Psychological News You Can Use - December 2005

Whether you are a newspaper reporter, educator, professional, legislator or an interested member of the public, we hope that this quarterly newsletter will help you stay current on mental health issues in Pennsylvania and the entire country.

Corporal punishment in Pennsylvania schools will soon be a thing of the past. On October 6, 2005 the State Board of Education (SBE) voted to change the School Code and eliminate corporal punishment. The Independent Regulatory Review Commission (IRRC) had the option to reject the change, but chose not to.

For the past 17 years The Pennsylvania Psychological Association has been promoting this change, educating lawmakers about the harmful effects of spanking and other corporal punishment.

While some people argue that teachers need the option of physical punishment in order to discipline effectively, research shows otherwise. Positive disciplinary approaches are more successful and longer lasting. Here are some links to online resources that explore positive approaches to avoiding and managing discipline problems:

The Behavior Home Page

School Psychology Resources Online

Keep Schools Safe: The School Safety and Security Resource

Center for Evidenced-Based Practice: Young Children with Challenging Behaviors

Addressing Student Problem Behavior: Part I – An IEP Team’s Introduction to Functional Behavioral Assessment and Behavior Intervention Plans 

Currently about 25% of children in the United States are overweight and another 11% are obese. Perhaps even more alarming is the fact that the number of obese children in the US has either doubled (children under five and aged 12-19) or tripled (ages 6-11) over the past 30 years.

How do you know whether your child is overweight or obese? The conditions depend on age, gender, percentage of body fat and the child’s height/weight ratio. A commonly used measure for both children and adults is called the Body-Mass Index or simply the BMI. BMI is the ratio of a person’s weight to the square of their height, and is a good indicator of body fat.

Being overweight is a risk factor in many physical diseases for both children and adults. These include type II diabetes, hypertension, osteoporosis, digestive and cardiovascular problems, asthma, sleep apnea and certain types of cancer. In addition, overweight children are often targets from teasing by their peers, social isolation and other emotional consequences that may lead to a lower self-esteem, anxiety, depression, eating disorders or perhaps even substance abuse disorders.

The cause of obesity in children as well as adults is multi-faceted and complicated. As Americans in general have become wealthier over the last several decades, the concept of eating has changed from simply satiating one’s appetite to one of society’s major forms of entertainment and celebration. At the same time, studies have shown that the size of food servings both at restaurants and in the home have dramatically increased, while overall physical activity has decreased. A good way to summarize obesity is that it is a bio-psycho-cultural process with many interacting conditions

Here are some suggestions that can help you prevent or decrease obesity with your children.

Try to reduce the number of soda, high caloric fruit juice or sports drinks that your child drinks every day

Encourage children to eat only when they are hungry, and do not use food as an emotional crutch.

Reduce the number of hours the child spends watching TV.

The complete article and many other suggestions can be found here.

It has been three months since Hurricane Katrina changed the life and history of Louisiana, Mississippi, Texas, and Alabama, among others. I had the privilege of being able to volunteer to help with the disaster relief efforts of the American Red Cross. Please note that this rendition of my experiences with this disaster relief effort have not been sanctioned or approved by either the American Red Cross (ARC) or the Pennsylvania Psychological Association.

One characteristic common to every disaster relief effort is unpredictability. I arrived early evening in Birmingham, Alabama, called the ARC to get further instructions and was told to stay the night in Birmingham, and to report to headquarters for the operation in nearby Montgomery the following morning. I found a couple of other volunteers in the airport (you can just tell who they are) and we rented a car, went to the hotel and checked in. Early the next morning, we made our way to Montgomery and located our headquarters. We reported to staffing for "in-processing,” got our health clearance, went through orientation, said our goodbyes, and reported to our function area. There were about a dozen new volunteers at the mental health function area. After introductions and another brief orientation, we received our assignments and made travel arrangements to carpool to our destinations.

I was one of six volunteers who were assigned to a shelter in McComb, MS, about 17 miles north of Louisiana. This shelter was located in a huge Baptist church and served as home to regional operations for five shelters and two family service centers. The sleeping arrangements for ARC staff weren't comfy, but by disaster standards they weren't bad. That night, I roomed with two other mental health and two health volunteers in a large church school classroom. The cots weren't comfortable and made a lot of noise, but I thought to myself how fortunate I was to be in a place with nice accommodations. The next morning all that changed.

I reported to the mental health meeting as instructed the next morning and was promptly reassigned to a different shelter with one other mental health volunteer named Laurie. We left immediately for Mars Mills, MS, a small town with one small convenience store and many churches. On the way there, we noticed obvious wind damage, downed trees and lines and occasional property damage but nothing too serious.

Laurie and I arrived at our new assignment and met the three other mental health volunteers and the two shelter operations volunteers. We soon found out that the next day was the last day for all three mental health volunteers and one of the two operations volunteers. That meant it would be the two of us and one operations volunteer in this shelter with about 55 adults and children. The shelter consisted of one large room with the kitchen and two bathrooms at one end of the room, with the rest dedicated to eating, sleeping, and recreation areas. There was a small area offset by a waist high gate that served as ARC sleeping quarters with cots. We then discovered that there were also half a dozen long overdue port-a-potties outside. The shower consisted of a shower curtain hung from a metal rod with a garden hose stretched to the top of the curtain. No hot water outside. Still, we had been prepared to do without electricity and running water and considering the destruction the hurricane had visited upon this region of the country, it still felt as if we had fairly comfy accommodations.

The rest of the day was spent getting oriented to the routine for the day, learning about the shelter residents and surveying the needs they had. It wasn't long before Laurie and I realized we would spend more time with helping to operate the shelter and less time serving the mental health function. After all, all the other mental health volunteers and one of the operations volunteers would be leaving the next day. And there was no hope of help on the way as there was a shortage of ARC volunteers to cover all the needs created by the disaster. Tired, we parked our suitcases and belongings in the staff sleeping area and prepared to retire for the evening.

The next day, the shelter residents decided to prepare a special goodbye dinner for the departing volunteers. I was impressed with the way they used limited resources to prepare a meal and celebration for them. At the end of the ceremony we all said goodbye to them and Laurie and I were left as the lone ARC volunteers to manage the shelter with the one operations volunteer – and about 60 adults and children ranging in age from less than a year to 60+ years old.

The following day, we realized what we had inherited. None of the school-aged children were receiving public education; there were a few residents who were abusing drugs and alcohol into the wee hours of the early morning - while leaving their children unsupervised with strangers in the shelter, then sleeping through the day. And yet, there was a sense that the people we were there to help were doing the best that they could.

Laurie worked hard to get the children into the public school system and succeeded. It took a day to achieve that, and we weren’t sure the details had been completely worked out until we entered the school building and were well received by school staff. But it worked out, and with the help of a local church, transportation was arranged and the school-aged children were again receiving a public school education. On their second day in school, the children returned with most of them in tears – the public school was allowed to administer corporal punishment and one of the children from New Orleans had been spanked. The children were distraught, as were most of the parents. We did our best to console them, and then developed a plan to educate the school administrators and counselors. This effort was well received and we felt as if we had accomplished something important.

As I mentioned at the beginning of this article, disaster relief is accompanied by unpredictability. In the next 24 hours, we were transferred back to the shelter in McComb and our responsibilities changed in major ways. Helping disaster victims obtain new housing was a priority; there were crises among shelter residents to be resolved and volunteers who had special needs; and the shelter where we helped the children get into the public school system was closed. Always present were the issues of the departure of staff and residents who had been at the shelter for long time, and the arrival of new volunteer staff and residents.

All of this wasn’t unpleasant. There were successes and challenges. We never believed in failure, and refused to accept that there were no good options. And there are many other stories from my experiences that I will always cherish for many reasons. But the rewards of providing people who were in need with food and emotional support, who didn’t know if their loved ones survived the disaster or where they would live next week were immeasurable.

Three months later, I was reminded of the unfilled needs that remain from Katrina. In a November 28, 2005, OpEd article in Time Magazine titled “Don’t Give In to Katrina Fatigue” by Donna Brazile, she notes that “Katrina Fatigue” has set in and there is a growing apathy toward what the victims’ needs and experiences are and have been. It is much like the grieving process that a person experiences when an important loved one dies. At first, there is great support and an outpouring of sympathy. But after some time has elapsed, the support dwindles and the grieving are left to fend for themselves.
I want to continue to give, in whatever way I can. And I hope you continue to remember the pain of those affected by this tragedy and give to them in your own way.

The procedures of some insurance companies discriminate against people with mental illnesses. One way in which this occurs is by requiring “authorizations” for routine or short term outpatient treatment. Similar authorization requirements do not exist for physical illnesses.

The authorization procedure uses up more than 50% of your mental health premium dollars for some HMO’s. Why
is such waste permitted in mental health when it would never be tolerated in the delivery of physical health services?

Data shows that the utilization of mental health service is primarily driven by the diagnosis of the patients and the amount of their copays. Authorizations do little or nothing to promote patient care.

• When Blue Cross/Blue Shield of Rhode Island abolished authorizations they found only a very small increase in utilization (85% of patients terminated before the 11th session before authorizations were abolished; 85% of patients terminated before the 12th session after authorizations were abolished).

• Several major insurers have recently abolished the routine use of authorizations for outpatient mental health treatment.

Both of the following bills are now in the State Senate. Contact your State Senator and support these bills!

Student Loan Forgiveness Bill (HB 49/ SB 413)

80% of recent doctoral graduates average almost $60,000 in debt upon graduation. House Bill 49 and Senate Bill 413 establish a student loan forgiveness program for those who go to work for county MH/MR or drug and alcohol programs.

These bills allow up to $5,000 per year for up to four years to be forgiven for qualified applicants who became full-time staff members of a county MH/MR agency, a private provider under contract to an MH/MR agency, or a licensed alcohol and drug treatment facility.

Child Custody Immunity Bill (HB1055/SB 845)

Health care professionals who assist the courts in custody decisions are subject to an extraordinarily high number of licensing board complaints. Many of these are frivolous and never accepted by the Bureau of Professional and Occupational Affairs as formal complaints. Some disgruntled parties view the complaint process as a tactic to attempt to disqualify a court-appointed evaluator who is likely to make an unfavorable report to the court. For example, some evaluators have been reported to the licensing board for reporting suspected child abuse, even though Pennsylvania’s Child Protective Services Law required them to do so.

This bill would not preclude aggrieved parties from filing complaints. However, it attempts to balance the right to file complaints with the need of the court for objective information to make the best determination in a child custody dispute. This bill would prohibit licensing board complaints while the case is pending and for 60 days thereafter. After that parties may file any complaints they want.

Frivolous complaints drive up the costs of evaluations. Those professionals who do custody evaluations have to include the cost of defending themselves against frivolous complaints (both in terms of money spent and time lost) as a factor in determining the cost of providing services. In addition, it drives up the costs for the Bureau of Occupational and Professional Affairs because they have to pay for the time spent by investigators investigating these frivolous complaints.

Frivolous complaints also discourage otherwise qualified mental health professionals from assisting the courts in making or implementing custody decisions. Currently courts are experiencing a shortage in professionals willing to undertake such responsibilities.

This bill would provide limited immunity for mental health professionals who are court-appointed to assist the court in child custody evaluations. HB 1055 has already been passed by the House and SB 845 has just been reported out of the Senate Consumer Protection and Licensure Committee and will be sent to the Senate Floor for a vote. We would like you to encourage your Senators to pass SB 845.

You work hard all year. Holiday office parties are a time to relax, have fun and get to know your co-workers better. But watch it, or you may undermine your chances for raises and promotions. You’re not on the clock, but for all intents and purposes, you’re still on the job.

Here are some tips to keep your behavior under control, and still have a good time at your office party:

• Dress modestly. If you want pizzazz, go for flashy jewelry. The office party is not the place to show off your new revealing outfit, especially if you care about your professional image.

• Limit alcohol. You’ll be less likely to say and do things that you’ll later regret. If you tend to have “way too much fun” when you drink, stay dry at the office party.

• Watch your mouth. Cursing and sexual innuendos may be taken the wrong way, even at parties. Play it safe by using language that won’t haunt you 6 months from now.

• Keep your hands to yourself. Under the guise of “fun” some folks get a bit too touchy-feely at parties. Don’t risk sexual harassment charges. If hugging is the norm among your coworkers, hug them as you would your great-aunt.