Stopping the Cycle of Violence

Monday, October 16, 2023

By Don Sapatkin

Also in today’s Daily: The American Medical Association confronts the challenges of providing mental health care to a growing older population. Plus: New research documents the ever-growing disparities in behavioral health rooted in educational attainment and race and ethnicity. The beloved poet Louise Glück dies at 80 after a lifetime writing about family, loneliness and loss. And more

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Stopping the cycle of violence: An interview with Jack Saul

Since 1948 – when a people decimated by anti-Semitic genocide and the deaths of 6 million Jews created the state of Israel and forcibly displaced millions of Palestinians – those two groups have been simmering in a cauldron of separate collective traumas. Nine days ago, that cauldron erupted in a horrific spasm of violence that is now creating an even deeper catastrophe.

To gain a deeper understanding, MindSite News turned to psychologist Jack Saul. When the 9/11 attack struck the World Trade Centers, Saul and his children lived and went to school just blocks away, part of a community that suffered a massive collective trauma. Saul helped lead a community-based response. Those efforts helped heal the people of lower Manhattan – but had little impact on the massive military response of the U.S. that turned into the two-decade long (and counting) Global War on Terror. Saul now fears that instead of learning the real lessons of 9/11, Israel and the U.S. are going back to the same disastrous playbook.

Saul’s work focuses on collective trauma – “the impact that traumatic events have on the disruption of relationships, the disruption of the sense of community, the sense of belonging.” The last week, of course, has sent that trauma into the stratosphere for both peoples. Now what? “The most important protective factor against this kind of stress is connecting with others, and not being alone with it – feeling a part of community,” Saul said. In the interview (and a book, “Collective Trauma, Collective Healing”), he describes the “community resilience” approach to healing that he helped organize in Lower Manhattan after Sept. 11, 2001. Read the full interview.

Here are some other worthwhile stories on the mental health aspects of this conflict:

Reporting about traumatized teens in Gaza… It’s been 20 years since Iman Farajallah, now a clinical psychologist in the U.S., left the Gaza Strip and she still can’t bear to watch fireworks. Farajallah, who now teaches graduate students in Berkeley and does research at Stanford University, published a paper last year on the mental health of Gaza’s children. It noted that 95% of them show signs of depression, hyperactivity, aggression and a preference for being alone. “They watch their family members, neighbors and friends being killed, this causes anger and frustration in them, they tend to be more aggressive and suffer from depression, anxiety, and continuous traumatic stress disorder,” she told Al Jazeera, the Qatar-based news agency.

…and Israel. As a child, 16-year-old Nevo told a youth reporter for the news agency JTA, he had nightmares that terrorists invaded his southern Israeli town, located just three miles from the Gaza border. In those dreams, he was the hero. But this time, when it actually happened, “I couldn’t be the hero,” he said. “I was sitting in silence.” He and other Israeli children throughout the country are struggling mentally and emotionally, according to the article, published in the Jerusalem Post.

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A conference vows to create mental health parity – and to build a mental health movement…

Sixty years after President John F. Kennedy signed the Community Mental Health Act of 1963, the first major legislation aimed at expanding community-based mental health care – before being assassinated three weeks later – his nephew has an even bigger dream. Former Rhode Island Congressman Patrick J. Kennedy wants to jumpstart a movement aimed at transforming the dysfunctional and inadequate American mental health system − to make prevention, care and support accessible to everyone. (Kennedy is a member of the MindSite News Editorial Advisory Board.)  

Kennedy declared his goal at a gathering of a coalition of mental health advocates and providers dubbed the Alignment for Progress. MindSite News covered the meeting and afterward interviewed David Lloyd, one of the architects of the national strategy, for a story posted on MindSite News. They discussed the state of mental health policy in the U.S., key goals of the new strategy, the definition and sad state of “parity” in mental health coverage, and the need for political power among the mentally ill. Read the full interview.

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…And a call for public comment on proposed mental health parity rules (deadline: midnight tomorrw)

“Calling all Americans who care about erasing roadblocks to mental health and substance abuse care!” –Attorney and patient advocate Domna Antoniadis.

Antoniadis authored a MindSite News guest essay urging Americans who care about removing roadblocks to mental health and substance use care to submit comments on a set of proposed new regulations to the federal mental health parity law by midnight tomorrow, when the window for public comment slams shut.

This is your last chance to send feedback and stories of your lived experience of barriers to mental health care. You have until October 17, 2023, at 11:59 pm ET – yes, two days from now – to give your much-needed feedback. Here is where you go to do that: https://www.regulations.gov/commenton/EBSA-2023-0010-0001

Read the guest essay here to get further suggestions from Antoniadis.

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‘Why Should We Care About the Mental Health of Older Adults?’ The AMA Journal of Ethics weighs in

Geriatric is defined as age 65 and older. (Three years past that date, I don’t think of myself that way. Alternative terms welcomed: newsletters@mindsitenews.org.) But whatever the  term, mental health care for this population poses unique challenges. One of them is that the number of older folks is growing faster than the workforce that provides mental health care for them, according to the American Medical Association, It devoted the October issue of the AMA Journal of Ethics to the hurdles facing geriatric psychiatry and related fields.

The 10 articles plus 10 podcasts (mostly interviews with authors) are largely about policy solutions. There is no paywall, and they avoid typical journal jargon.Topics include:

•How to address the warehousing of people with serious mental illness?

•Is using antipsychotics acceptable to ease behavior problems in short-staffed nursing homes?

•Why are there so few geriatric psychiatrists, and why does the U.S. rely so much on graduates of overseas medical schools?

•And what should we do with older incarcerated people who struggle with dementia?

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In other news…

Local call centers that staff the 988 crisis hotline have a problem: repeat callers, ABC News reported. Surging demand over the 15 months since the three-digit number went national has outpaced short-staffed call centers’ ability to handle them, forcing some locations around the country to make tough decisions that go against their mission to help people in crisis. Strategies include limiting calls from frequent callers to 20 minutes each, restricting them to three calls over a specified period and, in some centers, referring frequent callers to non-crisis lines before terminating the call.

Arts roundup: The lyrical Nobel Prize-winning poet Louise Glück, who wrote about childhood, family, loneliness and loss, died at 80. Her poem about dying,“The Wild Iris,” is told from the perspective of a flower:

Overhead, noises, branches of the pine shifting. Then nothing. The weak sun flickered over the dry surface.
It is terrible to survive as consciousness buried in the dark earth.

Read more in the Washington Post obituary.

“Joan Baez: I am a Noise,”a new documentary now in theaters explores “an unknown dimension about the musician and activist − her lifelong struggles with depression, childhood trauma and mental illness,” Reuters reported. And the brutal “Megalomaniac” (Amazon Prime Video and other streaming services) is loosely inspired by several unsolved murders of women in Belgium – source material that filmmaker Karim Ouelhaj “unflinchingly mines to examine generational wounds and mental illness,” Erik Piepenburg wrote in the New York Times. He called it “one of my favorite horror movies of 2023.”

Kaiser Permanente’s $200 million settlement last week for repeatedly failing to provide timely and sufficient mental health care sends a powerful message to providers that ignore patient needs, according to the nonprofit news site Capital & Main. The agreement with California’s Department of Managed Health Care includes a record $50 million fine and a pledge by the health plan to spend $150 million to expand behavioral health services over the next five years. Critics say Kaiser has underinvested in mental health providers for years, leading to wait times that averaged 19 days for follow-up therapy appointments in 2021, nearly double the legal maximum. Ana B. Ibarra’s report on the settlement for CalMatters was republished by MindSite News.

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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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