NNED - National Network to Eliminate Disparities in Behavioral Health

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Without an Honorable Discharge, Mental Health Options are Limited for Veterans

When service members separate from the military, their futures depend on something called a characterization of service. There are five different possibilities: honorable, general under honorable conditions, other than honorable, bad conduct, and dishonorable.

“Other than honorable” means the service member has had a pattern of misconduct or has been convicted by a civilian court of a crime. Meanwhile, “bad conduct” and “dishonorable” result when a service member commits a felony-level offense. Those two categories, the lowest on the military scale, are also known as “punitive discharges.”

Military discharges are a reward system. Serving without bad behavior or crime earns service members support from the VA. But if they cause trouble, they’re mostly on their own.

“When you get an other than honorable discharge or a bad conduct discharge or a dishonorable discharge, you lose virtually all of your access to VA benefits,” said South Texas College of Law Professor Geoffrey Corn. “They’re supposed to be reserved for service members who served under honorable conditions.”

In July, the VA revised its policies and began offering 90 days of emergency mental health care to veterans with other than honorable discharges – people who it says are at greater risk of suicide and homelessness. But there are still limits. Ex-service members with punitive discharges – bad conduct or dishonorable – are not included. They can only access short-term humanitarian services from the VA, which have to be repaid.

That would have been true for Devin Kelley, who killed 26 people at a Sutherland Springs, Tex. church Nov.5. Kelley – a former Air Force airman – received a bad conduct designation after being court-martialed for domestic assault in 2012. At a National Press Club meeting shortly after the shooting, VA Secretary David Shulkin said he considered Kelley a criminal, not a veteran.

“Those with bad conduct or discharges, such as this gentleman, have violated the law, have violated our morals and ethics, and I do not believe deserve services and benefits,” he said. Shulkin laid the responsibility for care elsewhere. “They have other systems where I believe they could get the help that they need, whether they’re prison systems or other community-based systems,” he said. “But not the Department of Veterans Affairs.”

But some say VA treatment should be available even for people who have received punitive discharges. Dr. Stephen Xenakis is a psychiatrist and retired Army brigadier general who used to administer Army hospitals.

“I don’t see treatment to someone who has a serious problem and committed an offense as a benefit. I see it as a responsibility,” Xenakis said. “In this particular case, it was a responsibility we dropped, and we had horrendous consequences from that.”

Xenakis argues that the military justice system doesn’t offer adequate treatment for offenders transitioning back to civilian life. He said the VA should help coordinate care for newly discharged people. “In the cases I’ve seen and worked with, there hasn’t been much coordination between the military services and the local communities or the states,” Xenakis said. “It really has varied a lot in terms of how closely the people are monitored and what the circumstances of parole are.”

Read more on WUSFNews.USF.edu.

Online Tool Helps PrEP Users Assess Marketplace Coverage Options

To help individuals using pre-exposure prophylaxis (PrEP) who are also seeking to get or renew coverage in the Insurance Marketplace during the current open enrollment period, NASTAD recently launched PrEPcost.org . The site is an online health plan finder that helps PrEP users or navigators identify and compare access to PrEP in Marketplace coverage options.

PrEP is an HIV prevention method that involves people at very high risk for HIV infection taking medicine daily to lower their chances of getting infected. PrEP can stop HIV from taking hold and spreading throughout your body. It is highly effective for preventing HIV if used as prescribed. Visit HIV.gov to learn more about PrEP.

PrEPcost.org features information on plans available through the 2018 Federally Facilitated Marketplace. Access to PrEP and its cost may be only one of the considerations that someone seeking coverage through the Marketplace may have. It is important to examine costs for all health, prescription, behavioral health and other covered services that are important to the individual. The open enrollment period has begun and ends December 15, 2017.

Use these tools provided by HIV.gov for help completing your application:

Read more on BlackAIDS.org

To Build Healthy Communities for Native Kids, Involve Them

In the heart of the Crow Reservation in southeastern Montana, the 450-person town of Valley of the Chiefs has faced mounting difficulties over the past several decades. In the last two generations, the Crow Nation has lost 80% of its population and 73% of its land. Economic dispossession has rattled Valley of the Chiefs, as members of the community have turned to substance abuse and violence. For youth, who make up around 43% of the population, the town is especially harsh.

Valley of the Chiefs is one of six communities selected this year to participate in Raising Places, a new initiative developed by the Chicago-based design firm Greater Good Studio and funded by the Robert Wood Johnson Foundation to initiate ground-up local projects that will support a healthier environment for children–and by extension, everyone around them. “The research has shown for a long time that where you grow up matters,” says Sara Aye, executive director of the Greater Good Studio. “It matters for your health, it matters for your broader success in life. We can’t create a culture of health in America if we don’t have healthy places for kids to live and grow.”

Raising Places partnered with local groups in each of the communities, which range from a street in Minneapolis to a town in upstate New York, to begin the process of designing and implementing child-centric projects that will bolster overall community health. While a number of projects have originated with children’s health in mind (like the nonprofit KaBOOM!’s initiative to fund innovative play spaces across the U.S.), Raising Places is taking it a step further by actually bringing children and teens into the brainstorming and design processes.

“It was really important to us to develop a diverse and engaged design team in each of the communities,” Aye says. And by “design team,” she adds, she means a cohort of local leaders–artists, organizers, planning department experts, school and youth group administrators, and youth themselves. “They’re not designers, but we’re training them to think as designers,” Aye says. With the help of the Raising Places program staff, these teams will be the ones who will come up with, test, and ultimately carry through the projects.

In Valley of the Chiefs, one of the ideas the team is working with is the concept of a culinary school, Aye says. “In their research, they really saw a focus on food, and the traditions around eating communally and Native food,” she adds. “There’s also a dire need for healthy food and jobs for young people–jobs that can lead to careers.” While the culinary school could act as an avenue to employment, the team is also looking into addressing that need through an idea to build out, from scratch, a real main street in the town, where local entrepreneurs could open businesses to sell goods. The main street, the team imagines, could also be supplemented by an online platform to expand their sales market, and the business owners could act as mentors to the town’s young people, who could also work at the businesses.

Across the country in the Downstreet neighborhood of Hudson, New York, the design team there is focusing on addressing a very different set of concerns. “One of the ideas there is around police and community interaction, particularly how police and youth interact,” Aye says. Hudson is a heavily policed town, and one that’s often plagued by violence; children and young people there, Aye says, often express a sense of trauma around dealing with police. “One of the insights they had is that police are often working to fix symptoms, but they don’t deal with root causes,” Aye says. Out of that observation came an idea for a civilian review board that would include youth, and focus on helping the police force become more self-aware and sensitive to the effect they have on young people.

Read more on FastCompany.com.

2017 ‘Move to End Violence’ Against Women and Girls Leaders

The NoVo Foundation, created in 2006 by Jennifer and Peter Buffett, has named 21 phenomenal leaders to participate in the 4th cohort cycle of Move to End Violence, a 10-year capacity building program designed to support those who are strengthening the movement to end violence against girls and women.

Move to End Violence grew out of the NoVo Foundation’s core commitment to social justice, and its vision of a future in which all girls and all women can live free from violence and discrimination, act as change agents on their own behalf, and lead us to a better world. Knowing that social transformation of this magnitude would require a powerful movement of well-resourced leaders from strong, healthy organizations, NoVo launched Move to End Violence in 2010.

Through the encouragement and teaching of many leaders in the movement, Move to End Violence is continually challenging itself to center the wisdom, experience, and leadership of the most affected. This cycle intentionally emphasized the leadership of those from and working within marginalized communities being politically targeted in this time, including Black, immigrant, Muslim and transgender communities – communities that have been historically under-invested in and under-acknowledged for their contributions to the movement. Twenty-one extraordinary leaders, all women of color and Indigenous women, have been selected for their work at the intersection of oppressions and their collective potential for leading us forward toward liberation.

Jennifer and Peter Buffett, co-presidents of the NoVo Foundation, celebrated the announcement of this cohort saying, “This phenomenal group of movement leaders will be given space to work and dream, time to connect more deeply with each other, and resources to tap into their collective wisdom—strengthening the deepest roots of the movements our world needs to create a future free from violence. With room to build relationships, grow and deepen their shared work, transformation is possible, just when our world needs it most.”

The new cohort unites leaders working across the intersections of many of the most powerful movements to end violence against girls and women in all its forms, including domestic violence, commercial sexual exploitation, sexual assault, environmental injustice and more. It bridges movement leaders working throughout 13 states across a variety of approaches, including organizing, advocacy, research, and direct service. United by an intersectional commitment to advancing gender and racial equity and addressing all interlocking forms of oppression, this diverse set of leaders is uniquely poised to advance deep-seated, long-lasting change.

“Amid a growing national dialogue around sexual harassment and assault, the urgent need for this work—as well as the possibility it brings for real and lasting change—are perhaps clearer and more prominent right now than they’ve been in decades,” said Pamela Shifman, executive director of NoVo. “We know that seizing this momentum, and truly ending a culture of violence against girls and women, requires long-term, fundamental change, led at every step by those who are most affected by it. That’s exactly what this new cohort is set to do.”

The heart of this 10-year program is building leaders’ capacity for transformative movement-building through a series of five cohort cycles focused on deep dialogue, training, and access to resources. Through convenings, workshops, skills training, coaching, and a community of fellow Movement Makers and allied leaders, participants in the fourth cohort will have a unique and transformational opportunity to powerfully contribute to a movement for social change.

Complete bios for the fourth cohort of Movement Makers can be found here.

Read the press release from the NoVo Foundation.

Moving the Race Conversation Forward

“Moving the Race Conversation Forward” is a report by Race Forward: The Center for Racial Justice Innovation that aims to reshape and reform the way people talk about race and racism in the United States.

Part One (pdf) includes:

  • Content analysis of mainstream media: Two-thirds of race-focused media coverage fails to consider how systemic racism factors into the story, instead typically focusing upon racial slurs and other types of personal prejudice and individual-level racism.
  • Seven harmful racial discourse practices, which reinforce the common misconception that racism is simply a problem of rare, isolated, individual attitudes and actions: Individualizing Racism, Falsely Equating Incomparable Acts, Diverting From Race, Portraying Government as Overreaching, Prioritizing (Policy) Intent over Impact, Condemning Through Coded Language, and Silencing History.

Part Two (pdf) features case studies and profiles of recent interventions and initiatives advanced by the racial justice field to challenge mainstream discussions of race and racism, and the negative policy impacts that dominant frames and narratives have on people of color. They include: Drop the I-Word, Migration is Beautiful, ALEC on the Run, Fruitvale Station, and Ending the Schoolhouse-to-Jailhouse Track.

Watch the accompanying video, produced by Jay Smooth, which breaks down the report in engaging, accessible ways. Smooth is the founder of New York’s longest running hip-hop radio show, WBAI’s Underground Railroad, and Race Forward Video & Multimedia Producer.

Learn more about the report at RaceForward.org.

World AIDS Day 2017

When the first World AIDS Day was launched in 1988 by the World Health Organization (WHO) and the United Nations, the disease had been identified only four years prior. As TIME reported that year, of the 65,780 cases reported in the U.S. since June 1981, 37,195 of those patients had passed away. As it continued to spread, more than 1,000 protesters seized the Food and Drug Administration’s headquarters to pressure the agency to hurry up its notoriously slow drug-approval process, and patients were desperate for some sort of magic bullet — or at the very least a drug that would provide a lifeline.

But there was one medicine that did not need government approval: information.

At least that’s how experts like Jim Bunn saw things at the time. Bunn came up with the idea for World AIDS Day with Thomas Netter while they were working as public information officers for WHO. Bunn, who had previously been the nation’s first full-time television AIDS reporter, knew that knowledge about HIV and AIDS would help people protect themselves. But conveying that information was easier said than done, especially as misinformation, prejudice and fear were passed along just as quickly. The awareness day was one part of a solution to that problem.

In the walk-up to World AIDS Day, the Peabody and Emmy Award-winning journalist spoke to TIME about what it was like to track the AIDS epidemic, both as a journalist and a public health professional.

TIME: Were there any particular obstacles you encountered as a journalist, and then spokesman, on the AIDS beat in the 1980s?

BUNN: Back in that day, TV technicians were reticent, sometimes refused, to even put microphones on people with AIDS. I made a point in my stories of bringing a crew with me that had been educated about how the disease is transmitted, because I felt that it was incumbent on me to show them the utmost respect. These people were coming out at a time when the result of them being interviewed could get them fired, evicted, “out” them to their families and friends. The epidemic thrust people out of the closet because they were now sick and dying. So there was a tremendous amount of courage being displayed just by agreeing to talk to me.

How did you make the epidemic hit home for people who thought they weren’t at risk?

When I was a journalist, what we’d try to focus on, in addition to those whose stories we were telling particularly at that time, [was that] the virus is not limited to gay or bisexual men, it’s not limited to IV drug users, this is a sexually transmitted disease. One of the things we didn’t do, we didn’t talk about what [the interviewee’s] sexual preference was. We talked about what their symptoms were. We talked about what it was like to live with this disease.

Was there a particular patient who inspired you to keep working for the cause along the way?

Yes, yes. I’ll never forget Tom Wicker — who reached out to me saying he had been denied Social Security benefits because he had AIDS — or Bobby Reynolds, a very soft spoken lineman for a phone company who climbed up telephone poles for a living. He was one of the leading voices, and I got to see him in the hospital before he died. During the AIDS epidemic, every single person you covered died for the reason you were covering them. There was nothing before then, outside of combat, with anything even close to that kind of calculus.

Things have changed so much since then, and the disease is no longer a death sentence. Do we still need World AIDS Day today?

I think so, for the following reasons: About two years ago I was the keynote speaker at a World AIDS Day observance at Duke, and this fellow came up to me and said, “I want to thank you.” He was an African-American man who had been in the closet until his church had put on a World AIDS Day. Once people were responding to the religious requisite of caring for people who are sick and dying, he felt like his congregation had come far enough that he came out to this pastor.

There are still people today who are newly infected. There are people today who engage in high-risk behavior. And without the horrible experience of seeing your peers dropping dead around you, it’s not going to get your attention the way it did to those people back then.

Read more of the interview on TIME.com.

Resources for World AIDS Day 2017