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Jeffrey L. Reynolds

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Consider Mental Health In The Way We Work Post-Pandemic 

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In coming weeks, New York will officially reopen for business and millions of us will shed our sweatpants, venture from our quarantined homes, and brave the rush hour commute. It won’t be like any other Monday morning. COVID-19 has changed the world, it’s changed all of us, and it’s changed the way we work. 

We’ll be returning to work assuming we are lucky enough to still have a job having survived the worst public health catastrophe in more than a century. With more than 60,000 fatalities nationwide to date, virtually everyone now knows someone who has died of COVID-19, a miserable death that’s been compared to drowning. Barred from gathering at bedsides and funerals, we have also lost the opportunity to grieve in the traditional ways.  

Our nation and the New York metro area as a pandemic epicenter is experiencing collective grief fueled by social media pleas from sick folks desperately trying to get tested, a steady stream of posts memorializing those who have perished, and 24/7 media images of body bags stacked in hospital hallways. We all feel vulnerable and scared. 

Social distancing has changed our routines and sleep patterns; our schedules have been upended. We find comic relief in social media memes about how much wine it will take to get through the quarantine and use “likes” to rationalize day drinking. We’re seeking comfort in food, and now locked out of the gym we barely visited anyway, have nicknamed our continued weight gain the “COVID 15.” Those who avoid life’s foibles by escaping into work are grinding harder and chastising themselves for not being more productive. In reality, we’re not simply working at home; we’re trying to get stuff done while surviving a financial and physical pandemic. 

Federal surveys by the National Institute of Mental Health suggest that half of American adults experience a diagnosable anxiety or depressive disorder at some point in their lives. That percentage will climb going forward, since virtually everyone is feeling anxious, stressed, frightened, and worried in ways they haven’t before. 

The trauma and its accompanying mental health conditions won’t automatically disappear because someone flips a switch and sends us back to the office. In fact, for some, anxiety or depression will become crippling. They may have a hard time leaving the house or may continue excessive drinking. At the very least, productivity will suffer. Now is the time for companies to consider an Employee Assistance Program for employees who need professional support. 

It is also the time for workplaces to begin designing their own rolling re-entry plan guided by lessons learned, gratitude for those who have persevered, and employee input. That plan should include social distancing, easy access to PPE, and other means of ensuring health and safety.

On a more positive note, we have come to understand that remote work makes good employees more productive, not less. While Common Core math is no party, working remotely has given many parents the opportunity to spend more time with their kids, their spouses, and their families. As such, they may not be eager to give back that hour per day to sit in traffic. Workplace flexibility will likely become as important, if not more so, than salary. 

We’ve figured out how many meetings could have been emails, but we’ve also come to appreciate how face-to-face contact, small talk, and nuanced exchanges harness our collective power. Re-entry should start with organization-wide gatherings to get everyone reconnected. 

Gov. Andrew Cuomo and many of his gubernatorial peers have all earned accolades for their clear, consistent, and honest briefings. Corporate executives and workplace managers should understand that honest, frank, and transparent communication is critical to good leadership. 

As horrific as COVID-19 has been, it presents a unique opportunity to rebuild our lives, our communities, and our workplaces with a renewed commitment to flexibility, fairness, transparency, humility, and kindness.

Long Island often leads the way, so let’s get to work. 

Jeffrey L. Reynolds is the President/CEO of Family and Children’s Association (FCA), one of Long Island’s oldest and largest nonprofit organizations.

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Bail Reform 2.0: Get People Out of Jail And Into Treatment

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There’s a guy who works two jobs, lives paycheck-to-paycheck and was recently arrested for a minor criminal offense. Under New York’s controversial bail reform law, he was released, went home to his family, returned to work the next morning, and will likely show up in court later this month. He didn’t spend six weeks in the Nassau County jail at taxpayer expense, lose his employment, or become estranged from his wife and kids who would have faced subsequent homelessness. He also didn’t make headlines.

Jordan Randolph, on the other hand, made news and became yet another poster boy for criminal justice reforms gone awry when a judge released the six-time felony offender after he was arrested for tampering with an ignition interlock device installed following a DWI conviction in Nassau County. Days later on January 12, cops say Randolph drove drunk with a blood alcohol content three times the legal limit at speeds of up to 137 miles per hour on the William Floyd Parkway in Suffolk before crashing into 27-year-old Jonathan Flores-Maldonado’s car and killing him.

In its simplest form, bail is the amount of money defendants must post in order to be released from custody while awaiting trial and pretrial hearings. 

Bail is not a fine and was never intended to be used as punishment, yet poor folks and a disproportionate number of minorities sat for months in jails having never been convicted of a crime. Monied defendants walked and sometimes committed additional offenses. That’s why New York State lawmakers, as part of last year’s budget process, eliminated cash bail for most misdemeanors and nonviolent offenses. 

The law took effect on January 1 and as the repeat-offender horror stories have mounted, cops, prosecutors, constituents, virtually every Republican, and more than a few Democrats are calling for a rollback that has driven a race-tinged wedge between urban and suburban legislators such as Long Island’s six Democratic state senators.

New York should not abandon cash bail reforms, but lawmakers need to do something: Simply narrowing the list of eligible offenses isn’t enough. 

Give prosecutors and judges discretion to consider not only flight risk, but potential danger to the community. Train them to recognize, evaluate and address mental health issues, and give them more anti-bias education. Get them to do a more thorough pretrial determination process that includes nonmonetary options such as electronic monitoring, day reporting, curfews, drug testing, and most importantly, mental health and addiction treatment.

Those services are critical because prior to January 1, the criminal justice system was the catch-all and default treatment option for people with mental health and substance use disorders. Parents would sigh with relief when their heroin-addicted sons or daughters were arrested and people with mental illness who once cycled in and out of now-shuttered psychiatric centers would visit the Nassau and Suffolk County jails with the same frequency. Sometimes they got help and sometimes they didn’t.

New York State emptied its psychiatric facilities from an inpatient census of 93,314 in 1955 to just 2,267 in 2018. Some of those folks got community-based care and others died, but in 2018 a whopping 90,500 New Yorkers, many of whom were really sick, were behind bars in local jails, prisons, psychiatric hospitals, and immigration detention and juvenile justice facilities.

It’s often easier to get arrested than it is to get help for a mental health condition, alcoholism or drug problem. Bail Reform 2.0 should be about getting people out of jails and prisons, but getting those who need help into treatment is just as important.

Jeffrey L. Reynolds, Ph.D., is President and CEO of the Family and Children’s Association

New York State is Cutting and Kids are Dying

An unprecedented number of New York’s kids are killing themselves with guns, ropes, and poisons and unless state officials intervene, 2020 may be a record year.

Suicide attempts among adolescents nationwide have risen sharply in the last decade, and according to federal statistics, suicide is now the second leading cause of death among New York teens ages 15-19. Seventeen percent of high school students nationwide report that they’ve seriously considered a suicide attempt in the last year. About one-third of high school students report feeling sad or hopeless almost every day for two weeks in a row and nearly one in three adolescents will meet diagnostic criteria for an anxiety disorder by the age of 18.

Local families are experiencing this crisis first-hand and are desperate to find adequate mental health care for their children, but many are struggling to access it. Getting an appointment with a child psychiatrist on Long Island in less than three months is nearly impossible. Underfunded community mental health providers often have long waiting lists and insurance companies routinely deny coverage and adequate reimbursement for conditions that occur above the neck.

That’s why more than half of New York’s children with a diagnosable behavioral health condition don’t get the treatment or counseling they need. The end result? Budget-busting psychiatric hospitalizations, life-changing arrests, foster care placements, chaos in schools, homes, and communities, habit-forming self-medication with alcohol, marijuana, and other drugs, and more lives lost. In short, a complete breakdown.

Indeed, New York has mounted an impressive response to our state’s opioid crisis and new mental health resources like Family Service League’s DASH crisis care center in Hauppauge and CN Guidance’s mobile counseling unit are making a difference. But the link between untreated mental health conditions and subsequent substance use to self-medicate away anxiety, pain and depression is well-established. Chasing the drug du jour may just be swatting at symptoms and announcing new opioid prevention and treatment funding while simultaneously slashing funds for mental health programs makes little sense. But that’s what’s happening here in New York.

Earlier this month, the New York State Department of Health reduced reimbursement rates for Medicaid-eligible children and families under a critical mental health program called Children and Family Treatment and Support Services (CFTSS). CFTSS, which only launched last year, is part of systemic multi-year Medicaid reforms designed to increase access to critical care, including crisis intervention, family peer support, community psychiatric supports and treatment, and substance use treatment. With enhanced financial reimbursements to fund the new program, nonprofit organizations like Family and Children’s Association (FCA) in Mineola have been able to better serve desperate families and turn a modest investment into big Medicaid savings for New York State.

Overall on Long Island, we’ve seen an increase in hospitalizations among kids with serious mental illness and multiple inpatient stays over the course of a year are common. But emergency room visits and hospital admissions among children enrolled in this CFTSS program are way down. The program is working as intended.

Sadly, the CFTSS program is serving only about 8,000 children statewide, less than five percent of the 200,000 New York State says are eligible, and only an estimated 1,000 of those children are new to receiving services. That’s because program start-up and accessibility has been spotty given state Medicaid changes that have thrown children’s mental health services into turmoil. Some small cash-strapped nonprofit organizations have successfully adapted, evolved and kept their doors open, even as more families in need come knocking. Others have been forced to stop offering mental health programs like CFTSS.

More will surely be forced to follow suit if New York continues to hold back enhanced reimbursements that barely covered program costs. That would mean fewer kids served, more young lives cut short and more families changed forever. Like most public health crises, suicide is a largely preventable and mental health disorders as the drivers are treatable. New York can save lives right now by abandoning these rate reductions and immediately declaring a moratorium on all cuts to behavioral health care services for children until our kids are healthy enough to start planning their own futures, rather than their own deaths.

Jeffrey L. Reynolds is the President and CEO of Family & Children’s Association (FCA) and a board member is NYS Council for Community Behavioral Healthcare