“A Sad Anniversary,” by Andrew Malekoff, Anton Media, May 29-June 4, 2019

“A Sad Anniversary,” by Andrew Malekoff, Anton Media, May 29-June 4, 2019

Just the other day I was reminded that May marks the anniversary of one of the saddest trending tweets in Twitter history. The reminder was a photo posted on Instagram of a girl holding a cardboard sign. The girl looked to be 13 or 14 years old. The sign read: If I die in a school shooting, leave my body on the steps of Congress.

#IfIDieInASchoolShooting was first tweeted a year ago, after 22 school shootings up to that point in 2018. Number 22 happened at Santa Fe High School in Texas on May 18, 2018, just a few months after the shooting at Marjory Stoneman Douglas High School in Parkland, FL, when a gunman killed 17 students and staff members and injured 17 others.

At Santa Fe, 10 people—eight students and two teachers—were fatally shot. Thirteen more were wounded.

As we mark the first anniversary of #IfIDieInASchoolShooting, the “statistics” have climbed. Eight school shootings have taken place on high school or college campuses in 2019 through the month of May. So far.

In a piece on the trending hashtag written by India Pougher for ELLE Magazine four days after the Santa Fe shooting, she wrote, “Students began tweeting…and sharing the things they would miss out on if their lives were taken too soon. The answers range from leaving their loved ones behind to never graduating college and never getting married.”
Here are some of the tweets:

#IfIDieInASchoolShooting:

Prop up my casket in front of the White House — @scottf6f

I want to be buried next to my best friend — @2muchisntenough

Make sure I am the last to do so — @ardenneastonn

Is a sad reality for America — @tiatameraa

Please make school shootings die with me — @madhavids

Don’t release pictures of my smiling face. Release pictures of my bloody dead corpse to show what school shootings really are. Politicize my death — @hmc823

I’ll never get to publish my book, celebrate my sweet 16, get married, or see my children grow to be wonderful people — @casforachange

Then my parents would have outlived their only child — @estef4change

Protect my little sister so she can stop “learning to hide from the bad guy” — @robinisme16

My 8 younger siblings will have to grow up without their oldest sister, i’ll never graduate high school or college, i’ll never get to work in dc like i’ve wanted to since i was young, i’ll never get to create change — @jaxonomara

My dogs would be left wondering why I never came home. My internet friends would be clueless. I wouldn’t achieve my dream. If I die in a school-shooting the government won’t do anything to prevent another — @TAKENBYDEMA

I will never become a nurse and fulfill my dream of helping children, teenagers, and young adults. My passion for wanting to save lives will die with me — @beachwonders

One adult saved me the trouble of writing a conclusion, when he tweeted:

If I Die In A School Shooting is the saddest hashtag I’ve ever read — @StevenBeschloss

Andrew Malekoff is the executive director of North Shore Child & Family Guidance Center, which provides comprehensive mental health services for children from birth through 24 and their families. To find out more, visit www.northshorechildguidance.org or call 516-626-1971.

“Guidance Center to Host 23rd Annual Jonathan Krevat Memorial Golf & Tennis Classic,” Anton Media, May 20, 2019

“Guidance Center to Host 23rd Annual Jonathan Krevat Memorial Golf & Tennis Classic,” Anton Media, May 20, 2019

From left: Michael Mullman, Ed Geller, Jeff Krevat and Peter Braverman

North Shore Child & Family Guidance Center will hold its 23rd annual Jonathan Krevat Memorial Golf & Tennis Classic on Monday, June 3, at the North Hempstead Country Club in Port Washington, one of the region’s premier courses.

Co-chairs Mike Mondiello, Michael Schnepper and Troy Slade are once again working together to create a stellar event filled with friendly competition, delicious dining and wonderful auction prizes. This year, the event is celebrating the dedicated mental health professionals at the Guidance Center—the people who are at the heart of the many success stories of moving families from hurting to healing.

“The reason the Guidance Center changes so many lives for the better is because the staff is composed of caring, compassionate and highly trained individuals,” said Slade, who is a member of the board of directors. “I’m thrilled that we are celebrating them at this year’s Krevat Cup.”

“This is going to be a phenomenal event,” said Mondiello, also a member of the Guidance Center’s Board of Directors. “The North Hempstead Country is a beautiful course, and we are excited to hold the Krevat Cup at this elegant location for the first time!”

 

Troy Slade, Mike Mondiello, Dan Donnelly and Michael Schnepper



Established on Long Island’s beautiful and serene Gold Coast in 1916, the North Hempstead Country Club features a tree-lined, superiorly manicured golf course designed by renowned architect A. W. Tillinghast, one of the most creative and productive golf course designers ever.

In addition to golf, the event will feature round robin tennis (for the non-golfers among the attendees), a delicious brunch and a gourmet dinner after the day’s games conclude. It will also feature a silent and live auction, with prizes ranging from club seats for a Yankee game to exciting vacation packages and much more.

Dan Donnelly, one of the Guidance Center’s most ardent supporters, as well as a former Krevat Cup honoree, will be serving again as the emcee and auctioneer. “I’m so pleased that this year’s event is celebrating the Guidance Center’s amazing staff,” said Donnelly. “The people working here are such caring souls who are truly devoted to saving lives.”

 

A tennis player readies her serve.



The other auctioneer for the evening portion of the event is Andrew Marcell, a Guidance Center Board Member. “The Krevat Cup is one of the most enjoyable events of the season,” Marcell said. “It’s a win-win: Everyone has a terrific time while supporting the lifesaving mission of the Guidance Center.”

Executive Director Andrew Malekoff said, “The event is crucial to our fundraising efforts, and will help us continue to help thousands of children each year who are struggling with issues such as bullying, depression, anxiety and substance abuse.”

Fifth Avenue of LI Realty/Americana Manhasset has signed on as a Diamond Sponsor.
For those interested in joining a team, attending the dinner, becoming a sponsor or placing a journal ad, contact Patrick Madden at pmadden@northshorechildguidance.org or 516-626-1971, ext. 309.

North Shore Child & Family Guidance Center is the preeminent nonprofit, children’s mental health agency on Long Island, dedicated to restoring and strengthening the emotional well-being of children (from birth to age 24) and their families. For more than 65 years, the Guidance Center has been a place of hope and healing, providing innovative and compassionate treatment to all regardless of their ability to pay.

For more information about the Guidance Center, visit www.northshorechildguidance.org
 or call 516-626-1971.
“Taking the Fight Out of Food,” By Andrew Malekoff, Anton Media/Long Island Weekly, May 13, 2019

“Taking the Fight Out of Food,” By Andrew Malekoff, Anton Media/Long Island Weekly, May 13, 2019

Is your child a picky eater? Does her or his eating create tension in your home? What was your experience in being fed growing up? Were your parents overly involved?

These are a few questions to consider if you are concerned with your child’s eating habits. Donna Fish, a licensed clinical social worker, offers parents and kids guidance in how to take the fight out of food.

I met Ms. Fish at her workshop that focused on learning how to prevent and solve childhood and teen eating problems. She advised that two questions to ask up front are: What is the problem? And whose problem is it?

These two questions are critical to understanding whether your child’s eating is problematic from a medical/developmental perspective.

If a medical problem has been ruled out, the child is not nutritionally compromised and there are no body image issues the child is experiencing, then there needs to be some better understanding about how their picky eating is affecting dynamics in the family. For example, does it lead to parents frequently fighting or to tension on vacations?

Basic parent education on nutrition and development go a long way in helping a parent to understand that their child is on a normal growth curve and that how they eat from a nutritional perspective is nothing to be worried about. Consulting with your pediatrician or finding a nutritionist is a good place to begin.

If education doesn’t do the trick, then it is helpful to understand a bit more about whose problem it is. This necessitates an understanding about the meaning of food in the family.

In many cultures food and feeding represent love, nurturing and bonding. If a child’s picky eating denies a parent a sense of nurturing it can lead to a battle of wills. In that case, a child quickly learns how their eating represents an ability to take control, which can lead to power struggles in the family.

For parents, understanding their own experiences eating when growing up can offer them some insight. For example, if their parents were overly involved with their eating it might suggest some difficulty trusting your own body signals regarding when you’re hungry or full and satiated.

If a parent makes this historical connection, it may help them to better understand the value in allowing their child to have more autonomy with eating. For example, they can be allowed to control their own meal portions. For a toddler that might mean putting finger foods on their tray so they can help themselves as opposed to being spoon fed.

In her work with children who are struggling with eating, Fish advises “You are the expert on your body. You need to be the best body detective possible. It’s your job, not your parents’ job.” This is important work that helps the child to separate emotions from feelings of fullness and comfort.

Ms. Fish sees “all food as good,” as having some value, and talks to kids about nutrition in a way that generates interest and curiosity.

Still, if your child appears to continually make poor choices, it is important that you set reasonable limits. As Fish puts it, “Parents think their job is to protect their child from disappointment, anxiety and hurt,” but it is okay for children to experience the disappointment of your setting limits on occasion. It’s just another of the many areas where parents can help their kids learn a valuable life lesson.

To learn more about Donna Fish, visit www.donnafish.com. Take the Fight Out of Food can be found on Amazon.

Andrew Malekoff is the executive director of North Shore Child & Family Guidance Center, which provides comprehensive mental health services for children from birth through 24 and their families. To find out more, visit www.northshorechildguidance.org or call 516-626-1971.

“Seeking Humane Solutions for Young Refugees,” by Andrew Makekoff, Anton/Long Island Weekly, December 14, 2018

“Seeking Humane Solutions for Young Refugees,” by Andrew Makekoff, Anton/Long Island Weekly, December 14, 2018

In a recent story in the Albany Times Union, reporter Mallory Moench paints a different picture about juvenile asylum seekers as compared to recent stories about caravans purportedly composed of gang members and Middle Eastern terrorists.

In the report we meet Rosa, who left El Salvador as a young adolescent after being targeted by a gang intending to prostitute her. To prevent becoming sexually exploited, she left her parents and crossed the border. She has been living in the Capital Region of New York for the past two years.

Rosa, now 17, is undocumented and is seeking special immigrant juvenile status that would enable her to apply for a green card which permits a foreign national to live and work permanently in the U.S.

Rosa understands that she could be denied and deported. More than 12,500 undocumented young people have participated in immigration court this year alone. For those without a lawyer, the odds of deportation are much greater.

According to the Albany Times Union report, “If juveniles [under the age of 21] have a relative who is a U.S. citizen or green card holder, they can apply for a family-based petition. If they are victims of trafficking, domestic violence or another crime they can apply for crime victim visas. If they’re fleeing persecution like Rosa, they can apply for asylum. If they’re missing one or more parents they’re eligible for special immigrant juvenile status.”

Former Attorney General Jeff Sessions had taken measures to fast-track deportations. Consequently, many juveniles may be sent back to their homelands—and the dangers and threats that await them—before legal proceedings are implemented.

Many of the young people living in New York’s Capital Region, ages 12 to 19, came from El Salvador, Guatemala, Honduras or Mexico after being confronted with gang violence. The profile and numbers of refugees on Long Island is similar. It is ironic that with the incendiary political rhetoric of the day, many asylum seekers have been labeled gang members, when it is gangs that they are trying to escape from.

Many young migrants endured trauma in their passage to the U.S. They faced starvation, violence and abandonment.

There are only two immigration courts in all of New York. One is located in New York City and the other is in Buffalo. For many asylum seekers, the cost for transportation to court hearings prevents them from following through. For example, for those living in the Capital Region, a bus ride can be as much as $100 and more than $500 for private transportation.

This is especially daunting when they are living in poverty.

Furthermore, there is a cap on the number of visas given each year and also each month. This contributes to inordinate delays in court.

For most of these juveniles the fear and anxiety of being deported as they await a final legal determination can be unbearable and impacts their ability to heal from the traumatic journey to the U.S.

Immigration laws do need to be enforced as open borders with endless flow of refugees is unsustainable.

The challenge is how to enforce the law, dial down the divisive and hateful rhetoric, demonstrate compassion and seek humane solutions for young migrants simply looking to live without fear. We’ve strayed from that ideal. I hope we can find our way back.

Andrew Malekoff is the Executive Director of North Shore Child & Family Guidance Center, which provides comprehensive mental health services for children from birth through 24 and their families. To find out more, visit www.northshorechildguidance.org.

“Flint Revisited,” by Andrew Malekoff, Anton Media Group, April 12, 2019

“Flint Revisited,” by Andrew Malekoff, Anton Media Group, April 12, 2019


(Image by Rudy and Peter Skitterians from Pixabay)

I have protested or testified before government bodies for issues including separating children at the border, school shootings and insurance parity for mental health and substance use disorders. I participated in a number of relief efforts after large-scale disasters such as 9/11 and Hurricane Sandy. Yet nothing haunts me as much as the poisoning of an American city.

The water crisis in Flint, MI, began in April 2014 when, in a cost-cutting measure, the drinking water supply from Detroit’s system was switched to the Flint River. When essential treatment and testing of the water did not follow, health issues ensued.

Government officials turned their backs on the residents of Flint by ignoring the problem that was signaled by foul smelling and discolored water being piped into people’s homes for nearly two years.

Five years later, in January 2019, Gov. Gretchen Whitmer assured Flint residents that they will continue getting free bottled water until all of the pipes are replaced. According to a Jan. 23, 2019 report in The Detroit News, “As of December, the city had replaced nearly 7,000 out of 18,300 lead or galvanized steel water pipes it had identified.”

Beyond the local community, where is the sustained outrage about this unfathomable crime against the children and families of Flint?

I’ve seen a lot in seven decades beginning in the early 1950s, and although I never attempted to rank the horrors over those years, I find the poisoning of Flint, MI, to be among the most troubling. Although there has been backlash, I find it to be muted in comparison to other disasters.

The poisoning of an American city and all of its children, mostly children of color, was a government cost-cutting measure that would have been considered ethnic cleansing by our government leaders if it happened in any other country but our own, according to filmmaker Michael Moore.

To be clear: The residents of an entire American city were poisoned for 19 months. There were warning signs—off-tasting water, body rashes, itchy skin, hair loss—yet government officials told the residents that the water was just fine. It took almost two years of poisoning for the government to wake up after researchers pointed to elevated levels of lead in children.

Corruption in New York State and the country at large is so common that clean government has become an oxymoron. Have we become so inured to it that our attention cannot focus on the latest scandal for very long? Has our capacity for empathy become drained by serial horrors?

If my children were among the poisoned I would likely have to contain feelings of murderous rage, because acting on such impulses would do nothing to help my children.

Yet how do the parents of Flint cope with the knowledge that their children, with still-developing brains, may sustain cognitive impairments that will last a lifetime?

Gov. Whitmer reflected, “Trust was not broken overnight, and it’s not something you can earn overnight.”

The Detroit News reported that “many residents remain wary of the water amid fears that pipe replacement efforts could dislodge lead flakes.” They likely remember that state regulators did not make sure that the city used corrosion control chemicals when it made the switch to the Flint River for its water supply in April 2014.

Will trust ever be restored by parents who understand that their children’s intellectual potential has been compromised by bureaucrats looking for a shortcut to balance the budget? What can one do or say to offer some relief? I cannot think of a thing. Can you?

Andrew Malekoff is the executive director of North Shore Child & Family Guidance Center, which provides comprehensive mental health services for children from birth through 24 and their families. To find out more, visit www.northshorechildguidance.org.

“Giving Hearts,” Anton’s Long Island Weekly, February 6-12, 2019, by Andrew Malekoff

By Andrew Malekoff

Why do people choose to support certain causes, while others look away?

Sometimes it’s personal. A family member dies in hospice where their dignity was preserved in their final days. Other times it’s not as close to home. A television spot features a child with a cleft palette, a shivering dog or a malnourished baby.

Certain causes seem easier to sell. For example, the school you attended or a research center that is making advances in treating cancer.

Other causes may be tarnished by misunderstanding. For example, I’ve worked in the mental health and addiction fields since the early 1970s. It is in this arena that some believe that one’s ailments “above the neck” are self-inflicted, failures of character or poor parenting or lack of will power. Consequently, they deem them unworthy of philanthropy.

Nevertheless, I must recognize the compassion and generosity of those who do understand and support the work we do at North Shore Child and Family Guidance Center and many of our sister agencies. It is important to acknowledge that these givers are more than do-gooders, despite the good that they do.

They are smart and empathetic. They know that what we do is cost-effective, saving tens of millions of dollars by keeping troubled kids at home and out of costly institutional settings. They look into the eyes of their own children or grandchildren and feel a deep connection to all children.

Family members and friends have asked me what led to my choosing a career in human services, intimating that it’s not a financially lucrative path. My greatest influence was observing the profound impact of the kindness of others during my childhood and youth.
The father of my closest childhood friend died in the 1950s when we were little kids. We lost touch as we grew older. When his mom died, I sent him a sympathy card.

Some weeks later my friend wrote back to me. His words brought a lump to my throat.

“Dear Andy: What a surprise to hear from you! My mom’s death has caused me to spend hours thinking about my childhood. Some of my most fond recollections involve you and your family. Your father was the dad I didn’t have…”

Throughout my childhood, my parents, as well as other adults in my family, performed acts of profound kindness and generosity without fanfare or any expectation of anything in return. I married a woman who came from a similar family. Her parents took in their nieces after the untimely death of their mother.

Now I have found these people with giving hearts again among our board of directors and community supporters. What they have in common with my family is their empathy.

Government bureaucracies have no empathy. They have rules and regulations. One can only hope that legislation they enact is guided by values rooted in the felt needs of real people.

We cannot rely exclusively on government to take care of us. We must rely on one another. We cannot allow empathy to slip away, as it sometimes seems it is. The demise of empathy is perhaps the most perilous consequence in today’s divided America.

When all else fails, empathy is all we have to maintain a humane society.

Andrew Malekoff is the Executive Director of North Shore Child & Family Guidance Center, which provides comprehensive mental health services for children from birth through 24 and their families. To find out more, visit www.northshorechildguidance.org.

“New Law Aims to Strengthen Access to Mental Health Care,” Anton Media, January 9-15, 2019

“New Law Aims to Strengthen Access to Mental Health Care,” Anton Media, January 9-15, 2019

By Andrew Malekoff

Thanks to a strong advocacy push by a broad array of consumer and provider representatives of behavioral health services, the Mental Health and Substance Use Disorder Parity Report Act was enacted into law by Governor Cuomo on Dec. 21, 2018, as Chapter 455 of the Laws of 2018.

The historic new law is a huge victory for North Shore Child & Family Guidance Center and the broader mental health and substance use care community as it will compel insurers to submit key information to the NYS Department of Financial Services (DFS) for analysis and evaluation of compliance with federal and state parity laws, culminating in the publication of a report on the DFS website that will provide much needed accountability and transparency.

Until now, existing parity laws, which demand that coverage and treatment for mental health and substance use disorders are on par with the coverage and treatment of physical illnesses, have been widely ignored, putting lives at risk. The failure to enforce parity laws was made clear in January 2018, when North Shore Child & Family Guidance Center released Project Access, a Long Island-wide study on the difficulty or ease in which families were able to access healthcare for mental illness and addiction.

This new legislation—which was passed one year after the release of Project Access—is a shared success and would not have been possible without strong grassroots support that included the generation of an enormous volume of letters, calls and tweets from consumer and provider advocates.

The enactment of the law at this time is especially symbolic as New York marks the twelfth anniversary of the passage of Timothy’s Law (the name of New York’s parity law), which Governor Cuomo recognized in his approval message: “Ensuring New Yorkers have access to care and treatment for mental illness and substance abuse disorders is critical and is the reason New York enacted one of the strongest mental health parity laws in the nation [Timothy’s Law] in 2006.”

2018 also marked the 10th anniversary of the federal Mental Health Parity and Addiction Equity Act. The new Mental Health and Substance Use Disorder Parity Report Act puts New York on a path to achieving full compliance and transparency with the state and federal parity laws, which are critical components in maintaining and enhancing access to care for those experiencing mental health and substance use disorders.

The challenge ahead will be to hold the NYS Department of Financial Services accountable, to be sure that they are taking adequate steps to verify the data and information that will be provided to them by health insurers.

Verification is essential to determining, for example, that the networks of providers on a health insurer’s rolls are in fact real as opposed to deceased, retired or no longer accepting insurance. They must also verify and report when waiting lists of valid providers are so long that access is delayed beyond a reasonable time with respect to the urgency of the need.

The reason why there is a paucity of mental health and drug treatment providers is due to the substandard rates of reimbursement that health insurers pay for mental health and addiction care as compared to what they pay physical health care providers. This must be exposed and corrected if found to be the case for denied access.

Access delayed is access denied.

Andrew Malekoff is the Executive Director of North Shore Child & Family Guidance Center, which provides comprehensive mental health services for children from birth through 24 and their families.

Kids First: Words Really Do Matter,” by Andrew Malekoff, Blank Slate Media, November 5, 2018

By Andrew Malekoff

Words matter. Today, this is no more evident than in the incendiary rhetoric spoken – and tweeted – that has contributed to American citizens being pitted against one another.

There is a growing sentiment that the mass shooting in a Pittsburgh synagogue that took the lives of 11 congregants was fueled by hate speech that ignited the shooter’s growing rage.

Although that subject is being abundantly covered in the media, it is the words associated with another kind of shocking death that I wish to draw attention to here. 

When someone takes their life, they are most frequently reported to have “committed suicide.” Commit is a word that connotes a criminal act. Yet, suicide is not a crime.

Desiree Woodland, a mom who lost her son to suicide shared her experience in a National Alliance on Mental Illness publication. “My son did not commit a crime. He believed the only way to end the unbearable pain was to end his life. He died because he didn’t have the words to express the deep psychological/biological turmoil he was experiencing.”

If not a crime, is suicide an immoral, depraved or sinful act? It isn’t if it is the consequence of mental illness, unbearable stress, or trauma.

Nonetheless, family members who are survivors of suicide loss report the experience of others speaking in hushed tones around them. Some people refer to suicide as a selfish act, the result of poor parenting, a deficit in the family or all of the above.

At the same time that there is a growing demand to tone down divisive and hateful rhetoric in order to prevent interpersonal violence, there needs to be discussion about mental illness and suicide. 

According to Denver psychotherapist Dr. Stacy Freedenthall, “If changing our language can help suicidal people to feel safer asking for help, then changing language can save lives.” 

In academic journals there appears to be an inclination to use the term “completed suicide.” However, committed and completed are terms that advance the stigma and shame related to suicide and should be avoided.

Increasingly there is preference to the expression “died by suicide,” which avoids the judgmental undertone of “committed suicide.” 

Perhaps a contributor to The Mighty, a digital health community created to empower and connect people facing health challenges and disabilities, said it best: “By shifting our language around suicide, we have the power to reduce some of the massive shame carried by survivors of suicide. If you feel scared or helpless about what to say to someone who’s lost someone to suicide, take comfort in knowing that, by changing your language about suicide, you’re offering an act of kindness.”

“Beyond Words: Trauma and the Arts,” by Andrew Malekoff, Anton Media Group, Oct 17-23, 2018

Powerful images that depict disturbing events in ways that literature alone cannot can be illuminating and healing. Following are three descriptions of different media that capture recent man-made disasters, still very close to the surface for many of us.

The first, Please Stand By, is an example of cartoon art in the aftermath of 9/11. The second, The Last Lockdown, is about a sculpture created after the mass school shooting in Parkland, FL. Both illustrate the fear-inducing paralysis of traumatic events. The last, Memorial Rock Garden, describes bereaved children painting stones to memorialize their deceased dads.

Please Stand By

In the immediate aftermath of the September 11, 2001, terrorist attack on America, several artists joined together to produce a soft cover book titled 9/11: Artists Respond. It is a collection of art, sequenced to showcase the artists’ response to the terror that befell the world.

One nine-frame piece entitled “Please Stand By…,” by Jeph Loeb and J. Scott Campbell, features a girl of about 8 years old watching cartoons on television. By the third and fourth frames, the image on the screen changes to a live feed of the Twin Towers ablaze.

As the little girl stands transfixed, stuffed animal in hand and her face less than 12 inches from the screen, the commentator announces, “We interrupt this program to take you live…”

The little girl turns away and cries out, “Mommy!” The next three frames begin with her mother dropping a basket of laundry. Then, with her face contorted in anguish, she embraces her daughter to shield her from the unrelenting televised images.

The final frame is a close up of the little girl asking, “Mommy, when are the cartoons gonna come back on?”

The Last Lockdown

The next image is a haunting statue, as described by journalist Josh Hafner, of a “small girl cowering beneath an open school desk, clutching a leg as she gazes into the distance with a look of fear in her eyes.”

The sculpture was created by Manuel Oliver, an artist who lost his 17-year-old son Joaquin in the Parkland, FL, mass shooting earlier this year.

As Oliver said, “It’s too late for us to save Joaquin from gun violence, but through art, my family and I are making sure that we protect the rest of the kids out there.”

“Talking about the trauma is rarely if ever enough,” advises noted trauma expert Bessel van der Kolk. He points to the Holocaust Memorial in Jerusalem and the Vietnam War Memorial in Washington, D.C., “as good examples of symbols that enable survivors to mourn the dead and establish the historical and cultural meaning of the traumatic events to remind survivors of the ongoing potential for communality and sharing.”

Memorial Rock Garden

In 2002 at North Shore Child & Family Guidance Center, a group of boys and girls who lost fathers in the attack on the World Trade Center decorated stones to be placed in a memorial rock garden.

The kids in the bereavement group sat together around a table covered with newspaper. In front of each of them was a large smooth oval-shaped stone. They decorated the stones with unique designs of paint and glitter, each one a personal remembrance of their fathers.
“Mine is painted gold,” beamed Mack. “I painted it gold because my dad is like gold to me.”
A heart framed Jenny’s design, “because my dad will always be in my heart.”

On Seth’s stone were two intertwined hands, a small one and a larger one that showed “me and my dad were best friends.”

Victoria painted a fire hat and said, “My dad is my hero.”

We might do well to remember that when funding cuts threaten to decimate arts programs in schools there is more at stake then we might imagine. The impact of the arts is not measured by standardized tests and its value is incalculable.

Andrew Malekoff is the Executive Director of North Shore Child & Family Guidance Center, which provides comprehensive mental health services for children from birth through 24 and their families. 

“Reach Out and Remember,” By Andrew Malekoff, Anton Media Group, September 12, 2018

In the aftermath of the 17th anniversary of September 11, I offer a remembrance of several groups of people—all Queens court personnel—whom I spent a day with in their courthouse, just three days after the 2001 terrorist attack.

The people I met with included individuals with missing relatives or friends, individuals with relatives or friends confirmed dead, individuals who were in the World Trade Center complex during the attack, individuals with family members who barely escaped, and individuals who witnessed the attack and collapse of the Twin Towers from courthouse windows. All were deeply affected. Most were in a state of shock and disbelief.

When I arrived at the courthouse, I learned that I would be meeting with three groups of 8 to 12 people each. I was called in by an official from an Employee Assistance Program to offer a supportive group experience. We met in a vacant courtroom. I arranged chairs around two adjacent prosecution and defense tables.

As I awaited the first group, a court officer said, “Today should be interesting.” I asked him what he meant. He said, “It’s foreclosure Friday.” He explained that every Friday they have an auction of foreclosed property and, typically, about 200 Arab-Americans participate in the auction, signaling a sense of mounting unease with people of Middle Eastern descent.

I greeted the first group, and one by one the participants revealed signs and symptoms of trauma and stress. These included numbness, shock, headaches, loss of appetite, aches and pains, frequent trips to the bathroom, sleeplessness, flashbacks, startle responses to loud noises (especially airplanes), helplessness, gruesome nightmares, anger, uncertainty, guilt and fear.

Fear was a powerful theme. Many felt that the courthouse was unsafe. During the final group meeting a female court officer walked in unannounced and searched for explosives, explaining there was a bomb threat.

At least one or two people wept openly in each group, women and men. In each group at least one person left the room to compose themselves and then came back. More than one person said, “I can’t stop crying.” And more than one said, “I can’t cry.”

Anger was a prevailing theme. There was anger at the government. “How could they let this happen?” they asked.

Many shared feelings of disbelief, saying how surreal it seems. One said, “I am in a semi-daze; I feel like I’m not even here.”

Guilt was prevalent, especially about going on with mundane day-to-day activities. A court officer said he felt insignificant, like “a grain of sand.” He said he felt helpless and wondered if he was going crazy.

One group participant’s son escaped from the 78th floor. He took the stairs. His co-workers waited for the elevator. They didn’t survive. The son’s story was retold by his mother through sobs. When he emerged from the building, she shared, he witnessed “flaming bodies falling from the sky.” Two others held her hands as she told the story.

In each group people reached out to comfort one another through physical touch and understanding words. In one group a woman who said she couldn’t understand why she hadn’t cried was brought to tears by another’s pain over a missing sister.

In closing, the participants in one group agreed that “it’s good to know you’re not alone,” and “it’s good to know you’re not going crazy.”

I found the intensity of that experience and the participants’ ability to reach out to one another moving. Although I was there to facilitate, my role was to bear witness. It confirmed for me what I was already feeling; when facing incomprehensible tragedy and overwhelming grief we must push ourselves to forgo isolation and reach out to one another.

Andrew Malekoff is the executive director of North Shore Child & Family Guidance Center.

“Kids First: Look at Where We Have Come,” by Andrew Malekoff, Blank Slate Media, August 31, 2018

“Kids First: Look at Where We Have Come,” by Andrew Malekoff, Blank Slate Media, August 31, 2018

Did you know that every day more than 290 Americans die from suicide or a drug overdose?

With proper treatment, many of these tragedies could be prevented — but despite a law that guarantees coverage, people face enormous roadblocks when they seek care.

In 2008 President George W. Bush signed the landmark Mental Health Parity and Addiction Equity Act (Parity Act).

The Parity Act mandates equal insurance coverage for mental health and substance use disorders as compared to other medical/surgical benefits covered by the plan.

According to its new website parityat10.com, “Parity at 10 seeks to ensure that insurance carriers and state Medicaid programs comply with the law so that consumers can access the evidence-based health care they need and are entitled by law to receive.”

What does equal insurance coverage mean?

It means ending insurer discrimination against access to timely and affordable care including high out-of-pocket costs and shorter lengths of care for MH/SUD.

Parity — which is another word for equity — in this case means that MH/SUD coverage must be provided on par with coverage of medical and surgical care.

Notably, this legislation was the result of a bipartisan effort by Sens. Paul Wellstone, a liberal Democrat, and Pete Domenici, a conservative Republican. What the senators had in common were personal family experiences that motivated their tireless efforts to pass this law.

Parity saves lives. Parity law is a civil rights law that has not been vigorously enforced by the States, which have the primary responsibility for enforcement of private insurance and Medicaid.

One of the most pernicious violations and barriers to care is inadequate networks of MH/SUD providers.

North Shore Child & Family Guidance Center documented this in its 2018 Project Access Study which surveyed 650 Long Island consumers of MH/SUD care. Nearly 50 percent of respondents said that it was easier for them to access medical/surgical care than MH/SUD Care.

Nationally, patients responding to a National Alliance on Mental Illness survey reported being denied twice as often for mental health care as for medical-surgical care under the Affordable Care Act.

The actuarial firm Milliman reviewed claims data in New York and found that patients had to go out-of-network for MH/SUD care far more often than for medical/surgical care — a very expensive proposition that flies in the face of the Parity Act.

At North Shore Child & Family Guidance Center, we are a proud partner of the Parity at 10 Compliance Campaign. On August 10 I attended an inaugural Parity at 10 meeting in Albany with my fellow advocates and top officials in the Cuomo administration.

Some of the details in this column were included in the policy brief provided to Gov. Cuomo. The consensus among the advocates was that insurers do everything in their power to skirt parity.

Another staunch supporter of the original legislation was Patrick J. Kennedy, a former member of the U.S. House of Representatives. Kennedy struggled with mental illness and addiction for most of his life.

In his book “A Common Struggle,” Kennedy said the battle ahead is for the law to be enforced in the face of health insurers who stand to profit by denying the full range of coverage for people living with mental illness and addictions.

Kennedy rightly frames the inequities that people with mental illness and addictions face as a matter of civil rights.

Discriminatory insurance coverage for those with mental health and substance use disorders must end. When insurers do not comply with the law and enforcement is inadequate, millions of Americans are at risk.

Andrew Malekoff is the Executive Director of North Shore Child & Family Guidance Center, which provides comprehensive mental health services for children from birth through 24 and their families. To find out more, visit www.northshorechildguidance.org.

“Lessons from the Field,” by Andrew Malekoff, Anton Media’s Long Island Weekly, Aug 22-28 2018

In recent years I have written about concussions in youth sports in this space, with a special focus on Chronic Traumatic Encephalopathy (CTE), a progressive degenerative disease of the brain that is the result of repetitive brain trauma. This was something I knew nothing about in my teenage years. As a high school and college football player in the 1960s and ’70s, using one’s head as a battering ram and shock absorber was expected.

Beyond the discovery of CTE and what it has generated in the way of much-improved player safety, August never fails to evoke memories of twice-daily summer practices when guys like me went to “training camp” before school started. Training camp lasted about two weeks. It was usually hot out. They were two weeks that felt like a year. Those were the make or break days of my youth. No one was cut from the team as long as they showed up, but many did not last.

The rawest depiction of a brutal summer football camp can be found in the book The Junction Boys by Jim Dent. The subtitle of the book is How Ten Days in Hell with Bear Bryant Forged a Championship Team. Although I never went through anything quite like the Junction Boys did, it seems that all high school and college football players have similar war stories about summer camp.

I’m not about to rehash what I’ve since learned since the discovery of CTE and the need for protective measures or share stories from my summer football camp days. However, at the risk of being cliché, there are some important lessons I learned from playing football.
As we round out another August, I thought I’d share a few of those lessons here. Most have served me well. Some have a downside.

1. Punctuality

As the saying goes, showing up is half the battle. But don’t just show up; be there on time. In football there were serious consequences for being late, but losing the respect of one’s peers eclipsed them all.

2. Hard work

Know that when you are working hard, there are others working just as hard and others who are not. Push yourself to surpass your opponents and inspire your teammates.

3. Stoicism

Keep your head up. Push through disappointment and injuries. This is mostly a good trait, but it can also prevent you from seeking the support you need when you really need it, physically and emotionally. Vulnerability is not a lesson I learned in football.

4. Dependability

It is essential that others who are pulling with you toward accomplishing a goal know that they can always count on you. There is a brotherhood that forms on a football team that demands dependability.

5. Humility

Enjoy success but don’t be boastful. Have gratitude for all those who helped to support your success.

6. Perseverance

Never give up. It is what your adversaries expect. By pushing through missteps and setbacks you learn what it takes to succeed and that your capacity to overcome failure is greater than you anticipated.

7. Resilience

As the legendary coach of the Green Bay Packers Vince Lombardi said, “It’s not whether you get knocked down; it’s whether you get up.” To survive playing football, resilience is essential.

Fortunately, these lessons can be learned in many places other than the football field. Any group activity that requires teamwork, sacrifice and shared goals generate important life lessons. Make sure the young people in your life put down their cellphones and other tech gadgets and take up a sport, join a club or get involved in the arts, to name a few possibilities. They’ll grow into better people—and with no head-butting required.

“North Shore Child & Family Guidance Center Partners with Neiman Marcus,” Anton Media, August 8-14, 2018

“North Shore Child & Family Guidance Center Partners with Neiman Marcus,” Anton Media, August 8-14, 2018

Roslyn Heights, NY, August 2, 2018 — North Shore Child & Family Guidance Center held its 5th Annual Ladies’ Night Out event on Thursday evening, July 19th, at the beautiful Neiman Marcus Garden City store. This marked the second year in a row that the Guidance Center partnered with Neiman Marcus in an event that offered exceptional beauty services and raffle opportunities to the women of our local communities and also raised awareness of the programs and services offered by the Guidance Center.

All proceeds from the event will support the Guidance Center’s mission to provide help and healing to children and families dealing with mental health issues and to combat stigma and discrimination. Guests savored delicious small bites from NM Cafe and sipped unique bubbly libations while they were treated to brow shaping and makeovers by Neiman Marcus makeup artists, along with blow-outs and hair styling from Manhasset salon nuBest.

North Shore Child & Family Guidance Center Partners with Neiman Marcus

Carol Marcell, a member of the Guidance Center’s Board of Directors, brought her mother Joyce Bruno and two of Bruno’s friends. “This was the second time my mom and I attended Ladies’ Night Out, and she didn’t hesitate to accept my invitation once again and to bring along her friends,” says Marcell. “We got our hair blown out by a charming young man from nuBest. And all of us loved looking at the clothes, jewelry and shoes at wonderful Neiman Marcus!”

“Neiman Marcus Garden City is very proud to be a supporter of the North Shore Child & Family Guidance Center,” says Doris Wilshere, Vice President, General Manager at Neiman Marcus, Roosevelt Field. “It is our corporate philosophy to support and give back to our local community, particularly with organizations that are centered on children and family. Since our opening in 2016, we have been an ongoing partner with the Guidance Center and will be for the future. We look forward to a growing partnership.”

“The Guidance Center is grateful to the philanthropic team at Neiman Marcus,” says Nancy Lane, Board President. “The events we hold at the store are very special.”

About Us:

As the preeminent not-for-profit children’s mental health agency on Long Island, North Shore Child & Family Guidance Center is dedicated to restoring and strengthening the emotional well-being of children (from birth – age 24) and their families. Our highly trained staff of psychiatrists, psychologists, social workers, vocational rehabilitation counselors and other mental health professionals lead the way in diagnosis, treatment, prevention, training, parent education, research and advocacy. The Guidance Center helps children and families address issues such as depression and anxiety; developmental delays; bullying; teen pregnancy; sexual abuse; teen drug and alcohol abuse; and family crises stemming from illness, death, trauma and divorce. For 65years, the Guidance Center has been a place of hope and healing, providing innovative and compassionate treatment to all who enter our doors, regardless of their ability to pay. For more information about the Guidance Center, visit www.northshorechildguidance.org or call (516) 626-1971.

About Neiman Marcus Group:

Neiman Marcus Group LTD LLC is a luxury, multi-branded, omni-channel fashion retailer conducting integrated store and online operations under the Neiman Marcus, Bergdorf Goodman, Last Call, Horchow, CUSP, and mytheresa brand names. For more information, visit www.neimanmarcusgroup.com.

Keep up with the latest news and events happening at Neiman Marcus by becoming a fan on Facebook, following us on Twitter, Instagram, Pinterest, and Snapchat.

Settling In, Chicken Style, July 2018, Anton Media

Settling In, Chicken Style, July 2018, Anton Media

Chickens Photos by Christy Hinko

Children, like chickens, need a few minutes to settle down. Above: Ethel, Margaret, Betty and Tori make the lawn furniture their perch. (Photo by Christy Hinko)

It’s a common refrain heard in classrooms and at dinner tables all across the country:

“Why won’t you just sit still?” Sometimes, with kids who seem especially hyperactive, there is an all-too-quick leap to giving the “problem” a psychiatric label and pulling out a prescription pad.

Although I’m a clinical social worker by training, I find that alternative sources of knowledge (what some may refer to as old-fashioned common sense) sometimes fit best. Here’s an example:

I recall a meeting with my colleagues regarding a newly formed after-school program for teenagers.

A shared frustration was getting things started on time. After some conversation, it became clear that the kids eventually settled down, but it always took more time than the
adults deemed necessary.

One of the women, my longtime colleague Dr. Nellie Taylor-Walthrust, an alcohol and substance abuse counselor and pastor, asked her colleagues, “Did any of you ever live on a farm?” They all signaled that they hadn’t. She smiled knowingly and responded, “Well, I did. And when you grow up on a farm you notice certain things.”

She went on to explain, “I’ve been watching closely, and in the afterschool program I’ve noticed certain behavior by a number of the youngsters each time they come to the group.

Whether they arrive early or after the group has already begun, they perform a certain ritual before connecting more consciously with what is going on in the group. It goes something like this: They move the chairs several times, place certain objects—coat, sweater, book bag—in a certain position on or near the chair, collect objects from their pockets or begin to crumple paper and place it in the waste basket, and so on. When confronted about their distracting behavior, they often reply, ‘OK, just one minute,’ meaning that they hadn’t quite completed their settling-in process.

“After weeks of observation, I was reminded that I had seen chickens perform similar rituals before laying eggs. I often wondered why they didn’t simply walk in, lay their eggs, and walk out. But instead, they would survey the nest, scratch and peck some more and sit down again. This behavior continued until they felt settled in. When the process was interrupted, I observed, they would start the ritual all over again. Now, I’m not suggesting that some youngsters are like chickens, but there seems to be a similarity in their need to release a certain amount of energy in order to focus on the task before them.”

Nellie’s “down home” observations captured the essence of the young people’s waking moments. The milling process seemed to be a normal resistance brought on by the daily residue of feelings either about home or school, perhaps intended to sidestep the work at hand.

For most kids, milling is a natural and normal process to be respected and left alone, as opposed to a manifestation of a disorder or some form of pathology. The kids eventually settled down and attended to task, as did the chickens.

This tale of the chickens had a soothing effect on Nellie’s colleagues, whose patience increased as a result.

What does this story about restless kids and chickens preparing to lay eggs mean? Sometime a kid is just a kid. That’s not to say that, for some, careful examination, diagnosis and specialized care are necessary and should be sought.

But for the others? Well, sometime they’re just being chickens. I mean kids.

Andrew Malekoff is the Executive Director of North Shore Child & Family Guidance Center, which provides comprehensive mental health services for children from birth through 24 and their families. To find out more, visit www.northshorechildguidance.org.

The Lives of Black Mothers and Babies, Anton Media, May 23-29, 2018

The Lives of Black Mothers and Babies, Anton Media, May 23-29, 2018

In a report issued by Nassau County’s Department of Health—Community Health Assessment and Community Health Improvement Plan (2016-18)—there is no mention of maternal mortality or information on social and environmental risk factors for women and infants of color. Consequently, no initiatives to address maternal and infant mortality disparities are recommended, yet overall Nassau County health data indicates that it ranks at the top of all counties in New York State.

To address this “invisible injustice,” maternal and child health advocates convened at Hofstra University on March 23 for a Birth Equity Breakfast organized by the Nassau County Perinatal Services Network.

Birth equity refers to the assurance that all human beings have the best possible births, buttressed by careful attention to racial and social disparities.

Keynoter Dr. Martine Hackett, assistant professor at Hofstra University’s School of Health Professions and Human Services, presented data from the state Department of Health that showed the disparate outcomes for black mothers and babies as compared with their white counterparts.

Infant mortality refers to the death of children before their first birthdays, which is a key indicator of the overall health of a population. According to the United Nations International Children’s Fund (UNICEF), Japan is the number one ranked country for newborn survival, while the United States ranks only 22nd in the world.

Among the eye-opening data that Hackett cited are the differences between the infant mortality rates in contiguous communities in Nassau County. For example, in Roosevelt there were 11.1 infant deaths per 1,000 births from 2012-14, while neighboring Merrick had zero deaths. Overall, in Nassau County the black infant mortality rate is more than four times that of the White infant mortality rate and even higher than in New York City.

Dr. Joia Creer-Perry, president of the National Birth Equity Collaborative, spoke about the perception of black mothers and the barriers to receiving holistic care by the health care system. If a woman is living under great stress she will have trouble carrying her baby to term. Premature birth to underweight babies is a leading cause of infant mortality.

Social justice activist and attorney Fred Brewington condemned the institutional racism prevalent in healthcare that has resulted in infant mortality figures today that are no different than they were almost a century ago.

Just weeks after the Birth Equity Breakfast, Tasha Portley, a nurse living in Tyler, TX, spoke at a similar forum halfway across the U.S. In a report published in the April 16 edition of the Tyler Morning Telegraph, Portley stated that “Pregnant black women often experience casually degrading remarks from white people when they seek maternal health care.”

Portley shared the story of a black woman who had some difficulty acquiring a breast pump from a local social services agency and, in the process, was the target of demeaning remarks by an employee. Portley went on to say, “We are dying because we are black and we are living in a country where there is inherent racism. It is systemic. It is the thread; it is the fiber of everything that exists.”

Hackett highlighted what needs to happen in order to turn the corner on disparities in Nassau County. Among her recommendations were to inform women after childbirth of warning signs for hemorrhage, embolism or infection, especially when there are preexisting conditions; to enhance service integration for women and infants; and to treat women of color with dignity, respect and culturally relevant care.

Bringing birth inequities to light is an important step forward. When this issue is not identified in Nassau County health data, people don’t know about it and it cannot be addressed. The breakfast concluded with the unveiling of the Birth Justice Warriors, an initiative envisioned by Hackett, to train birth advocates with the hope of ameliorating the birth inequities in Nassau County.

American In Every Way Except on Paper, From Anton Media, April 17, 2018

American In Every Way Except on Paper, From Anton Media, April 17, 2018

By Andrew Malekoff

Imagine being American in every way except on paper and knowing that if you are the victim of violent crime you cannot report it out of fear of being deported. This is the sad reality for nearly 800,000 young immigrants who found hope in DACA.

If you’ve heard the acronym but are not familiar with DACA, it refers to Deferred Action for Childhood Arrivals, a federal program that began in 2012 permitting any person who was brought into the U.S. before the age of 16 the temporary right to live, study and work legally in America, providing they meet certain criteria including no criminal record and attending in high school or college, or serving in the military.

According to the Pew Research Center, two-thirds of current DACA recipients are 25 or younger, many of whom were brought to the U.S. as children so they might escape persecution, violence and poverty for the promise of a better life.

One young immigrant, Rodrigo Trejo, shared his story with United We Dream, the largest immigrant youth-led organization in the country: “When I was in the 11th grade my step dad was deported to Mexico, but he had a conversation with me before he was sent back. He told me that I was going to have to be the man of the house because he didn’t think he was ever coming back. I didn’t know what he was trying to say at the time, until he passed away crossing the U.S border. He couldn’t bear to be away from his family.”

Although Rodrigo became depressed and dropped out of school he bounced back. He reenrolled and graduated at the age of 20. Soon thereafter he applied for DACA in order to continue his education. “I plan to continue my studies and want to help others who have the potential of becoming someone great but because of similar life circumstances, don’t believe in themselves,” he said.

On September 5, 2017, U.S. Attorney General (AG) Jeff Sessions pronounced, “I am here today to announce that the program known as DACA that was effectuated under the Obama administration is being rescinded [effective March 5, 2018].”

On January 9, 2018, four months after AG Session’s announcement, a U.S. District Judge temporarily blocked the Trump administration from ending DACA, thus allowing recipients to renew their protected status for two years, re-affirming their legal legitimacy to remain in the U.S. A subsequent appeal of the judge’s ruling to keep DACA going failed.

If DACA were to be permanently rescinded it would prevent young immigrants like Rodrigo from applying for deportation protections and work permits, exacerbating the isolation, uncertainty, hopelessness and terror that preceded DACA becoming law.

If you follow national news, there is a cat-and-mouse game being played with DACA recipients in our nation’s capital. Let’s not lose sight of the fact that what is at stake is the physical and emotional well-being of young people like Rodrigo who came to the U.S. as children by no fault of their own.

In addition to the shifting sentiments expressed by the president, there is an organized anti-immigrant movement underway in the U.S. led by groups such as the Federation for American Immigrant Reform (FAIR), Center for Immigration Studies and Numbers USA. These nativist groups advocate for white European power and political control, and paint undocumented immigrants with a broad criminalized brush.

The issue of immigration in the U.S. is much broader than DACA. Nevertheless, we need to stand up to protect these young people from being rounded up and sent away. If you believe in human rights, doing nothing is not an option.

Andrew Malekoff is the Executive Director of North Shore Child & Family Guidance Center, which provides comprehensive mental health services for children from birth through 24 and their families. To find out more, visit www.northshorechildguidance.org.

This article was first published in Long Island Weekly of the Anton Media Group, April 18-24, 2018

Andrew Malekoff discusses the Struggle for Access to Mental Health Care

Andrew Malekoff discusses the Struggle for Access to Mental Health Care

From Anton Media: Andrew Malekoff discusses the Struggle for Access to Mental Health Care

health insurance roadblocksIt’s a heartbreaking scenario that is far too common: someone makes the difficult decision to seek out professional help for a mental health or substance abuse problem for themselves or their loved one and is faced with a myriad of roadblocks. They start calling providers on their insurance plan and find that they are not taking new patients, or they no longer accept insurance and only want cash. And the cost of paying out of pocket is too much for many to afford.

Here is the reality: Health insurers are required by law to offer an adequate network of providers for their beneficiaries to choose from, and not just for physical illnesses. This requirement is known in the health insurance industry as network adequacy.

Along with the difficulty of finding a provider who will accept your insurance, the problem is often complicated by a family’s reluctance to seek help for a mental health or drug problem, as opposed to physical illnesses like cancer or diabetes. Despite progress in public education, stigma still looms large.

Once someone takes the leap of faith to ask for help, he or she is too often told, “I’m sorry, I don’t accept your insurance any longer.” When this happens there is a chance they will give up.

It is this reality that spurred North Shore Child & Family Guidance Center to launch a research initiative called Project Access. This entailed creating a survey that was completed by almost 650 people across Long Island. Here is some of what we found:

• Almost 50 percent of the participants said that it was more difficult finding help for mental health or drug problems than finding help for physical illnesses, especially when they were in crisis.

• Nearly 40 percent said that their insurance company did not have an adequate number of providers.

• 66 percent reported that their insurance company was not helpful in finding a suitable provider for themselves or a loved one.

One survey respondent wrote: “A family member within my household required therapy and we had difficulty finding a provider; when we did, scheduling was a nightmare because so many patients were trying to see him. I believe it was because he was one of the few willing to accept multiple insurance policies.” This was a familiar refrain.

Health insurers reimburse mental health and addictions care providers at such low rates that they flee health insurers in droves. This is a civil rights issue and a situation that puts lives at risk.

The NY State agency that Governor Cuomo has charged with monitoring and enforcing network adequacy is the Department of Financial Services. We are using the Project Access data to demand that Governor Cuomo and the Department of Financial Services launch a full scale investigation of access to care in New York State and to hold commercial health insurers’ feet to the fire.

If you agree, print this column, add a note saying “I agree” and include your name and address. You can write to the governor at: The Honorable Andrew M. Cuomo, Governor of New York State, NYS State Capitol Building, Albany, NY 12224; email him at Press.Office@exec.ny.gov; or call him at 518-474-8418.

To read the full Project Access report go to: www.northshorechildguidance.org and click on the Project Access tab.

Andrew Malekoff is the Executive Director of North Shore Child & Family Guidance Center, which provides comprehensive mental health services for children from birth through 24 and their families. To find out more, visit www.northshorechildguidance.org.

One Good Parental Turn

From Anton Media, Feb.7, 2018

Remembering without awareness is a phrase I really like. It suggests the retrieval of a memory that escapes conscious awareness.

Recently, I passed the 20-year mark without either parent, and many more years without grandparents. One grandmother, Annie, died before I was born. I was named after her. The other, Jenny, died when I was too young to remember her. My grandfathers, Harry and Joseph, died a few years later, still during my childhood years, but I have memories of both of them.

Each had disabilities and prostheses. Both of Grandpa Harry’s legs were amputated as the result of diabetes. Grandpa Joe lost his eye as the result of a carpentry accident. Their disabilities were never hidden from me. I went with my dad and Grandpa Harry when he had his prosthetic legs fitted. Grandpa Joe regularly took his eye out and showed it to me on request. I used to wonder if I would have artificial parts when I got older.

In my first year of graduate school in 1976, I was assigned to intern in a program called “Aged in Distress.” It was a crisis intervention program for older people. I made home visits to people with physical and mental disabilities, as well as one woman who was bedridden and terminally ill.

Although my primary interest in becoming a social worker was to work with children and teenagers, I was surprised at how much I liked working with older people. I was 25 at the time. Thinking back, it shouldn’t have come as such a surprise to me. Sometime after the internship, I realized that I was remembering without awareness the short time I had with my grandfathers.

Now I know that my early memories and recollections, whether I am consciously aware of them or not, influence how I feel about and relate to others in the present. As a child who experienced my grandfathers’ lives and deaths, I wasn’t conscious of the fact back then that one day I would be dealing with my parents’ aging, illnesses and deaths.

My father had cancer and my mother had heart and kidney problems. I traveled often from my home on Long Island to New Jersey to help care for them, some of that time at the same hospital in Newark where I was born in 1951.

One memorable evening—which also happens to have involved artificial body parts—was the time my mother fell and was taken to the hospital. She called me at 2 a.m. and said, “Andy, will you bring my Polident to the hospital?” Broken arm and bruised face, all she could think about was what she needed to keep her dentures in place so that she would look good.

I took the 90-minute drive from Long Beach to Newark at 2:30 am, retrieved her tooth powder from the medicine cabinet in her home, headed to Beth Israel hospital, spent a few hours with her and drove back to Long Island with enough time to make it to my office for work.

Although the trip was inconvenient, I was aware all along that one good turn deserves another. Both my mother and father took time caring for their parents when they aged while also caring for me and my brother. It is these kinds of life lessons that seep into your unconscious and define the person you become, with many generations to thank.

By Andrew Malekoff, Executive Director of North Shore Child & Family Guidance Center, which provides comprehensive mental health services for children from birth through 24 and their families.

Published in the Anton Media Group papers, Feb. 7, 2018.

When Your Child Relates Better To Screens Than Human Beings

When Your Child Relates Better To Screens Than Human Beings

North Shore Child & Family Guidance Center recently hosted psychotherapist, author and parenting expert Sean Grover for a workshop titled “When Your Child Relates Better to Screens than Human Beings.” We were pleased to offer this program to help fortify parents during these difficult times.

As tech-dependence increases, many kids move through the world in a self-centered bubble, separated from their own thoughts and feelings, as well as the thoughts and feelings of others. As conversation skills and positive interactions crumble, technology even starts to change kids’ sense of humanity; they are less compassionate and sensitive to others. The workshop explored these vital issues and offered advice about what parents can do to help.

“Everywhere you look, children are staring into cell phones, screens, computer screens, tablets, iPads and more,” said Grover, who has appeared on the Today Show, in the New York Times and in many other media outlets. “While some kids use technology as a pastime, others are absorbed by it. Technology devours their lives. They can’t put it down or turn it off. These kids tend to be more isolated and anxious, have poor people skills, difficulty maintaining friendships or an unstable sense of self.”

In his workshop, Grover gave parents guidelines on how to take back control and help their offspring wean off their technology addiction. Here are some of his tips:

Tech Blackouts

Set aside specific times at home when no one (parents included) uses technology. Cell phones, computers, iPad…everything is off. If you want your kid to be less tech-addicted, you must lead the way. Tech-free time can be spent reading, talking, playing games, cooking, making art…anything creative or social will do.

Tech Hours

Kids resist structure—but fall apart without it. Technology needs limits. For instance, I often recommend that families establish tech hours; time for homework, gaming or surfing the Internet. Scheduling tech time will help to limit battles by setting clear guidelines. For instance, when it comes to gaming, many parents may allow thirty minutes a day during the school week and two hours a day on the weekends.

Tech Spaces

When possible, keep all technology in a common space like the living room — not in a child’s bedroom. Establish communal places for tech time; try to avoid allowing your kid to disappear for hours behind a closed door.

Tech Limits

There are plenty of online services that can filter out inappropriate or violent material. These services can also limit Internet access by scheduling times that the Internet is available and times when it is not. One example of such a service is Net Nanny.

If you haven’t already read between the lines, you should know that how you use tech devices influences your ability to effectively guide your kids. Although your example is not the sole factor, keep in mind that as distant as some kids become from adults as they are moving through their teen years, they continue to observe you, and more closely than you know.

As the lyrics from the 1970s-80s new wave rock band the Police advise: “Every breath you take, Every move you make, Every bond you break, Every step you take, I’ll be watching you.”

Andrew Malekoff is the executive director of North Shore Child & Family Guidance Center, which provides comprehensive mental health services for children and their families. Visit www.northshorechildguidance.org for more.

In The Company Of Oneself

In The Company Of Oneself

Anton Media’s Long Island Weekly, Parenthood Plus by Andrew Malekoff

In New York it is illegal to use a handheld cellphone while driving. Although drivers have the option to use hands-free devices, studies show that talking or texting on any cellphone while driving is so mentally distracting as to suggest it is a serious safety hazard. Nevertheless, not a day goes by that I do not see drivers talking on both hand-held and hands-free devices. Safety aside, what does all this chatter in the car portend about one’s ability to be alone?

More than 50 years ago Clark Moustakas, a psychologist and the author of the existential study Loneliness, wrote, “Being alone, for me, usually means an opportunity to think, imagine, plan. I choose to be alone because I desire to be quiet for awhile to consider aspects of my life. It is usually a tranquil time of self-expression and self-renewal.”

Can you remember a time when a solitary ride in the car offered such an opportunity, to simply be alone with your thoughts, feelings and sensations—maybe with your favorite soundtrack playing in the background?

We now live in an era when, because we are plugged in 24-7, the simple pleasure of being alone is something that we avoid. For many people, young and old, aloneness is a source of discontent. Why? Are we afraid that it might lead to loneliness?

Loneliness is not just about a lack of companionship but an inner sense of being alone, regardless of the external circumstances—of feeling lonely even when with friends or family.

I believe that the recent popularity of mindfulness—a mental state achieved by directing one’s awareness on the present moment, while calmly noticing and accepting one’s feelings, thoughts and bodily sensations—is a counterforce to the busy-ness of our perpetually plugged-in lives.

As if to foreshadow the current era of mindfulness, Moustakas said, “Loneliness anxiety is a widespread condition in contemporary society. The individual no longer has an intimate sense of relatedness to the food he eats, the clothing he wears, the shelter which houses him.”

According to Maria Gonzalez, an author and corporate executive whose most recent book is Mindful Leadership, 9 Ways to Self-Awareness, Transforming Yourself, and Inspiring Others, “The daily commute is a great opportunity to train the mind.” She recommends practicing simple techniques, repeatedly, to train the mind in three areas:

1. To be more focused and better able to concentrate;

2. To experience more clarity in our thinking and decision-making; and

3. To approach all of life with a sense of balance, whereby we can “go with the flow” when a situation cannot be changed in the moment.

“The idea,” Gonzalez says, “is that you are continuously aware of three things: your body, what you see and what you hear. This is what it is to be mindfully present as you drive. Do your best to stay present for the entire commute.”

Although it seems elementary, it’s not as easy it sounds. As your mind wanders you may have the impulse to check your phone, or give in to some other distraction. When that happens, intentionally pull yourself back.

Like all things worth mastering, being mindful takes practice. As you do this you are preparing yourself to be present, to be at ease in your own company and, at the same time, you’re making the road a safer place for us all.

Andrew Malekoff is the executive director of North Shore Child & Family Guidance Center, which provides comprehensive mental health services for children from birth through 24 and their families. Visit www.northshorechildguidance.org to find out more.

In the Company of Oneself

In New York it is illegal to use a hand-held cell phone while driving. Although drivers have the option to use hands-free devices, studies show that talking or texting on any cell phone while driving is so mentally distracting as to suggest it is a serious safety hazard. Nevertheless, not a day goes by that I do not see drivers talking on both hand-held and hands-free devices. Safety aside, what does all this chatter in the car portend about one’s ability to be alone?

More than 50 years ago Clark Moustakas, a psychologist and the author of the existential study Loneliness, wrote, “Being alone, for me, usually means an opportunity to think, imagine, plan. I choose to be alone because I desire to be quiet for awhile to consider aspects of my life. It is usually a tranquil time of self-expression and self-renewal.”

Can you remember a time when a solitary ride in the car offered such an opportunity, to simply be alone with your thoughts, feelings and sensations—maybe with your favorite soundtrack playing in the background?

We now live in an era when, because we are plugged in 24-7, the simple pleasure of being alone is something that we avoid. For many people, young and old, aloneness is a source of discontent. Why? Are we afraid that it might lead to loneliness?

Loneliness is not just about a lack of companionship but an inner sense of being alone, regardless of the external circumstances—of feeling lonely even when with friends or family. 

I believe that the recent popularity of mindfulness—a mental state achieved by directing one’s awareness on the present moment, while calmly noticing and accepting one’s feelings, thoughts and bodily sensations—is a counterforce to the busy-ness of our perpetually plugged-in lives.

As if to foreshadow the current era of mindfulness, Moustakas said, “Loneliness anxiety is a widespread condition in contemporary society. The individual no longer has an intimate sense of relatedness to the food he eats, the clothing he wears, the shelter which houses him.”

According to Maria Gonzalez, an author and corporate executive whose most recent book is Mindful Leadership, 9 Ways to Self-Awareness, Transforming Yourself, and Inspiring Others,The daily commute is a great opportunity to train the mind.” She recommends practicing simple techniques, repeatedly, to train the mind in three areas:

1. To be more focused and better able to concentrate;

2. To experience more clarity in our thinking and decision-making; and

3. To approach all of life with a sense of balance, whereby we can “go with the flow” when a situation cannot be changed in the moment.

“The idea,” Gonzalez says, “is that you are continuously aware of three things: your body, what you see and what you hear. This is what it is to be mindfully present as you drive. Do your best to stay present for the entire commute.”

Although it seems elementary, it’s not as easy it sounds. As your mind wanders you may have the impulse to check your phone, or give in to some other distraction. When that happens, intentionally pull yourself back.

Like all things worth mastering, being mindful takes practice. As you do this you are preparing yourself to be present, to be at ease in your own company and, at the same time, you’re making the road a safer place for us all.

Andrew Malekoff is the Executive Director of North Shore Child & Family Guidance Center, which provides comprehensive mental health services for children from birth through 24 and their families. To find out more, visit www.northshorechildguidance.org

Mental Health Education A Must For Schools

Mental Health Education A Must For Schools

New legislation signed by Governor Cuomo in 2016 requires that public schools in New York State begin providing instruction in mental health on or after July 1, 2018. The legislation was co-sponsored by Senator Carl Marcellino (R-Nassau) and Assemblywoman Kathy Nolan (D-Queens).

The new legislation adds mental health education to areas of learning that were already required by law, including education on the use and misuse of alcohol, tobacco and other substances and the early detection of cancer.

According to Glen Liebman, CEO of the Mental Health Association in New York State, “By ensuring that young people are educated about mental health, we increase the likelihood that they will be able to recognize signs in themselves and others that indicate when help is needed and how to get help.”

Why is this legislation so important? One in five adolescents ages 13-18 is diagnosed with a mental health problem, yet only 40% get help. The average time from onset to seeking help is eight to 10 years.  According to Centers for Disease Control and Prevention, one in 12 high school students attempt suicide, the third leading cause of death for 10 to 24 year olds.

Teaching about mental health in schools and educating to reduce stigma is long overdue. There is great misunderstanding and fear among many who have erroneous ideas about people with mental illness. Consequently, young people suffering with mental illness walk around school feeling isolated, believing that there’s something inherently wrong with them that will never change.

These children and teens often feel shunned, unlike their peers who have a physical health problem and who have others rally around them. I can vividly recall a news report and photo of a middle school boy afflicted with cancer who was receiving chemotherapy. In the photo he was surrounded by his teacher and a smiling group of his classmates, all of whom shaved their heads in solidarity with him.  Imagine if instead of cancer he was depressed and suicidal. There would be no such image of public support, only one of isolation, shame and despair.

A caring school community can offer a young person a safety net of meaningful and helpful connections. It is not unusual for a teenager to feel defective when struggling alone with a mental illness. Mental health education in schools can begin with mental wellness practices for children as early as four or five years old, for example, by teaching social skills and how to manage angry feelings.

As children grow they can learn about the concept of wellness including self-care and personal responsibility. They can learn to recognize the signs and symptoms of developing mental health problems, how to manage crises such as the risk of suicide and self-harm and how to identify appropriate services and supports for treating and maintaining recovery from mental illness.

I can already hear those voices that will decry using educational resources for addressing the emotional needs of kids. If that is your view, I ask you to consider that approximately 50% of students age 14 and older who are living with a mental illness drop out of high school. Youngsters’ mental health and their ability to learn and become productive citizens in the community and workplace go hand-in-hand.

We owe it to our children to support this vital new legislation by encouraging schools to incorporate meaningful education into the curriculum that reinforces the idea that mental health is an integral part of wellbeing. Our children need to learn that there is help that can lead to recovery.

Bio: Andrew Malekoff is the Executive Director and CEO of North Shore Child & Family Guidance Center, which provides comprehensive mental health services for children from birth through 24 and their families. To find out more, visit www.northshorechildguidance.org.

from Anton Media, Sept. 27-Oct. 3, 2017

An Abundance of Heart

An Abundance of Heart

September marks the start of another new school year and, for football diehards, it’s also the kickoff to a new season. The flowing together of the two brings to mind the moving story of former Florida State University (FSU) wide receiver Travis Rudolph and Bo Paske, a sixth grade boy with autism.

At the start of the school year in 2016, Rudolph and several teammates visited Montford Middle School in Tallahassee, located near the FSU campus. When Travis spotted 11-year-old Bo sitting alone in the cafeteria, he walked over with his slice of pizza, joined him, and struck up a conversation.

Travis’ simple act of kindness drew national attention when a photo of the two sitting across from one another went viral. Bo described the lunch as “kind of like me sitting on a rainbow.” Travis remarked: “A lot of people give me credit for doing what I did, even though I just see it as that is me.”

Bo told Travis that he was a big FSU fan. The two of them stayed in touch after their first encounter.

Leah Paske, Bo’s mom, wrote about it on Facebook: “Several times lately I have tried to remember my time in middle school. Did I have many friends? Did I sit with anyone at lunch? Just how mean were kids really? Now that I have a child starting middle school, I have feelings of anxiety for him, and they can be overwhelming. Sometimes I’m grateful for his autism. That may sound like a terrible thing to say, but in some ways I think, I hope, it shields him. He doesn’t seem to notice when people stare at him when he flaps his hands. He doesn’t seem to notice that he doesn’t get invited to birthday parties anymore. And he doesn’t seem to mind if he eats lunch alone.”

She went on to say, “A friend of mine sent this beautiful picture to me today and when I saw it with the caption ‘Travis Rudolph is eating lunch with your son’ I replied ‘Who is that?’ He said ‘FSU football player,’ then I had tears streaming down my face. I’m not sure what exactly made this incredibly kind man share a lunch table with my son, but I’m happy to say that it will not soon be forgotten. This is one day I didn’t have to worry if my sweet boy ate lunch alone, because he sat across from someone who is a hero in many eyes.”

Difference and inclusion are terms that are increasingly in vogue in today’s public schools. Growing numbers of children who were previously separated in special education classes and schools are being integrated into the “mainstream” in order to reduce costs and provide less restrictive environments for learning and social-emotional development.

Labeled children, particularly as they approach adolescence, are often objectified, devalued, isolated and ridiculed by their peers. Objectification robs individuals of their humanity. In such relationships the different child simply becomes “the other,” the one too often left out in the cold.

In an era when there seems to be no shortage of awful stories generating from college campuses, the story and photo of Travis and Bo is a breath of fresh air. Henry James said that “a good story is both a picture and idea, and that the picture and the idea should try to be interfused.”

The picture of Travis joining Bo at the lunch table tells us that a simple act of kindness can go a long way to making a difference in someone’s life. We learned from Travis that what it takes is just a little effort—and an abundance of heart.

Andrew Malekoff is the Executive Director of North Shore Child & Family Guidance Center, which provides comprehensive mental health services for children from birth through 24 and their families. To find out more, visit www.northshorechildguidance.org.

Anton Media, August 2-8, 2017

View Larger Image

A Tree for All Seasons

A Tree for All Seasons

In a four year span during the mid to late 1990s my now-grown children lost three of their grandparents and their dog. My boys were 10 and 6 when my father died in 1994. Three years later there were three more losses. My mom died in 1997.  A little more than one year later my father-in-law and dog Kirby, a cairn terrier, died on the same day in August 1998. My wife and I were in Quebec City at a music festival, at the time, on our first extended vacation away from our children when we received the news in two heartbreaking telephone calls just six hours apart.

As a mental health professional who has spent time with bereaved children and adults over many years, I had extensive knowledge about how children process death at different ages. Over the years I developed good skills in listening and gently encouraging the expression of feelings through talk and play. But I also knew that addressing the death of strangers was not the same thing as coping with one’s own losses.

Like so much that I have struggled with as a parent, I knew I had to put my credentials aside and simply do the best I could to support my family and take care of myself, as I was bereaved as well.

Soon thereafter my family and I experienced  another death—this time  with an impact I had not expected and effects that linger to this day. In our yard was an old pine tree that had to be felled after it contracted a disease. None of the tree “experts” that I employed could bring it back to health.

It was a splendid tree of great character, oddly shaped, home to a squirrel’s nest and countless birds, and with branches sitting low enough for swinging and climbing. Its trunk was thick enough to run around to evade contact during games of tag. It was free enough of branches in one high spot to support a backboard and hoop.

It wasn’t easy to dribble on the grass but it was just perfect for endless games of H-O-R-S-E. On the warmest summer days its shade offered respite from the oppressive sun. Each fall I was left with the unpleasant task of raking pine needles. But our tree also bore pine cones that I threw into the winter fireplace for extra snap, crackle and pop that rivaled Rice Krispies.

It was our family tree, a tree for all seasons.

Today, when I look outside or sit in the yard I am flooded with memories of my old friend and the times we had together. We’ve planted a few new trees around the perimeter of the yard in the intervening years, but the hole in the center remains.

Henry David Thoreau wrote, I frequently tramped eight or ten miles through the deepest snow to keep an appointment with a beech-tree, or a yellow birch, or an old acquaintance among the pines.”

Life is full of surprises, and it came as a surprise to me to think that I would one day be thinking about how much I really loved that old tree.

Andrew Malekoff is the Executive Director of North Shore Child & Family Guidance Center, which provides comprehensive mental health services for children from birth through 24 and their families. To find out more, visit www.northshorechildguidance.org.

A Chance Encounter – Or More?

A Chance Encounter – Or More?

Have you heard of godwinks? A godwink is an experience where you’d say, “What are the chances of that!” It’s been described by some as a spiritual message of reassurance, especially in times of uncertainty, maybe the impetus for restored faith during difficult times. Some see it as divine intervention, others as pure coincidence.

Although I was not familiar with the term, it reminded me of something that happened to me that I thought was astonishing. In 2005 I lost a very good friend and colleague named Roselle. We had become business partners in 1990. The longtime editors of a popular professional journal decided to step down and asked the two of us, strangers at the time, to become their successors.

Years later we both revealed that we were, at first, wary of each other. After all, we’d never met, and so we had no idea what it would be like working together as co-editors of an esteemed quarterly publication. Roselle was a university professor and I was a frontline mental health practitioner. What we shared in common was that we were both published authors.

After a relatively short period of testing and unease we not only became great collaborators but fast friends. The relationship ended in June of 2005 when I received a call that Roselle had died. It was sudden, unexpected and heartbreaking.

Shortly thereafter, in December 2005, I organized a meeting with two of Roselle’s fellow professors and friends. Together we decided to develop a special publication in Roselle’s honor. We were to meet in Manhattan at their university. Normally, I would have just taken the LIRR into the city them morning of our meeting, but, as luck would have it, at the time there was a transit strike. So I decided to play it safe and get in the night before and stay in a hotel while the trains were still running.

That night I took a walk and stopped in a bar to get a glass of wine. I walked to the end of the bar and there was my cousin Amy whom I had not seen in years. Unbeknownst to me, she lived across the street from the bar and was working as a real estate broker. It was great catching up with her.

Fast forward some months later. I was back in Manhattan to take care of some business regarding my partnership with Roselle at a local university. Having reconnected, I called Amy to see if she was free for lunch. She was and so we got together. She asked me why I was in the city. I told her I had to go to Hunter College School of Social Work to take care of some business related to a partnership I had with a professor there. I explained that she died last June. She asked me, “What was name?” I told her, “Roselle Kurland.” She gasped and said, “Oh my God, I just sold her apartment!”

Was this a godwink? Was it a tangible signpost giving me hope and faith that someone is watching over me and everything is going to be alright? Or was it pure coincidence, a fluke? I choose to think that it was more than that. During these uncertain times, a source of faith, however unusual, is a welcome reminder that we are not alone and that there is hope.

From Anton Media Group, May 24-30, 2017