News

According to a new study from Pew Research Center on Teens, Social Media & Technology 2018 :

• Forty-five percent of teens now say they are online on a near-constant basis, up from 24% the last time that Pew surveyed teens on technology use in 2015.
• Smartphones ownership seems to be driving this trend – 95% of teens now report they have a smartphone or access to one, a trend which holds regardless of race or income.
• 85% of U.S. teens ages 13 to 17 say they use YouTube, followed by Instagram (72%), and SnapChat (69%).
• Facebook is reportedly used by a little over half (51%) of teens today, while in 2015, 71% of teens used Facebook
• More than two-thirds of teens living in households earning less than $30,000 a year say they use Facebook (70%), compared with 36% whose annual family income is $75,000 or more. In comparison, In 2015, 51% of teens from households earning less than $30,000 a year say they use Facebook, compared with 35% whose annual family income is $75,000 or more.

What does this mean for HIV? In 2016, according to the CDC, youth aged 13 to 24 made up 21% of all new HIV diagnoses in the United States. Most (81%) of those new diagnoses occurred among young gay and bisexual men. Young black/African American and Hispanic/Latino gay and bisexual men were especially affected.

In addition, according to the CDC, among people living with HIV and receiving medical care, young people aged 18 to 24 are more likely than older people to be living in households with low-income levels, to have been recently homeless, recently incarcerated, and uninsured or to have only Ryan White Program-funded health care.

Therefore, HIV service organizations need to consider how best to reach these populations to provide HIV, prevention, care and treatment, and data like this may provide some of the answers. Social media and websites designed to provide information on mobile devices and smartphones could help address stigma and misperceptions about HIV as well as deal with feelings of isolation that can lead to risky behaviors among LGBT youth.

However, according to Dr. Maranda C. Ward, from Promising Futures, a D.C. based youth development program, “Youth-serving organizations just having an online and/or social media presence is not enough, if youth are not actually using YouTube and Instagram for non-entertainment purposes. Further exploration is needed to determine the type of online health information accessed by youth so we adequately supplement our face to face HIV prevention services.”

For more insights, and to begin your own exploration, read the Pew Research Center’s report on Teens, Social Media & Technology 2018. Also look out for more posts on youth, HIV and digital media from HIV.gov over the rest of the summer.

For technical assistance on how you can use your organizations’ website and social media to reach at-risk populations, sign up for HIV.gov’s free, on-demand technical assistance program, Virtual Office Hours. In addition, consider adding like HIV.gov’s HIV Testing Sites and Care Services locator, to help connect youth with services.

Read more on HIV.gov.

A mindfulness-based therapy in which individuals learn to repeat personalized mantras to relax their thoughts appears to be more effective at reducing posttraumatic stress disorder (PTSD) symptoms than a problem-solving psychotherapy known as present-centered therapy, reports a study in AJP in Advance.

Mantram therapy is based on the premise that silently repeating a personally meaningful word or phrase (mantra) promotes relaxation, increases emotional regulation, and reduces stress. Present-centered therapy is a psychotherapy that focuses patients on the present to help them actively target daily challenges related to their past trauma and PTSD symptoms.

“Mantram therapy may be a valuable addition to current PTSD treatments because it incorporates some components of evidence-based treatments, yet without the trauma focus that can deter some clients,” wrote Jill Bormann, Ph.D., R.N., of the University of San Diego and colleagues.

Previous uncontrolled studies of veterans have suggested that mantram therapy can reduce PTSD symptom severity, help veterans manage sleep disturbances, and more. For the current study, Bormann and colleagues compared PTSD outcomes in veterans who were randomly assigned to either mantram therapy or present-centered therapy. A total of 173 veterans from two Veterans Affairs outpatient clinics diagnosed with military-related PTSD were assigned to receive eight individual weekly one-hour sessions of either mantram or present-centered therapy.

The mantram group experienced significantly greater improvements in their symptoms as assessed by the Clinician-Administered PTSD Scale at both the end of the study and at a two-month follow-up. Additionally, 59% of participants in the mantram group who completed the two-month follow-up no longer met criteria for PTSD, which was significantly higher than the 40% rate in the present-centered group. Participants who received mantram therapy also reported greater reductions in insomnia, a common occurrence in patients with PTSD, compared with those who received present-centered therapy.

Bormann and colleagues acknowledged that the study did not compare mantram therapy with either cognitive processing therapy or prolonged exposure, two evidence-based PTSD therapies currently used by the Veterans Health Administration. “It would be premature to draw any conclusions about the efficacy of mantram therapy compared with these established treatments, or other treatments, without head-to-head trials,” they wrote.

“Further assessment of mantram therapy in trials and real-world settings is clearly desirable, especially because mantram therapy may appeal to some veterans who may prefer therapies that are not trauma-focused, that include some element of spirituality, or that reduce sleep disturbances,” they concluded.

Read more on Alert.PsychiatricNews.org.

The following is a transcript created from the Hawai’i Public Radio interview by Chris Vandercook of Heather Lusk, the Executive Director of the Hawai‘i Health & Harm Reduction Center.

CHRIS: HIV and AIDS may no longer dominate the headlines but more than 2,500 deal with it and its stigma every day. The new Hawai’i Health & Harm Reduction Center has as its mission: “Reducing harm, promoting health, creating wellness, and fighting stigma in Hawai’i and the Pacific.” It’s Executive Director Heather Lusk is with us in our studio.

CHRIS: This is a new organization formed of two existing organizations, tell me about that.

HEATHER: Yes, the Hawai’i Health & Harm Reduction Center, which launched July 1st is combined from two organizations, the Life Foundation which is 35 years old, and the largest and oldest HIV organization in the Pacific; and the CHOW Project which stands for Community Health Outreach Work Project, which is a 30-year-old agency dedicated to state-wide outreach, harm reduction, and runs our state-wide syringe exchange program.

CHRIS: I’m figuring that in the past, their missions pretty much overlapped?

HEATHER: Yes, and ironically, syringe exchange started at the Life Foundation over 35 years ago, then CHOW came along, so they’re kind of coming back full circle to combine.  We’ve been co-located for about 7 years and collaborating, so our joke is that we lived together and now we’re married.

CHRIS: Well, many happy returns!

HEATHER: Thank you.

CHRIS: But it’s an increasingly difficult situation that you folks face, and it’s not, as I said in the lead, HIV and AIDS aren’t at the top of the news anymore, it’s not a new crisis right?

HEATHER: Right. Why it’s not a new crisis is we have medications that can basically manage HIV, it’s really a chronic, manageable disease.  The reality is in Hawai’i, we still have many people who don’t know that they have the disease, or don’t have access to the lifesaving treatments they need – so that’s a big focus of our work to address the homelessness, the substance use and mental health issues of our whole community. But then using that to leverage and supporting people with HIV in a kind of whole, comprehensive approach.

CHRIS: Because enormous overlap between homelessness, opioid addiction, HIV, you know a lot of HIV is transmitted through needles right?

HEATHER: Exactly.  Because of the state-wide needle exchange that started here in Hawai’i in ’89 – we were the first state to have state-wide syringe access – we have lower HIV rates than many states on the continent, but that doesn’t mean it doesn’t still happen.  And particularly our folks with HIV now have a lot more other issues, such as I mentioned, substance use, homelessness, mental health, and then we’ve broadened beyond HIV because we now have street-based outreach for homelessness, substance use outreach, we have a street-based wound care, and now a clinic in our office for would care.  So we’re trying to use a kind of “no wrong door” approach to be able to get folks into the care they need and then address a multitude of issues.

CHRIS: What’s it like out on the street these days?

HEATHER: Oh Chris, as folks know, homelessness is a very complex issue and therefore we really need kind of complex, multi-sector responses to homelessness.  I will admit that as we’ve done a big success in getting folks off the street with housing first, it’s also led to, we believe some instability because we’ve kind of worked with the folks that we were able to more easily able to connect with services. And who’s still on the street they often have many more reasons why they’re still out there.  And that’s led – we have seen- to some increased chaos and even violence.  So we’re partnering right now, honestly, with HPD (Hawai’i Police Department) and other public safety folks to do more public health, public safety outreach.  So on Wednesday night, you may have heard that a group of folks went out with HPD and 23 people were able to get into housing because they could go do outreach in places they may not normally be able to because they had HPD there for the safety part.  So I think we’re looking at unique partnerships to be able to address this in a multitude of ways.

CHRIS: Is there housing available and people out on the street who could be in that housing but aren’t, is it just there’s no room at the inn?

HEATHER: Yeah, you’re right.  So one thing that we do for these coordinated outreaches, is we get a shelter vacancy count so that we know exactly how many spots and we used kind of all 23 open spots on the island the other night.  But honestly Chris, we have 3,000 people on what’s called the binay list, so these are 3,000 people that are homeless that our outreach workers across all of the agencies- they know them, they’re ready, they’ve been assessed, they’re document ready -but there’s no housing for them to go into.  So honestly, we have more of a housing crisis than a homelessness crisis.  We don’t have the inventory to put people even when they’re ready, willing, and able into housing.  We have 3,000 on Oahu ready and we don’t have the spaces for them. So our systems are coordinating better, we’re working with city, state, and our community partners better, but as you know, it’s still a big issue out there.

CHRIS: Well that’s 3,000 documented.

HEATHER: Right. Not even counting those that aren’t documented, exactly.

CHRIS: One of the criticisms that’s been advanced of the point-in-time count is that a lot of people chronically homeless, the last thing they want is someone coming toward them with a clipboard asking them for personal information, is that fair to say?

HEATHER: I think that is fair to say and in order to get them to the list for housing, you have to be willing to share some information about yourself. And so that’s what our outreach workers do every day is build rapport, and go out there and be consistent.  We just got someone that’s been 30 years on the street, got them into housing because it took years of relationship building, but when they were ready, the outreach worker was there to do that what we call “warm handoff” to that next level.  But it’s constant building.  And then working with our business community, we know that they’re very frustrated with what they see as lack of progress, so we’re really hoping that we can continue to build upon the successes we’ve seen over the past couple of years.

CHRIS: A lot of the people, that the frustrated business owners you just alluded to, might see are those who are pretty far gone, and not likely to be filling out forms and able to get a job, and you know, chronically, because now we’re talking about the intersection of homelessness and mental illness.

HEATHER: Exactly Chris, with mental illness. And as we were discussing earlier, our criminal justice system is unfortunately somewhat of our de facto mental health system.  We don’t have community mental health, particularly residential mental health services unless you’re involved in the criminal justice system.  So there’s really very few options for these folks who don’t even have the capacity to make the decisions that they would need to do to get into the housing.

CHRIS: Is that a growing number? The off-the-books homeless?

HEATHER: Yes.  At least the data that we’ve seen. There’s a lot of focus on mental illness this year.  I don’t know if you’ve heard of Assisted Community Treatment? which is trying to make it easier for folks that are working with those with mental illness to get a court order so they can get some access to treatment. There’s more and more focus.  So this year I’m part of Partners in Care, I’m the vice chair, that’s our homeless coalition, and we’re about to apply for our 10 million dollars from HUD (Office of Housing and Urban Development) for the island, and there’s a focus this year on the chronically homeless with mental illness – that’s who we’re going to really try to focus on for that application.

CHRIS: You know Heather, there are so many brick walls that you hit in the work that you do.  How do you hold on to the optimism?

HEATHER: I’ll be honest, for me it’s the staff of Hawai’i Health & Harm Reduction center, we’re rooted in 6 core values of compassion, respect, advocacy, quality care, harm reduction, and integrity.  And the staff really reflect that, not just in the way they deliver services, but in the way that we treat each other.  We want to, we’re really a sanctuary, not only for those struggling with mental illness, homelessness, substance use, and HIV, but the center also is that sanctuary for the staff.  Because they’re out in the streets doing incredible work, they see so much trauma every day, so I think that together we try to highlight the light in someone – I know that sounds a little bit cheesy, but we really are looking at a strength-based model of where’s are, where’s our strength, where’s our community resilient, where they are doing well, and how can we build on that? Instead of focusing on the, all the hard part.

CHRIS: Well the community clearly needs your strength, Heather. Thanks very much for coming in.

HEATHER: Yeah, thank you so much for having me.

Listen to the full interview on HawaiiPublicRadio.org.

The Center for Juvenile Justice Reform has released a request for applications for the 2018 Reducing Racial and Ethnic Disparities Certificate Program, which will take place November 5-9, 2018, at Georgetown University in Washington, DC.

About

The Reducing Racial and Ethnic Disparities in Juvenile Justice Certificate Program is an intensive training program designed to support local jurisdictions in their efforts to reduce racial and ethnic disparities in their juvenile justice systems. The program seeks to reduce over-representation of youth of color in the juvenile justice system, disparate treatment of youth of color as compared to white youth within the juvenile justice system, and unnecessary entry and movement deeper into the juvenile justice system for youth of color. While the program will primarily address disparities in the juvenile justice system, it will also include a focus on the relationship between disproportionality in the juvenile justice system and disparate treatment in other child-serving systems, including child welfare and education.

Participants will receive instruction from national experts on cutting-edge ideas, policies, and practices. Upon completion of the program, participants will receive an Executive Certificate from Georgetown University, membership into CJJR’s Fellows Network, and ongoing support from the staff.

Capstone Project

As part of the Certificate Program, participants are required to develop and submit a Capstone Project – a set of actions designed to initiate or enrich collaborative efforts related to reducing racial and ethnic disparities. The Capstone Project can be a large, systemic change initiative, or it can be a targeted proposal.

Examples of Capstone Projects include: implementing an objective decision-making tool, such as a detention risk assessment instrument; creating a system of graduated incentives and sanctions for youth supervised in the community; implementing a multi-system strategy to address the disparate treatment of youth that is resulting in disparities in the juvenile justice system, such as the development of a protocol among police, schools, and juvenile justice officials aimed at reducing arrests of students.

Learn more about Capstone Projects.

Tuition & Application

The application period is now open through Friday, July 27, 2018. Download the 2018 Application Packet.

Tuition subsidies are available through CJJR’s Janet Reno Scholarships and the Office of Juvenile Justice and Delinquency Prevention’s Center for Coordinated Assistance to States. These competitive scholarships of up to $1,000 per person will be provided to teams that show a heightened readiness to utilize the curriculum to undertake changes in their local community, as determined by CJJR’s review of the individual and team applicants. There will also be a separate category of need-based subsidies available through CJJR to support the participation of individuals and teams with demonstrated need.  Read more about tuition.

Learn more & apply at Georgetown.edu.

Too many stories point to the troubled minds and mental struggles of our youth with the tragic event in Parkland, Florida being one of the latest. Even more saddening, these children’s cries for help are often misunderstood or ignored.

Suicide is the second leading cause of death for children between the ages of 10–24 years old, accounting for 17.6% of deaths in this age group 1 The American Academy of Pediatrics recently updated their guidelines to include universal screening for adolescent depression (youth 12 years of age and older). According to the 2016 National Survey on Drug Use and Health, one in eight youth ages 12–17 years old has had a  major depressive episode in the past year, with 70% of them having severe impairment.

For young Asian Americans and Pacific Islanders (AAPIs), the suicide rates are also bleak. AAPI adolescent females (15-19 years old) have a higher rate of suicide deaths (21.9%) compared to non-Hispanic Whites, non-Hispanic Blacks, and Hispanics. AAPI males aged 15–19 years have comparable or higher rates of suicide deaths (27.1%) when compared to all other racial and ethnic groups.

The Model Minority Myth is a stereotype that portrays all Asian Americans as academically gifted and successful. This myth wrongly portrays AAPIs as a prosperous group who have secured economic and educational success, have fewer health problems than the overall population, and do not need public assistance. In reality, AAPIs are a very heterogenous group with immigration from more than 30 different countries and ethnic groups, hundreds of languages and unique dialects, and varying degrees of economic and academic success.

In the U.S., only half of adolescents with depression are diagnosed, and among them, approximately 60% do not receive appropriate treatment.  This situation is amplified in the AAPI community due to stigma and cultural barriers.

Many AAPIs face multiple challenges, including lack of health insurance, limited English proficiency, difficulty of acculturation and lower socioeconomic status. Less than half of AAPIs would seek help for their emotional or mental health concerns than their white counterparts. AAPIs tend to dismiss, psychosomaticize, deny or neglect their depressive symptoms for different reasons, such as different conceptualizations of mental health and illness or avoiding family shame.

These reasons have prevented many AAPIs from seeking mental health counseling or medication. Parental expectations in academic excellence, cultural/family obligations, identity conflicts, societal unconscious bias, and discrimination are some of the daily challenges confronting AAPI youth and young adults.

Parental warmth, family cohesion, and strong intergenerational relationships can help AAPI adolescents in expressing experiences with bullying and minimizing internalizing issues with immigrant parents, teachers, or the education system. It is critical for the AAPI community to continually strengthen family/parenting skills, build resiliency, and reduce risks for adolescent anxiety and depression. Safe, supportive, and nurturing relationships are important to children. Strong and positive self-esteem is extremely vital and can be associated with reduced risk of depression.

There is an urgent need to improve the mental well-being of future AAPI generations. Learning how to cope with various stressors that life throws at them, work productively and fruitfully, and contribute to their community and society are key for the younger AAPI generations to actualize the great potential that lies within them. It is equally important to reduce the stigma about mental health among the AAPI community and encourage seeking help and counseling when needed. We have a lot of work to do.

Parents, teachers and friends need to know the signs of anxiety and depression, and “act early.” The Centers for Disease Control and Prevention (CDC) offers several suggestions on their Children’s Mental Health website:

Anxiety

• Being very afraid when away from parents (separation anxiety)
• Having extreme fear about a specific thing or situation, such as dogs, insects, or going to the doctor (phobias)
• Being very afraid of school and other places where there are people (social anxiety)
• Being very worried about the future and about bad things happening (general anxiety)
• Having repeated episodes of sudden, unexpected, intense fear that come with symptoms like heart pounding, having trouble breathing, or feeling dizzy, shaky, or sweaty (panic disorder)

Depression

• Feeling sad, hopeless, or irritable a lot of the time
• Not wanting to do or enjoy doing fun things
• Changes in eating patterns – eating a lot more or a lot less than usual
• Changes in sleep patterns – sleeping a lot more or a lot less than normal
• Changes in energy – being tired and sluggish or tense and restless a lot of the time
• Having a hard time paying attention
• Feeling worthless, useless, or guilty
• Self-injury and self-destructive behavior

Read more on NIMHD.HIV.gov.

One of the less visible effects of Hurricane Maria has been PTSD. Many Puerto Ricans are dealing with trauma related to the storm, especially as the next hurricane season begins.

MICHEL MARTIN, NPR HOST: It’s beautiful here in Puerto Rico. The palms have grown back. The flame-red flamboyan are flowering again. But the beauty cannot hide a hard fact – just about everyone here has a story of loss – of homes, of property, of loved ones, even of faith. Mental health professionals here say that they’ve seen an increase in depression, anxiety, insomnia – even suicide.

And yet, people have found ways to cope. In Humacao, the volunteer cooks at the Apoyo Mutuo have become defacto therapists, checking in on the well-being of their neighbors who stop by for a hot lunch. Maria Laboy is one of the ladies working here.

MARIA LABOY: After the storm, everybody was depressed, sad and everything.

MARTIN: She scoops up a huge slice of steamed pumpkin for one of the regulars, Georgie Ortiz, who makes the trip up the hill every day for lunch and conversation. He used to make his living as an auto mechanic, but people around here aren’t maintaining their cars anymore, he says. They’re saving their money for more urgent expenses like home repair and fuel for generators. He didn’t have any documentation to prove that he owned his home, so he wasn’t eligible for emergency funds from FEMA. He says he does have a blue tarp.

GEORGIE ORTIZ: (Speaking in Spanish).

MARTIN: But he lives alone, and he can’t install it by himself. During the day, he finds ways to stay busy and distracted from his problems. But at night…

ORTIZ: (Speaking in Spanish).

LABOY: He say he sleep depressful (ph). It won’t go down.

MARTIN: Over the past few months, Maria Laboy and the other lunch ladies have become friends with neighbors like Georgie.

LABOY: I really worry about him because he just lost his mother, and he’s – he don’t have work now. (Unintelligible) and he can’t survive like that. And he’s down because no help – he haven’t have no help from nobody. So, you see, it’s not a pretty picture right now.

MARTIN: There was a 29 percent increase in suicide on the island in 2017 according to the Puerto Rican Department of Health. The majority were men and people over 50 years old. Researchers are working to determine how many of those were hurricane-related. Calls to the suicide prevention hotline have spiked, but with so many people without phone service months after Maria, that method of getting help was not a reliable option.

Down the mountain from Georgie Ortiz and the community kitchen, five EMTs are gathered at the emergency management center of Humacao.

UNIDENTIFIED PERSON: (Speaking in Spanish).

MARTIN: They’re here for mental health and resiliency training to learn how to cope with their own stress so they can help people struggling in their communities. It starts by acknowledging the fact that they’re stressed. One exercise near the end of the session brings the point home. The trainers ask everyone to participate.

ELEXIA SUAREZ: I’m going to go through some phrases, and if anyone has – you have experienced it or touch you, please stand up. (Speaking in Spanish). I have lost a loved one through Hurricane Maria or after.

MARTIN: One EMT stands up. But by the end of the list – if you’ve had damaged property, if you’ve seen your community impacted, if you worked through the disaster – everyone in the room is standing. After the session, I asked the EMT supervisor, Frank Torres, why he thought this training was important for his employees.

FRANK TORRES: (Speaking in Spanish).

MARTIN: He says the hurricane was difficult on first responders. He has 18 EMTs to cover the whole city of Humacao, and everyone worked around the clock for four days straight responding to emergencies. The stress of working the hurricane was coupled with the personal stresses the EMTs faced at home.

TORRES: (Speaking in Spanish).

MARTIN: And they’ve still not rested, Torres tells us. Nobody has had any vacation. They work all the time, and on all their days off, they rebuild. Caesar Rosario was one of the EMTs who stood up when asked if anyone lost their home due to Maria. He lost his home of 20 years but didn’t find out for a few days because he was on duty.

CAESAR ROSARIO: (Speaking in Spanish).

MARTIN: He walked from the station to his house once the storm had passed.

ROSARIO: (Speaking in Spanish).

MARTIN: He lost everything, says Rosario. It’s not easy.

The training these EMTs are receiving today is part of an island-wide initiative from the nonprofit group Americares to address the mental health crisis in Puerto Rico. Ivalis Morales and Elexia Suarez are the two people leading the session. Both of them are psychologists who practiced in the region before Maria. One’s office was destroyed, along with her 25-year private practice. The other’s home experienced major damage. They agree that these sessions help them feel useful to the island’s overall recovery. Elexia Suarez says that strong communities and relationships are essential for surviving a major event like the hurricane last fall.

SUAREZ: As we have seen and again and again and again, the community leaders, the community resources – between one another, people have become so tight, so together. That is a collective hope, a collective support, because you could not have survived this without someone, even if it is one neighbor – you couldn’t.

MARTIN: They end the session by passing around a photo of a mango tree. The trunk is completely severed, but one little branch shoots off the stump. Off the fragile shoot hangs a huge, bright mango. Suarez says this is a symbol for post-Maria Puerto Rico.

SUAREZ: Saying that we have been cut, taken away. Even though we’re together, we’re standing. We’re giving fruits, and we’re blooming. We’re doing it for ourselves, our family, our communities in Puerto Rico.

Read more and listen to the story on NPR.org.