Thanks and giving

Thanksgiving is a time to express our gratitude for what we have received yearlong in the presence of family and friends. This time offers us an opportunity to reflect on the charitable favor we have been given—a generous donor and a volunteer community who has dedicated years to our mission of creating lasting change.

This particular holiday, on this centennial year, gives pause to think about our 100 years of serving children, youth, and families in need. We’ve seen children abandoned by parents, others who have faced violent tragedies, and those who suffer from emotional turmoil. We’ve worked with youth who have left the foster care system and faced homelessness, battled mental disorders or struggled with maintaining employment. We’ve served families who have been distraught by traumatic situations, impacted by mental illness, and challenged by children enduring behavioral issues. At the end of the day, we have remained hopeful for each one. Each child, youth or family has been effectively touched by our staff’s expert care, compassion, and dedication to meet their individual needs.

How is it that we are able to do this for 100 years? Thanks and giving. Our founder Deaconess Evelyn Wile laid the foundation for the charitable work we do in our community. She demonstrated thanks to every person, church, company, organization, and foundation that supported Hillsides mission. Our donors and volunteers’ commitment to continually give to our mission has enabled us to continue to the do the individualized treatment for each child, youth, and family. We continue to give thanks. The giving pledges of support that we receive from you help us ensure our clients’ well-being, safety, and permanency. Giving keeps the hope alive for thousands each year.

There is a movement spearheaded by Bill and Melinda Gates and Warren Buffet called the Giving Pledge that was featured on “60 minutes” recently. Two requirements must be met to be part of this movement: individuals must have an excess of one billion dollars in wealth and be willing to give half of it away to charity. Buffet says that the wealth has no real utility to billionaires, but that “wealth has incredible utility to other people. It can educate children, it can vaccinate children. It can do all kinds of things.” Billionaires like the Gates and Buffet realize that government alone cannot solve the world’s problems. Philanthropists who have wealth can influence and collaborate with foundations and charities to problem-solve today’s issues.

Those who pledge to Hillsides understand that their philanthropic giving means providing hope and changing the lives of other people—children who have never had childhoods can regain them, youth who have lived under bridges or on the streets can find a safe apartment, and families who have been torn apart by domestic violence can break the cycle for generations who follow. This is the utility to other people, to organizations like Hillsides.

As you read this blog post, let’s imagine a virtual table where we can give thanks together for what we share in common: People. People who demonstrate unconditional support for the work we do, who improve our lives, and who dedicate time to serve. Let us also be mindful that the giving pledges we receive for our programs and services to children, youth, and families in need enhances and strengthens the quality care we provide. May we continue to share a bountiful table of thanks and giving.

Happy Thanksgiving!

Understanding the effects of trauma

This past spring I attended a conference that featured a presentation on the effects of trauma on the brain. Seeing the images of the brain before and after treatment was fascinating. Stress, resulting from trauma, can have any number of negative impacts and serve as the source of persistent ailments and disorders. The relationship between trauma, stress, and illness are well known, but for the first time we can see its impact and track improvement as a result of treatment.

For all the children, youth, and families we serve, trauma is a given. For many, their trauma is rooted in violence, loss, and so many persistent life challenges. As this issue has become more dominate in the practice field, we at Hillsides have taken on the challenge of becoming more effective at addressing trauma, confident that the treatment we offer can help restore hope and health to all we serve.

The starting point in this process is to recognize the trauma that we ourselves have experienced. The ability to be in touch with what has been traumatizing in our own lives allows us to empathize with others who have experienced trauma. Beyond the common experience, the challenge is to provide an environment that allows the causes of  trauma to be addressed effectively.

Hope is robbed when trauma rules, however, hope is restored when a hurt can be recognized and addressed. Treatment conducted in a respectful environment where safety is assured and compassionate care is offered relieves the stress caused by trauma and sets a path to restoring hope.

As I visit with our residents and follow their progress, I see the impact of trauma lessen and their childhoods restored. I may not be able to see a brain scan to demonstrate the improvement, but I can see the smile on a face and a carefree demeanor that indicates for me that something good has happened...hope has been restored.

The truth is that no one gets through life without experiencing trauma along the way in some manner. For each of us, caring people in our lives have helped us deal with challenges without losing hope. For those we serve, Hillsides offers a cadre of people whose sole purpose is to help address the traumas of life effectively and in the process make a lasting change in their lives. 

Common Sense

Photo credit: www.usatoday.com

Washington, DC has become a place of sound bites, posturing, and token measures meant to appease as opposed to addressing issues in a meaningful way. Next week I head to Washington, DC for the annual meeting of the Child Welfare League of America. As part of the conference, delegates will walk the halls of Congress advocating for the needs of vulnerable children and families. Without exception, we will get a cordial reception by all our elected officials. Their staff will acknowledge our contribution to the field, our indispensable services, and assure us that they will advocate for those we serve. However, even the most effective of our legislators, like Representative Karen Bass, are up against a system that is driven by priorities that do not include the needs of those for whom we care.

The current debate on “gun control” is the most recent example. Will the modest measures that have survived the winnowing legislative process make any difference? Without being too skeptical, I suggest that more attention has been placed on the actual process than the intended outcome. As a result, no measurable benefit will come from whatever legislation may emerge. Perhaps less legislation and more common sense measures is the answer.

How can we address maintaining a secure society let alone one that is safe for our children without addressing the need for resources to provide adequate care for those who are most vulnerable? For many, they are made vulnerable by crisis and trauma that impact their mental health. Mental illness is an epidemic in our country that barely is recognized. The majority of those suffering mental illness are untreated either because of a failure to diagnose or limited access to care. Those experiencing mental illness are not to be feared; treatment can be very effective. But without an awareness of the illness and the necessary resources to provide effective interventions, it can be deadly!

I can only hope that the lack of mention of the need to reinforce the mental health service delivery system in the gun control debate is an attempt to appropriately disconnect the two and develop legislation that exclusively addresses the resources needed to adequately provide good and quality mental health services.

Common sense dictates that we keep guns out of the hands of those who would do us harm. Common sense motivates us to keep those most vulnerable safe. Common sense helps us to establish priorities in allocating precious resources to address the most vulnerable effectively.

At the end of the day, measures in Sacramento, CA and Washington, DC are important, but never a substitute for common sense and the commitment of each of us to hold the safety and security of our society, and especially our children, as a priority.

Senseless?

There is no good explanation for the tragedy at Sandy Hook Elementary School in Newtown, Connecticut. There are no simple answers to the question: How can we prevent this from happening again?  Efforts to pin blame are ineffective and serve only to vent our anger. It will be awhile before emotions subside and we are free to examine the situation. However, already some indisputable facts are clear:

• Only one third of those diagnosed with mental health disorders in this country are treated.
• Violence is ubiquitous in our culture.
• Assault weapons are incredibly accessible.

Twenty “angels” and their “guardians” perished as these realities came together and brought evil upon a most unlikely place. 

Mental illness continues to be an unspoken disorder that more often than not goes undiagnosed and when diagnosed untreated because of a lack of resources, the fear of stigma and denial. Very successful therapies are available to address mental illness. Like any illness, the sooner the issue is diagnosed and treatment initiated and sustained the greater likelihood of success. Only when we begin to treat mental illness as any other life altering or threatening disease can we begin to hope that it will cease to be a factor in such a horrific event as the massacre at Sandy Hook.

When mental illness is ignored in a society where violence is considered entertainment disaster is inevitable. Maybe I was especially sensitized to this because of the events of this past week, but as I sat in a movie theater Saturday, I was impressed by how ubiquitous violence has become in our culture and how entertaining it is. Although no studies indicate a relationship between violence on the screen with actual acts of violence, I don’t think I am risking my credibility by suggesting that there may be a correlation.

Why are we an armed society? This question is not an affront to the 2^nd Amendment. The right to bear arms for either personal defense or sport does not require the kind of military like assault guns that have been used in these most heinous crimes. In the most recent cases where assault weapons destroyed innocent lives, they were obtained legally. Some gun shops indicated that sale of the same kind of assault rifle has multiplied significantly in the days since the Sandy Hook incident. How can that be? How can the instrument of such violence become the gift of choice for Christmas? Surely we must understand that the proliferation of assault weapons will only lead to more senseless violence.

As we mourn, testimonials have emerged to the innocence and vitality of these “angels” and their heroic “guardians.” May they be more than heartfelt expressions of grief but become a reason for our resolve to address the issues that contributed to this tragedy.  To take no action is to be party to future atrocities.

Mitigating Tragedy

Once again, the nation is shocked dealing with the absurdity of a mass shooting rampage in Aurora, Colorado. The senseless nature of the act is mind boggling. At some level, we have become disabled by the shear magnitude of such violence. How can such a bright, capable graduate student defy all typical expectations associated with someone like him to become the perpetrator of the worst mass shoot in our history?

On one of the recent news programs, a former FBI profiler questioned whether an insanity plea could be argued in defense of the shooter because he was so rational and intentional in executing his plan for mass destruction and chaos. As I sat there listening to the commentary, I was struck with the reality that reason sometimes has nothing to do with sanity.

For those of us involved in the mental health field for many years, the profile of this young man is not unusual. The fact of the matter is that most folks who have any sort of chronic mental illness often begin to display it as they approach adulthood. Sullen, withdrawn behavior that may have been excused as a phase of adolescents can indeed be an indicator of mental illness and often comes as a surprise to those closest to the individual. I don’t know the details surrounding the shooter’s life to analyze his mental health state, but it certainly seems to me that it is a factor in understanding how such an otherwise nondescript graduate student could achieve such infamy.

I do not offer these observations in any way to excuse the violence or to suggest leniency, but rather to raise the question that seems to be missing in the discussion. What is the mental state of this young man? How does it influence our understanding of this tragedy? How can we prevent a recurrence?

As we move from shock to understanding and hopefully resolve to avoid repetition of this kind of situation, I suggest that we adopt a greater vigilance when it comes to the mental health of our young people. There is no need to become paranoid, but rather attentive to be a true resource that supports the well-being of our youth. A mental health diagnosis continues to bring with it tremendous stigma. Incredibly, in some sectors, it is almost taboo to consider a mental health disorder. Like a physical illness, mental health requires attention to be preventative and offer successful treatment.

Lost in the debate is perhaps the most reasonable solution. Screening for mental illness should be as routine as an annual physical, not by way of exception. Physicians, educators, families need to recognize the signs of a mental health disorder and feel free to seek treatment. Resources needed for treatment are required and may just be the best investment in riding the nation of this kind of heartbreak.

What's in a Budget?

As many of you know, Hillsides has a fiscal year that starts on October 1. As a result, the summer months are busy with budget preparations in order to have a proposed budget presented to Hillsides Board of Directors in early September. In spite of the financial woes in California, we anticipate the same level of public funding we received this past year. Given some of those funds are inadequate to meet our needs and staff costs and other expenses continue to rise, preparing a budget during these months can make for a long, hot summer in more ways than one.

In the midst of the preliminary budget drafts, setting priorities, examining efficiencies and making difficult decisions, I usually take a break from the budget exercise to walk the campus to remind myself why we make this effort. Inevitably, I come back energized and committed to somehow stretching the dollars to allow us to continue to serve some of the most vulnerable children and families in Los Angeles County.

One evening after a Finance Committee meeting as I was leaving the meeting room, one of our clinicians was waiting with a resident and her family to use the room for a counseling session. I know the challenges of this young girl, who one day recently was so despondent that she could barely contain herself in any one place and wandered restlessly around the campus with staff in tow walking off her anxiety. As they entered the room, I asked her how she was doing and had the opportunity to meet her parents and speak with them about her treatment. As always, they spoke of how appreciative they are for all we do for them and how in spite of some setbacks, were pleased with her progress and hopeful about her return home at some point.

It is not easy to provide such intensive treatment; it is expensive to have a child accompanied all day with a staff member. Reaching out to parents and providing them with counsel and support is essential. These efforts may be expensive and certainly are labor intensive, but the end result is all worthwhile. Though this young girl will continue in our care for the immediate future, she and her family are able to see a path that will lead her home with hope for a good life together.

Is it worth the effort? Absolutely. Is it worth the sacrifice? No question about it. And so in spite of the short fall in public funding, our efforts to successfully raise $2.5 million each year to augment our public funding sources is essential if we hope to continue to help these vulnerable children, youth and their families find their way to a fuller life.

As we have in the past, we build into our budget the continued capacity to raise  private dollars to maintain our mission. Please consider supporting this effort by contributing to our annual fund. Know that your generous support makes a big difference in the lives of all we serve. Thank you!

Access to Mental Health is Diverted

This past week I attended the annual meeting of the National Council of Community Behavioral Healthcare. Promoting effective and quality care, the conference gathered an extraordinary array of providers and consumers of mental health services from around the country.

As is often the case, I leave these conferences invigorated and resolved to be evermore committed to the care we offer to all we serve. Almost 60 percent of the revenues of Hillsides' annual operating budget is derived from mental health reimbursable services. The provision of mental health services is the greatest common denominator of care within all our programs and so it is essential to stay current with practice and trends in the delivery of care.

Because perhaps I take for granted the availability of mental health services, I was surprised to learn that only one-third of children in need of mental health care are ever treated. This kind of care denied during childhood and adolescence results in the need for mental health treatment of 50 percent of adults in care!

How is it that only one-third of children in need are treated? More likely than not, it is the result of poor diagnosis or the temptation to minimize any disorder hoping the child will "out grow it." Even when symptoms persist, the stigma associated with mental illness is also a deterrent.

In addition to our predisposition to tolerate, ignore or minimize mental health issues of children, care is also costly, providing yet another reason to avoid treatment. This is a very dangerous combination that results in creating considerable risks for our children. Often it is early intervention and treatment that are most effective in helping children and their families to successfully address the challenges presented because of mental illness.

Beginning in July, the burden of providing mental health services for children in California shifts from the responsibility of the local Mental Health Departments to the local public school systems. Most of these school systems are poorly equipped to take on this responsibility and are lacking the funds necessary to provide the services. At least 15 of our residents will have funding curtailed because of this shift, placing in jeopardy their need for ongoing treatment. Although we may identify some resources to prolong their care for a while longer, the chances of providing needed mental health services for children who may surface in the near future is pretty grim.

When you take all this into account, is it any wonder that only one-third of children in need of treatment receive it?

School systems are inadequately funded to provide these services and are in desperate need of our support. Resources are necessary to help them meet their responsibilities to their students. Although the solution goes beyond just additional funding, every effort must be made to adequately provide our schools with the resources needed to provide the care that our children require. Failure to address our children's mental health needs today only increases the likelihood of their suffering serious disorders as adults.

Homeless Youth Step into Affordable Housing

More than 5,000 youth, when they turn 18, emancipate or “age out” of California’s foster care system, and nearly 1,000 youth exit care each year in Los Angeles. They lose access to all state-funded foster care services and, for the most part, also lose connections to adult support received while in the foster care system. Research has indicated that without housing, education or emotional support, 65 percent of foster youth will face homelessness, twenty percent will be arrested or incarcerated, 46 percent will complete high school and only one percent will graduate from college. For these reasons, Hillsides founded Hillsides Youth Moving On (YMO) in 2004. 

By providing comprehensive services such as transitional housing, education, employment, mental health and mentoring support, we help youth transition successfully into adulthood. YMO helps youth avoid negative circumstances and achieve long-term self-sufficiency. Former foster care and probation youth take their first steps to independence when they arrive at YMO. Today, YMO has increased its capacity to accommodate ten more youth in permanent housing. 

Over the summer, we began a collaborative effort with First Place for Youth to secure funding from the Los Angeles Homeless Services Authority (LAHSA) to provide affordable housing and support services for a minimum of twenty youth over the next two years.  Permanent Housing, unlike transitional housing, has no pre-determined amount of time for youth to receive housing.  Youth can stay in their apartments and assume the lease as long as they pay their rent on time.  To ensure their success in this endeavor, YMO will continue to provide comprehensive case management, mental health, and career planning to all youth to guarantee a seamless transition to full self-sufficiency.

YMO also partnered with New Economics for Women (NEW), an organization that empowers disinvested communities, who willingly offered eight one and two bedroom units for our youth located at La Villa Mariposa apartments in Los Angeles. At our YMO complex, we have assigned two studio units for youth participating in this new collaborative.

This week we hosted a dedication and ribbon-cutting ceremony at La Villa Mariposa apartments. The Reverend Cecil L. Murray, board member of LAHSA, shared words of inspiration and encouragement to our youth. Youth present were overwhelmed with the thought of having their first place. They expressed how far they have come.

For these youth, reaching this milestone in their journey is incredibly significant. Having experienced systemic trauma, abuse, run-ins with the law, or bouts of homeless, they have prevailed from these situations. We have created conditions and placed a great deal of attention to offering a comprehensive program whose pathway leads to their successful transition into self-sufficiency and independence.

Our collaborative relationship with LAHSA, First Place for Youth and NEW is so important in trying to alter the daunting statistics for these youth. With the help of others, whose goal is also to support youth in their transition from foster care to successful adulthood, we can make significant impacts in the lives of these youth. I am privileged to be part of their journey into adulthood and thankful that others have joined along their path.

Roaming the Halls in Sacramento

From L to R: Sam Garrison, Joe Costa, Assemblymember Ricardo Lara, Marisol Barrios and Thomas Lee

Yesterday the Los Angeles Times had an article on the proposed budget cuts that Governor Brown will be addressing later this week. And so begins the annual ritual of adjusting the budget to reflect revenues. Given that these revenues do not match the budget’s projected revenue stream, we envision additional cuts to services. As always, this discussion will trigger an acrimonious round of proposals to determine which of the poor options we have will be selected.  Inevitably, these cuts will further erode the already fragile “safety net” that supports education and services to vulnerable children and families.

In an effort to play a role in the process, Sam Garrison, Hillsides board member and chair of our Government Affairs and Public Policy Committee, facilitated a round of conversations in Sacramento this past week with staff of our local elected officials. We introduced ourselves and hopefully established the kind of rapport with these policymakers that will keep them sensitive to the needs of all we serve. Besides Sam, Thomas Lee, director of Youth Moving On, and Marisol Barrios, director of communications and advocacy, joined me in these meetings. We met with staff from the offices of Gilbert Cedillo, Kevin de Leon, Ricardo Lara, Roger Hernandez, Carol Liu, and Felipe Fuentes.

There is no way to avoid some very significant cuts in this kind of constrained public funding environment. No elected official relishes making decisions that sacrifices needed services. Our visit last week was an opportunity for us to suggest to the legislators some criteria and priorities to consider in making these very difficult decisions. We can only hope that such advocacy will lead to decisions that support the delivery of care to the most vulnerable.

We advocated the importance of not being shortsighted in what funding reductions must be made--some level of support must be maintained in order to minimally sustain the needs of the most vulnerable. Cuts to avoid would include those that only exacerbate poor situations and eventually lead to more costly solutions, often placing the needy at a greater risk of harm. Certainly from our perspective it is very important to maintain the already significantly reduced funding for education. Fewer school days, more children in a classroom, and further elimination of ancillary and support services for school-aged children only threaten the integrity of the public education system and reduces it to not much more than custodial care.

In addition to advocatingfor support of education, in particular funding for special education, we also informed staff of the need for continued funding of mental health services to support children who have experienced abuse, neglect or violence.  Inadequately funding these kinds of services places these children and families at considerable risk of further harm. As resilient as children can be, they are especially vulnerable when needed services are sacrificed, threatening to weaken the gains that they may have made. Failure to effectively address the needs of these children and youth only opens the door to chronic behaviors and disorders that jeopardizes their long-term well-being and that of our society and community as a whole!

Challenging times require courageous and prudent actions. Legislators are typically receptive to the input of their constituents. As we begin the arduous exercise of balancing the State budget and making very difficult decisions, we ask you to join with us in any way you can to encourage our representatives to hear the voices of the vulnerable children, youth and families as they deliberate in January.