagnosis, it helped to “increase important conversations at kitchen tables and in doctor’s offices around the country.” As first lady, Carter made mental health advocacy her platform and formed a presidential commission on the matter during her time in the White House, a legacy that continues today.

    President Carter, 98, began home hospice care in February after a series of short hospital stays.

    The Bidens have “stayed in touch” with the former president’s team to “ensure that their family knows that they are certainly in the president and first lady’s thoughts,” White House press secretary Karine Jean-Pierre said at a Tuesday press briefing.

    At an event in Norcross, Georgia, last week honoring the former president, President Carter’s former UN ambassador, Andrew Young, described the former president to WSB-TV as being in good spirits during a visit with him last month.

    “They’re coming to the end,” the Carters’ grandson, Jason Carter, said at the event. “He’s going to be 99 in October, but right now, it’s sort of the perfect way for them to spend these last days together at home in Plains. They’re together, and they’ve been together for 70-plus years.”

    Rosalynn Carter traveled across the country and the world as first lady in support of breaking mental health stigmas.

    “Since 1971, Rosalynn had been a champion of mental health issues, and her leadership in this cause continues even now,” President Carter wrote in “White House Diary,” an annotated account of his time in the White House published in 2010.

    Carter continued, “She mounted a worldwide crusade to reduce the stigma associated with mental illness and helped persuade the World Health Organization and Centers for Disease Control to include mental health on their agendas.”

    Dementia is a broad term for an impaired ability to remember, think and make decisions, according to the CDC. People with dementia may have trouble with memory, attention, communication, judgment and problem-solving, and visual perception beyond typical age-related vision changes.

    Dementia is not a normal part of aging, according to the National Institute on Aging, but about one-third of all people age 85 and older may have some form of dementia.

    This story has been updated with additional background information.

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  • Arkansas sues TikTok, ByteDance and Meta over mental health claims | CNN Business

    Arkansas sues TikTok, ByteDance and Meta over mental health claims | CNN Business

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    Washington
    CNN
     — 

    The state of Arkansas has sued TikTok, its parent ByteDance, and Facebook-parent Meta over claims the companies’ products are harmful to users, in the latest effort by public officials to take social media companies to court over mental-health and privacy concerns.

    All three lawsuits claim the companies have violated the state’s Deceptive Trade Practices Act, and seek millions, if not billions, in potential fines. The suits were filed in Arkansas state court.

    The complaints come amid mounting pressure in Washington on TikTok for its ties to China and as states have grown more aggressive in suing tech companies broadly, particularly on mental health claims. Suits by school districts or county officials in California, Florida, New Jersey, Pennsylvania and Washington state have targeted multiple social media platforms over addiction allegations.

    The suit against Meta particularly zeroes in on the company’s impact to young users’ mental health, alleging that Meta’s implementation of like buttons, photo tagging, an unending news feed and other features are addictive and “intended to manipulate users’ brains by triggering the release of dopamine.”

    In a statement, Meta’s global head of safety, Antigone Davis, said the company has invested in “technology that finds and removes content related to suicide, self-injury or eating disorders before anyone reports it to us.”

    “We want to reassure every parent that we have their interests at heart in the work we’re doing to provide teens with safe, supportive experiences online,” Davis said in the statement. “These are complex issues, but we will continue working with parents, experts and regulators such as the state attorneys general to develop new tools, features and policies that meet the needs of teens and their families.”

    The remaining two suits, both naming ByteDance and TikTok as defendants, target TikTok’s alleged shortcomings in content moderation and also reiterate claims about TikTok’s alleged threat to US national security.

    The first suit alleges that TikTok has misled users by identifying its app as suitable for teens on app stores because of the “abundant” presence of content showing profanity, substance use and nudity. The suit further alleges that TikTok’s Chinese sister app, Douyin, does not make such content available within China.

    “TikTok poses known risks to young teens that TikTok’s parent company itself finds inappropriate for Chinese users who are the same age,” the complaint said. “Yet TikTok pushes salacious and other mature content to all young U.S. users age 13 and up.”

    The second suit against ByteDance and TikTok accuse the companies of having made misleading statements about the reach of Chinese government officials and their purported inability to access TikTok user data. TikTok has migrated US user data to servers operated by the American tech giant Oracle and has established organizational controls intended to prevent unauthorized data access. But, the suit alleges, that does not mean the data is necessarily protected.

    “Neither TikTok’s data storage practices, nor its data security practices, negate the applicability of Chinese law to that data or to the individuals and entities who are subject to Chinese law and have access to that data, or the risk of access by the Chinese Government or Communist Party,” the complaint said.

    The suit also claims TikTok has misrepresented its approach to privacy and security by omitting the potential risks of Chinese government access from its privacy policies and in its statements to app store operators.

    TikTok and ByteDance didn’t immediately respond to a request for comment.

    In a statement announcing the lawsuits, Arkansas Gov. Sarah Huckabee Sanders said the suits reflect a “failed status quo.”

    “We have to hold Big Tech companies accountable for pushing addictive platforms on our kids and exposing them to a world of inappropriate, damaging content,” Sanders said. “These actions are a long time coming. We have watched over the past decade as one social media company after another has exploited our kids for profit and escaped government oversight.”

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  • YouTube rolls out new policies for eating disorder content | CNN Business

    YouTube rolls out new policies for eating disorder content | CNN Business

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    CNN
     — 

    YouTube on Tuesday announced a series of changes to how it deals with content related to eating disorders.

    The platform has long removed content that glorifies or promotes eating disorders, and YouTube’s Community Guidelines will now also prohibit content that features behaviors such as purging after eating or extreme calorie counting that at-risk users could be inspired to imitate. For videos that feature such “imitable behaviors” in the context of recovery, YouTube will allow the content to remain on the site but restrict it to users who are logged into the site and are over the age of 18.

    The policy changes, developed in consultation with the National Eating Disorder Association and other nonprofit organizations, aim to ensure “that YouTube creates space for community recovery and resources, while continuing to protect our viewers,” YouTube’s Global Head of Healthcare Garth Graham told CNN in an interview.

    “We’re thinking about how to thread the needle in terms of essential conversations and information that people might have,” Graham said, “allowing people to hear stories about recovery and allowing people to hear educational information but also realizing that the display of that information … can serve as a trigger as well.”

    The changes come as social media platforms have faced increased scrutiny for their effects on the mental health of users, especially young people. In 2021, lawmakers called out Instagram and YouTube for promoting accounts featuring content depicting extreme weight loss and dieting to young users. And TikTok has faced criticism from an online safety group that claimed the app served eating disorder related content to teens (although the platform pushed back against the research). They also follow several updates by YouTube in recent years to how it handles misinformation about medical issues such as abortion and vaccines.

    In addition to removing or age restricting some videos, YouTube plans to add panels pointing viewers to crisis resources under eating disorder-related content in nine countries, with plans to expand to more areas. And when a creators’ video is removed for violating its eating disorder policy, Graham said YouTube will send them resources about how to create content that’s less likely to harm other viewers.

    As with many social media policies, however, the challenge often isn’t introducing it but enforcing it, a challenge YouTube could face in discerning which videos are, for example, pro-recovery. YouTube said it will be rolling out enforcement of the policy globally in the coming weeks, and plans to use both human and automated moderation to review videos and their context.

    “These are complicated, societal public health [issues],” Graham said, “I want never to profess perfection, but to understand that we have to be proactive, we have to be thoughtful … it’s taken a while to get here because we wanted to articulate a process that had different layers and understood the challenges.”

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  • Texas sends ban on gender-affirming care for minors to governor’s desk | CNN Politics

    Texas sends ban on gender-affirming care for minors to governor’s desk | CNN Politics

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    CNN
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    The Texas legislature Wednesday night voted to ban gender-affirming care for most minors, sending a bill to the governor’s desk that, if enacted, would put critical health care out of reach for transgender youth in America’s second-most-populous state.

    Senate Bill 14 would block a minor’s access to gender reassignment surgeries, puberty blocking medication and hormone therapies, and providing this care to trans youth would lead to the revocation of a health care provider’s license.

    The legislation was held up for days by protests and procedural delays by Democrats in the House. House Republicans approved an amendment that makes minor exceptions for children who had begun receiving non-surgical gender-affirming care before June 1, 2023, and underwent 12 or more sessions of mental health counseling or psychotherapy six months prior to beginning prescription drug care.

    Children to whom those exceptions apply can continue their care but must “wean” off from the treatment with the help of their doctor. The Senate vote to agree to that change was the last step required for final passage.

    “Here in Texas, we will protect our kids! Thank you to everyone who supported and helped pass my bill. I look forward to @GovAbbott’s signature soon,” bill sponsor state Sen. Donna Campbell tweeted after the Senate’s vote.

    If signed by Abbott, the ban will take effect September 1.

    Gender-affirming care spans a range of evidence-based treatments and approaches that benefit transgender and nonbinary people. The types of care vary by the age and goals of the recipient, and are considered the standard of care by many mainstream medical associations.

    Though the care is highly individualized, some children and parents may decide to use reversible puberty suppression therapy. This part of the process may also include hormone therapy that can lead to gender-affirming physical change. Surgical interventions, however, are not typically done on children and many health care providers do not offer them to minors.

    Some Republicans have expressed concern over long-term outcomes of the treatments. But major medical associations say that gender-affirming care is clinically appropriate for children and adults with gender dysphoria – a psychological distress that may result when a person’s gender identity and sex assigned at birth do not align, according to the American Psychiatric Association.

    If Abbott signs the bill, it would make Texas the fifteenth state to restrict access to gender-affirming care for trans youth this year. Florida’s Republican Gov. Ron DeSantis signed a bill banning the care in his state Wednesday and Oklahoma placed their own care ban on the books at the beginning of May. Around 125 bills that target LGBTQ rights, especially health care for transgender patients, have been introduced nationwide this legislative session, according to data compiled by the American Civil Liberties Union.

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