Monday, January 31, 2011

Caring for our Anxious Students

This weekend I attended a Harvard-sponsored conference on Mental Health in our Schools. Here at home we are also responding to what we perceive from the trenches to be rising levels of stress and anxiety among our students. My office, BridgeSpan Medicine in White Plains, is sponsoring a conference on March 11 to bring professionals together.

Click here for the flyer and registration form for "Caring for our Anxious Students." We will be gathering on the expansive Fordham graduate school campus in White Plains to share strategies, resources and information between mental health professionals in the community and those who work in schools. Presentations of and management of anxiety for Grades K-12 will be covered.

Dr Alec Miller from Cognitive and Behavioral Consultants of Westchester will be the keynote speaker, bringing his extensive experience in CBT/DBT to bear on the subject. In addition, dedicated mental health clinicians in the schools will share what they are seeing, what works and what doesn't. Each participant will go away with a trove of resources, including professionals, agencies, clinics, websites, dvd's, and books.

A major goal of the conference is to increase communication and fluidity between disciplines so that we can more readily help our students and in the end make our own work more effective and rewarding.

We hope you will sign up soon. Space is limited. Please bring your experience, expertise and inquiries.

"Caring for our Anxious Students"

Thursday, January 27, 2011

"Does Football Have a Future?"

I didn't ask that question. I continue to beat my drum about concussions,  and the sound of the many drumbeats out there is getting louder and harder to ignore. The question is the title of a fascinating, in-depth article in this week's New Yorker by Ben McGrath about America's gladiator sport and the latest on the resulting brain damage.

McGrath intrepidly raises the thorny issues of the socioeconomic aspects of this sport. He says:
"The people most inclined to ask the question 'Would you let your kid play football?' did not play football themselves growing up, because their parents were put off by the sport's brutish culture, regardless of any understanding of brain science....How many of the men on the field in the Super Bowl will be playing with incipient dementia?"
McGrath quotes extensively from and praises the work of Alan Schwarz of the New York Times. A comprehensive list of his recent research and articles can be viewed here.  Among other aspects of Schwarz' work, we learn about the likely link between teenage and high school football and later brain damage.

The many coaches, students, athletes, and parents who have wondered over the past few years about the new concussion guidelines and policies that I have helped implement in the Mamaroneck schools all need to read this article. As a teenager noted to me recently--as only a 21st century teen could--The New Yorker articles are very lengthy, but I assure you that if you have anything to do with football it is an engrossing and worthwhile read.

In the mean time, while our schools develop and refine their thinking and policies about concussion management, I encourage all athletes to invest the small fee required for a baseline Impact test (described here) and to be tested if there is any concern that a head injury or significant blow might be strong enough to warrant the new, conservative approach. As a Credentialed ImPACT Consultant, I am one of three providers in Westchester who can test, interpret, educate and counsel athletes and parents on this important issue.

Friday, January 21, 2011

"Hi Mom" from Everest base camp

Recently I have been thinking about how we can build resilience in our children and taking my lead from Dr Kenneth Ginsburg, a pediatrician in Philadelphia and the author of Building Resilience. Ginsburg talks about the Seven C's of resilient people and how we can foster these qualities in our children. The C's are: Competence, Confidence, Character, Connection, Contribution, Coping and Control. I think Ginsburg is really on to something and in fact have printed these "Seven C's" on the back of my business cards. I've been wondering if these are the qualities that my own young adult children carry with them.

And then came this extraordinary photo from my son, Simon's Facebook page.  I had very little contact with him for two weeks while he was on vacation from his teaching job as a Fulbright fellow in Nepal. I knew he was out on icy, cold trails with a colleague, but I had not really been able to imagine what that could be like. Until he called me from about 16,000 feet in the Himalayas and said:"Oh, Mom it's SO BIG."

And now with this photo posted since his--Thank God--safe return to Kathmandu I can see for myself those Ginsburg qualities that he carries inside him. This is the stuff that allows you to think you can do this sort of thing pretty much on your own in a place that is about as foreign as it gets with unspeakable risks and dangers. And rewards. Thanks, Simon, for one in a long string of lessons for me as your Mom.

Monday, January 17, 2011

Momosaurus to Cyberwoman

From Jezebel,  the entertaining website that has its pulse on the culture of American women comes the amusing article titled The Evolution of Moms. From soccer moms to the latest--tiger moms-- this short piece is a witty, tongue in cheek profile of the many faces of Mom in the last twenty years. 

And before that? I challenge my readers to invent names for moms of the seventies, sixties, fifties, forties, thirties, twenties, and teens from the twentieth century.  Looking forward to your comments.

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Monday, January 10, 2011

Gabby, We Can Do Better.

Gabby Giffords is a heroine of mine. I have supported her candidacy from afar for some time since Emily's List first introduced me to her years ago.  I like the words used to describe her: spunky, tenacious, smart, optimistic, a pioneer, a true friend, and especially a Democrat Arizonans can get behind. 

Since Saturday when my distraught brother and mother both called from Arizona to alert me to the news of the shooting, I have been glued to the television and the news.  Themes keep repeating themselves: vitriolic politics, right-wing Arizona, the perils of democracy, gun control matters, and of course mental illness.  Today, I heard that there is debate in the Obama administration about how to turn this, spin it, twist it all so that it might be massaged to the Democrats' advantage.  How, someone mused, could the President keep his health care bill fighting for its life just as Gabby lies in coma fighting for hers in Tucson?

I think the link is clear.  The gunman's story is all too familiar.  A disgruntled, odd adolescent, expelled from college for bizarre behavior, ranting in cyberspace and elsewhere, buys a military-grade weapon and lets loose.  When we briefly put aside our outrage at him, if we can possibly put on our compassionate hats for just a minute, we realize that one way or another the system of health care and mental health treatment failed him.  And by failing him and his family, it has jeopardized all of us. 

Mental illness, after all, is a health issue.  If the Republican congress were to repeal Obama's healthcare legislation as it has threatened, the tiny steps that were put in place to improve access to care will be eroded. 

And that could matter for someone like the Arizona gunman.   These grave mental illnesses most often present and get diagnosed during late adolescence.  Coverage through parents' insurance up to age 26 can help these suffering young adults get the help they need.  The certainty that pre-existing conditions-like schizophrenia-will not bar a young person from insurance coverage will go a long ways to supporting these difficult patients.  And an attitude and philosophy that moves us all to see illness as bad luck rather than a badge of moral failing will go even further toward creating a more compassionate and safer society that we can be proud to call ours. 

Thursday, January 6, 2011

Remembering Haiti one year later

January 12 marks the one year anniversary of the earthquake. Haiti still has no government, no housing for most quake homeless, no clean running water, no public pediatric hospital in Port au Prince, and plenty of other things.  But Haiti still somehow seems to carry on with hope.

Partners in Health, the august organization founded bythe pediatrician, Paul Farmer, is sponsoring a commemorative event in Boston and online on January 14, 2011. 
The world is moving on to trying to comprehend the devastation of the quake, the reasons for the slow recovery and the extraordinary spirit of the Haitian people in the face of chronic and acute disasters.  Having been to Haiti twice this year to help in the disaster and recovery efforts, I can only exhort all those who care to continue to commit themselves to understanding and supporting Haiti in its prolonged time of need. Whether through your house of worship, your school, your government, UNICEF, or from your own heart, please remember.

You can get started at Partners in Health's special site:  Many different events are listed here as well as links to amazing organizations that are working to rebuild Haiti, including Fonkoze, a microfinance system sponsored by Partners in Health and described by Nicholas Kristof in the January piece entitled Ladders for the Poor in the New York Times.

Thanks from my all Haitian friends who read my blog.
If all my readers could send a word or two of encouragement by commenting on this post, I know they will be grateful for them.

Wednesday, January 5, 2011

Deployment Burden Hits Home

"When a parent in the military is deployed, children have an 11% increased risk for requiring mental and behavioral health doctor visits, compared with when the parent is home. This information is the conclusion of a large chart review-type study published in Pediatrics in December, 2010. Frankly I found the number relatively low compared to what I had imagined. Some interesting findings of the study were:
  • Older children experienced more mental health visits while the parent was deployed than younger kids.
  • Having a father deployed, as compared to mother carries a thirty percent greater "risk" of mental health visits.
  • Anxiety, behavioral and stress disorders were the most common diagnoses.
The report in the pediatric literature bears spreading to others who care about and know children. Teachers, family, clergy and friends need to be aware that "the psychosocial burden of war extends beyond the military service members' combat time...perhaps unfolding years after combat exposure," according to Dr Beth Ellen Davis, a retired colonel in the US Army. Resources cited in the 2010 Pediatric News where this study was reviewed include The American Academy of Pediatrics Military Deployment support web site: This features videos and an interactive "youth stress management plan". Other resources include Military One Source and Military Home Front.

A simple acknowledgment of the parents' deployment and a simple "How are you doing with that?" can be an important outreach question. And let's not forget the siblings, cousins, and neighbors who may also be deployed and weighing on young hearts and minds.

I welcome feedback and sharing of experiences from readers who have experienced deployment themselves or have waited at home for a loved one.
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