Tag Archives: Mental Health

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Better days ahead

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What are you going to do when COVID-19 quarantine ends — and why are those your choices? While daydreamingresearch abounds, including that which asserts that daydreaming can be associated with positive psychological consequences, I’m not interested in pie-in-the-sky mind wanderings. I’m interested in your plans, as much as any of us can plan anything these days. As the Yiddish aphorism observes, “Mann tracht un Gott lacht” (Man plans and G-d laughs) or as the great Scottish poet, Robert Burns noted, “The best laid schemes o’ mice and men/gang aft a-gley.”

Quarantine restrictions vary throughout the world and throughout areas of countries, and the end of quarantine is not near in many places. As we return to school — in whatever ways we return — what do you and your students plan to do when quarantine ends? To what are you looking forward?

Before asking friends and colleagues for their post-quarantine plans, I identified five of my own: Hug my loved ones; go with my sister-of-choice, K, to our favorite women’s-only spa for a full day of treatments and relaxation; resume regular massages; have a prime rib dinner with an iceberg lettuce and blue cheese salad, sautéed mushrooms, mixed vegetables, and warm sourdough bread slathered with butter at The Keg; and spend time immediately before, during, and after my birthday at a secluded beach.

I chose hugging because, as many people, I miss the warm, comforting, and inspiring connection of human contact with those I love. I chose spending a long, luxurious day with K at Olympus Spa because it is the one place where we are in an unencumbered space for many, many hours of intimate connection. Neither of us is distracted by work. She is not distracted by her boyfriend, cat menagerie, or garden, and I am not distracted by my studies, writing deadlines, or doctor and dental appointments.

I chose to resume regular massages because I carry great physical, emotional, and spiritual stress, which manifests unhappily in my body causing me troubled sleep or sleeplessness, body aches, worry, and overall, a weakened immune system, which, of course, leads to illness.

I chose a hearty dinner because I miss treating myself to delectable food that I don’t have to prepare. While I love to cook, I’m ready for a break, and because a prime rib is not for one and is expensive, it’s unrealistic for me to buy and cook one. Likely, K and I will enjoy The Keg together; it’s another opportunity for us to visit. We’ve been friends for nearly 20 years, and this is the first time we’ve ever lived in the same place.

For decades, before I moved overseas, I spent time at year’s end on the Jersey Shore — the home of my heart — where I’d walk for hours on the beach, photographing, centering myself, and reflecting upon the ending year and the approaching one. Now that I’ve returned to the U.S. and am living on a coast, I can get to a secluded beach for a few days. My choices have everything to do with self-care, and my self-care has to do with relationship.

Those I asked range in age from 18 to 69 and live throughout the U.S. and in Russia and Italy. Many said they plan to hug people. To a person, they said they plan to visit with family and friends. For those whose family and friends are local, they are eager to invite loved ones over or to go to others’ homes for dinner, barbecues, and game nights and to be in close proximity. Others must travel nationally or internationally and are impatient to do so. Some are looking forward to returning to hiking, going to parks, and birdwatching.

Eating in restaurants and going to movies were common answers, which intrigues me given that, for many, food delivery and on-demand viewing have become standard parts of our daily lives. A number are restless to return in person to their faith congregations. One person said she is eager to return to volunteering with her congregation’s homeless project. Not surprisingly, everyone I asked responded with desire for attachment, reconnection, kinship. Online media from around the world have reported others saying the same thing.

Dr. Matthew Hertenstein, DePauw University associate professor of psychology and neuroscience and head of the Touch and Emotion Laboratory, and colleagues observed, “Touch is central to human social life. It is the most developed sensory modality at birth, and it contributes to cognitive, brain, and socioemotional development throughout infancy and childhood.”

Two years before the COVID-19 pandemic demanded that, for our health and the health of others, we should physically distance, Jonathan Jones wrote in Greater Good Magazine, “From the time we are in the womb through our elderly years, touch plays a primary role in our development and physical and mental well-being. New studies on touch continue to show the importance of physical contact in early development, communication, personal relationships, and fighting disease.”

Over the decades of her career, Dr. Tiffany Field, Director of the Touch Research Institute in the Department of Pediatrics at the University of Miami School of Medicine, has researched the role of healthy touch. Her findings, and the findings of other researchers, is formidable. In one research review, Field notes, “[…] the rapidly increasing literature on touch and massage therapy highlights the need for touch for social-emotional and physical development and well-being and the therapeutic benefits of massage.”

Moreover, Field observes, “warm touch stimulates release of the ‘cuddle hormone,’ oxytocin, which enhances a sense of trust and attachment.” In the 2015 New Yorker article, “The Power of Touch,” author Maria Konnikova wrote that “The right kind can lower blood pressure, heart rate, and cortisol levels, stimulate the hippocampus (an area of the brain that is central to memory), and drive the release of a host of hormones and neuropeptides that have been linked to positive and uplifting emotions. The physical effects of touch are far-reaching.” It’s no wonder that so many people are looking forward to physically reconnecting with their loved ones when it is safe to do so.

Now it’s your and your students’ turn. What plans do you have and what are you looking forward to post-COVID-19? Why have you made the choices you have?

Students can answer the questions with five responses and reasons and, in pairs or small groups, compare them with classmates’ responses and reasons after which they can share their answers and rationales with the entire class. For a project of more depth and breadth, students interview family members. To use this as a math activity, students can identify and graph the patterns and/or calculate percentages for each group of answers. Students can illustrate their choices and give short presentations. From their own list or by combining the pairs’, small groups’, or class’ list, students can create poems or song lyrics.

The news during the COVID-19 pandemic has been bleak with much of it necessarily focused on those who have been tragically affected by the virus. And the bombarding bleakness weighs heavily on us, causing rising despair. What if, for a time, our focus was on life after the crisis? On the sunny day, the better days of which Bruce Springsteen sings, when we can again share a little bit of that human touch? I don’t think it’s asking too much.

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Offset trauma for students by promoting positive experiences

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When Christina Bethell was little, she lived in a low-income housing complex in Los Angeles where her neighbor, a quiet lady the kids called Mrs. Raccoon, always had her door open for the neighborhood kids. Every Saturday she threw a little tea party with candy to celebrate any child with a birthday that week. Bethell fondly remembers the woman’s kindness as source of comfort during her challenging childhood.

Dr. Bethell, now a professor at the Johns Hopkins Bloomberg School of Public Health, shared this story in an NPR interview last September on the release day of her study on the long-term effects of Positive Childhood Experiences (PCEs) on mental health.

Like the well-documented effects of Negative Childhood Experiences (NCEs) on childhood trauma and adulthood health outcomes, she found PCEs have a greater effect when they’re cumulative. That means every encounter makes a difference — especially for children living in conditions where problems like poverty and discrimination propagate negative experiences.

“Every interaction with a child has a reaction in that child,” says Bethell. “Even as we keep working to address the many social and cultural factors we need to address to prevent negative experiences, we should be focused on proactive promotion of the positive.”

Getting schools ready for a ‘tsunami of trauma’

The findings of Bethell’s study are especially significant for educators today as we face huge emotional fallout from the ongoing pandemic. While trying to support students with their varying degrees of anxiety, negative experiences and trauma — educators are grappling with their own.

In an Education Post article, sixth grade social studies teacher Stephen Guerriero writes about the paradox of offering his students support and consistency every morning at 9 a.m. on Zoom despite the anxiety and turmoil churning inside him.

“In my lifetime or even in the past century, there has never been a situation quite like this, where trauma is systemic, sustained and societal,” he says. “What is certain is that a coming tsunami of trauma will test our schools as never before.”

How districts and schools face that challenge will impact students long term.

The priorities Guerriero would set include training and support for teachers: putting student social and emotional well-being before academics; manageable counselor caseloads that foster personal connections such as a tiered approach where students with more intensive needs would work with counselors that have a much smaller counselor-student ratio.

While the severity of the situation is clearly beyond the scope of the individual teacher, each teacher has a critical role in proactively promoting positive experiences for the children in their care — as does each pediatrician, law enforcement officer and even community member like Mrs. Raccoon.

Building relationships that value and validate students

“The strong, stable, and nurturing relationships that we build with our students and families can serve as a conduit for healing and increasing resilience,” says Matthew Portell, executive principal at Fall-Hamilton Elementary, in an Edutopia article where he debunks myths around a trauma-informed approach to education.

He clarifies that helping students with trauma is not in lieu of professional therapy. The focus of educator and administrator’s is on developing relationships, as we do with all students. A trauma-informed approach isn’t about fixing our kids — systems and structures that alienate and discard students who are marginalized are the problems, not the children.

Khafre Jay, founder and director of the non-profit Hip Hop for Change who has invested in trauma training for all its artist educators, shares an incident that illustrates how educators may slip into bias that alienates students.

Once as he initiated a hip-hop project with a group of teens, the educator in charge pulled Jay aside and said, “And get those boys to pull up their pants!”

Jay’s response was this, “If that’s the first thing you want me to do is try to tell these kids not to be themselves, you’ve got the wrong guy.”

He explains that young Black, brown or trans kids constantly get the message that they’re not valued, and they don’t see themselves up on the walls in their classrooms. Even worse, their identity and culture are actively devalued. In such incidents, it’s important to call out other educators for how they approach, value and validate kids, otherwise instead of supporting them, we’re adding to their negative experiences.

“When you’re dealing with traumatized kids where they don’t have any understanding of self-worth, you cannot come in that room and evaluate them first off,” he says.

Along with creating positive experiences for kids, Jay’s work with Hip Hop for Change gives kids tools for personal and artistic expression that helps them process traumatic experiences.

Supporting kids with trauma during virtual learning

“Just listen without trying to fix things, often kids just want to be heard and validated,” advises Caprice Young in an Education Post blog on how trauma-informed approach especially applies in a virtual environment.

Research shows that when adversity feels like a shared experience, we cope better emotionally and neurologically, she explains. This is why we should reassure our students that they’re not alone in their struggles. One way is by creating opportunities for peer support.

Young also tells us to be clear with students about our expectations, which should be appropriate based on that student’s ability and circumstances. Finally, never forget to notice and celebrate each success, no matter how small.

“Traumatized children who learn to thrive have someone in their life who encourages them and believes in their success,” says Young. “Educators should strive to be that support, and make sure this is a constant part of their educational experience.”

As we face this daunting reality, Portell reminds educators that trauma-informed work is a journey and not a destination. Sometimes, like Dr. Bethell’s kind neighbor Mrs. Raccoon showed us, it’s about being there with the door open.

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How doctors and patients can best use healthcare apps during COVID-19

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As we continue to deal with life during the pandemic, physicians and healthcare organizations want to make essential medical information easier to access and more accurate. With the healthcare landscape literally changing on a second-to-second basis, however, you may think that the go-to solution of apps might not be as up-to-date or reliable as is necessary.

The good news is there are great apps that are being developed and refined on a constant basis right now so healthcare organizations, physicians and patients can get the very latest data they need.

What are some of the most interesting and effective new app technologies being used for coronavirus-related healthcare concerns? Read on to learn more.

Contact tracing apps.

According to research published in The Lancet, South Korea, which has consistently recorded some of the lowest per-capita COVID-19 death rates in the world, has focused on app tools that use GPS and recognition technology to be able to monitor people’s travel and alert them to danger of exposure.

This way, citizens can receive emergency text alerts about new COVID-19 cases where they are, be alerted that they may have been in contact with someone who is infected and get instructions on testing and self-isolation.

Of course, patient privacy and HIPAA concerns must be paramount when taking this kind of technology into consideration but considering the powerful potential this kind of app has for mitigation, it’s worth educating yourself about, and then potentially discussing with your teams and patients.

Patient self-monitoring apps.

The Lancet study also found that in Germany, apps on smartwatches can easily collect a patient’s pulse, temperature, and sleep patterns to screen for possible signs of COVID-19 symptoms. Patients can then be told they need to contact a healthcare professional for further screening if the info collected indicates they may have contracted the virus.

This kind of technology has clear benefits when trying to stem hotspot transmission rates.

Apps that allow your patients to maintain treatment of chronic conditions.

Doctors are understandably concerned that their patients may be avoiding regular care visits to avoid COVID-19 at this time. An easy solution? Using new apps for patients to self-track their progress, keep up with meds, and make telehealth appointments easier.

And it works: Express Scripts finds that there has been a 10% increase in overall utilization of diabetes monitoring programs during the pandemic. Using these apps can be a literal lifesaver for many of your patients.

Of course, in using any app, it’s key that you remind your patients to look for data from reliable organizations and agencies rather than following rumor or hearsay.

The bottom line: the right apps can give patients a sense of control. During these uncertain times, doctors can do a lot to help a patient understand the specifics of the pandemic.

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Study: How doctors can identify the kinds of stress patients are dealing with due to COVID-19

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As a healthcare professional, you know the abrupt and traumatic physical impact that the COVID-19 pandemic has had on your patient population. The life-changing emotional ramifications for those patients are much harder to assess for your organization but are no less important to address. A new study can help your doctors determine which stressors are causing your patients the most difficulty so action can be taken to help them get relief quickly and effectively.

A research team from the University of Connecticut recently published “Americans’ COVID-19 Stress, Coping, and Adherence to CDC Guidelines.” The team surveyed over 1,000 U.S. adults in April. They found that the following issues created by the virus caused the most distress to the individuals participating:

  • Reading or hearing about the severity and contagiousness of COVID-19. Almost 97% of people stated this was a huge issue for them.
  • Being unsure about how long social distancing will have to continue.
  • Dealing with unwanted changes to interactions people have day-to-day.
  • Managing concerns about personal care and safety on a constant basis.
  • Financial worries due to job loss or lack of money.
  • The prognosis of a loved one diagnosed with COVID-19.

The researchers also found that the best way doctors can discourage patients who report dealing with these stressors from indulging in negative distraction strategies like unhealthy eating or substance abuse is to provide specific telemedicine services for emotional support.

Telemedicine evaluations and mental health treatment options should certainly be a priority for all organizations right now. What can make these services even more beneficial to your patients? Considering ways that your doctors can incorporate their understanding of the study’s findings into their discussions with, and subsequent treatment of, all patients experiencing COVID-19 stress.

Communicate the following key points to your physicians to help them do this the right way.

Ask the right questions. Your doctors should clearly cover each of the areas the study authors found are concerning patients. Then, follow up by asking about any other stressors tied to the pandemic a patient may be dealing with and ask the patient to describe in as much detail as they can how pandemic stress is affecting them. Cover both emotional and physical symptoms.

Know the right way to address these concerns in conversation. Your physicians should listen supportively and express to patients who are struggling that their feelings are valid and important. Reminding patients that the world is living through an unprecedented health crisis that happened very suddenly can be very helpful in terms of giving them the proper big picture perspective, too.

Address physical symptoms that are related to COVID-19 stress through performing a complete examination, and ordering further testing and treatment as warranted.

Provide the appropriate support resources via collaboration with your organization’s mental health team if that’s indicated for an individual patient.

Offer the right follow-up and ongoing treatment strategies. Your doctors should remain a supportive and trustworthy presence as patients continue to work through COVID-19 stress, checking in frequently to see how they’re feeling and doing everything they can to facilitate progress so patients feel better as quickly as possible.

Awareness, compassion and proper action — these three elements should be the core of your strategy when dealing with your patients in the context of pandemic stress. Helping every one of your patients move forward in every way you can is a crucial contribution you can make to protect their overall health — for now and for the future.

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Supporting student mental health through distance learning

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Students have faced multiple hurdles throughout the current pandemic. Some of them saw their prom and graduation dreams shattered, struggled with their grades during online learning, or missed out on the comforting social interaction of attending school. Others postponed their plans to go to college or don’t know what next year will bring for their college applications.

How can you support student mental health while teaching virtually? While distance learning does present unique challenges, the following activities can help you better care for your students.

Activities and Resources for Students

You can provide support through what you do in class and give parents and students the outside resources they may need. Here several ways to support your students’ mental health throughout the pandemic.

Counseling Resources

Many students with mental health struggles need counseling. However, if their parents lost their medical insurance with their job, they might not be able to afford it. You can provide them with a list of free counseling resources they can access. Your school nurse, likewise, may have a list that you can offer to your students.

Emergency Supplies and Aid Resources

You have heard of 911, but did you know that dialing 211 can put you in touch with resources for housing, health services and other social assistance programs? The dedicated line is courtesy of the United Way, and the available help varies from region to region. However, it’s an excellent starting place for connecting struggling families with the support they need in times of crisis.

Recommended Reading Lists

Reading is an ideal pandemic activity because it distracts your students from unhappy thoughts while keeping their brains engaged. Recommend reads like “The Pursuit of Happyness” — which was later made into the hit movie — to help students feel less alone in their struggles. When they see fictional characters overcome extreme adversity, it inspires them to believe they can do the same.

Class Discussions

You can also promote student mental health by discussing it in the classroom. Many students with disorders feel trapped underneath the stigma. Help them break free by normalizing these conversations. In addition, simply connecting socially can be beneficial to mental health — so make sure you’re making time for face-to-face virtual interactions.

Teaching Mental Health Concepts

If you’re reading “The Catcher in the Rye,” you have the perfect starting point for a discussion on teenage mental health issues. However, you can build these conversations across the curriculum. Chemistry teachers, for example, can devote time to the way neurotransmitters influence human thought patterns. History teachers can debate the relative mental health of past and present political leaders and how their psychology changed world events. Make sure you’re bringing mental health to the table in some aspect of your curriculum.

Invite Guest Speakers

If you can locate guest speakers, having them address your class provides a welcome treat for all. If you have a friend or colleague who is a psychologist, you could have them provide insights into a literary character’s behavior.

Create a Safe Zone

Let your students know — repeatedly — that your classroom is a judgment-free zone. As long as they express themselves appropriately and refrain from hateful speech, they can discuss mental health matters. Sometimes, family dynamics make such matters challenging to address inside the home.

Identifying Students in Crisis

As an educator, you have a mandated professional responsibility to report suspected abuse or neglect. How can you tell if a student might need mental help? Look for the following:

  • Atypical behaviors: If a student who formerly spoke up regularly stops participating in discussions, take notice. Ask questions if their discussion posts start to stray into more negative expressions instead of shaming them for complaining. There may be more going on under the surface than their current rant.
  • Lagging performance: If a student who formerly got straight As starts struggling to earn Cs, you might chastise them for not living up to their potential. However, there is always a reason why student achievement falters. Do some investigative work by asking questions.

How to Support Student Mental Health As They Learn Online

It’s challenging to navigate this pandemic’s scary new world, and it will impact human psychology. Use these activities and suggestions to learn how to support student mental health as a distance learning teacher.

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Outdoor classrooms could improve student mental health

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As the nation’s school districts plan strategies to keep students safe when schools reopen for the 2020-21 school year, repurposing outdoor areas as learning spaces is getting growing support from parents.

Expanding the physical space used for education beyond its brick-and-mortar facilities may help schools meet physical distancing requirements aimed to protect students’ physical health and promote better mental health.

Indeed, with kids at home over the past months more parents have observed how reduced contact with nature is wreaking havoc on their children’s emotional state. In a recent New York Times article, some parents related how reduced outdoor time due to playground closures and overcrowded parks during the pandemic has brought on short tempers and notable anxiety. Calmer, more regulated, and happier were words one mom used to describe her kids after they could play at a friend’s backyard instead of being cooped up inside their condo.

Since journalist Richard Louv coined the term Nature-Deficit Disorder in 2005 with his book, “Last Child in the Woods: Saving Our Children from Nature-Deficit Disorder,” increasing evidence suggests that this nonmedical condition contributes to a diminished use of the senses, attention difficulties, conditions of obesity, and higher rates of emotional and physical illnesses.

Unsurprisingly, many parents are reluctant to see their children return to another semester of remote learning where they’re tied to the computer for so many hours each week.

Paige Ela, whose children are six and 10, recently testified before the Washington DC school board to propose outdoor classrooms when the district reopens. In a WUSA-TV news interview, she spoke to the mental exhaustion her children felt doing serial Zoom calls and how she instead thinks children now need the healing that comes with exposure to nature.

“Specifically, after events of trauma — and I think all of us have experienced that with COVID and Black Lives Matter events happening simultaneously — there’s a tremendous amount of research that suggests that getting out, breathing fresh air, seeing greenery is just really important to the healing process,” Ela told reporter Delia Goncalves.

Parents are well-accompanied in their push for alternatives to online classes. In light of “evidence of the negative impacts on children due to spring 2020 school closures,” the American Association of Pediatrics states that it, “strongly advocates that all policy considerations begin with the goal of having students physically present in school for the coming school year.”

Utilizing outdoor spaces when possible is one of the high-priority strategies the association recommends for physical distancing in pre-K though secondary schools.

“You can really have equity of access by using public parks, by using outdoor space, by closing streets around our schools to make sure that all schools have access to be able to use that,” says Scott Goldstein of EmpowerEd, who has started a petition advocating for outdoor education in Washington, D.C. “The more space you have, the more creative you can be about things like inclement weather.”

Moving chunks of classes outdoors in time for next school year is daunting task for districts and educators, yet the long-term benefits for students may make it worth it. Fortunately, organizations with experience in this area are stepping forward to offer support. Childhood by Nature just published a list of resources to help schools start the process of repurposing the outdoors as a learning space.

For example, a recent webinar hosted by the International School Grounds Alliance and the Children & Nature Network on designing and using school grounds to support mental health featured creative and low-cost ways schools around the world have brought the outdoors into education.

U.S.-based Green Schoolyards America has excellent resources available online for using outdoor spaces on PreK-12 school grounds. The site offers planning case studies, site-design and cost-estimating tools so school and district administrators can weigh the various options for bringing students outside for academic classes, school lunch and other programs.

On July 4, Green Schoolyards America along with the San Mateo County School District and other organizations hosted an online forum with initial ideas on how outdoor learning could be an asset for districts. They are currently inviting educators to join a series of working groups that will create frameworks, strategies, and guidance to share with school districts across the country.

To sum it up, according to Green Schoolyards America, “Repurposing outdoor spaces is a cost-effective way to reduce the burden on indoor classrooms while providing fresh air, hands-on learning opportunities, and the health benefits associated with increased access to nature.”

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Pediatric mental health ED visits spike during recent years

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While the number of overall pediatric emergency departments visits has remained stable over the past decade, the number of children who have presented with mental health disorders has increased by 60% and cases of self-harm have skyrocketed by 329%.

“We’re seeing more and more children presenting with mental health disorders,” said Dr. Rachel Stanley, chief of emergency medicine at Nationwide Children’s Hospital in Columbus, Ohio.

Stanley authored a study published in the journal Pediatrics that sheds light on emergency department utilization for mental health symptoms among patients between the ages of 5 and 17. Data was drawn from the Nationwide Emergency Department Sample, a databases that produces estimates about emergency department visits in the United States.

The study showed the overall number of ED visits for mental health disorders increased by 60% from 2007 to 2016. Conditions treated included mood disorders, behavior problems, anxiety and substance use disorders.

Cases of intentional self-harm tripled in that time period, and substance abuse cases increased by 159%. The type of substance was not identified in the data. Suicide rates were higher among males. The only mental health diagnosis that decreased was alcohol-related disorder, which saw a 38% decline.

“Right around 2014 there was a big increase in substance-use disorders,” said Dr. Charmaine Lo, epidemiologist at Nationwide Children’s Hospital and co-author of the study. “We can speculate [the opioid crisis] has to do with that uptick,” she said, adding that marijuana and e-cigarettes also likely contributed but there is no way to know for certain.

The study’s authors also speculate the prevalence of social media has played a part in the increases.

While these numbers are alarming, the study’s authors say they may have missed a lot of kids since the database uses billing data. Diagnoses not counted by the system would go uncounted. “We think we missed a lot of kids,” Lo told ABC News.

Even so, compiling the data helps hospitals better prepare to treat children experiencing mental health crises, especially given the geographic challenges faced by patients who live in rural communities where access to psychiatric care may be limited, Stanley said. Often, families are forced to travel hundreds of miles to access emergency pediatric psychiatric care.

“The overall goal of our work is to improve preparedness of EDs for children,” she said. “Large children’s hospitals with psychiatric providers can offer outreach services to these smaller EDs in the form of telehealth. Another solution is more training for emergency physicians and nurses, so they know how to treat and triage children.”

Some EDs are adding pediatric mental health providers to address this surge in cases. Children’s Wisconsin ED will add a mental health team this summer using a $2.5 million grant from the United Health Foundation. The hospital says it sees 70 patients a month who need mental health intervention. Their team will include a pediatric psychiatrist, three social workers and a navigator to help patients access further care.

Children’s Hospital Colorado and Children’s of Alabama also have dedicated mental health beds in their EDs.

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Being so sensitive in a world that is sometimes not

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When my physical therapist told me years ago I was a “delicate, little flower,” I flat out denied it. I’d always thought of myself as strong, powerful and indestructible. Don’t we all?

Maybe because I’m getting older or, perhaps, more in tune with myself, I’ve realized how sensitive I really am. Ouchingly so.

I’m acutely aware of a single hair strand falling upon my shoulder, the subtle moment summer shifts to fall, the itchy label on the back of my camisole. Somewhat of an empath, I’m hypersensitive and hypervigilant to nuances, nonverbals and vibrations. Often, I feel, “I am not of this world.”

Hearteningly, there are other “sensitives” out there and what gifts they bring! Think about the artists, outliers and geeks you know.

Step it up a few notches. Consider the genius and visionary “sensitives” of Silicon Valley, MIT, NASA and beyond. Steve Jobs of Apple, Elon Musk of Tesla, Bill Gates of Microsoft, and teenage climate activist Greta Thunberg. None are typical.

More males than females, they are often endowed with superpowers or what we’ve traditionally labeled as “special needs” or “on the spectrum.” Remember the brilliant main characters in the movies “A Beautiful Mind” and “Rain Man?”

While I’m certainly not of this ilk, actually boringly neurotypical in contrast, all of us “sensitives” need strategies to safeguard ourselves living in a world that sometimes is not.

How do we do this? Here are four suggestions:

Shower yourself with buckets of self-empathy.

That is, if it’s within your capacity and is useful to you. Don’t think of yourself as crazy, wild or weird. Or do, if it helps.

Either way, realize you’ve got much to give and share in your own unique ways. Remind yourself of that — often.

Others may not quite yet understand or know how to work with your unconventionality. Kevin Murphy’s article, “The Utter Hell of Working for a Visionary,” speaks to such struggles.

Protect yourself.

Reflect on who you associate with. Are they helpful or harmful?

Diversity in a team often makes for greater good. Ensure, though, that those closest to you are supportive. Otherwise, make some changes, pronto!

Also, examine how you are spending your time. What are you filling your head with?

Choose what you watch, read and listen to carefully. Stay true to your vision, your mission, your purpose and your legacy.

Pre-plan and pre-play tricky interactions.

Rehearse and prepare for situations that challenge you, just like elite athletes do. Practice what you will say and how you will respond. Envision what you are wearing, your posture, your countenance.

Our thoughts determine our actions. See yourself as you wish to be, then imagine it so. Gandhi wrote:

Your beliefs become your thoughts, your thoughts become your words, your words become your actions, your actions become your habits, your habits become your values, your values become your destiny.

Refuel and nourish yourself.

Be mindful of not only the food you eat but what else sustains you. What feeds your spirit?

Walking in nature is one of my best self-soothing practices. Another is doing yoga.

Whatever your resets are, commit to and do them regularly.

These techniques serve as bubble wrap, taking the brunt of the blow of the bumps we feel that others around us don’t seem to.

Whether you’re a savant or simply a sensitive human being, handle yourself with care as you navigate a world that sometimes is not. Some of us are born to be wild.

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Why we need differentiated instruction now more than ever

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Carol Ann Tomlinson defines differentiation as a continual process of assessing and monitoring students’ readiness levels, interests, and learner profiles. We are in an unprecedented time and unchartered teaching territory as we aim to support all students virtually (synchronous or asynchronous).

As such, our learners are logging into our virtual classrooms with various emotional and academic needs. Based on such diversity, differentiating instruction is the one approach that will work. Upon pre-assessment/diagnosis in virtual and online environments, teachers can differentiate with the following:

Learning environment.

Learning environment is the where. The learning environment is a strong community of learners. It involves the organization of time, space, and resources for teaching and learning. In our online environments, we can provide students with check-ins, fun community builders, and offer gratitude journaling to support the emotional well-being of students.

One of my favorite starting activities for online communities is to provide students an opportunity to use a mood meter to share how they are feeling. National Educators for Restorative Practices provides lots of self-awareness meters for students to check in. Lucky Little Learners provides dozens of community builders and fun activities for zoom. Also, Hooked On Innovation provides fun games to reinvigorate students before starting academic instruction.


Content is the what. Content is defined by the curriculum guides based on standardized assessment. The content is what students will know, understand, and be able to do. In our online environments, we can provide diverse materials with varied readability (NewsELA.com and Scholastic Learn At Home) and elicit student interest and multiple ways to access ideas/information.


Process is the how. Process is how students will make sense of the content. The process is made up of the strategies and methods that form the sequence of teaching and learning. In our online environments, we can use small-group instruction; provide choices about how to work (alone, pair, small group); assign tasks in multiple modes; and provide a variety of scaffolding.

For example, many teachers are using YouTube or Vimeo to create videos as another form of instruction. LearnZillion.com, CrashCourse.com, and Edpuzzle.com are also great video alternatives for students to navigate content for review or acceleration.


Products are the evidence of student’s knowledge, understanding, and skills. They are the tools teachers use to assess student progress toward the content goals. In our online environments, teachers can provide product assignments with multiple modes of expression; choices about how to share learning; and opportunities to connect learning with individual interests. If the objective allows for flexibility, students can create a skit or use household objects to create diagrams (no-tech) and record their voice using Educreations.com or Flipgrid.com (with tech).

As always, teachers RISE, showing just how amazing and important we are in facilitating more kind, critical thinkers of the future.

Please find time to rest, self-care, and celebrate the victories over the past few months. I look forward to working with you in August!

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Medical practices are up against it as they struggle to retain patients, cash

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For some more than others, the COVID-19 pandemic rages on. Still, medical practices remain at the center of battling the virus as they treat patients. They also face personal financial pressures like many of their American counterparts.

More than half of clinicians (55%) fear another wave of the virus. They are stressed because of potentially limited access to testing and personal protective equipment, according to a survey of 730 primary care clinicians in 49 states and Washington, D.C.

Caregivers say they are under severe stress (76%). Fifty-one percent worry they will have trouble accessing testing, and 59% say they have no PPE.

The Larry A. Green Center conducted the survey with the Primary Care Collaborative from May 15-18.

Along with these struggles, most clinicians (84%) indicate that their practice’s finances are in trouble, too, as they have reduced patient volumes, with 53% saying they want “payment of any kind at this point,” the survey found. Patients are delaying and postponing chronic and preventive health concerns due to stay-at-home orders, clinicians report.

Because of the current conditions, physicians are facing similar struggles as others. Some say they’ll try to sell their practices; others will close or retire.

Follow-ups for lung disease, hypertension, and diabetes is happening “very little” (58%) or “not at all” (2%). New symptom evaluation or acute injuries and accidents continues unchecked, however.

“We see a growing concern among clinicians about preventive and chronic care that isn’t happening, either because patients are putting off anything but the most urgent health concerns during the pandemic or because some preventive and chronic care needs are not amenable to digital health platforms,” said Rebecca Etz, Ph.D., co-director of The Larry A. Green Center.

According to the survey, 40% of primary care clinicians said they’ve laid off or furloughed staff, and 42% say staff has been out because of illness or quarantine.

Like many businesses that have been forced to pivot models because of a changing business environment, clinicians turned their attention to virtual care during the pandemic to care for patients remotely.

Telehealth isn’t the be-all-end-all, though. Eighty-four percent of clinicians measured in the study said they continue to encounter patients who struggle with virtual health.

“Front-line clinicians are in a double bind: They can take care of their patients without sufficient payment and personal protection from COVID-19, or they can abandon their patients. They choose to continue to serve, despite the hardships. It’s inspiring,” Etz added.

In a separate report featured by the American Medical Association, physician practices of all sizes state that they face financial problems caused by the countermeasures designed to mitigate COVID-19. Almost all (97%) of practices experienced a negative financial impact. Less than half of primary caregivers have enough patient volume and cash to stay open for the next four weeks. The AMA posted its update regarding the study on May 8.

These data were present in a webinar hosted by Henry Schein Medical, “Physician Practice Financial Sustainability During the COVID-19 Pandemic,” and featured AMA experts. The AMA said the discussion focused on financial strategies and new federal programs available to physician practices to address the challenges brought on by COVID-19.

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