(NEW YORK) — Influenza and other respiratory viruses are starting to circulate but so far remain lower than this time last year, according to the Centers for Disease Control and Prevention.
As of Oct. 7, CDC’s FluView weekly report showed that the percent of flu cases were relatively unchanged, rising about 1% compared to the week prior.
In that same timeframe, 1,127 people were hospitalized with influenza, up from 1,050 people the week prior. About 35% of all flu hospitalizations were reported in the southeast of the U.S., which experts say is a typical trend at the start of the flu season.
Most of the flu cases detected were Influenza A and the most common subtype was Influenza A(H1N1), which is the strain of the virus that the flu vaccine usually offers better protection from, according to the CDC.
The percent of all reported respiratory viruses circulating over the past week have been relatively unchanged nationally, but there is regional variability. Region 9 — made up of Arizona, California, Hawaii, and Nevada — was the only region that saw an increase.
Still, the numbers in all regions of the U.S. remain below their baseline and outpatient respiratory illness activity is either minimal or low throughout most of the U.S., according to the CDC.
Alaska is the only state that is currently experiencing moderate respiratory illness activity. Influenza typically circulates this time of year and peaks between December and February for most of the U.S., according to the CDC.
Respiratory syncytial virus (RSV) numbers are on the rise and are projected to increase further, according to the CDC’s weekly surveillance. RSV typically circulates from October to April, according to the CDC.
How to prepare for this year’s cold and flu season
This time last year, the U.S. was bracing for a “tripledemic” amid rising cases of COVID-19, influenza and RSV after the seasons became more unpredictable during the COVID-19 pandemic.
Dr. John Brownstein, chief innovation officer at Boston Children’s Hospital and an ABC News contributor, said these early cases are behaving in a more predictable pattern.
“The data is pointing to something a little bit more par for the course. We’re seeing the early rise of RSV and flu at a time when you’d expect it,” Brownstein said.
Brownstein, however, cautioned that cases of respiratory viruses are expected to increase further, and higher levels still have potential to strain health systems and cause severe illnesses, Brownstein said.
“I think there’s still concern around the threat of all three respiratory viruses plus, of course, the rest of the seasonal mix [of viral illnesses], wreaking havoc on our health systems,” he said.
Experts are hopeful that new and updated immunizations that protect against COVID-19, influenza and RSV will stave off the strain on health care systems.
These viruses may only cause mild illness for many people, but young babies, pregnant women, people who are immunocompromised and the elderly are at highest risk for severe disease.
Everyone 6 months and older is eligible for an updated COVID-19 shot and the annual flu vaccine.
The Department of Health and Human Services told ABC News that, so far, more than 7 million updated COVID-19 shots have been administered. The CDC recommends getting the COVID-19 and flu vaccines by the end of October and encourages both to be given at the same time.
Adults who are 60 years and older can get an RSV vaccine and pregnant women who are in their third trimester can get an RSV shot that provides protection against RSV to their baby for the first 6 months of life.
Babies less than 8 months old who are born to mothers who did not get an RSV vaccine during pregnancy can get a protective shot called nirsevimab that offers about five months of protection against RSV.
Nirsevimab is a one-dose shot made of monoclonal antibodies, which are proteins manufactured in a lab and mimic the antibodies the body naturally creates when fighting an infection. This is different than a vaccine, which activates the immune system.
Brownstein said the pandemic has helped make many health systems better prepared for seasonal spikes in respiratory viruses and is hopeful that people are more motivated to stay up to date on shots that are available for protection and prevention this respiratory virus season.
“Now is really the time to get the protection advanced of the seasons really heating up,” Brownstein said.
Dr. Jade A Cobern, M.D., M.P.H, a licensed and practicing physician, is a member of the ABC News Medical Unit.
(NEW YORK) — When Carolina Pino was pregnant, she discovered she lived in a so-called maternal care desert, a county with limited or no access to maternity care services.
Pino said the closest hospital where she could deliver her baby was more than 20 miles away, and the town where she lives in the San Francisco Bay Area had only one OB-GYN.
As a Hispanic woman, Pino said she especially wanted to find someone to guide her through her first pregnancy and childbirth with whom she related on a cultural level. So, Pino sought out a doula, a trained professional who provides support to moms before, during and after childbirth alongside doctors.
“Even though mothers are the ones going through the journey of delivering the baby, doulas contribute to keeping the environment more family-oriented,” Pino told “Good Morning America.” “So it’s not just that you’re in a hospital. You’re actually going through a transcendental time of welcoming your baby and starting a new family, becoming a mother.”
In Pino’s case, she found a Hispanic doula with whom she could not only communicate in Spanish, her first language, but who understood how she wanted her delivery to happen, which included a lot of family support.
Maria Antonieta Jandres, who also lives in the San Francisco area, said she too had a Hispanic doula in the delivery room with her during her 10-hour labor, someone with whom she could communicate in Spanish, her native language, and who made her feel safe and comfortable.
“My doula was so knowledgeable,” Jandres told “GMA.” “She spent 10 hours with me through my entire labor, and never left.”
After their own experiences giving birth with doulas by their side, both Pino and Jandres went onto become certified doulas themselves.
As doulas who are Hispanic, they are part of a growing movement in the San Francisco area and across the country to provide better support to Spanish-speaking women throughout pregnancy, during childbirth and postpartum through the use of doulas.
Both women work with Doulas Telar, a grassroots organization that offers free doula care to Latina immigrant women.
Like Jandres and Pino, all of the doulas who work with Doulas Telar are also Latina immigrant women themselves.
“Spanish is my first language so I can speak the language to these pregnant women that are going through the labor, the pain and also the stress that a labor can have by itself,” Jandres said. “Needing to communicate to a nurse that only speaks English or a midwife that only speaks English, it’s hard and the message is being displaced.”
Martha Franco created Doulas Telar in 2017 after seeing the need for Spanish-speaking doulas at hospitals in the San Francisco area. At the time, the organization provided volunteer doulas to women during delivery.
Now, the organization has expanded to include a center, Casa Doulas, where women can attend everything from free prenatal yoga classes to educational classes on topics like childbirth and breastfeeding. The doulas at the center offer support both before, during and after delivery, according to Franco.
“We become their family,” she said. “We come into their story and we want to know them so we can understand and support them not only as a doula, but as a family, as a human, so that they won’t feel they’re here by themselves.”
Diversifying care for pregnant patients through doulas
Part of the gap Franco said she and the doulas she works with are trying to fill is the lack of Hispanic health care workers in the United States, particularly in the maternal care sector.
A report released last year by the U.S. Health Resources & Services Administration found a “lack of racial and ethnic diversity” in the maternal workforce.” Specifically, the report found that Hispanics make up less than 8% of all maternal health physicians and less than 15% of maternal health registered nurses.
At the same time, over 80% of doulas in the U.S. are white, according to figures shared by the U.S. Department of Labor.
In June 2022, the Biden administration released a plan to reduce the maternal health crisis in the U.S. that called for increasing diversity in the maternal workforce. The plan cited doulas as a way to help both increase diversity and better support pregnant women, but noted there is a “short supply” of doulas that is compounded by an “exceptional lack of diversity in these professions and limited pathways for historically underrepresented communities to enter.”
The maternal health crisis the Biden administration seeks to address is one that is unique to the U.S., where around 700 women die each year from pregnancy-related complications, according to the Centers for Disease Control and Prevention, more than any other developed nation.
The crisis is one with huge racial disparities: Data released last year showed mortality rates nearly doubled among pregnant Hispanic women since March 2020, according to a study published by JAMA Network in June 2022.
Dr. Sheela Maru, an attending physician at NYC Health + Hospitals/Elmhurst and assistant professor at the Icahn School of Medicine at Mount Sinai, said immigrant women face additional disparities when it comes to maternal care.
“People who are not born in the United States, most of whom are of Hispanic origin, have a higher rate of maternal morbidity or near-misses, as well as pregnancy complications,” Maru told “GMA,” noting that many of the complications immigrant and minority pregnant women face come from a lack of respectful maternity care.
“About 1 in 5 moms describe mistreatment or violations of physical or verbal abuse during maternity care, and that number is even higher, about 30%, for Black, Hispanic and multiracial mothers,” Maru said, citing CDC data released in August. “Similarly, about 40% of Black, Hispanic and multiracial mothers experienced discrimination, and 45% reported holding back from answering questions or discussing concerns with their provider.”
Maru leads a joint initiative at Mount Sinai and NYC Health + Hospitals called the HoPE Doula Program, which provides free, community-based doula support to pregnant women at certain hospitals in New York. The doulas are matched with women based on their neighborhood, language and ethnicity.
The bridge doulas can build, according to Maru, is to be a voice for the patient in the delivery room and beyond.
“Even with excellent translation services and video translators and all the new technology that we have, nothing really replaces someone who is accompanying you, at your side, who speaks your own language and with whom you’re super comfortable when you’re in a medical setting,” she said. “That environment can be very scary and jarring and nothing really replaces that in-person accompaniment with someone you feel comfortable with.”
Anabel Rivera, a bilingual doula at Ancient Song Doula Services in New York City, said her experience of giving birth in the U.S. after moving from Puerto Rico motivated her to work as a community-based doula specializing in helping Hispanic women.
“I arrived to a completely new health care system. I was a Medicaid recipient, and the providers that I got were not responding to my questions. They couldn’t communicate in a cultural congruency towards me,” she said, noting that she believes the lack of communication led to a delayed diagnosis for preeclampsia, a pregnancy complication.
Now as a doula herself, Rivera said the most critical part of her job is to simply listen.
“The important thing is that we listen to their wishes, and not only that, but that we just listen to them,” she said. “When we’re working with a pregnant person or a birthing person, nobody knows best, just them, on what’s going on in their body, and treating someone with respect and listening is going to make a whole difference in their in their outcome.”
The struggle to recruit more Hispanic doulas, get fair pay
Both Rivera and Franco and her fellow doulas in San Francisco said the hardest part of their job is trying to recruit enough Spanish-speaking doulas to meet the need that exists across the country.
Currently, across all races, only around 6% of pregnant women receive doula care, according to a Department of Labor report on diversifying the doula workforce.
One of the biggest challenges, according to the doulas as well as Maru, is that doulas have traditionally not been well-compensated for the work they do, and it is a 24/7, unpredictable job in which they can only take on so many patients.
“We need space between client[s],” said Rivera. “We don’t want to leave someone unsupported through their journey … because then we will fall in the same circle of not being a solution, but being part of the problem.”
At Doulas Telar, Franco said the free doula services they offer to the community are a result of grants and donations. She said many of the organization’s doulas work in a volunteer capacity, most have other side jobs and many have other full-time jobs because they cannot live on a doula salary alone.
One of the biggest initiatives to help provide for doulas has been a push to have doula services adequately reimbursed by Medicaid and private insurers. Currently, fewer than one dozen states and the District of Columbia reimburse doula services through Medicaid, according to the Department of Labor.
“That has been an ongoing struggle, in terms of making sure that both people who need the services are able to afford them and obtain them at low or no cost, but then also that doulas are able to earn a living wage and be able to provide for themselves and their families and then provide high-quality care to their clients,” explained Maru.
Earlier this year, California became one of the latest states to offer doula reimbursement through its Medicaid program, a step that Franco and others said is slowly starting to help doulas in that state.
Franco has tried to ease another obstacle that blocks many Hispanic women from entering the doula field, the cost and lack of access to training, by offering free training classes at Doulas Telar, also supported by grants and donations.
The goal, she said, is to make sure that every Hispanic women who wants a doula has access to one.
“Nothing is going to stop us as long as the community needs us,” Franco said. “We always see more Latinas every time we go to take care of mothers. We want to go out there and let them know that we’re here and this is what we do.”
(NEW YORK) — As the Israel-Hamas conflict continues, stories of devastation have emerged including injuries, disablement, destruction of buildings and loss of life.
However, experts say war is not just an international relations crisis but also a public health crisis that can result in long-term consequences.
Israelis and Palestinians — as well as residents in other conflict zones — may be cut off from food and water, and be under severe mental health stress. Those who flee may suffer from health risks because of being displaced.
What’s more, the physical distress and psychological effects are not just present of those living in war-torn areas but people abroad as well.
“One of the very disturbing things in virtually all wars nowadays is that civilians, noncombatant civilians, bear the brunt of war, be it the conventional war or terrorist attacks,” Dr. Barry Levy, a physician and an adjunct professor at Tufts University School of Medicine who studies the public health impacts of war and terrorism, told ABC News.
“Civilians are the ones who are caught in the middle, and not only by the direct effects of explosive weapons, but by the indirect health effects that sometimes linger long after the war is over,” he continued.
Lack of access to food, water
It’s common for those living in war-torn areas to be unable to have access to food, clean water and heat.
Israel declared a “complete siege” on the Gaza Strip, blocking food and water and cutting off power to the area.
Levy said that civilian infrastructure being attacked and destroyed often prevents people from being able to search for food and leaves them without shelter or sanitation.
This raises the risk of malnutrition, particularly among infants and young children, which can lead to abnormal development and even cognitive impairment.
Stress beyond the war zone
Research has shown people living in war zones are at increased risk of many mental health issues, including depression, anxiety, post-traumatic stress disorder (PTSD) and more.
However, there may be stress, anxiety, depression and PTSD experienced by the family and friends of loved ones in conflict areas and even the general population at large.
Dr. Jack Tsai, a professor and regional dean at UTHealth Houston School of Public Health in San Antonio, explained that the Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition — a diagnostic tool published by the American Psychiatric Association — now classifies PTSD as something that someone can experience directly but can also be witnessed.
“So, some people can get PTSD by witnessing horrific events and I think now with social media, we see it now with the conflicts in Middle East, is really facilitating a lot of visuals that most people in the past weren’t able to see,” he said.
“And so, I do think that is increasing risk for PTSD, not just for people there, but lots of people just watching and observing what’s happening,” Tsai said.
He added that people seeing the events unfold in the conflict may not meet the full criteria for PTSD but still have some of the symptoms, which can linger and have an effect on a person’s ability to function.
Health risks of displacement
Many Israelis and Palestinians have been forced to flee to other cities, and even neighboring countries, which can affect mental health.
“It can be very disruptive to their mental health in everyday activities,” Tsai said. “I imagine these folks that are being displaced are going to have to kind of reset, in new environments, new people and new cultures, and that can be unsettling in all kinds of ways they can affect their mental and physical health.”
However, people who are forcibly displaced are at greater risk of communicable diseases such as COVID-19 and measles, which could lead to an outbreak.
Amid Russia’s invasion of Ukraine, public health experts warned about the spread of COVID, particularly because Ukraine had a low vaccination rate prior to the war.
“Communicable diseases, infectious diseases are a major problem, mainly respiratory diseases, which often occur at increased rates during war, because people are crowded together,” Levy said. “You can imagine people crowded together in shelters, for example, or in refugee camps or other areas.”
He said another problem is the potential spread of diarrheal diseases, such as cholera, which often occur due to the lack of safe water supply.
(NEW YORK) — Convinced social media platforms are fueling a mental health crisis among the nation’s youth, public officials in New York announced new legislation Wednesday that would restrict algorithms that target young users.
“Young New Yorkers are struggling with record levels of anxiety and depression, and social media companies that use addictive features to keep minors on their platforms longer are largely to blame,” New York Attorney General Letitia James said.
The legislation would, among other things, give her office new enforcement power over social media companies.
Algorithmic feeds are designed to harness personal data to serve users content that keeps them engaged for as long as possible. Sponsors of the legislation said that has increased the addictive nature of social media platforms and heightened the risk to young users’ well-being.
Facebook, Instagram, TikTok and YouTube would all be subject to the legislation that allows users under 18 to opt out of receiving algorithmic feeds, allow parents to allow algorithmic feeds to limit access between 12 a.m. and 6 a.m. and prohibit social media platforms from sending notifications to minors during those same hours without verifiable parental consent.
The attorney general’s office would be authorized to bring an action to enjoin or seek damages or civil penalties of up to $5,000 per violation.
Back in May, U.S. Surgeon General Vivek Murthy warned that excessive social media use can be a “profound risk” to the mental health of youth in the United States.
“I’m very concerned that social media has become an important contributor to the pain and the struggles that many of our young people are facing,” Murthy said in an interview on ABC News Live.
A surgeon general’s advisory is “reserved for significant public health challenges that require the nation’s immediate awareness and action,” according to the report released by the surgeon general’s office.
The surgeon general said that while we’re in the “middle of a youth mental health crisis” it’s important to identify possible causes. The advisory recognizes that social media has both positive and negative effects on young people, but that ultimately there’s not enough “research and clear data” to determine if it’s “safe” for adolescents to use.
(BOSTON) — Harvard-affiliated scientists say they have been able to keep a monkey alive for two years with a genetically engineered pig kidney. Although preliminary, transplant experts say this research is an important milestone in the search for an alternative source of organs.
Scientists are hopeful that one day, genetically modified organs grown in pigs may be able to significantly extend the life of people with end-stage organ failure.
In recent months, other high-profile research teams at New York University and the University of Alabama at Birmingham announced successful transplants of genetically modified pig-kidneys into brain dead human donors. But those experiments ended after a few weeks.
“Duration of survival has been an Achilles heel of genetically modified pig organs to date due to a combination of rejection and opportunistic infections,” said Dr. Peter Chin-Hong, director of the transplant infectious disease program at University of California, San Francisco.
This new research, published in Nature, represents the longest period of time that scientists have been able to keep a non-human primate research animal alive.
“This proof-of-concept study provides real hope that transplantation of porcine [pig] donor kidneys into humans is very much on the horizon,” Chin-Hong said.
Still, experts cautioned that this new research was preliminary, and the idea of pig-grown organs is likely several years away from becoming a reality.
“If ultimately proved successful in human organ recipients – which is still years away at this point – this could be one of the key advances needed to make xenotransplantation a reality in clinical practice,” said Dr. Josh Levitsky, president of the American Society of Transplantation.
The new research was led by eGenesis, a company co-founded by Harvard geneticist George Church. In a press release, scientists at eGenesis said the new research will help lay the groundwork for formal clinical trials.
In prepared remarks, eGenesis CEO Michael Curtis, PhD, said the company is focused on “improving long-term survival for transplant recipients from months to years.”
Eventually, the hope is that transplant doctors will be able to use genetically modified pig organs instead of solely relying on deceased human organ donors.
“Among all solid organs transplanted, kidneys are most sought after, expected to increase in demand further, and there is a significant shortfall of organs leading to premature deaths,” Chin-Hong said.
Every day, 17 people die waiting on the organ transplant list, according to the Health Resources & Services Administration. There are currently more than 100,000 people waiting on the national transplant list and a new person is added to the list every 10 minutes.
(NEW YORK) — Andrew, a 39-year-old New Yorker who identifies as queer, says he got lucky with his first primary care provider, who was very queer friendly.
“He was straight, but raised by two dads and created a very welcoming environment,” Andrew told ABC News of his former doctor.
When his doctor moved, Andrew says he realized how much it mattered for his health. He says his new doctor was less comfortable around queer issues. “There was always a barrier and a sense of awkwardness,” he said.
Andrew says the lack of good communication left him feeling he could not tell his doctor everything. “Having experienced queer friendly doctors and not queer friendly doctors you see the importance of nonjudgment,” he said.
Being able to have open conversations about sexual identity can be important for health care, experts say, especially around issues like appropriate general health, STI, and mental health screenings.
The LGBTQ+ community disproportionately experiences barriers to health care, and studies have shown this can lead to worse health outcomes stemming from things like untreated depression or anxiety, unaddressed cardiovascular health risks, or missed vaccines that can prevent infections or even cancer.
But many members of the LGBTQ+ community don’t feel able to talk openly with their doctor. In one study, 39% of bisexual men and 33% of bisexual women reported that they had not disclosed their sexual identity to their medical provider, often for fear of stigmatization or judgment.
Some members of the LGBTQ+ community fear discrimination and others have reported being denied care by health care providers solely due to their sexual orientation or gender identity. The fear of outright discrimination and implicit bias can deter people from seeking care, making them less likely to complete recommended health screenings, research shows.
“Some of the barriers are about access and some are about willingness to engage with the health care system,” says Dr. Renee Crichlow, vice chair of health equity for the Department of Family Medicine at Boston University Medical School.
Dr. Crichlow also notes a big issue is that LGBTQ+ individuals are less likely to have a consistent source of primary care. This is why women in the LGBTQ+ community are significantly less likely to access preventative health care than other women, according to a study in the Journal of Urban Health. After adjusting for other factors, these women were ten times less likely to have received a timely pap test and four times less likely to have received a timely mammogram, the study said. This likely contributes to higher rates of various cancers in that community, as another study indicated.
Health providers can take steps to address disparities and lessen these barriers, and many are. Providers can implement intentional strategies to recognize and overcome implicit biases. This includes asking patients open-ended questions without assumptions or judgment. “If people don’t feel comfortable in a healthcare environment, you have to create a very overt atmosphere of safety,” Dr. Crichlow says.
For patients, there are resources that can assist in finding health care providers who are LGBTQ+ affirming, like GLBT near me and GLMA: Health Professionals Advancing LGBTQ+ Equality. And Dr. Crichlow’s advice is to use the community as a resource, “Check with your friends and colleagues. Do they have a trusted clinic they can go to?”
And bring a friend: “You don’t have to do any of these things alone and there are lots of people willing to engage in a compassionate supportive way with the LGBTQ+ community. If the first clinic doesn’t work for you, trust me, there is another place out there for you,” Dr. Crichlow says.
Patients could also try having an open conversation with their current doctor, says Alex Sheldon, executive director of GLMA: Health Professionals Advancing LGBTQ+ Equality. “Express your concerns, feelings, and discomfort in a respectful but firm manner. Your provider may not be aware of your concerns and addressing them directly can lead to improvements in your relationship,” Sheldon says.
If people don’t feel comfortable with their current doctor, they may be able to use telehealth for some services, Sheldon says.
In addition, LGBTQ+ youth dealing with depression or anxiety can reach out to the Trevor Project crisis help line. Individuals in the transgender community can reach out to the Trans Lifeline peer support hotline to be connected with resources, including mental and health care services. Finally, Sheldon notes, people can reach out to patient advocacy groups or support networks to learn more about your conditions and treatment options.
Even after finding a doctor they are comfortable with, LGBTQ+ patients don’t always know what issues they should bring up. GLMA provides resources to patients about things to remember to discuss with your doctor. These include things that all patients should discuss, like concerns about screenings, heart disease risk factors, diet and exercise. But there is more to consider for people in the LGBTQ+ community, including risks for intimate partner violence, PREP for HIV, and screening for depression and anxiety.
There are also things that trans patients should bring up, including questions about side effects or drug interactions with hormone therapy.
As for Andrew, he says he has again found a doctor he can trust, and says it makes all the difference. “Every time I go into the doctor now, we have a good conversation, and it helps me feel at ease because it’s not just a sterile environment, it’s a place of trust,” he says.
Dr. Elizabeth Ghandakly, MD JD, is a resident physician in Internal Medicine from The Cleveland Clinic in Ohio and a member of the ABC News Medical Unit.
(NEW YORK) — Things at Family Services of Northeast Wisconsin have not slowed down since July 2022.
The center, which runs the 988 crisis hotline for the state, worked hard to expand its mental health services following the hotline’s national relaunch. Like many centers across the country, they have has experienced surging demand that has outpaced anything experienced prior, Shelly Missall, the organization’s 988 program manager, told ABC News.
That level of surging demand has led Missall to make tough decisions. She says among them: limiting services provided to frequent users of the line.
“Restricting callers is not ideal for anyone,” Missall said. “But given the extent of the demand, and the state of their staffing, few choices remain.”
“We’re looking at our needs as a call center, to be able to meet the needs of the entire state and to be able to get to the…other folks who need help,” she added.
Since its launch in July 2022, demand for 988 has swelled. As of September 2023, five million individuals had received support by calling, texting or messaging the line. During that time, the federal government has invested nearly $1 billion into the hotline, including specific subnetworks for veterans, LGBTQ+, Spanish speakers and users of American Sign Language designed to meet each group’s distinct needs.
In the face of widespread staffing shortages amid the ballooning demand, 988 centers all over the country are being forced to make these same tough decisions for frequent callers, sources informed ABC News.
988 Suicide & Crisis Lifeline
According to Vibrant Emotional Health, the national organization administering the new 988 hotline, crisis centers across the country are using callers’ names, numbers or even “the sound of their voice” to potentially limit services.
“Based on our policy requirements, centers are able to determine for themselves how they want to address familiar voices,” Divendra Jaffar, a spokesperson for Vibrant, told ABC News.
In an ideal world, the goal of a crisis hotline is to stabilize symptoms—not provide ongoing care—according to Tia Dole, 988 lead at Vibrant. But experts say that restricting callers goes against best practice for mental health care in a world where non-crisis care—like regular therapy—is hard to come by. With waitlists stretching into the hundreds —and wait times of weeks or months—988 is the backstop.
Yet, centers are struggling to be that backstop for recurrent users while also staying available for everyone.
In response to this reporting, the Substance Abuse and Mental Health Services Administration (SAMHSA) said it is now working with Vibrant, and in turn local centers, to evaluate the need for restrictions on frequent callers and develop alternatives to those measures.
“Even with familiar callers, each contact is unique and crisis counselors use their experience to listen, support and connect people to various types of community-based care, if needed, while [also] making sure they are able to respond to incoming calls,” Monica Johnson, SAMHSA’s 988 director, told ABC News.
Difficult trade-offs
According to data from Vibrant, at least 1,000 callers across the country have been flagged as familiar voices. Centers in 39 states have consulted with Vibrant about placing restrictions on frequent callers, Jaffar told ABC News. The organization declined to share additional statistics or resources for determining how frequent callers are managed.
While a frequently asked questions page on SAMHSA’s website states that the line is “confidential,” that does not preclude cataloging callers’ phone numbers, names or the sound of their voice in order to identify frequent callers, Jaffar said.
Vibrant also does not have a universal definition for “familiar voices,” he added, “so some centers may identify an individual as being familiar to them with relatively few contacts, while others…may have a higher threshold.”
Family Services of Northeast Wisconsin has restricted frequent callers in various ways, Missall said. In some cases, they’re limiting calls to 20 minutes each, in others, they’re limiting individuals to 3 calls over a certain period of time and for some, they’re referring callers out to other resources such as a National Alliance for Mental Illness “warmline,” before terminating the call. Such non-crisis helplines are typically less equipped to respond to emergency situations, according to the American Psychiatric Association.
“Some of those boundaries might be necessary to help them build some of their own personal skills as far as being able to self-manage,” she said, “it’s never healthy for somebody … to become too overly dependent on any singular resource.”
Leading mental health professionals disagree that such an approach is likely to help patients.
“I am aware of no evidence that restricting crisis mental health services leads to positive outcomes,” Mark Olfson, a psychiatrist at Columbia University and former chairman of the scientific advisory committee for the American Psychiatric Association, told ABC News.
If resources are limited, “some mechanism may unfortunately be needed to ration care,” he acknowledged. But an inherent challenge persists in determining who needs care first, and whether calling frequently means each call is less serious, Chinmoy Gulrajani, a psychiatrist at University of Minnesota and medical director with the state’s Department of Human Services, told ABC News.
Tia Dole, at Vibrant, said that the organization encourages call centers to ensure a safety plan is in place and to coordinate other follow-up care when possible.
“[But] boundaries need to be set for a certain group of people,” Dole added, “and that’s the reality of running a crisis center.”
Nowhere else to go
Experts say there are ways to help frequent callers other than restrictions alone, which SAMHSA says it’s helping to roll out.
One approach involves developing specific protocols for brief, recurring check-ups with frequent callers, Madelyn Gould, a professor of psychiatry at Columbia University whose research informed the 2020 law inaugurating 988, told ABC News. Another strategy includes using peer supporters—a historically underutilized group of behavioral health workers who have been largely excluded from the 988 rollout—to staff hotlines devoted specifically to familiar callers.
These pathways, using 988 centers to direct those in need to additional follow-up care, would be consistent with SAMHSA’s 2020 guidelines on crisis care. But until that process is readily available, advocates worry about the effect restrictions may have on those in need.
Ellen Dayan, for one, is concerned.
Dayan herself has faced an enduring battle with mental illness time and time again, after a diagnosis of bipolar disorder in her twenties, she’s found herself relying on strangers on the other end of a telephone for support in moments of crisis, including suicidality.
Later, she took on the role herself, answering calls for a Toledo crisis prevention center, Help Network of Northeast Ohio. Dayan’s own experience with calling the helpline left her appalled when she was increasingly pressured by management to restrict services offered to repeat callers. They were only to be allowed a certain number of calls per week, or for a certain duration per call.
“The attitude was … that they’re clogging up the lines,” Dayan said, “but that’s a problem, you have to sustain those relationships because otherwise it’s just a slamming door.”
Help Network of Northeast Ohio did not respond to requests for comment.
Dayan said she tried to do what she could amid the restrictions, she had a list of roughly three dozen local mental health organizations that she’d distribute to callers to get plugged in. But those would often have months-long waitlists if they’d take her callers at all.
Which meant for many of those callers, 988 was the only option left.
In those cases, Dayan said, “a conversation — that’s all we have.”
If you or a loved one is struggling with a mental health crisis or considering suicide, call or text 988.
ABC News is looking into challenges and successes with implementation of the 988 Suicide and Crisis Lifeline. If you have had issues or successes with the line, please contact us here.
(NEW YORK) — Things at Family Services of Northeast Wisconsin have not slowed down since July 2022.
The center, which runs the 988 crisis hotline for the state, worked hard to expand its mental health services following the hotline’s national relaunch. Like many centers across the country, it has experienced surging demand that has outpaced anything experienced prior, Shelly Missall, the organization’s 988 program manager, told ABC News.
That level of surging demand has led Missall to make tough decisions. She says among them: limiting services provided to frequent users of the line.
“Restricting callers is not ideal for anyone,” Missall said. “But given the extent of the demand, and the state of their staffing, few choices remain.”
“We’re looking at our needs as a call center, to be able to meet the needs of the entire state and to be able to get to the…other folks who need help,” she added.
Since its launch in July 2022, demand for 988 has swelled. As of September 2023, five million individuals had received support by calling, texting or messaging the line. During that time, the federal government has invested nearly $1 billion into the hotline, including specific subnetworks for veterans, LGBTQ+, Spanish speakers and users of American Sign Language designed to meet each group’s distinct needs.
In the face of widespread staffing shortages amid the ballooning demand, 988 centers all over the country are being forced to make these same tough decisions for frequent callers, sources informed ABC News.
According to Vibrant Emotional Health, the national organization administering the new 988 hotline, crisis centers across the country are using callers’ names, numbers or even “the sound of their voice” to potentially limit services.
“Based on our policy requirements, centers are able to determine for themselves how they want to address familiar voices,” Divendra Jaffar, a spokesperson for Vibrant, told ABC News.
In an ideal world, the goal of a crisis hotline is to stabilize symptoms — not provide ongoing care — according to Tia Dole, 988 lead at Vibrant. But experts say that restricting callers goes against best practice for mental health care in a world where non-crisis care — like regular therapy — is hard to come by. With waitlists stretching into the hundreds — and wait times of weeks or months — 988 is the backstop.
Yet, centers are struggling to be that backstop for recurrent users while also staying available for everyone.
In response to this reporting, the Substance Abuse and Mental Health Services Administration (SAMHSA) said it is now working with Vibrant, and in turn local centers, to evaluate the need for restrictions on frequent callers and develop alternatives to those measures.
“Even with familiar callers, each contact is unique and crisis counselors use their experience to listen, support and connect people to various types of community-based care, if needed, while [also] making sure they are able to respond to incoming calls,” Monica Johnson, SAMHSA’s 988 director, told ABC News.
Difficult trade-offs
According to data from Vibrant, at least 1,000 callers across the country have been flagged as familiar voices. Centers in 39 states have consulted with Vibrant about placing restrictions on frequent callers, Jaffar told ABC News. The organization declined to share additional statistics or resources for determining how frequent callers are managed.
While a frequently asked questions page on SAMHSA’s website states that the line is “confidential,” that does not preclude cataloging callers’ phone numbers, names or the sound of their voice in order to identify frequent callers, Jaffar said.
Vibrant also does not have a universal definition for “familiar voices,” he added, “so some centers may identify an individual as being familiar to them with relatively few contacts, while others…may have a higher threshold.”
Family Services of Northeast Wisconsin has restricted frequent callers in various ways, Missall said. In some cases, they’re limiting calls to 20 minutes each, in others, they’re limiting individuals to three calls over a certain period of time and for some, they’re referring callers out to other resources such as a National Alliance for Mental Illness “warmline,” before terminating the call. Such non-crisis helplines are typically less equipped to respond to emergency situations, according to the American Psychiatric Association.
“Some of those boundaries might be necessary to help them build some of their own personal skills as far as being able to self-manage,” she said, “it’s never healthy for somebody … to become too overly dependent on any singular resource.”
Leading mental health professionals disagree that such an approach is likely to help patients.
“I am aware of no evidence that restricting crisis mental health services leads to positive outcomes,” Mark Olfson, a psychiatrist at Columbia University and former chairman of the scientific advisory committee for the American Psychiatric Association, told ABC News.
If resources are limited, “some mechanism may unfortunately be needed to ration care,” he acknowledged. But an inherent challenge persists in determining who needs care first, and whether calling frequently means each call is less serious, Chinmoy Gulrajani, a psychiatrist at University of Minnesota and medical director with the state’s Department of Human Services, told ABC News.
Tia Dole, at Vibrant, said that the organization encourages call centers to ensure a safety plan is in place and to coordinate other follow-up care when possible.
“[But] boundaries need to be set for a certain group of people,” Dole added, “and that’s the reality of running a crisis center.”
Nowhere else to go
Experts say there are ways to help frequent callers other than restrictions alone, which SAMHSA says it’s helping to roll out.
One approach involves developing specific protocols for brief, recurring check-ups with frequent callers, Madelyn Gould, a professor of psychiatry at Columbia University whose research informed the 2020 law inaugurating 988, told ABC News. Another strategy includes using peer supporters — a historically underutilized group of behavioral health workers who have been largely excluded from the 988 rollout — to staff hotlines devoted specifically to familiar callers.
These pathways, using 988 centers to direct those in need to additional follow-up care, would be consistent with SAMHSA’s 2020 guidelines on crisis care. But until that process is readily available, advocates worry about the effect restrictions may have on those in need.
Ellen Dayan, for one, is concerned.
Dayan herself has faced an enduring battle with mental illness time and time again, after a diagnosis of bipolar disorder in her twenties, she’s found herself relying on strangers on the other end of a telephone for support in moments of crisis, including suicidality.
Later, she took on the role herself, answering calls for a Toledo crisis prevention center, Help Network of Northeast Ohio. Dayan’s own experience with calling the helpline left her appalled when she was increasingly pressured by management to restrict services offered to repeat callers. They were only to be allowed a certain number of calls per week, or for a certain duration per call.
“The attitude was … that they’re clogging up the lines,” Dayan said, “but that’s a problem, you have to sustain those relationships because otherwise it’s just a slamming door.”
Help Network of Northeast Ohio did not respond to requests for comment.
Dayan said she tried to do what she could amid the restrictions, she had a list of roughly three dozen local mental health organizations that she’d distribute to callers to get plugged in. But those would often have months-long waitlists if they’d take her callers at all.
Which meant for many of those callers, 988 was the only option left.
In those cases, Dayan said, “a conversation — that’s all we have.”
If you or a loved one is struggling with a mental health crisis or considering suicide, call or text 988.
(NEW YORK) — As the conflict in Israel moves into its fourth day, thousands of people are caught in the war zone.
Hundreds of Israelis and Palestinians are dead, according to authorities, and more than 5,000 in Israel and Palestine have been injured since Saturday, when the militant group Hamas launched an unprecedented attack from air, land and sea.
Some residents in villages and towns along the Gaza border have been forced to hide in bomb shelters, while others have been evacuated to other parts of Israel and even to neighboring countries.
For those caught in such conflict areas, global health experts and psychologists said there is not only a significant physical toll, but a mental health toll as well.
“When we think about trauma in a war, in a conflict zone, I think it’s important to remember that what war brings is a convergence or a realization of all of our worst nightmares about fears of loss, of our own lives, about the lives of people we love, damage to our bodies, loss of control and also the loss of a familiar anchor in the routine of daily life,” Dr. Steven Marans, a child and adult psychoanalyst and professor at the Yale University Child Study Center, told ABC News. “And so, the symptoms that we see here are really a reflection of some of the tremendous impact that these sudden unanticipated threats and realization of these nightmare scenarios are created in in wartime.”
Impacts to human health
There are physical risks beyond the obvious for people living in war zones, such as breathing in smoke and ash from fires and blasts, which can affect the nose and lungs.
Dr. Ubydul Haque, an assistant professor of global health at Rutgers Global Health Institute, has studied how living in a conflict environment, such as during a war, can affect human health. In his research on the war between Ukraine and Russia, for example, which has been ongoing since February 2022, he found impacts on physical health that, again, may not be obvious at first thought.
“They have no access to medication, food, water, electricity, heating,” he told ABC News. “You know that during the war, their energy infrastructure was destroyed, and our study showed people had cold injuries that might make a lot of them permanently disabled.”
Further, people who suffer illness, malnutrition, injury, or sexual violence in a conflict environment may have trouble getting medical attention if hospitals are taken out of service, he said.
Mental health impact
Research also has shown that people living in war zones are at increased risk of a myriad of mental health issues, including depression, anxiety, post-traumatic stress disorder and more.
Marans said the general public often underestimates the mental health challenges of being caught in a war zone, due to fears such as the possibility of being injured or disabled.
“This is one of the costs of armed conflict,” he said. “Not just the destruction of buildings, not just the loss of lives, which are terrible enough, but also the impact on entire communities of young people and older people, the risks for their subsequent functioning, being able to live happily with greater freedom is significantly jeopardized.”
Dr. Angelica Diaz-Martinez, a teaching professor at Rutgers University’s Graduate School of Applied and Professional Psychology, told ABC News that people respond to trauma in different ways, with some acting more stoic and others unable to regulate their emotions.
She said that for people living in a state of limbo who are “having anxiety about what could happen, what may happen, trying to predict what’s going to happen — those are all things that are going to impact people for a long time, past the trauma.”
What’s more, if adults find it difficult to understand what’s happening and make sense of the conflict, children and teenagers may find it especially difficult.
“There might be some regression with children in terms of, if they were potty trained, they may have accidents,” Diaz-Martinez said. “There might be concerns about people leaving, so they might be a little more clinging, there might be anger or emotional dysregulation.”
Experts add that being in caught in a war zone may be especially difficult for those with pre-existing mental health disorders, making it difficult to access their medication or speak to their doctor,
Even so, Diaz-Martinez and Marans said there is hope that those affected can recover from trauma. Methods include establishing a routine for a sense of normalcy and talking to someone, if possible. Parents should have conversations with their children and listen to any concerns they may have.
(NEW YORK) — Two neonatal intensive care unit patients who were once given a 40% chance of survival are now thriving years later.
Tate Lewis and Seth Rippentrop were born weeks apart in 2002. They were diagnosed in utero with hypoplastic heart syndrome, a congenital condition where the left side of the heart doesn’t form properly, and treated at Children’s Health.
Dr. Steve Leonard, a pediatric cardiothoracic surgeon at Children’s Health, who treated Tate Lewis, said the diagnosis can be deadly if not treated immediately.
“It’s a defect that is uniformly fatal if it’s not taken care of within the first few days of life,” Leonard told Good Morning America.
Cheri Lewis, Tate’s mother, recalled the moment she first heard about her son’s diagnosis.
“We were terrified when we found out about Tate’s diagnosis,” she told GMA.
Seth Rippentrop’s mother, Kimberly Rippentrop, said she also remembers that moment over two decades ago.
“I would pray, just asking God to let him come home and sleep one night,” she said.
The boys would need multiple surgeries and extensive treatment for their condition, which requires the reconstruction of the right side of the heart so it can do the job of a typical heart.
Their mothers met in the hospital NICU with their sons in side-by-side rooms.
Seth Rippentrop had to have three major surgeries and Tate Lewis, who also had a stroke that paralyzed one of his vocal chords, needed to have five surgeries.
Despite the odds, both boys survived and built a close bond together.
“I was just always very aware of the fact that I had half of a heart as a kid and I just always knew that there was something different,” Seth Rippentrop said.
“What we’ve been through in the past, I feel like, gives us hope,” he continued.
Today, the two close friends are both juniors in college and roommates at the University of Texas at Dallas, where Seth Rippentrop is a dean’s list student and Tate Lewis is a member of the men’s golf team.
Although they may have lifelong complications, both Seth Rippentrop and Tate Lewis say they feel positive about their future and know to never take life for granted.
“This was something we were born with and so we have to treat it with care but also we have to live life as well and set goals,” Tate Lewis said.
Said Seth Rippentrop, “We’ve already defied so many odds and we’ve already gone against so many expectations of what our life was going to be like so it makes me really hopeful for the future.”
Leonard added separately, “That’s the most rewarding aspect of what we do is to see these patients reach adulthood and to be able to fulfill their dreams.”
