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	<title>State of Health Blog from KQED News &#187; Newtown Shootings</title>
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		<title>A Public Health Approach to Gun Violence</title>
		<link>http://blogs.kqed.org/stateofhealth/2012/12/21/a-multi-pronged-approach-to-gun-violence/?utm_source=rss&#038;utm_medium=rss&#038;utm_campaign=a-multi-pronged-approach-to-gun-violence</link>
		<comments>http://blogs.kqed.org/stateofhealth/2012/12/21/a-multi-pronged-approach-to-gun-violence/#comments</comments>
		<pubDate>Fri, 21 Dec 2012 17:34:46 +0000</pubDate>
		<dc:creator>Lisa Aliferis</dc:creator>
				<category><![CDATA[KQED blogs]]></category>
		<category><![CDATA[Place Matters]]></category>
		<category><![CDATA[Policy]]></category>
		<category><![CDATA[Newtown Shootings]]></category>
		<category><![CDATA[Violence Prevention]]></category>

		<guid isPermaLink="false">http://blogs.kqed.org/stateofhealth/?p=9666</guid>
		<description><![CDATA[        <media:content url="http://blogs.kqed.org/stateofhealth/files/2012/12/Screen-Shot-2012-12-21-at-9.17.32-AM.png" medium="image" />
So now we've heard from the NRA which asserts that we need to put armed police in every school, then adding, "The only thing that stops a bad guy with a gun is a good guy with a gun."

It sounds good, but as Josh Sugarmann of the Violence Policy Center said today in a statement, that's been tried already -- and it didn't work. "There were TWO armed law enforcement agents present at Columbine High School during the assault by Eric Harris and Dylan Klebold that left 15 dead and 23 wounded. They twice engaged and fired at Eric Harris in an effort to stop the shooting, but were unsuccessful because they were outgunned by the assault weapons wielded by the two teens.” <a href="http://blogs.kqed.org/stateofhealth/2012/12/21/a-multi-pronged-approach-to-gun-violence/">Continue reading <span class="meta-nav">&#8594;</span></a>]]></description>
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			<content:encoded><![CDATA[<p>So now we&#8217;ve heard from the NRA which asserts that <a href="http://www.nytimes.com/2012/12/22/us/nra-calls-for-armed-guards-at-schools.html?hp&amp;_r=0" target="_blank">we need to put armed police in every school</a>, then <a href="http://www.sacbee.com/2012/12/21/5069433/nra-returns-to-public-debate-to.html" target="_blank">adding</a>, &#8221;The only thing that stops a bad guy with a gun is a good guy with a gun.&#8221;</p>
<p>It sounds good, but as Josh Sugarmann of the Violence Policy Center said today in <a href="http://www.vpc.org/press/1212nra.htm" target="_blank">a statement</a>, that&#8217;s been tried already &#8212; and it didn&#8217;t work. &#8220;There were TWO armed law enforcement agents present at Columbine High School during the assault by Eric Harris and Dylan Klebold that left 15 dead and 23 wounded. They twice engaged and fired at Eric Harris in an effort to stop the shooting, but were unsuccessful because they were outgunned by the assault weapons wielded by the two teens.”</p>
<p>And if you&#8217;re thinking that having a gun protects you from guns, think again. After all, Rachel Davis, Managing Director of the Prevention Institute points out, in Newtown, Adam Lanza first killed his mother, a gun enthusiast. &#8220;The first victim of this shooting was a gun owner who was not able to stop this from happening,&#8221; Davis says. &#8220;The problem of guns is they raise the risk of lethality.&#8221;</p>
<p>We are a society that craves simple solutions, yet violence is a complex problem. That doesn&#8217;t mean nothing can be done. While Davis favors an assault weapons ban, she says that&#8217;s only one piece of a comprehensive approach. &#8220;Another piece,&#8221; she adds, &#8220;is addressing mental health needs &#8212; that includes access to high quality mental health services, reducing the trauma people are exposed to and then addressing the trauma.&#8221;</p>
<p>Mass shootings in Newtown understandably capture widespread media attention, but remember that children are murdered every day by firearms. In 2010, according to CDC numbers, 1,260 children up to age 18 were killed by someone who used a gun. That&#8217;s more than three children every day &#8212; or 21 children in the week since Newtown.</p>
<p>Davis argues for broad community-based prevention programs. Davis points to &#8220;GRYD&#8221; &#8212; the Gang Reduction Youth Development program which has been in place for several years in Los Angeles. GRYD is multi-pronged. &#8220;It&#8217;s not one single thing,&#8221; Davis says, &#8220;but a combination of strategies and efforts that are coordinated in the neighborhoods that are most affected by violence.&#8221;</p>
<p>For example, in LA&#8217;s successful <a href="http://mayor.lacity.org/issues/gangreduction/summernightlights/index.htm" target="_blank">Summer Night Lights</a> program, parks are open after dark &#8212; prime gang-activity time &#8212; with free food and extra programs. Families flock there.</p>
<p>And it&#8217;s effective. Here are some statistics from the Summer Night Lights website:</p>
<div id="attachment_9669" class="wp-caption aligncenter" style="width: 630px"><a href="http://mayor.lacity.org/issues/gangreduction/summernightlights/index.htm"><img class="size-large wp-image-9669" title="Screen Shot 2012-12-21 at 9.17.32 AM" src="http://blogs.kqed.org/stateofhealth/files/2012/12/Screen-Shot-2012-12-21-at-9.17.32-AM-620x305.png" alt="" width="620" height="305" /></a><p class="wp-caption-text">(Image from Summer Night Lights website)</p></div>
<p><span id="more-9666"></span></p>
<p>Got that? &#8220;Gang related homicide&#8221; down 57 percent &#8212; those are real lives saved.</p>
<p>In a profile, the <a href="http://articles.latimes.com/2011/sep/12/opinion/la-oe-newton-column-gangs-20110912" target="_blank">LA Times</a> showed how GRYD also takes at-risk youngsters and not just stops violence but puts kids on a better path:</p>
<blockquote><p>According to a study by the Urban Institute, since GRYD began operating, gang crimes have fallen by 21.6%, faster than crime overall in the city; in the two years before it opened, they dropped 14.9%. Moreover, GRYD is reaching large numbers of at-risk youngsters: Young people enrolled in the program were 29% less likely to skip class, while those from the same neighborhoods not in the program increased the amount they cut class by 53%.</p></blockquote>
<p>What all these statistics show is that violence is preventable. &#8220;There&#8217;s growing evidence for it,&#8221; Davis concludes, &#8220;but there&#8217;s no simple solution for it. We need to put in comprehensive solutions that are working in places around the country.&#8221;</p>
<p><strong>Learn More:</strong></p>
<p>KQED Forum:<br />
<a href="http://www.kqed.org/a/forum/R201212210900" target="_blank">Living with Gun Violence</a></p>
<p>KQED Lowdown Blog:<br />
<a href="http://blogs.kqed.org/lowdown/2012/12/19/the-geography-of-u-s-gun-homicides/" target="_blank">The Geography of U.S. Gun Homicides</a>;<br />
<a href="http://blogs.kqed.org/lowdown/2012/12/14/the-united-states-of-firearms-americas-love-of-the-gun/" target="_blank">The United States of Firearms: America&#8217;s Love Affair with the Gun</a></p>
<p>Fresh Air:<br />
<a href="http://www.npr.org/2012/12/20/167694808/assault-style-weapons-in-the-civilian-market" target="_blank">Assault-Style Weapons in the Civilian Market</a></p>
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		<title>After Newtown Shootings: Questions about Mental Health Insurance Coverage</title>
		<link>http://blogs.kqed.org/stateofhealth/2012/12/18/after-newtown-shootings-questions-about-mental-health-insurance-coverage/?utm_source=rss&#038;utm_medium=rss&#038;utm_campaign=after-newtown-shootings-questions-about-mental-health-insurance-coverage</link>
		<comments>http://blogs.kqed.org/stateofhealth/2012/12/18/after-newtown-shootings-questions-about-mental-health-insurance-coverage/#comments</comments>
		<pubDate>Tue, 18 Dec 2012 16:56:32 +0000</pubDate>
		<dc:creator>Lisa Aliferis</dc:creator>
				<category><![CDATA[Policy]]></category>
		<category><![CDATA[Reform]]></category>
		<category><![CDATA[Affordable Care Act]]></category>
		<category><![CDATA[Mental Health]]></category>
		<category><![CDATA[Newtown Shootings]]></category>

		<guid isPermaLink="false">http://blogs.kqed.org/stateofhealth/?p=9555</guid>
		<description><![CDATA[        <media:content url="http://blogs.kqed.org/stateofhealth/files/2012/12/PresObamaNewtownOlivier-DoulieryGetty-Images.1.jpg" medium="image" />
In his speech at the memorial service for the Newtown victims, President Obama included mental health in calling for a national response to the massacre, a conversation that so far has focused on gun control. "I will use whatever power this office holds to engage my fellow citizens -- from law enforcement to mental health professionals to parents and educators -- in an effort aimed at preventing more tragedies like this," the president said.

On Monday White House spokesman Jay Carney pointed to the federal health law as evidence that the administration has already started to tackle the issue. Mental health issues are "clearly a factor that needs to be addressed in some of these cases of horrific violence," Carney said. "Obamacare, if you will, has ensured that mental health services are a part of the services" provided under the health law. <a href="http://blogs.kqed.org/stateofhealth/2012/12/18/after-newtown-shootings-questions-about-mental-health-insurance-coverage/">Continue reading <span class="meta-nav">&#8594;</span></a>]]></description>
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			<content:encoded><![CDATA[<p>By Jenny Gold, <a href="http://www.kaiserhealthnews.org/Stories/2012/December/18/Mental-Health-Insurance-Coverage-Questions-After-Shooting.aspx" target="_blank">Kaiser Health News</a></p>
<div id="attachment_9564" class="wp-caption alignright" style="width: 310px"><a href="http://blogs.kqed.org/stateofhealth/files/2012/12/PresObamaNewtownOlivier-DoulieryGetty-Images.1.jpg"><img class="size-full wp-image-9564" title="President Obama Visits Newtown, CT, Consoles Families Of Shooting Victims" src="http://blogs.kqed.org/stateofhealth/files/2012/12/PresObamaNewtownOlivier-DoulieryGetty-Images.1.jpg" alt="President Obama speaks at an interfaith vigil for the shooting victims at Sandy Hook Elementary School (Olivier Douliery-Pool/Getty Images)." width="300" height="199" /></a><p class="wp-caption-text">President Obama speaks at an interfaith vigil for the shooting victims at Sandy Hook Elementary School (Olivier Douliery-Pool/Getty Images).</p></div>
<p>On Monday White House spokesman Jay Carney pointed to the federal health law as evidence that the administration has already started to tackle the issue. Mental health issues are &#8220;clearly a factor that needs to be addressed in some of these cases of horrific violence,&#8221; Carney said. &#8221;Obamacare, if you will, has ensured that mental health services are a part of the services&#8221; provided under the health law.</p>
<p>While the Affordable Care Act, along with the Mental Health Parity Act of 2008, go a long way toward assuring coverage for most Americans, some gaps remain.</p>
<p>Here are some answers to frequently asked questions about mental health coverage:</p>
<p><strong>Didn&#8217;t the Mental Health Parity Act already guarantee coverage for Americans with insurance?</strong></p>
<p>The <a href="http://www.kaiserhealthnews.org/features/insuring-your-health/mental-health-coverage.aspx" target="_self">Mental Health Parity and Addiction Equity Act</a>, signed into law in 2008, <a href="http://archpsyc.jamanetwork.com/article.aspx?articleid=208673" target="_blank">made a big dent</a> in the problem of mental health coverage. But it depends on how you get your insurance</p>
<ul>
<li><strong>Large Employers (more than 50 workers): </strong>If large companies include mental health services in their insurance plans, they must cover those services at same or higher level as other medical conditions. That means that the plans could not provide fewer inpatient hospital days or require higher out-of-pocket costs, more cost sharing or separate deductibles for mental health conditions. But Paul N. Samuels, director and president of the Legal Action Center, says that some people still aren&#8217;t receiving equal coverage, and the law is not always enforced. &#8220;That&#8217;s a problem we&#8217;re really concerned about,&#8221; he says. Note that large employers are not <em>required </em>to offer mental health insurance, but most do.</li>
<li><strong>Small Business/Individual Plans: </strong>Not included in the Parity Act.</li>
</ul>
<p>In short, whether you have mental health coverage in an employer-sponsored insurance plan depends on where you work.</p>
<p><strong>What if I don&#8217;t have mental health coverage in my employer’s insurance plan? Will the ACA change that?</strong></p>
<p>Small group and individual plans will be required to offer the coverage in 2014 through health exchanges created under the law. But employers with 50 or more workers can continue to not offer the benefits.</p>
<p><strong>I&#8217;m planning to buy an insurance plan through one of the new exchanges. What kind of mental health coverage will I have?</strong></p>
<p>Again, as noted above, all plans sold in the exchanges <a href="http://www.kaiserhealthnews.org/Stories/2012/December/18/www.ncsl.org/documents/health/MHparity&amp;mandates.pdf%20">will be required</a> to provide coverage for mental health and substance abuse. The exchanges will be open to individuals and small businesses.</p>
<p>The same rules will apply to small group and individual plans purchased outside of the exchange.</p>
<p>In other words, beginning in 2014, if you (or your small employer) are purchasing any new insurance plan, coverage will include mental health benefits on par with any other medical condition.</p>
<p><strong>I&#8217;ll be covered under the Medicaid expansion authorized by the law. What kind of mental health coverage will I get?</strong></p>
<p>If you earn less than 138 percent of the federal poverty level (about $32,809 for a family of four), you may be newly eligible for Medicaid coverage in 2014. Like people who purchase coverage through the exchange, new Medicaid beneficiaries will receive mental health benefits on par with other medical or surgical needs.</p>
<p><strong>What problems might arise?</strong></p>
<p>While the ACA &#8220;provides enormous potential and opportunity to make sure than many millions more Americans obtain the services they need,&#8221; says Samuels, &#8220;that will only happen if the implementation of those reforms is effective.&#8221; Samuels worries that the rules from HHS will not be clear or strong enough to make the parity laws meaningful. He also worries about getting everyone who is eligible for coverage enrolled, particularly those with severe mental health disorders who be may homeless or living on the fringes of society.</p>
<p>Access to treatment will likely also remain a serious stumbling block. As many as 30 million people are expected to gain insurance coverage beginning in 2014. Of those, the U.S. Substance Abuse and Mental Health Services Administration <a href="http://www.samhsa.gov/samhsanewsletter/Volume_18_Number_5/HealthReform.aspx">estimates that 6 to 10 million will have untreated mental illnesses</a> or addiction, adding additional demands to a system that is already overwhelmed. Patients may experience long wait times to see a psychiatrist, for example, and may require additional investments to expand the mental health workforce.</p>
<p><strong>Learn More: KQED Forum <a href="http://www.kqed.org/a/forum/R201212171000" target="_blank">Shooting Puts Spotlight on Mental Health</a></strong></p>
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			<media:title type="html">President Obama Visits Newtown, CT, Consoles Families Of Shooting Victims</media:title>
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		<title>Newtown Shootings: Talk &#8212; or Don&#8217;t Talk &#8212; To Children?</title>
		<link>http://blogs.kqed.org/stateofhealth/2012/12/17/newtown-shootings-talk-or-dont-talk-to-children/?utm_source=rss&#038;utm_medium=rss&#038;utm_campaign=newtown-shootings-talk-or-dont-talk-to-children</link>
		<comments>http://blogs.kqed.org/stateofhealth/2012/12/17/newtown-shootings-talk-or-dont-talk-to-children/#comments</comments>
		<pubDate>Mon, 17 Dec 2012 22:16:27 +0000</pubDate>
		<dc:creator>Lisa Aliferis</dc:creator>
				<category><![CDATA[You're the Boss]]></category>
		<category><![CDATA[Newtown Shootings]]></category>

		<guid isPermaLink="false">http://blogs.kqed.org/stateofhealth/?p=9533</guid>
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I have an 8-year-old son and an 11-year-old daughter. On Friday, like parents across the country, I was shaken. I spent part of the day reading tips about how to talk to children about "scary news."

Friday afternoon, my son went to a birthday party. I figured he would not hear anything about the shootings. But it was my daughter I worried about. She watches ESPN religiously after school, and I knew there would be some mention of the tragedy. I wanted to be the one who told her about what had happened. <a href="http://blogs.kqed.org/stateofhealth/2012/12/17/newtown-shootings-talk-or-dont-talk-to-children/">Continue reading <span class="meta-nav">&#8594;</span></a>]]></description>
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			<content:encoded><![CDATA[<div id="attachment_9543" class="wp-caption alignleft" style="width: 310px"><a href="http://blogs.kqed.org/stateofhealth/files/2012/12/schoolshooting20121214.jpg"><img class="size-medium wp-image-9543" title="(Douglas Healey/Getty Images)" src="http://blogs.kqed.org/stateofhealth/files/2012/12/schoolshooting20121214-300x199.jpg" alt="(Douglas Healey/Getty Images)" width="300" height="199" /></a><p class="wp-caption-text">(Douglas Healey/Getty Images)</p></div>
<p>I have an 8-year-old son and an 11-year-old daughter. On Friday, like parents across the country, I was shaken. I spent part of the day<a href="http://www.pbs.org/parents/rogers/special/scarynews.html" target="_blank"> reading tips</a> about how to talk to children about &#8220;scary news.&#8221;</p>
<p>Friday afternoon, my son went to a birthday party. I figured he would not hear anything about the shootings. But it was my daughter I worried about. She watches ESPN religiously after school, and I knew there would be some mention of the tragedy. I wanted to be the one who told her about what had happened.</p>
<p>By the time I reached her, I was too late; she&#8217;d already heard. But she seemed oddly unaffected, leaving me conflicted. I was glad she wasn&#8217;t worried, but concerned that she seemed so unmoved.</p>
<p>Then I caught KJ Dell-Antonia&#8217;s <a href="http://parenting.blogs.nytimes.com/2012/12/15/how-not-to-talk-with-children-about-the-sandy-hook-shooting/" target="_blank">blog yesterday</a> in the <em>New York Times Motherlode</em> column.<span id="more-9533"></span></p>
<p>First, Dell-Antonia argued for saying nothing, especially to younger children. After all, she wrote, &#8220;A child whose television comes from Disney and whose primary use of a mobile device involves throwing birds at pigs may not be inundated with information in the ways we fear.&#8221;</p>
<p>Parents must look at their own feelings, Dell-Antonia continued, and address whether you are talking to your children for <em>them</em> &#8212; or for yourself. It&#8217;s in situations like this that a parent&#8217;s self-awareness is most important, as Nancy Rappaport, associate professor of psychiatry at Harvard Medical School and director of school-based programs for the Cambridge Health Alliance explained in <em>Motherlode</em>:</p>
<blockquote><p>“If you’re feeling panicked, and like there’s no place safe in the world, then that’s a good time to step back and get those thoughts in order,” Dr. Rappaport suggested. “But if we try to wait until we’ve fully come to terms with something like this, then we’ll never be able to talk. In fact, we’d never be able to get out of bed in the morning.”</p>
<p>She brought up a strategy that’s commonly used for anxiety in children: “worried thought, brave thought.” “We teach kids to counter a worried thought with a brave thought,” she said, and to “know that although the worried thought may come back, the brave thoughts are always there as well.” A worried thought might be “A shooter will come to my children’s school and there is nothing I can do about it,” with the brave counter “School shootings are still rare, and countless people are working to make them rarer still.”</p></blockquote>
<p>But for the kids who are aware, but not obviously worried, Dell-Antonia included another great piece of insight:</p>
<blockquote><p>“Most kids are pretty self-centered,” Nancy Rappaport [said]. “Some may be more vulnerable to these kinds of fears, but many may just say, ‘Oh, that’s too bad,’ and move on.” This is a reaction that’s hard to understand for an adult, but fine, Dr. Rappaport said, for children whose focus is still naturally on themselves.</p></blockquote>
<p>It turned out my daughter was not completely focused on herself after all. On Sunday at church, it rapidly became apparent that the sermon would be devoted to Newtown. My daughter looked at me, somewhat distressed, and said distinctly, &#8220;I don&#8217;t want to hear this, Mommy. Can I wait in the back?&#8221;</p>
<p>I walked her to another part of the church where she could wait &#8212; while adults in the sanctuary grieved.</p>
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