It’s a summer afternoon and parents with their young children have gathered to hear what a nutritionist with Women, Infants and Children (WIC) has to offer. They watch with intrigue as Mary Paige demonstrates how to make yogurt dots from frozen Greek yogurt and French fries from roasted parsnips and carrots. After a 10-minute demo in the WIC office at Yale New Haven Hospital’s Primary Care Center, Stephany Uriostegui of West Haven is sold. She can’t wait to try the recipes at home for her 10-month-old son and 5- and 7-year-old daughters. “I always buy the [yogurt dots] from Walmart,” she said.
Among women, those who are low-income or minority are less likely to get treatment for depression, according to multiple studies. A report by the Connecticut Behavioral Health Partnership found that women were underrepresented in Medicaid-funded behavioral health services in the state even though research shows that women suffer from the most commonly diagnosed mental health disorders more frequently than men. Racial and ethnic disparities, while still considerable, are decreasing in some physical illnesses. “But in mental health care, in the last 10 years, we see those disparities widening,” said Megan Smith, associate professor in the Departments of Psychiatry and in the Child Study Center in the Yale School of Medicine, who runs the Mental health Outreach for MotherS (MOMS) Partnership®, a program that offers mental health services to “overburdened and under-resourced mothers.”
In this podcast, sponsored by ConnectiCare, Colleen Shaddox discusses the hurdles to mental health care and the programs breaking barriers to care with Yale’s Megan Smith and UConn Health’s Dr. Sarah Nguyen. Lack of insurance coverage, the cost of treatment, a shortage of qualified clinicians, stigma and even fear of losing custody of their children can keep women from seeking help, Smith said.
Iasiah Brown, 25, of New Haven, said he does not see a need for a primary care doctor for himself and his daughter, opting to visit clinics in the area instead of waiting up to two weeks for an appointment at a doctor’s office. Brown is among the 83 people who said they didn’t have a primary care doctor in response to a health-care usage survey by the Conn. Health I-Team and Southern Connecticut State University. The team surveyed 500 people and interviewed dozens statewide between January and March. About 83 percent of respondents said they had a primary care doctor, but the rate was lower for African American (78 percent) and Hispanic respondents (75 percent).
Once a week, every week, the health center at Stamford High School offers sophomore Roger Sanchez an oasis—someplace he can talk to a trusted adult about life’s pressures and problems, a place he feels free and unjudged. School work, sports commitments, family and social obligations: life as a teenager can be stressful, he says. If it weren’t for the health center, conveniently located where he spends most of his days, he would have a much harder time accessing counseling sessions that help him cope with anxiety. “The health center helps me out academically, emotionally and physically,” he said, and he recommends it to friends. “They get nervous, kind of, but I try my best to get them to come in.
When 9-year-old Jeremy Brown is in pain, it feels like he is being stabbed, while the pain experienced by Deborah Oliver, 40, is like a hundred simultaneous charley horses. Brown, of Bridgeport, and Oliver, of New Haven, have sickle cell disease (SCD), a genetic blood disorder that causes excruciating pain, life-threatening complications and a shortened life expectancy. Almost one-half of sickle cell patients die in their 40s. The disease affects some 100,000 Americans, about one in 365 African Americans and one out of 16,300 Hispanics; and in lesser numbers, people with Middle Eastern, Indian, Caribbean and Mediterranean ancestries. An estimated 2,000 people in Connecticut have SCD.
Tens of thousands of adolescents in Connecticut still do not have access to effective mental health care, despite the passage of a 2008 federal law requiring health insurers to provide equal benefits for mental health. Poor access to care leads to undiagnosed or misdiagnosed mental illness in children and adolescents, an increase in use of emergency rooms for psychiatric issues, and is a risk factor for severe mental illness, substance abuse, failure in school, and entering the juvenile justice system. National studies show that about 1 in 5 children and teens have mental illness, but only one quarter of them receive services. “That leaves about 125,000 children without mental health care in Connecticut,” said Susan Kelley, director of the Alliance for Children’s Mental Health. Some say that estimate is low, partly because it doesn’t capture mental illness misdiagnosed as behavioral problems. “I think that’s a very optimistic figure,” said Eliot Brenner, PhD, president and CEO of the Child Guidance Center of Southern Connecticut.
Depending on your ZIP code, Connecticut is a wonderful place to live. A recent United Health Foundation report said Connecticut ranks sixth in the nation for women and children’s health. The state scored high because of a low teen birth rate, as well as a high percentage of publicly funded women’s health services needs being met. But the state faces a yawning disparity of health status among residents—and its segregated towns. That’s significant because research shows that if you want to calculate your life expectancy, check your ZIP code and your median household income.
With Connecticut children testing positive for lead at consistently high numbers, and millions of dollars thrown at the problem with tepid results, lawmakers may finally be stepping up to seek an effective solution. The Banking Committee is considering a bill that would create a task force to study better ways to finance the removal of the toxin from thousands of homes around the state. The task force would also investigate how to enforce abatement measures, including rental property inspections, and look into increasing workforce training in the specialized process needed to remove lead. State Department of Public Health (DPH) numbers from 2015, the latest available, show more than 72,000 children under the age of 6 testing positive for some level of lead in their blood. More than 900 children were at levels two to four times the baseline at which a child is considered poisoned.
Joanne Goldblum of New Haven is on a mission to get health care clinicians to recognize that poverty may be the underlying cause of their patients’ illnesses and that the best treatment might be as simple as a brown bag of food or a tube of toothpaste. Goldblum is CEO of the New Haven-based National Diaper Bank Network (NDBN), an organization dedicated to getting basic needs to people. She co-authored the Basic Needs-Informed Care Curriculum—with support from Yale School of Medicine faculty—designed to help clinicians, social workers and educators recognize the myriad ways a lack of resources can present itself. For example, a baby comes to a well child visit in dirty clothes. Clinicians might typically ask: Is the mother too depressed to care for the infant?
On a snowy Saturday morning in January, Selvin, 13, and his mother were in the basement of the First and Summerfield United Methodist Church in New Haven, to support a friend in sanctuary. As they sat there, the boy tried to push away thoughts of how it would be when ICE came to take away his own mother, who is also under a deportation order. “I’m going to be alone with my little brother and my dad,” Selvin said. “Sometimes I feel I don’t want to talk to anybody. I just go to my room, lock the door, and I feel depressed.”
Selvin – whose family asked that his last name be withheld – is among thousands of immigrant children in Connecticut and nationally feeling the effects of prolonged stress, which can become so toxic it can damage the developing brain.