October 10, 2022

By Don Sapatkin

Good morning, MindSite News reader. Today is Indigenous Peoples’ Day, which has the added imprimatur this year of a presidential proclamation (also made for Columbus Day, which some argue should be scrapped). It’s also World Mental Health Day, which everyone reading this can agree on.

Today’s Daily explores why acknowledging and celebrating culture and history is essential to the mental health of indigenous people. It reports the halting progress toward parity in mental health coverage. It looks at the ways Georgia’s crisis-ridden mental health system harms children and families. And it shares some new TV series and a blog that explains why our mental health system was designed to fail.

Indigenous culture and mental health are deeply entwined

via Twitter

Doug McDonald, a member of the Oglala Lakota and Northern Cheyenne tribes and professor of clinical psychology at the University of North Dakota (UND), remembers watching in graduate school as a non-Native therapist-in-training tried to help a young client. When the girl came for her third session, the trainee noticed her hair had been cut and said, “’What did you do with your hair? You had such beautiful hair,’” McDonald recalled. The client burst into tears and left. “It was a huge blunder,” he told Minnesota Public Radio. Some Native people cut their hair when they’re mourning ─ in this case, he later found out, the girl’s mother had died.

McDonald offered the story as an example of the importance of increasing the number of Native clinicians and the cultural competence of non-Native providers. He started a program at UND that has graduated 30 Native psychologists over the past 30 years. Annaleis Michel, a member of the Ione Band of Miwok Indians put it another way. Cultural practice “means everything to me; it’s what I know. It’s my life basically,” she said in a video accompanying an ABC10-Sacramento story about what it means to grow up Native American.  

Also embedded in the collective memory of indigenous people is trauma ─ in a way that is nearly impossible for non-Native people to comprehend. Centuries of genocide, racism, forced removal and dissolution of culture and language have “left American Indians and Alaska Natives at the margins of health and the health care system. The effect is devastating psychologically,” a group of indigenous scholars wrote in a recent article in Health Affairs. Kaiser Health News editor-at-large Céline R. Gounder pulled these strands together in an essay for Time magazine and in the latest episode of her “American Diagnosis” podcast. Both examined the factors that lead to early death in indigenous communities.

Teaching tribal culture, history, language and values to Native youth is part of the solution. A program called Remember the Removal that teaches Cherokee youth the tribe’s culture, history, language and values helped lower levels of stress, anger, anxiety, PTSD and depression, according to research at the University of Missouri School of Medicine. “This study adds to the body of research that supports culture as a critical component of positive health and well-being in Indigenous communities,” said Melissa Lewis, an assistant professor of family and community medicine and member of the Cherokee Nation. “This evidence shows it is time to elevate Indigenous knowledge and principles of health and wellbeing into health care delivery.”

MindSite News is excited to continue its series of conversations on psychedelic research and therapies with a live interview with David Bronner on October 13, 2022.

U.S. House passes parity enforcement bill, California creates funding mechanism for crisis calls

The two-steps-forward-one-step-back movement to get insurers to cover mental health on par with medical care advanced in Washington. As outlined by the Kennedy Forum, the House narrowly approved HR 7780 – the Mental Health Matters Act – that empowers the Department of Labor to fine health plans for failing to make good-faith efforts to comply with federal parity law. (Right now, DOL’s only real power is the ability to shame violators.) It also would prohibit employer plans from including mandatory arbitration provisions that keep consumers from challenging coverage denials in court and other clauses that require an extraordinarily high burden of proof to win.

In the background of this bill is the recent reversal of a landmark ruling that United Healthcare improperly made up its own guidelines for when to approve claims in an effort to save money. Our own Tom Insel, former NIMH director and MindSite News co-founder and advisory board member, discusses the implications of that case, Wit vs United Behavioral Health, in a Psychiatric Times commentary.

And in California, Gov. Gavin Newsom signed AB 988, which the Kennedy Forum says will “transform the way California responds to mental health emergencies” by providing durable funding for operation of the 988 crisis line. MindSite News took a look at the operation of the 988 hot line in Illinois, including concerns that Chicago’s South Side is not adequately served by the city’s one call center.

Blogs to read, shows to stream

Our mental health system isn’t just broken, it’s “Designed to Fail.” So says a Mental Health America blog series that seeks to “reframe how we talk about mental health” and offers suggestions for how it can be re-designed for success. Read the first post in the series as a MindSite News guest essay here.

A new United Nations Development Program series, “Settled Minds, Settled Lives,” looks at how mental health services and psychosocial support can build resiliency, which is essential to peace-building.

The news network Newsy will launch “America’s Breakdown: Confronting Our Mental Health Crisis,” a month-long series on mental health, with a two-hour forum featuring conversations with Surgeon General Vivek Murthy and child safety activist Elizabeth Smart Monday at 9 p.m. ET. View a series trailer or find your local Newsy station; many streaming devices and video platforms will show it as well.

Hilary Swank stars as a reporter who leaves New York and moves to Anchorage, where she investigates real-life cases of missing and murdered indigenous women in the new ABC series “Alaska Daily,” airing Thursdays at 10 p.m. ET. ABC posted a disturbing set of statistics and resources about American Indian and Alaska Native females, including:
•84% have experienced violence during their lifetimes
•5,712 went missing in 2016
•Suicide and homicide are among the top 3 causes of death for Native women.

Finally, the award-winning suspense thriller “Take Back the Night,” which uses a monster attack as an allegory for sexual assault and the horrors that victims often face afterward, begins streaming Monday on Arrow. One scene shows a survivor getting victim-shamed on social media as she’s under attack from a hard-to-see monster she just frantically sent out on video. View the movie trailer.

Georgia’s failed mental health system: “Navigating treatment is like a roadmap through hell.”

A 14-year-old girl gets involuntarily committed to a psychiatric hospital by an ER physician, leading to a series of crisis admissions that leave her worse and force the family to pay out of pocket. A 12-year-old boy’s suicidal thoughts lead to a short stay at a Georgia psychiatric hospital and bruises on his face that he says came from a staff member assaulting him in the bathroom. And another 14-year-old girl suffering from depression spends a few days at a psychiatric facility and later tells her parents that she’d been raped by a night-shift employee.

This is just a smidgen of what reporter Carrie Teegardin uncovered in an Atlanta Journal-Constitution investigation examining the failings of the mental health system in Georgia, where 119 children and teens took their own lives last year – a number that doubled over the last decade. Ironically, a federal lawsuit exposing abusive conditions in state psychiatric facilities prompted a shift in 2010 to community services. Some general hospitals sold their psych wards, leaving for-profit hospitals to admit most children who need inpatient care. “Navigating treatment is like a roadmap through hell,” said Michael Ellis, a child psychiatrist who searched in vain for inpatient care for his autistic 17-year-old daughter.

Georgia’s facilities “are not equipped to handle juveniles in any way, shape or form,” said Republican state Rep. Todd Jones, who co-sponsored mental health parity legislation signed into law this year but said much more needs to be done. His son, Justin, was hospitalized 31 times in a “rinse and repeat cycle” before the family was advised that he should threaten a police officer and get charged with a crime in order to get placed at a state hospital. “They would not let him go until they got him out of psychosis. And that was the very, very, very, very, very first time that happened,” said Justin’s mother, Tracey Jones.

In other news…

Part 3 of “It’s Not Just You,” the New York Times opinion series on the mental health crisis rolls on with a series of essays and photos on “Power, Politics and Feelings” including a Times editorial, The Solution to America’s Mental Health Crisis Already Exists.

Three subgroups of dementia patients are at increased risk for suicide following diagnosis, according to a Medscape story on a JAMA Neurology study: those whose dementia began before 65, those diagnosed in the previous 3 months and those who also had mental illness. News Medical reported on a Psychological Medicine meta-analysis of 11 studies that found people with schizophrenia and related diagnoses are 2.5 times more likely to develop dementia than those without. 

Dr. Sanjay Gupta and his CNN video crew ride along with Durham, N.C.’s Holistic Empathetic Assistance Response Team (HEART), a pilot program that works to match 911 responses to callers’ needs by using mental health professionals in the call center and sending them out to assist in emergencies.

Myne Body & Soul, a mental health gym opened by a restaurateur in central Kansas is an anxiety-reducing space intended to build on, not replace, traditional mental health services, KWCH/12News reports. People walk in off the street or buy memberships to ease their minds with calming features like a vibroacoustic bed.

If you or someone you know is in crisis or experiencing suicidal thoughts, call or text 988 to reach the 988 Suicide & Crisis Lifeline and connect in English or Spanish. If you’re a veteran press 1. If you’re deaf or hard of hearing dial 711, then 988. Services are free and available 24/7.

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Type of work:

Don SapatkinReporter

Don Sapatkin is an independent journalist who reports on science and health care. His primary focus for nearly two decades has been public health, especially policy, access to care, health disparities...