Source

The Trevor Project

Summary

“Indigenous LGBTQ young people face numerous social threats that can harm their overall mental health and well-being, including the historical and ongoing impact of colonization and anti-LGBTQ sentiments. Despite this, significant gaps in research persist due to the underrepresentation of Indigenous young people in U.S. studies. The failure to obtain adequate sample sizes to examine the unique experiences of Indigenous LGBTQ young people perpetuates inequities and inhibits progress toward dismantling structural forces that continue to oppress them. This report uses data from a national sample of nearly 2,000 Indigenous LGBTQ young people aged 13 to 24 who participated in The Trevor Project’s 2023 National Survey on the Mental Health of LGBTQ Young People to contribute to our understanding of their mental health and well-being.

Key Findings:
Indigenous LGBTQ young people are diverse with respect to nation/tribe, sexuality, and gender.
• Of the 1,792 Indigenous LGBTQ young people in our sample, 26% identified as exclusively Indigenous and 74% identified as multiracial Indigenous.
• Just over a quarter (28%) of Indigenous LGBTQ young people reported that they identify as Two-Spirit, a term used in many tribal communities to describe those who embody diverse sexualities, genders, gender expressions, and/or gender roles in their community.
• Two-thirds (66%) of Indigenous LGBTQ young people self-identified as transgender or nonbinary.

Indigenous LGBTQ young people report higher rates of mental health challenges compared to other LGBTQ young people.
• Over three quarters of Indigenous LGBTQ young people (77%) reported recent symptoms of anxiety and 66% reported recent symptoms of depression.
• Over half of Indigenous LGBTQ young people (54%) reported seriously considering suicide in the past year, compared to 41% in the broader sample of LGBTQ young people.
• Nearly a quarter of Indigenous LGBTQ young people (23%) reported attempting suicide in the past year, compared to 14% among the overall sample of LGBTQ young people.

Indigenous LGBTQ young people experience disproportionate structural inequities, as well high rates of anti-LGBTQ stressors.
• Nearly one in ten Indigenous LGBTQ young people (8%) reported having been subjected to conversion therapy, and 70% reported experiencing an attempt to change their LGBTQ identity.
• Over a third of Indigenous LGBTQ young people (34%) reported past or current homelessness, which is more than double the rate of homelessness among their non-Indigenous LGBTQ peers.
• Nearly half of Indigenous LGBTQ young people (48%) reported experiencing food insecurity, compared to just under a third of non-Indigenous LGBTQ young people (30%).

Support from others is an important protective factor for Indigenous LGBTQ young people.
• Indigenous LGBTQ young people who reported high levels of support from their families had significantly lower rates of attempting suicide in the past year (13%), compared to their Indigenous LGBTQ peers who reported low levels of family support (24%).
• Indigenous transgender and nonbinary young people who reported that all of the people they live with respect their pronouns reported having attempted suicide in the past year at nearly half the rate of those who reported that none of the people they live with respect their pronouns (17% vs. 33%).”

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Today’s youth are experiencing unprecedented levels of stress and anxiety. According to the World Health Organization (WHO), 3.6% of adolescents ages 10-14 and 4.6% of those ages 15-19 have experienced an anxiety disorder. Mental health challenges among youth have been steadily rising since before the COVID-19 pandemic and have only gotten worse. The Centers for Disease Control (CDC) reports that 37% of youth experienced poor mental health during the pandemic. Teen girls and teens who identify as LGBTQ+ are the most at risk for experiencing substance use disorders, thoughts of suicide and violence.

There are many potential reasons for the increases in mood and behavioral disorders among youth: isolation caused by the pandemic, rising global threats as well as increased stress and anxiety among caregivers are just a few things impacting today’s adolescents.

Teachers and youth-serving professionals may not be able to tackle these challenges head-on, but they can find ways to support the youth they serve. The CDC found that students who feel more supported by their school (termed “school connectedness”) are less likely to experience feelings of sadness and hopelessness. One way that schools and other youth organizations can support students is by implementing a wellness room for kids who need space to sort out their emotions before returning to the classroom or other activities.

What is a wellness room?

A wellness room is a space where students can go when they feel overwhelmed, anxious, or unable to regulate their emotions. It includes different sensory activities students can partake in to refocus their attention before they return to the classroom.

While wellness rooms have found success in classrooms nationwide, there is also potential for using them in nonprofit organizations, after-school programs, and in juvenile justice and child welfare systems.

Benefits of wellness rooms

Research has shown that offering students access to wellness rooms can help them regulate emotions and stress. This can make them more attentive and active participants in the classroom and improve their chances of achieving academic success.

 Many schools have implemented wellness rooms with success. According to past recipients of grants from The Cook Center for Human Connection, students use these rooms weekly. On average, 90% of students return to the classroom after spending 10 minutes practicing wellness techniques.

[Related: Zen dens, peace rooms, chill-out spaces: How schools and afterschool programs are giving kids space to reflect and regulate]

I myself have heard a number of student success stories. One that stands out comes from a young female adolescent who went into her school’s wellness room after having a panic attack. The room monitor asked her to try a tool to help her focus on squeezing and pulling. At the same time, the principal called the student’s mom and asked her to stand by to see how her daughter progressed.

 The student was able to self-regulate and return to class after using that tool in the wellness room. The principal let her mom know about the success, and the mom expressed her pride in her daughter learning to self-regulate at school instead of being asked to go home for the rest of the day. As a result, the family increased their communication with each other and the school about self-assessment and self-regulation.

Six tips for using wellness rooms

A wellness room needs to have certain standards, training, and plans of action in place to be effective, and students must be aware of the expectations. Here are some tips to make those expectations a reality.

1. Staff, parents, and students should be trained how to use the space before it opens. 
2. There should be a time limit to how long a student stays in the wellness room. At many schools, students receive an hourglass sand timer upon entering the room. The timer lasts for 10 minutes. Once the timer is up, the student is expected to return to their classroom.
3. A dedicated professional should be assigned to check students in and out of the room and monitor the students to ensure they are safe while they are in the wellness room. This professional monitor should also be trained to identify when to escalate the student to the principal or school psychologist.
4. The wellness room should be a no-phone space to encourage students to use analog coping mechanisms that they can use in and out of the classroom when they need to regulate their emotions. 
5. The room should have sensory activities, including fidget objects, sand, stress balls, and soothing music or sounds. Ideally, it will also have comfortable furniture that helps students feel safe and supported.
6. Finally, parent involvement is critical for wellness rooms to work for students. The data schools collect can help identify students who are most at risk based on the frequency of their visits to the wellness room. This information should be shared with parents, who can work with the school psychologist and other professionals to determine a plan to help their students improve their mental health and positively impact all aspects of their lives.

[Related: Adults need calming rooms too]

Parents should reinforce the importance of taking a break when needed. Recognizing the need to step away and go to the wellness room is the first sign of success for students and an encouraging signal that they are learning how to self-regulate their emotions.

Wellness rooms set students up for success

I also have heard an overwhelmingly positive response from previous grant awardees. Students do not abuse the privilege of sitting in the room as long as there are clear expectations and training for students, teachers and parents. I have even heard feedback that some teachers start their day in the wellness room and that some principals use the space to conduct parent meetings. It is important for a school’s community to understand the wellness room is there to stay and continually enhanced to fit student needs.

***

Anne Brown is the Utah-based founding president and CEO of the Cook Center for Human Connection and has previously served as a public school teacher and an edtech executive.

Source

Johns Hopkins Bloomberg School of Public Health

Summary

“In 2019, the Congressional Black Caucus Emergency Task Force on Black Youth Suicide and Mental Health sounded the alarm about concerning suicide trends among Black youth in their report, Ring the Alarm. This present report not only urges us to renew the urgent call to action, but also to critically interrogate the socioecological factors and structures—including institutional racism—that contribute to suicide risk among Black youth and how those factors create significant barriers for researchers and implementors trying to save their lives.

The data are alarming—Black youth have the fastest rising suicide rate among their peers of other races and ethnicities. Even more disconcerting, we may not have the full picture of how suicide deaths are impacting Black youth due to misclassification errors. In the 13-year period between 2007 and 2020, the suicide rate among Black youth ages 10–17 increased by 144%. Black boys ages 0–19 have more than twice the suicide rate compared to Black girls of their age group. In 2021, one in five Black high school students reported seriously considering attempting suicide in the past year. That same year, nearly 18% of Black high school students had made a suicide plan in the past year, and 15% reported attempting suicide. Nearly 1 in 20 needed medical attention as a result of their suicide attempt.”
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View Youth Today’s Report Library

Importantly, this research also points to ways we can all support the LGBTQ young people in our lives by highlighting protective factors like creating affirming spaces and respecting pronouns, as well as the topics about which LGBTQ young people wish those in their lives knew more.”
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The police had been called to find her after she ran away from a nearby youth homeless shelter, where she had been placed by the state child welfare agency.

It was at least the 16th time in six months that staff at shelters had called 911 about the girl, including five calls for suicide attempts or threats. This time, police caught up with her and another runaway foster child at the gas station.

After officers put the 16-year-old in the back of a police SUV, she became agitated and started kicking and hitting the vehicle. Officers expressed frustration about having to deal with yet another child in the custody of the state Children, Youth and Families Department.

“I don’t understand why they do that, why they bring high-risk kids here, and they can’t even handle them?” said Officer Lucy Milks, recorded by her body camera.

The girl pushed and scratched Milks when she tried to handcuff her. That’s when officers brought out the wrap restraint. Three of them held the girl on the pavement and bound her legs, her white sneakers poking out from under the dark fabric and reflective strips.

Officers tried to figure out what to do next. “This happens all the time,” one of the nine officers who responded to the call said to another. “It’s so frustrating.”

More than 1,100 times from January 2019 through June 2022, someone at a shelter housing foster kids in New Mexico called emergency dispatchers for help with runaways, violent outbursts, disorderly conduct or mental health crises.

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Many of the kids placed in these shelters by CYFD have severe mental health or behavioral problems, including PTSD and depression, but shelters don’t provide psychiatric services. Kids break down, get into fights, destroy property, threaten staff or run away. Sometimes they say they want to kill themselves or try to.

In these moments of crisis, it’s police and paramedics, not mental health professionals, who intervene.

Searchlight New Mexico and ProPublica set out to understand what happens when shelters call 911. We obtained nearly 6,000 pages of dispatch logs, dozens of call recordings and more than 120 incident reports. In addition, we reviewed 26 hours of body camera videos for 16 incidents involving foster teens who appeared repeatedly in emergency calls.

Videos show police arriving to find broken windows and doors, sobbing teens and rattled staffers. Officers know little about the kids and have trouble getting guidance from CYFD. They’re often bewildered about what to do.

“We’re trying to figure out why, like — what we’re doing here,” a Bernalillo County sheriff’s deputy told his supervisor after responding to a call at a shelter outside Albuquerque in October 2021. “We’re a little confused.”

Searchlight and ProPublica contacted every law enforcement agency involved in incidents in this story; they didn’t respond, declined to comment or didn’t take issue with our findings.

Experts say encounters like these can damage a child’s mental health for years. Virtually every foster child is dealing with extraordinary psychological damage, and many have had run-ins with police, said Tim Gardner, legal director of Disability Rights New Mexico. Dealing with law enforcement when they’re in crisis, he said, “just further traumatizes them.”

Kids like this are not supposed to be in shelters. Three years ago, the state promised to stop housing kids in shelters, offices and other places that don’t provide the mental health care that they need — except in “extraordinary circumstances” when needed to protect the child. CYFD has delivered on just a portion of those promises.

In the meantime, the referrals keep coming.

“We’ve had countless conversations with the department to say, hey, these are not kids that should be in shelter,” said Jennica Bustamante, a manager at My Friend’s Place, the facility in Las Cruces that the 16-year-old ran away from. “These are not kids that we can properly care for, that we can safely care for.”

Emily Martin, CYFD Protective Services Division chief, said the department exhausts every other option before placing a child at a shelter; the number of placements, according to figures provided by Martin, has dropped by about 40% since 2019. Since last fall, the department has licensed two more specialized group homes, which they say offer expanded mental health services.

Currently, she said, some 50 foster youth are cycling in and out of shelters in New Mexico. That’s a small fraction of all children in custody of CYFD’s protective services office.

In the gas station parking lot, a police officer asked the 16-year-old what she was doing in southern New Mexico when she was from Albuquerque, roughly 200 miles away. “There’s nobody that would take me in,” the teenager replied.

Officers took the girl to a hospital for a medical evaluation because they had used force on her. She was escorted through the emergency room in handcuffs. That night, she was back at the shelter.

Five days later, officers were called to find her again.

Crisis. Call. Repeat.

When foster kids run away, shelters call 911.

When kids break down or express suicidal thoughts, shelters call 911.

When kids hurt or threaten others, shelters call 911.

Shelter managers say they often have little choice. They are required to notify police about runaways so kids can be located or entered in a missing persons database. And kids in crisis often need to be taken to a hospital for a psychiatric evaluation.

Of the more than 1,100 calls regarding shelter residents, more than 460 were for physical violence, disorderly conduct or mental health crises. That includes more than 70 calls for suicidal youth. At least 650 calls were for runaways.

These records didn’t always say whether a shelter resident was in CYFD custody, but managers of shelters involved in the vast majority of calls said most of their residents are foster kids. All of the body camera videos reviewed by Searchlight and ProPublica involved foster kids, according to police records.

After police get involved, CYFD often moves the kids to another shelter. And the cycle repeats. The girl at the gas station was one of at least 24 foster kids who were the subject of calls from three or more shelters in the period analyzed by the news outlets.

In 2021, a Bernalillo County sheriff’s deputy arrived at the Amistad Crisis Shelter in Albuquerque’s South Valley after that same girl tried to strangle herself. She was quietly telling another deputy that she was depressed.

“You look familiar. Have I talked to you before?” Deputy Adrienne Seay asked the girl, their conversation recorded on her body camera.

Seay realized she had — four months before, when she had responded to a call at Amistad after the girl had cut herself and made suicidal threats. In that short time span, the girl had bounced around among at least four shelters throughout New Mexico and had been the subject of at least eight calls to police, dispatch records show.

This time, EMTs took the girl to a hospital for a psychiatric evaluation. She asked a deputy to fetch her stuffed animal first.

Deputies responded to calls at Amistad for residents in crisis more than once a week, on average, over three and a half years, according to dispatch records. Every deputy in the Bernalillo County Sheriff’s Office, the largest in New Mexico, has responded to calls at the youth shelter, said Undersheriff Aaron Williamson.

Sometimes law enforcement must stay with kids for hours, unable to respond to other calls, as they wait for a CYFD employee to show up or tell them what to do, according to videos and interviews with law enforcement.

“So now we’re waiting. We’re waiting for somebody to show up that can make a decision about this kid’s care,” Bernalillo County Sheriff’s Office Lt. Amy Dudewicz said in an interview. “It is a frustration. And it is a huge concern for those of us that are answering those calls, like, is this the best response that we have to offer?”

CYFD gives staff three hours to respond in such cases, department spokesperson Rob Johnson said in an email. Staff are almost always working on something else and could be hours away. “That’s why the department routinely sends a nearby case manager, even if that person might not know anything about that young person,” he said.

Even CYFD staff themselves sometimes call 911 seeking help.

Over the course of 2020 and 2021, dozens of 911 calls were made from the agency’s Pine Tree office, a complex in Albuquerque where foster kids sleep when CYFD can’t find any other place for them. At least 14 calls were for violent behavior, runaways or mental health crises.

CYFD told Searchlight and ProPublica that was during the heart of the pandemic, when shelters were limited in how many kids each could accept. But they acknowledged that kids continue to sleep at the office.

One of those calls involved the same 16-year-old girl. In October 2021 she broke a window at the office building. CYFD staff called police and urged officers to arrest her, saying they planned to press charges.

“It’s not safe for staff or any of our youth right now to have her there in the state of mind she’s in,” Leticia Salinas, a CYFD regional manager, told state police officer Kevin Smith.

But the girl’s actions didn’t warrant juvenile detention, Smith replied. “It’s a nonviolent crime. They’re not going to book her,” he said.

Staff escorted her back inside for the night. She ran away the next day, and state police were called again.

Sweeping up the pieces

When police arrive, they see the fallout from placing foster kids with serious mental health problems in facilities that aren’t equipped to deal with them. Staffers at those facilities say they don’t always know foster kids’ backgrounds and sometimes have to handle volatile or violent incidents. Officers’ body cameras record it all.

Managers of every shelter that housed foster kids during the period analyzed by Searchlight and ProPublica said they had taken in kids without being informed of their mental health conditions or histories of aggressive or suicidal behavior. If staff had been informed, they could’ve taken steps to safeguard residents, they said.

CYFD’s Johnson disputed that contention. “That’s not what has been expressed to us by the shelters,” he told the news outlets. “​​We know that the shelters struggle sometimes, but they have the option to decline admission.”

He said shelters receive a screening form that includes information about prior arrests and any history of substance use, aggression, self-harm, suicide or psychosis. Shelter managers say it’s often not complete.

In August 2020, CYFD placed a 15-year-old at Youth Shelters & Family Services in Santa Fe shortly after he was charged with battery of a police officer and stealing a car. A shelter manager told police that CYFD didn’t disclose that the boy had a juvenile probation officer until a few days after he was placed there.

About two weeks into his stay, the boy smashed several windows and threatened to kill a staff member while wielding a broken piece of door frame, according to a police report. Employees frantically dialed 911. Police located the boy in a field, his fists bleeding from punching out windows, and charged him with aggravated assault and criminal damage to property.

When police responded, Jennifer Reese, a shelter manager, told Officer Mariah Gonzales about the boy’s history, their conversation recorded by Gonzales’ body camera. Reese declined to comment for this story, saying she was bound by a confidentiality agreement.

“Is this a common thing you guys experience, with no one communicating with each other?” Gonzales asked as Reese swept up glass from the broken office door.

Reese said it was. “If we had known what the deal was, then we could have maybe prevented this,” she said. “But we had no idea.”

Reese recounted how CYFD had placed a girl at the shelter about a month earlier without her medications and without informing staff of her medical history. Several days later, she was found in the backyard trying to cut her wrists.

CYFD later tried to place her in the same shelter but still didn’t have her medications. Reese told Gonzales the shelter wouldn’t accept her — “not because we don’t want to help her, but we can’t help her.”

CYFD should have taken care of her meds, Reese said: “She’s a little kid. I mean, it’s bad enough when it’s a grownup, but a little kid? Do your job.”

“Yeah, it’s frustrating,” Gonzales replied.

Johnson, the CYFD spokesperson, said caseworkers must hand a foster child’s medication to a shelter employee. “Why wouldn’t a youth have meds?” Maybe the prescription hasn’t been filled, he said. “Maybe the youth had meds at a foster-home placement and didn’t bring them. Maybe they’ve been on the run.”

After taking photos of the damage, Gonzales told Reese to let her know if she needed anything else.

“Hopefully I won’t see you guys for a long time,” Reese replied.

Santa Fe police would be called to the shelter 44 more times for incidents involving residents in the next 17 months.

“A Survival Response”

Experts, shelter staff and even police agree: Cops aren’t the best people to deal with these kids. The mere presence of police can be triggering to a youth in crisis. Sometimes kids fight back and get into more trouble.

In September 2021, police and EMTs responded to a shelter in Hobbs after a foster teenager destroyed property and allegedly hit a staffer. She struggled and made suicidal statements as officers tried to restrain her, drawing their stun guns three times in the process. The girl was forced onto a gurney so she could be taken for a psychiatric evaluation, screaming as she was loaded into an ambulance.

The next month near Albuquerque, after a teenager threatened shelter staff, an on-call CYFD employee unfamiliar with his case said the boy should go to a hospital for a psychiatric evaluation, according to police records and body camera video. When the kid tried to run, deputies handcuffed him and EMTs sedated him. Then CYFD changed course, telling emergency responders not to take the boy to the hospital. By then, he was already on a gurney.

When a police officer chased down a 17-year-old runaway in Taos at about the same time, the girl turned around and punched him in the face. It was at least her sixth runaway incident in the previous three months, according to dispatch logs.

“I’m sorry I attacked you, but I did not feel safe,” she told the officer at the station. “I’ve been getting hurt so many times, and that’s why I’m running away, because I don’t want to get hurt no more.”

Children older than 14 have the right to refuse placements, and it’s not a crime to run away, said Martin at CYFD. But when they do, police have to be called, in part because CYFD needs to determine the children aren’t in danger. “I’m worried about them” when they’re on the run, Martin said. “I want them to be safe.”

Scenes like the ones captured by body cameras are “extremely predictable,” said George Davis, CYFD’s former chief psychiatrist and a leader in efforts to change how the department deals with foster kids.

These kids can have extreme mood swings, Davis said, “because of the trauma they’ve already been through.” Putting them in a shelter, rather than a foster home where they can access appropriate mental health care, is almost certainly going to cause an emergency, he said.

“Reacting to police this way is a survival response for them,” he said.

In many of the videos viewed by Searchlight and ProPublica, police officers try to defuse the situation, even attempting to counsel teenagers. Sometimes they sit with a child in crisis for an hour or more, talking to them as they wait for the child to be transferred to another shelter or sent for a psychiatric evaluation.

In November 2020, a teenage girl in foster care threatened to kill herself at the DreamTree Project shelter in Taos. A team of officers stayed with her on the front porch and tried for over an hour to talk her down.

“I’ve been here at DreamTree for two months. I can’t do this anymore!” she cried to the officers. “I just want the pain to end.”

“You’re 15 years old, you’re a young lady. You have your whole future ahead of you,” Officer Gilbert Martinez said. “You don’t want to give up. I have kids. They’re already older, but if I ever heard my daughter say, ‘That was it,’ I would be devastated.”

Roughly an hour later, two CYFD employees arrived.

“She needs to go to the hospital,” one said to the other. Then they would try to find the girl a bed at another shelter. “You gotta start calling and looking around.”

***

This story is part of a ProPublica series, Nowhere to Go: New Mexico’s Troubled Foster Care System.

ProPublica is a Pulitzer Prize-winning investigative newsroom. Sign up for The Big Story newsletter to receive stories like this one in your inbox.

BOISE, Idaho (AP) — A bill that would criminalize helping minors obtain an abortion without parental consent won final passage in Idaho’s legislature on Thursday and is headed to the desk of Republican Gov. Brad Little.

The measure would be the first of its kind in the U.S. It seeks to restrict travel by creating the crime of “abortion trafficking” and would bar adults from obtaining abortion pills for a minor or “recruiting, harboring or transporting the pregnant minor” without the consent of the minor’s parent or guardian.

Anyone convicted of breaking the law would face two to five years in prison and could also be sued by the minor’s parent or guardian. Parents who raped their child would not be able to sue, though the criminal penalties for anyone who helped the minor obtain an abortion would remain in effect.

To sidestep violating a constitutional right to travel between states, Idaho’s law would make illegal only the in-state segment of a trip to an out-of-state abortion provider.

Once it lands on his desk, the governor will have five days to either sign or veto the bill or allow it to become law without his signature. Little is against abortion and has supported Idaho’s stringent abortion bans.

Opponents are promising a legal battle if the bill becomes law.

[Related: How proposed laws and medical innovation target better reproductive health care for women with disabilities]

“Whether it comes from us or one of our coalition partners, there will be a legal challenge,” Mack Smith, a spokesperson for Planned Parenthood Alliance Advocates, said. “We definitely will be fighting this with everything that we’ve got. There is just absolutely no way that this is constitutional.”

Idaho is one of 13 states that already effectively ban abortion in all stages of pregnancy, and is one of a handful of states that already have laws penalizing those who help people of any age obtain abortions.

During the Senate debate Thursday morning, Democratic Sen. Melissa Wintrow said the legislation “further shackles young girls that need help,” and harms those who try to help them.

“I think we all know that Idaho has the strictest abortion bans in the country,” Wintrow said. “It is criminal, it is totally banned, and this bill adds insult to injury in my estimation.”

But Sen. Todd Lakey, a Republican and a co-sponsor of the bill, said it will “help protect our kids. It does help prevent and protect against abortion, especially those that occur without consent of a parent in another state.”

The legislation would give the attorney general the authority to prosecute people for violating the law if the county prosecutor, which would normally handle criminal cases, declines to press charges.

People accused of abortion trafficking wouldn’t necessarily be able to avoid charges by showing that the minor’s parent approved of the travel. Instead, they would be able to use that information as an “affirmative defense” by attempting to prove in court that the minors’ parents or guardians signed off on the plan.

[Related: For foster youth, new restrictions make abortion access even more difficult]

Rep. Chris Mathias, a Democrat, noted Idaho’s rape and incest rates are at a “five year high,” and many of those victims are minors who have been victimized by a parent. The Idaho State Police “Crime in Idaho” annual report showed a nearly 12% increase in rape or attempted rape reports in 2021 compared to the previous year, as well as 28 cases of reported incest — compared to three incest reports made in 2020 and 14 in 2019.

The bill requires that both parents be informed of a plan to take a minor out of state for an abortion, Mathias said, even if one of the parents is “potentially a felonious, incestuous, rapist father.”

Democratic Sen. James Ruchti said the legislation would likely be difficult to enforce. He compared it to a hypothetical scenario, in which a neighboring state might attempt to bar its own residents from traveling to Idaho to buy a gun.

“It’s probably why we let federal laws handle these things when it comes to crossing borders,” Ruchti said.

State leaders in Washington, Oregon and California have promoted the West Coast as a safe haven for abortion procedures, and lawmakers in Oregon and Washington are considering bills to shield abortion providers and patients from criminal liability. Oregon’s bill would allow physicians to provide abortion to anyone regardless of age, and would bar them in certain cases from disclosing that information to parents.

National Right to Life, an anti-abortion organization, lauded the bill as protecting parental rights by keeping parents involved in a child’s decisions.

“Parents have the right to love their daughter and be there for her in her time of need,” National Right to Life president Carol Tobias wrote in a news release. “No one should take that away.”

Thirty-six states require parental involvement in a minor’s decision to have an abortion, though most allow exceptions under certain circumstances like medical emergencies, according to the Guttmacher Institute, a research group supporting abortion rights.

***

AP writers Geoff Mulvihill in Cherry Hill, New Jersey and John Hanna in Topeka, Kansas, contributed.

DENVER (AP) — Stranded at home amid pandemic lockdowns in spring 2020, Emma Warford stumbled down a social media rabbit hole in her quest to get in shape. Viral 28-day fitness challenges. YouTubers promising “hourglass abs.” Diet videos where slim-stomached influencers peddled calorie-tracking apps.

Warford, then a 15-year-old starting volleyball player, bought a food scale and began replacing meals with energy drinks hawked by social media stars.

Soon, her calorie cutting became a compulsion. The thought of eating cake for her 16th birthday induced severe anxiety. By season’s end, she began volleyball games benched, too feeble to start. A year into the pandemic, her heart rate slowed and she was rushed to the hospital.

Stories like Warford’s are why lawmakers in Colorado, California, Texas, New York and elsewhere are taking big, legislative swings at the eating disorder crisis. On Thursday, Colorado lawmakers advanced a bill that would create a state Office of Disordered Eating Prevention, intended in part to patch holes in care, to fund research and to raise awareness.

The bill passed committee by a 6-3 vote with Republicans demurring, partly concerned with the creation of a new government office and skeptical of its efficacy.

Warford, who’s now in recovery after two years of treatment, is among nearly 30 million Americans — about the population of Texas — who will struggle with an eating disorder in their lifetime. Every year over 10,000 die from an eating disorder, according to data cited by the National Association of Anorexia Nervosa and Associated Disorders.

Proposals across the U.S. include restricting social media algorithms from promoting potentially harmful content; prohibiting the sale of weight loss pills to minors; and adding eating disorder prevention to middle and high school curriculums.

The slew of legislation follows a spike in eating disorder cases as pandemic lockdowns pushed youth into long bouts of isolation. Hospital beds filled and waiting lists swelled as many struggled to find treatment for an illness that already had few care options. In Colorado, only one hospital was equipped to offer inpatient care for Warford, who was diagnosed with anorexia.

Anorexia typically involves restrictive eating habits and can cause abnormally low blood pressure and organ damage. Binge eating disorder is a compulsion in the other direction. Still, having an eating disorder does not invariably mean someone is overweight or underweight — and that’s left many who suffer with the mental illness to go undiagnosed, experts say.

Colorado’s bill creates a state office that is broadly charged with, in part, closing gaps in treatments, offering research grants, and working to educate students, teachers and parents. Bills in New York and Texas similarly seek to educate students on mental illnesses including eating disorders.

Katrina Velasquez, chief policy officer of the national Eating Disorder Coalition, said these policies will give students the tools to catch signs of disordered eating habits in themselves or their peers early — potentially giving them a critical head start in treatment.

Colorado is also taking a swing at axing the the use of body mass index, or BMI, even though it remains the industry standard. The measurement is used often to determine the level of care required for those with eating disorders, but mental illness is not invariably linked to body weight or BMI, said Claire Engels, program coordinator for the Eating Disorder Foundation. That means that those who fall outside of the BMI prescription are often denied care, or kicked out of treatment prematurely.

“Eating disorders are not necessarily about food. It’s about mental illness, anxiety, depression, trauma” and control, Engels said.

When Riley Judd was around 12, she saw a photo of herself on vacation in a bathing suit. Turning to her mom she said, “I look like a whale.” It was the first time she remembered a voice in her head ruthlessly comparing her to the beaming, thin celebrities on the cover of Seventeen Magazine and Girls’ Life. “If I lose all this weight, people will like me,” the voice muttered to her. She attempted suicide at age 13.

“It was an all-consuming voice,” said Judd, now a legislative intern and student at the University of Denver.

California lawmakers are targeting social media with a bill prohibiting social media platforms from having algorithms or features that expose children to diet products or lead them to develop an eating disorder. Platforms that violate the legislation could be fined $250,000.

Another California bill would expand the list of approved facilities that can provide inpatient treatment to people with eating disorders — similar to a Texas proposal that would expand Medicaid coverage for mental health services, including eating disorders.

Texas state Rep. Shelby Slawson, a Republican, also introduced a bill to protect minors who use digital platforms.

Cathy Johnson, a school counselor of 24 years who testified on the Texas proposal, said “one of the biggest issues” she has seen from social media is an increase in eating disorders.

“We have kids having panic attacks in school because their anxiety is so high, they are comparing themselves, they think they are going to be like one of the influencers on TikTok,” Johnson said. ___ Associated Press reporters Sophie Austin contributed from California, Acacia Coronado contributed from Texas, and Michael Hill contributed from New York. Jesse Bedayn is a corps member for the Associated Press/Report for America Statehouse News Initiative. Report for America is a nonprofit national service program that places journalists in local newsrooms to report on undercovered issues.

These days, I often think about one particular girl, a bright eyed 18-year-old from Florida’s Palm Beach County who had a difficult childhood. Growing up, she witnessed and experienced substance, emotional, and physical abuse. To cope with this trauma, she started using drugs at 12. But the pain she felt only got worse, and by the time she was entering high school, she had attempted suicide and had been sent to a psychiatric hospital seven times.

I wish I could tell you that her story is unique – but it’s not. Four in ten of the girls and young women I work with experience suicidal ideation and the majority struggle with depression, anxiety and other mental health issues. 

This mental health crisis has only gotten worse as a result of the COVID-19 pandemic. In 2019, 31% of girls at Pace Center for Girls, a network of academic and social service programs for girls and young women who experience trauma, reported suicidal ideation. Today that number is 43%.

This isn’t unique to Pace: across our country, more young people are struggling. But the burden of the crisis is not equally distributed across boys and girls. High school girls reported declining mental health and reduction of usual activities at more than double the rate of boys during the COVID-19 pandemic. And while emergency room visits for suspected suicide attempts increased in 2020, it rose by more than 50 percent for adolescent girls and only four percent for boys.

There are several reasons for this dramatic increase in mental health challenges. School shutdowns at the beginning of the pandemic left students feeling isolated at a time of a national crisis and many simply haven’t recovered. Young people often reach for social media in hopes of connecting with peers but leave feeling worse about themselves, an effect that is especially pronounced among teen girls.

The pandemic’s economic challenges have also had devastating impacts on families, especially those already struggling to make ends meet. That puts a heavy burden on girls, who even prior to COVID spent more time on household tasks than boys, to help out by taking on part-time work, cooking or taking care of younger siblings.

[Related content: Pandemic youth mental health toll unprecedented, data show]

As a result, many students are simply dropping out of school, leaving them even more isolated. During the 2020–22 school year, more than 1 million students were “unaccounted for” nationally.

These statistics are harrowing, but it is proven that prevention and intervention measures can change these outcomes.

The girls and young women I work with receive academic instruction and work closely with counselors trained in trauma-based therapy and suicide screening. Through this we see real change, with 9 out of 10 girls improving academically in school or employed one year after completing the program.

These results show the importance of prioritizing interventions addressing girls’ mental health challenges head-on. Too often, however, schools lack the resources needed to do this.

School counselors play a crucial role in screening for mental health challenges, but many schools simply do not have enough counselors on staff.

Lawmakers, both at the state and national level, need to prioritize providing schools with continuous and consistent funding to ensure they can do so. And schools need to ensure that counselors are trained in gender-responsive care and the unique ways in which the mental health crisis affects girls and young women.

We also need to raise awareness about services available to young people, such as the National Suicide and Crisis Lifeline. Since the hotline switched its number to 988 six months ago, it has seen a record number of calls, highlighting the high demand and importance of raising awareness about this service.

I am currently working with a girl-led task force to create campaigns to raise awareness of the hotline and other free services available in our community. Girls tell me that we need to meet them where they are, which includes social media platforms like Instagram, TikTok and BeReal. More efforts, informed by the experiences of our young people, should be rolled out in communities across the country.

With these dedicated investments, we can start building a better future for young people.

As for that bright-eyed 18-year-old who has survived so much trauma, she has found new ways of coping. Today she is actively involved in her community, was recently awarded a college scholarship and dreams of one day being a real estate agent.

“I am excited about my future. That’s something I never thought was possible,” she says.

*** 

April Brownlee is the senior director of program performance and innovation at Pace Center for Girls, supporting continued development of gender responsive programming initiatives to support at-promise girls. She is a licensed mental health counselor and the current co-chair of the Girls Coordinating Council of Palm Beach County, a community collaborative focusing on reforming and strengthening the system of care for girls.

Late last year, the Disability Rights North Carolina and the North Carolina chapter of the NAACP filed a class action suit against North Carolina Department of Health and Human Services Secretary Kody Kinsley, seeking to end discrimination regarding children with disabilities who are placed in foster care (as wards of the state), and who are then unnecessarily segregated from their home communities. 

As a result, they are often isolated in heavily restrictive and clinically inappropriate institutional placements called psychiatric residential treatment facilities (PRTFs). This is not the first such class action. Ad litem attorneys (and others standing as “next friends”) to children with disabilities relegated to PTRFs all over the country are seeking similar relief. As noted in the North Carolina complaint:

“PRTFs are designed to provide intensive, short-term, residential psychiatric treatment for temporary stabilization. They are generally unsuitable as a long-term ‘place to live,’ but that does not stop DHHS from allowing children to languish there for extended periods of time. Unsurprisingly, research shows that children with disabilities confined to PRTFs suffer much worse outcomes than non-institutionalized children. These outcomes include spending longer periods of time in child welfare custody without a permanent home; losing critical family connections with parents, siblings, and extended family due to their confinement; and experiencing higher rates of maltreatment while in child welfare custody.” 

A PRTF is not a hospital facility. However PTRFs offer inpatient services, funded by Medicaid, to individuals who are under the age of 21 and who have mental health issues.  The services are to be provided and or supervised by a physician. The PRTF’s goal is to monitor, secure and enhance the child’s condition until mental health services are no longer necessary. 

Through their attorneys, the North Carolina lawsuit alleges that the children who stand as named plaintiffs (using pseudonyms), are “receiving heavy cocktails of mind-altering psychotropic medications” while at North Carolina PRTFs.

Who are these children? The complaint describes them as:

• Timothy B., a 14-year-old disabled boy and member of the Lumbee Tribe of North Carolina who has been in a PTRF for over three years. His grandmother would welcome him into her home.

• Flora P., a 15-year-old, African American disabled girl whose diagnoses include post-traumatic stress disorder, disruptive mood dysregulation disorder, and attention-deficit/hyperactivity disorder. She first entered the system at age 3, was later adopted, but came back into the system as a teen when her parents divorced and abandoned her.

• Isabella A., a 13-year-old girl who has spent five years in the North Carolina foster care system. She has endured 20 placements in 5 years, and a plethora of psychopharmacology.

• Steph C., a 15-year-old male who has been diagnosed with post-traumatic stress disorder, disruptive mood dysregulation disorder, and attention-deficit/hyperactivity disorder. He has endured 50 placements in eight years, including seven PTRFs. 

The lawsuit outlines a litany of harms done to the children at these facilities:

Flora P., Isabella A. and Steph C. have allegedly endured physical restraints at PTRFs. Timothy B. has allegedly been bullied by PTRF employees. Isabella A. has allegedly been the target of bullying and sexual harassment. And Steph C., has allegedly been beaten by peers, and had two significant head injuries while in care; in one case he was allegedly rendered unconscious by a physical attack at a PTRF and airlifted to a hospital. 

The plaintiffs in the North Carolina case assert that although the dangers inherent to placement in a PTRF are known, North Carolina DHHS sent at least 572 children in foster care to PRTFs in fiscal year 2020 to 2021.

The claims in the North Carolina lawsuit appear to be consistent with concerns lodged in other cases; to wit: there are more placements of brown and black children at PTRFs. Despite its awareness of the negative impacts of such placements on children, North Carolina continues to spend millions of dollars to place children with disabilities at PTRFs.

Other than the financial cost to the state of North Carolina, what are potential issues with placement of children with disabilities at PTRFs? The plaintiffs contend that the state’s “unnecessary institutionalization” of children with disabilities is exactly the sort of unlawful discrimination prohibited by Title II of the Americans with Disabilities Act under the Supreme Court’s landmark Olmstead decision, as well as by Section 504 of the Rehabilitation Act of 1973.

The North Carolina plaintiffs argue that the state is legally obligated to “administer its services, programs, and activities to children with disabilities in the most integrated setting appropriate to their needs,” and is “prohibited from unjustifiably institutionalizing and segregating children in PRTFs.”

While the worst of the COVID pandemic may have passed, many social workers faced with a lack of appropriate facilities, choose to continue the longstanding practice of warehousing children in their offices or hotels, rather than pursuing other more appropriate placement alternatives.

These children are not mainstreamed with other children. They are typically denied the opportunity to be enrolled at regular schools and/or to have the ability to interact with children outside of institutional care. 

While the complaint seeks relief on behalf of all people with disabilities in North Carolina, the North Carolina NAACP joined the case as a putative plaintiff, seeking to protect disabled children of color. 

To justify its receipt of federal funds, North Carolina must provide services to children with disabilities pursuant to Title II of the ADA and Section 504. As the complaint notes:

“DHHS must take over the provision of child welfare services when its agents do not meet their obligations or fail to provide child welfare services in accordance with state law. N.C. Gen. Stat. § 108A-74(a3)-(c1), (c) & (h). DHHS has exercised this power as recently as May 2022.” 

The ADA recognizes society’s propensity to differentiate and treat those with disabilities differently.  In implementing Title II of the ADA, Congress puts the onus on public entities to “administer services, programs, and activities in the most integrated setting appropriate to the needs of qualified individuals with disabilities.” How to define the “most integrated setting”? The most integrated setting is one “that enables individuals with disabilities to interact with nondisabled persons to the fullest extent possible.” Public entities such as DHHS are charged with a duty to  “make reasonable modifications in [their] policies, practices, or procedures” in order to avoid being accused of engaging in disability-based discrimination.

Some PTRFs arguably take children who have already been traumatized and traumatize them further, by preventing them from interacting with peers outside of the system, by forcing them into on-campus schools, by failing to allow them privacy, and by subjecting them to inflexible rules, rather than creating plans geared to meeting the individual needs of each child. Some PTRFS use physical restraints, emotional blackmail, and psychopharmacological restraints on children with disabilities.

What can be done for these children? The lawsuit argues that DHHS at the state and local levels must be held accountable. While safety of social workers is an understandable concern, the welfare of children with disabilities is of paramount importance.  Social workers deserve to feel safe in their work environments in the balance of equities.  Children with disabilities should not be warehoused; every effort should be made to assure that children with disabilities have the benefit of a nurturing, integrated, safe living conditions.

Why does this matter? These issues are not isolated to North Carolina. These issues are present in every state. Hopefully, after reviewing Timothy B. et al vs. Kinsley, attorneys ad litem in other states will be inspired to file similar class action suits, seeking to rectify what has for too long been tolerated in regard to the warehousing of children in PTRFs nationwide. 

***

Elisa Reiter is board certified in family law and in child welfare law by the Texas Board of Legal Specialization. She has served as an adjunct professor at Southern Methodist University and is a senior attorney with Underwood Perkins, P.C. in Dallas.

Daniel Pollack, who holds a master’s in social work and a law degree, is a professor at Yeshiva University’s School of Social Work in New York City. He was also a commissioner of Game Over: Commission to Protect Youth Athletes, an independent blue-ribbon commission created to examine the institutional responses to sexual grooming and abuse by former USA Gymnastics physician Larry Nassar. 

See Full Report

Author(s): The Trevor Project

Published: Dec. 15, 2022

Report Intro/Brief:
“Since 2019, our annual national surveys have been among the largest and most diverse surveys of LGBTQ young people in the U.S. For the first time ever, we’re publishing the findings of our national survey, which captured the experiences of nearly 34,000 LGBTQ people ages 13-24 across the United States in 2022, segmented by all 50 states.

These data provide critical insights into the suicide risk faced by LGBTQ young people, top barriers to mental health care, the prevalence of anti-LGBTQ victimization, and the negative impacts of recent politics. Importantly, this research also points to ways in which we can all support the LGBTQ young people in our lives by detailing per state LGBTQ young people’s access to accepting communities, LGBTQ-affirming spaces, and social support among family and friends — protective factors that are consistently associated with better mental health and lower suicide risk.

It’s essential to emphasize that because we still do not have known counts or registries of the LGBTQ youth population comprehensive data on the mental health and well-being of LGBTQ youth remains limited. These findings strive to underscore the unique challenges faced by young LGBTQ people, a group consistently found to be at significantly increased risk for suicide because of how they are mistreated and stigmatized in society.

We hope that LGBTQ young people in every state will see themselves reflected in these experiences that so many have bravely shared; and that these data will equip fellow researchers, policymakers, and other youth-serving organizations in every state with the data necessary to celebrate and uplift LGBTQ young people and advocate for policies that work to end the public health crisis of suicide.”

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