News Mashup for June 2022
LGBTQ+ Pride And Prejudice
June is Pride month—a month to celebrate the cultural richness of the LGBTQ+ community and to recognize the progress, and work left to do, on achieving interpersonal and systemic acceptance. This year’s celebration is marred by what many mental health professionals and child health advocates see as a deluge of anti-LGBTQ+ legislation that stigmatizes young people and puts their mental well-being at risk. A review by the Human Rights Campaign found that more than 250 anti-LGBTQ+ bills were introduced in state legislatures in 2022. So far, 24 measures were enacted in 13 states codifying curriculum censorship, medical care bans, sports bans, and bathroom bans.
Access to gender-affirming care is perhaps the most politicized of anti-LGBTQ+ legislation targets. In June, The Kaiser Family Foundation reported that 15 states introduced 25 bills imposing criminal or disciplinary actions against providers of gender-affirming care, penalties on parents aiding youth in accessing care, and/or limitations on insurance coverage.
In a recent interview with the news service Health, Dr. Jessica N. Fish (University of Maryland School of Public Health) expressed concern over the “the breadth and the speed at which anti-trans policies are popping up in states all over the country." In March of this year, Dr. Warren Ng, the President of the American Academy of Child and Adolescent Psychiatry, issued the following statement: “In the midst of a national crisis on youth mental health, it’s unconscionable to target and harm LGBTQ+ youth and families. LGBTQ+ youth during the pandemic have suffered, with 42% of LGBTQ+ youth, and over half of transgender and nonbinary youth, seriously considering attempting suicide in the past year.”
In response to the rash of anti-LGBTQ+ legislation, and in recognition of Pride month, President Biden signed an executive order on June 15 advancing LGBTQ+ equality. The order includes directives promoting increased access to gender-affirming and mental health care, full inclusion of LGBTQ+ students, and data collection efforts aimed at documenting the needs of LGBTQ+ youth and their families.
Click on the links below to learn more.
Mental Health America. June 2022. Pride and mental health. Retrieved June 15, 2022 from https://www.mhanational.org/lgbtq/pride?eType=EmailBlastContent&eId=82b2f50a-a7c5-48bf-9d89-7e12b2a1aa55 .
Lindsey Dawson, Jennifer Kates, and MaryBeth Musumeci. June 1, 2022. Youth access to gender affirming care: The federal and state policy landscape. Kaiser Family Foundation. Retrieved June 15, 2022 from https://www.kff.org/other/issue-brief/youth-access-to-gender-affirming-care-the-federal-and-state-policy-landscape/.
Marc Caputo. June 3, 2022. DeSantis moves to ban transition care for transgender youths, Medicaid recipients. NBC News. Retrieved June 16, 2022 from https://www.nbcnews.com/politics/politics-news/desantis-moves-ban-transition-care-transgender-youth-medicaid-recipien-rcna31736.
Anthony Izaguirre. June 6, 2022. Transgender youth treatment under fire in Florida again. MedScape. Retrieved June 18, 2022 from https://www.medscape.com/viewarticle/975119.
Karen Pallarito. June 15, 2022. How anti-LGBTQIA+ legislation harms youth mental health. Health. Retrieved June 20, 2022 from https://www.health.com/news/lgbtqia-laws-and-youth-mental-heath.
Carolyn Jones. June 15, 2022. Biden order expands protections for LGBTQ youth and families. EdSource. Retrieved June 16, 2022 from https://edsource.org/news-updates#biden-order-expands-protections-for-lgbtq-youth-and-families.
Briefing Room. June 15, 2022. Executive order on advancing equality for lesbian, gay, bisexual, transgender, queer, and intersex individuals. The White House. Retrieved June 20, 2022 from https://www.whitehouse.gov/briefing-room/presidential-actions/2022/06/15/executive-order-on-advancing-equality-for-lesbian-gay-bisexual-transgender-queer-and-intersex-individuals/.
Beth Hawkins. June 17, 2022. The kids hiding in plain sight: Advocates push to collect data on LGBT students. The 74. Retrieved June 20, 2022 from https://www.the74million.org/article/the-kids-hiding-in-plain-sight-advocates-push-to-collect-data-on-lgbt-students/.
Erica L. Green. June 23, 2022. New Biden rules would bar discrimination against transgender students. New York Times. Retrieved June 24, 2022 from https://www.nytimes.com/2022/06/23/us/politics/biden-transgender-students-discrimination.html.
U.S. Department of Health and Human Services. June 27, 2022. Readout of HHS Secretary Becerra’s roundtable with trans youth. Press Release. Retrieved June 30, 2022 from https://www.hhs.gov/about/news/2022/06/27/readout-hhs-secretary-becerras-roundtable-with-trans-youth.html.
Hannah Natanson. June 28, 2022. LGBTQ clubs were havens for students. Now they’re under attack. The Washington Post. Retrieved June 30, 2022 from https://www.washingtonpost.com/education/2022/06/28/gay-straight-alliance-indoctrination-school-club/.
Sexual Minorities As A Protected Group
A study published this month in the American Psychological Association’s journal Psychology, Public Policy, and Law revealed an unexpected benefit of hate crime legislation in which sexual minorities are specifically included as a protected class—youth suicide attempts dropped by 16% relative to rates before enactment of such laws. Interestingly, the effects were seen in both LGBTQ+ and heterosexual youth.
The results add to a mounting body of evidence demonstrating that structural, policy-level interventions promoting the rights and protections of sexual minorities reduce victimization and enhance well-being in communities across the board. One of the authors of the study, Aaron Kivisto, said in an interview with Health Day news service that such legislation sets a tone of belonging and acceptance that extends well beyond the people directly involved.
In contrast, states with generalized hate crime laws—those without specific protections for sexual minorities— had no effect on youth suicide attempts. The non-specific laws in these states had the same null result as states without hate crime laws. The benefit, the authors conclude, is contingent on naming sexual minorities as a protected group.
The hate crimes research comes on the heels of a large population-based study of 6,800 youth published this month in the Canadian Medical Association Journal. The study shows that transgender youth are particularly vulnerable to poor mental health. Adolescents aged 15-17 identifying as transgender were almost eight times more likely to have attempted suicide than their cisgender or heterosexual peers. Considering causative factors, the authors point to research showing that transgender youth are at greater risk of interpersonal and systemic victimization and violence.
Click on the links below to learn more.
Keeya Prairie, Aaron J. Kivisto, Samantha L. Gray, Nicole Taylor, and Avery M. Anderson. June 2022. The association between hate crime laws that enumerate sexual orientation and adolescent suicide attempts. Psychology, Public Policy, and Law. Retrieved June 27, 2022 from https://www.apa.org/pubs/journals/releases/law-law0000360.pdf .
Amy Norton. June 23, 2022. Youth suicide attempts drop in U.S. states with hate crime laws. Health Day. Retrieved June 27, 2022 https://consumer.healthday.com/6-23-youth-suicides-drop-in-states-that-enact-hate-crimes-laws-2657534168.html.
Megan Brooks. June 10, 2022. A 'crisis' of suicidal thoughts, attempts in transgender youth. MedScape. Retrieved June 18, 2022 from https://www.medscape.com/viewarticle/975399?src=wnl_edit_tpal&uac=409113PG&impID=4323784&faf=1.
Mila Kingsbury, Nicole Hammond, Fae Johnstone, and Ian Colman. June 6, 2022. Suicidality among sexual minority and transgender adolescents: A nationally representative population-based study of youth in Canada. CMAJ. Retrieved June 18, 2022 from https://www.cmaj.ca/content/cmaj/194/22/E767.full.pdf.
Christiane Cordero and Grace Manthey. June 3, 2022. School mental health resources essential in decreasing high risk of suicide among LGBTQ+ youth. Retrieved June 16, 2022 from ABC Eyewitness News https://abc7.com/suicide-risk-for-lgbtq-kids-school-resources-students-mental-health-professionals/11915988/.
Hiding In Plain Sight
On June 27 and 28, PBS released a two-part film by Ken Burns, Erik Ewers, and Christopher Loren Ewers on youth mental illness. The series is part of the Well Beings Youth Mental Health Project campaign to create awareness of critical health care needs of Americans through broadcast content. Well Beings’ synopses of the films follow (reproduced verbatim):
Hiding in Plain Sight: Youth Mental Illness Episode 1: The Storm
The Storm, the first two-hour episode of Hiding in Plain Sight, focuses on more than twenty young people who provide an intimate look at what it’s like to experience the symptoms of mental illness, from depression to addiction to suicide ideation. The film includes insights from families, providers, and advocates and explores the impact of childhood trauma, stigma, and social media.
See it here: https://wellbeings.org/hiding-in-plain-sight-youth-mental-illness-episode-1-the-storm/
Hiding in Plain Sight: Youth Mental Illness Episode 2: Resilience
In Resilience, the second episode of Hiding in Plain Sight, our “heroes” speak about finding help and inpatient and/or outpatient treatment. It also explores the criminalization of mental illness, tragedy of youth suicide, and “double stigma” that occurs when mental illness is combined with racial or gender discrimination. Throughout, the interviewees demonstrate the power of resiliency and hope.
See it here: https://wellbeings.org/hiding-in-plain-sight-youth-mental-illness-episode-2-resilience/
Click on the links below to learn more.
Christina Zeiders. June 22, 2022. Ken Burns presents “Hiding in Plain Sight: Youth Mental Illness”. WITF Broadcast Services. Retrieved June 24, 2022 from https://www.witf.org/2022/06/22/ken-burns-presents-hiding-in-plain-sight-youth-mental-illness/ .
Anne Azzi Davenport, Alison Thoet, and Jeffrey Brown. June 27, 2022. Ken Burns film explores youth mental health. PBS. Retrieved June 30, 2022 from https://www.pbs.org/newshour/show/ken-burns-film-explores-youth-mental-health.
Sophie Beney, Hermes Falcon, Sreehitha Gandluri, Michelle Mairena and Rick Hampson. June 26, 2022. Youth mental illness: Four young people’s views on new documentary. MindSite News. Retrieved June 30, 2022 from https://mindsitenews.org/2022/06/26/youth-mental-illness-in-america-four-views-on-a-new-documentary/.
Update On Wit v. United Behavioral Health Mental Health Parity Ruling
In a June 25, 2021, post, The Kennedy Forum reported that the defendant in Wit v. United Behavioral Health appealed the District Court’s decision to the U.S. Court of Appeals for the 9th Circuit. The Kennedy Forum argued that “the Wit case highlights how health plans often ration care based on faulty utilization review criteria—and how they use this as a strategy to avoid compliance with the Federal Parity Law.”
In YMA’s March 2022 News Mashup we reported on the 9th Circuit’s overturn of the 2019 District Court ruling — Wit v. United Behavioral Health (UBH) — seeking fair and equitable coverage of UBH patients with mental health and/or substance abuse disorder. To consumers and mental health advocates, this reversal flies in the face of federal law requiring insurers to cover treatment for mental health and substance use disorders in a manner no more restrictive than treatment for illnesses of the body (2008 Mental Health Parity and Addiction Equity Act).
On May 5, 2022, David and Natasha Wit, Plaintiffs-Appellees, filed a petition for a 9th Circuit rehearing and rehearing en banc claiming a rehearing is required because:
The 9th Circuit panel’s reasoning has no application to one of the three certified classes; The decision undermines ERISA with nationwide consequences; and The panel disregarded UBH’s overwhelming conflict of interest.
Defendant-Appellant United Behavioral Health (UBH) filed its Response on June 16, 2022. Plaintiffs-Appellees were granted leave to file a reply brief filed June 23, 2022.
Information for consumers, providers, and other stakeholders filing appeals for denials of mental health and substance use disorder care may benefit from user guides published jointly by The Kennedy Forum and NAMI, The Health Insurance Appeals Guide, and by SAMHSA Understanding Parity : A Guide to Resources for Families and Caregivers.
Click on the links below to learn more.
Lenny Bernstein. June 2, 2022. Equal mental health insurance coverage elusive despite legal guarantee. The Washington Post. Retrieved June 30, 2022 from https://www.washingtonpost.com/health/2022/05/25/equal-mental-health-insurance-coverage-elusive-despite-legal-guarantee/ .
The Kennedy Forum. June 25, 2021. Wit v. United Behavioral Health: Where does it stand? Retrieved June 20, 2022 from https://www.thekennedyforum.org/blog/wit-vs-united-behavioral-health-where-does-it-stand/.
Substance Abuse and Mental Health Services Administration. 2021. Understanding parity: A guide to resources for families and caregivers. Publication No. PEP21-05-00-002. Retrieved June 30, 2022 from https://www.dol.gov/sites/dolgov/files/ebsa/laws-and-regulations/laws/mental-health-parity/understanding-parity-a-guide-to-resources-for-families-and-caregivers.pdf.
Garry Carneal, Mary Covington, and Justin Eckman. 2021. The health insurance appeals guide: A consumer guide for filing mental health and substance use disorder (MH/SUD) appeals. The Kennedy Forum and National Alliance on Mental Illness. Retrieved June 30, 2022 from https://www.paritytrack.org/app/uploads/2021/04/KF-NAMI-Appeals-Guide-April-2021-final-middle-size.pdf.
A Smorgasbord Of Access-To-Care Failures
Access to quality and timely youth mental health services is a growing crisis in the U.S. This month, officials in New York, Illinois, Maine, and California were in the hot seat following reports of excessive wait-times for therapists, “hoteling” of high-needs foster youth, shuttering of residential treatment facilities, and jail stays in lieu of treatment or placements.
A recent analysis by the Rand Corporation suggest that the access crisis is likely to accelerate with the July 2022 rollout of 988 — the new nationwide mental health equivalent of the 911 emergency response system. The 988 code is intended to connect callers to trained counselors for immediate support and information on where to go for services. Unfortunately, only 48% of the jurisdictions reviewed in the Rand study had short-term crisis stabilization programs and only 28% possessed urgent care units for mental health.
Click on the links below to learn more.
Sam Whitehead. June 1, 2022. ‘Desperate situation’: States are housing high-needs foster kids in offices and hotels. Kaiser Family Foundation. Retrieved June 15, 2022 from https://khn.org/news/article/foster-care-hoteling-temporary-placement/.
Jonathan Cantor, Ryan McBain, Stephanie Brooks Holliday, Samantha Matthews, Armenda Bialas, Nicole Eberhart, and Joshua Breslau. June 2, 2022. Preparedness for 988 throughout the United States. Rand Corporation. Retrieved June 16, 2022 from https://www.rand.org/pubs/working_papers/WRA1955-1.html.
Abigail Kramer. June 8, 2022. New York let residences for kids with serious mental health problems vanish. Desperate families call the cops instead. ProPublica. Retrieved June 18, 2022 from https://www.propublica.org/article/mental-health-beds-new-york-children-disappearing.
Lewis Bossing. June 14, 2022. A new day or more of the same? Our hopes & fears for 988 (and 911). Bazelon Center for Mental Health Law. Retrieved June 20, 2022 from http://www.bazelon.org/wp-content/uploads/2022/06/A-New-Day-or-More-of-the-Same-Our-Hopes-Fears-for-988-and-911.pdf.
Patrick Smith. June 15, 2022. Some youths in Illinois' foster system who are hard to place are being left in jail. NPR. Retrieved June 20, 2022 from https://www.npr.org/2022/06/15/1105318196/some-youths-in-illinois-foster-system-who-are-hard-to-place-are-being-left-in-ja.
Abigail Kramer and Gabriel Poblete. June 23, 2022. “We’re at a crisis point”: NY Attorney General hearing spotlights child mental health care failures. ProPublica. Retrieved June 24, 2022 from https://www.propublica.org/article/new-york-psychiatric-hospitals-hearing.
Cathie Anderson. June 30, 2022. Kaiser mental health patients waiting months for appointments in Sacramento-area, employees say. The Sacramento Bee. Retrieved June 30, 2022 from https://www.sacbee.com/news/politics-government/capitol-alert/article263070053.html#storylink=cpy.
U.S. Department of Justice, Civil Rights Division. United States’ investigation of Maine’s behavioral health system for children under Title II of the Americans with Disabilities Act. Assistant Attorney General Kristen Clarke. June 22, 2022. Letter retrieved June 30, 2022 from https://www.documentcloud.org/documents/22072431-20220622_maine_kids_loffinal_accessiblepdf_0-1?responsive=1&title=1.
More Stories in June: The rise of firearm suicide among young Americans Everytown Research & Policy — 06.02.2022; Regaining momentum toward permanently funding the Children’s Health Insurance Program Health Affairs — 06.02.2022; How community schools help kids thrive EdSource — 06.02.2022; Covid challenges, bad student behavior push teachers to limit, out the door EdSource — 06.02.2022; How teens navigate school during COVID-19 PEW Research Center — 06.02.2022; The pandemic: Has it caused mental illness in kids or made it worse? CNN — 06.03.2022; How an East Bay school turns into a community school under California's model EdSource — 06.10.2022; More states are allowing students to take mental health days off NPR — 06.10.2022; As terms like ‘SEL’ draw fire, organizations supporting schools sharpen their message Education Week — 06.13.2022; California bill would give homeless high school seniors $1,000 a month EdSource — 06.15.2022; Only safety standards will prod Big Tech into protecting children CalMatters — 06.27.2022; Supporting students: What’s next for mental health Hechinger Report — 06.29.2022; Recent trends in mental health and substance use concerns among adolescents Kaiser Family Foundation— 06.28.2022; New program will put AmeriCorps public health volunteers in school EdSource — 06.30.2022.
