Join Us on January 17th for Truth, Racial Healing, and Transformation

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Morning Zen Guest Blog Post ~ Brian Smedley ~ 

Dear Health Equity Ally:

Eight years ago, many Americans were lulled into believing that our country had become a "post-racial" society with the election of Barack Obama as the 44th President.  It's now clear that such talk was premature. Racism, xenophobia, homophobia, and sexism remain powerful social and political forces that continue to divide us and keep us from achieving greatness as a nation. 

The only way to make America great is to promote inclusion, equity, and tolerance. That's the objective of the W.K. Kellogg Foundation's Truth, Racial Healing, and Transformation initiative: to engage communities in racial healing and change efforts that address historic and current inequities. 

Importantly, the only way to achieve this objective is for many people of good will to come together in collective action to denounce intolerance and divisiveness. This will be a long journey. But an important step in the journey will take place on January 17, when over 130 organizations and many thousands of committed individuals join together in a National Day of Racial Healing

Please consider joining forces with fellow allies on this day to participate in healing actions and mobilizations. The Kellogg Foundation website lists many resources to help you engage on this day. In addition to coming together in person, please also join us in a Twitter Thunderclap to elevate our voices and concerns the morning of January 17th. Please help us reach our goal of 500 participants, to potentially reach tens of thousands of people via social media.

You can join us by visiting this link:

Thank you – our collective efforts will help beat back the forces of intolerance, and promote love and healing!


Brian D. Smedley, PhD                                                                                                    
Executive Director
National Collaborative for Health Equity

smedleyBrian D. Smedley, PhD, is co-founder and Executive Director of the National Collaborative for Health Equity, a project that connects research, policy analysis, and communications with on-the-ground activism to advance health equity. In this role, Dr. Smedley oversees several initiatives designed to improve opportunities for good health for people of color and undo the health consequences of racism. From 2008 to 2014, Dr. Smedley was Vice President and Director of the Health Policy Institute of the Joint Center for Political and Economic Studies in Washington, DC, a research and policy organization focused on addressing the needs of communities of color.



Can Families Afford Gloating Over Failure to Prevent Stage 4 Mental Illness?

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Morning Zen Guest Blog Post ~  Dennis D Embry, Ph.D.~ 

A few weeks ago, I received a snarky email, gloating over the fact that a study failed to replicate a study to prevent first episode psychosis. Can you imagine receiving a snarky email about a failure to prevent any cancer or any other terrible disease? Probably, not. Disappointment is not an abstraction for any afflicted person or their loved ones, facing death or lifetime disability.

Sixty years ago, our nation faced a crisis affecting our children—polio. Some 30,000 died in the early 1950s. Millions of families prayed for a cure. Children like me contributed dimes to the cause. There were false starts and failures for sure. The serious failures made national news. We never gave up hope. Eventually, science triumphed. First, Jonas Salk proved that a vaccine caused antibody expression. Second, Thomas Francis and the March of Dimes launched a massive study of hundreds of thousands of children in 44 states. It worked, and soon polio vanished as a terrifying force.

There were financial losers when polio was prevented: the people who made crutches, wheelchairs and iron lungs. There will be financial losers when psychiatric disorders are prevented, too,

The notion that serious psychiatric disorders are an inevitable lottery of genes is nothing short of self-serving marketing voodoo. I seriously doubt most readers have heard that prevalence rate of schizophrenia goes up with the increasing latitude North or South of the Equator. Or, almost nobody has heard that rates of schizophrenia get even worse with the darker one’s skin color, from the equator. Yet, the more people who eat oily fish, the lower the rate of schizophrenia. And, then there is the fact that 85% of the children who develop schizophrenia do not have parents with schizophrenia. So is all this the result of some unknown biological, genetic cause like the TV ads suggest? Perhaps not, and there are other data just like these.

One might recall the epidemic of cholera in London, and the famous study by John Snow. All sorts of theories abounded about the cause of cholera. Those theories were wrong, and perhaps a bunch of people made money from their implausible theories. Simply tearing off the handle of the Broad Street water pump stopped the epidemic.

We are close to tearing off the pump handle of the epidemic of mental illnesses. Millions will rejoice, though the purveyors who accrue money or status from the sales equivalent of iron lungs may not. Prevention is coming.

embryDennis D. Embry, Ph.D., is a prominent prevention scientist in the United States and Canada, trained as a clinician and developmental and child psychologist. He is president/senior scientist at PAXIS Institute in Tucson and co-investigator at Johns Hopkins University and the Manitoba Centre for Health Policy. Dr. Embry was recently appointed to the member of the SAMHSA Center for Mental Health Services National Advisory Council. His work and that of colleagues is cited in 2009 the Institute of Medicine Report on The Prevention of Mental, Emotional, and Behavioral Disorders Among Young People. Clinically his work has focused on children and adults with serious mental illnesses. Dennis Embry is a member of the Children's Mental Health Network Advisory Council.

Honoring Anas al-Basha - the Syrian Clown Who Gave His Life to Make a Difference

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Morning Zen Guest Blog Post ~ Colonel George Patrin, MD ~

Readers may recall the post of my story meeting the real Patch Adams, MD and Humanitarian Clown, on retiring from 23 years of service as an Army Pediatrician and Healthcare Administrator, and going on a humanitarian clown mission trip to Russia in 2012. Patch has been doing clown trips for over 18 years. That trip was my first clown trip, and changed my life. It gave me a new perspective on being an American and healthcare advocate, as well as a citizen and good neighbor. An unexpected side benefit was the release of much of the grief over the suicide loss of my youngest son only three years prior along with pent-up frustration from 20 years of post-traumatic stress providing the best healthcare possible for military families who put their lives on the line every day, worrying about deployed service members, again and again. Patch Adams, through his Gesundheit! non-profit, and the 23 international clowns I met and clowned with for two weeks in Moscow and St. Petersburg, demonstrated unconditional love and giving with no expectation of return, doing it just because they could. Clowning, as practiced by The Gesundheit! Institute and Dr. Patch Adams, produces an amazing transformation in those who avail themselves of the opportunity to go on any number of International Humanitarian Clowning Trips conducting Patch’s version of “Nasal Diplomacy.” I came home a changed person, doctor, and advocate. 

Together with Patch and the Chicago VA we planned and launched the first-ever humanitarian clown trip for U.S. and Canadian Veterans suffering from post-traumatic trauma of their own, in October 2015, to Guatemala, just after the devastating mud slide that buried over 200 townspeople. I was determined to see if a clown trip had the same effect on them it had on me. All ten volunteers had a story of their own, struggling to leave military (and life) trauma(s) behind to be able to lead peaceful, productive lives as civilians. We had Vets from every service and every war back to Vietnam, men and women. We changed our itinerary on arrival in Guatemala City from the usual hospitals and orphanages to be able to visit the make-shift mudslide refugee village. The Veterans rose to the occasion, had children hanging all over them, sitting in laps, laughter and tears mixing in spontaneous joy. With the help of Patch Adams and the Clown Staff of ten, the Vets, who certainly knew sorrow and trauma, discovered again they still knew how to love, from the heart, and re-found their child selves, bringing them back to the surface. To the person, they resolved to go home changed, having gotten more from the citizens of Guatemala, who fight a 'war' every day of their lives, than we gave them. "Your trip to Russia wasn't a fluke," said a former Marine the day before we left for home, now all smiles.

And now this - a story from war torn Aleppo, where a beloved Syrian youth worker, town clown and caregiver, Anas al-Basha, who knew the 'power of the nose', was killed in an airstrike. Five years ago, Anas was studying history at Aleppo University when anti-government protests broke out in Syria, sparking the civil war. He left school and began working with NGOs to do something to save the children of his beloved country.

As Scott Bryant-Comstock wrote to me, "this is less about the terror and tragedy of the event, but more about the unbridled commitment to bring joy into the lives of children." Yes, people like Anas and Patch Adams, and so many other International Clowns from nearly every country on this planet I have been privileged to meet, are increasingly rare, but they are out there. We all need to take a lesson from them. Al-Basha dressed as a clown to entertain children trapped in the besieged city, and put his life on the line every day, sure that releasing laughter and good-will could, and would, overcome hatred and political competition, to bring peace. He was a brother and colleague, and now his genius and altruistic presence has been silenced. A missile struck in the Mashhad neighborhood of the city's rebel-held east ending his mission to make a difference every day, with real people. His brother, Mahmoud Al-Basha, a director at Space for Hope, a local non-profit providing civil services to people living in the war-torn opposition area said, "He just wanted to bring them happiness and smiles, in spite of the airstrikes and destruction they're being exposed to." 

The Vets who went with us to Guatemala now know that feeling, too, and saw those faces, returning home to make a difference, not only in their lives, but the lives of people they come into contact with. (A documentary is being made of that trip as we speak.) However, unlike Anas al Basha, who refused to leave Aleppo, we were able to leave Guatemala and return home. To be sure, all "wanted to stay to continue this work, to help the children and orphans," as well as adult citizens living under stress, worried about those children, in a country where they can't escape their situation. 100,000 children are living under siege in eastern Aleppo alone.

Unfortunately, this type of suffering is happening in many countries on this planet, Syria is just under the spotlight right now. I first saw it when deployed as an Army Pediatrician to Saudi Arabia during the Gulf War in 1993. The children there were not out playing in playgrounds, playgrounds populated with replicas of military fighting planes and missiles to play on, if they did venture out. Then I went to Bosnia, in 2000, and saw homes with roofs torn off, homeless refugees walking the streets as our convoys cruised past. What is happening in Aleppo is not a 'new event,' but ongoing, sadly enough. It seems the world is accepting of it as an unavoidable consequence of life. We are better than this. We can, and must, do what we can, in our 'circle of influence' to make a difference, every day.

The ten Vets who dared to put on a nose in Guatemala now have an ongoing opportunity to turn their suffering into personal development and growth on a daily basis, giving back to others, released from the visions and trauma that trapped them previous to clowning with Patch Adams and the G!  Carl Hammerschlag, the Arizona Psychiatrist and friend of Patch who conducts street clowning therapy sessions, accompanied us on this historic trip. He said, "We’ll see what the long-term impact of this experience will be on these Vets, but the trip reminded me that the greatest act of revolution in contemporary life is to be able to come to every day with joy. Let your clown out Relatives, because it will make you feel good and lighten your load." (He came home and put a lifelong dream of his own into action, holding the world's first Clown Town Healing Fest in February 2015, where clowns create a healing community in Phoenix, AZ. This transformation is possible, because a person immersed in clowning learns, in a matter of a few minutes, they can, and will, give out compassion, receive care and emotional and practical support themselves from loved ones and their community. They discover one can approach another in distress without fearing, or avoiding, the contact, as they have lived outside their former comfort zone and found the circle has been widened exponentially. They have accepted their tragedy, and that of others, knowing the history may be irreversible, but their response to it is not.  They come home “in charge” of how they move forward, regroup, and gain control over their recovery and growth, and ready to take the risk to go out into the streets to spread joy.

Kasley Killam, of Harvard University and the UnLoneliness Project, said, “No one is exempt from suffering, yet we can thrive and flourish despite it—and, in some cases, because of it.” Happily, trauma can, and will, drive positive change… and clowning can be a natural catalyst for that change with as little as a week of team clowning, the Gesundheit! way. Scott and the Children's Mental Health Network published my short article "Leaders as Clowns." I strongly advise the military, of all countries, to incorporate clowns and Patch's "nasal diplomacy" as perhaps more effective tools to fight wars as well as treat the post-traumatic stress it generates. I highly advise everyone reading this to dare to put on a nose, if only in honor of this wonderful Syrian clown who gave his life to make a difference. You will be changed...forever. Send in the clowns!

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georgeGeorge Patrin spent over 23 years as an Army Pediatrician and Healthcare Administrator concentrating on Family Advocacy and Healthcare Process Improvement. A graduate of the U of MN Medical School and Army-Baylor Masters in Healthcare Administration, his assignments span from Medical Director of the European Regional Medical Command Exceptional Family Member Program and TRICARE-Europe to Branch Chief of Healthcare Business Operations for the Joint Task Force Capital Medical Region and Special Projects Officer for Patient-Family Centered Healthcare in Army Medical Home Clinics, assisting in writing DoD Patient Centered Medical Home (PCMH) Guidelines and Training. COL Patrin developed an innovative pre-deployment risk analysis Soldier Readiness Program addressing both soldier and family member readiness while deploying to Bosnia. Directing community volunteers, he developed a DoD video program series for children undergoing deployment separation and reintegration stress called “Mr. Poe and Friends Discuss Family Reunion After Deployment” and “Military Youth Coping with Separation: When Family Members Deploy” along with LTC Keith Lemmon. He commanded the California Medical Detachment and Presidio of Monterey Army Health Clinic, aggressively revamping healthcare services in support of the Defense Language Institute and Naval Postgraduate School while garnering support for a new DoD-VA Clinic on Old Fort Ord. He is a sought after speaker on parenting education, child abuse prevention, school learning and behavior problems, and healthcare administration optimization. He can be contacted at

The Answer to Failing Schools Rests in Early Childhood: A Response to Trump's DeVos Appointment

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Morning Zen Guest Blog Post ~ Jessica Bergeron ~

The popular movie "Waiting for Superman" details the lives of several families anxiously waiting on their acceptance to charter schools lotteries as an answer to their failing public school option. The plight of these mostly black and brown families ignites a strong feeling of unjustness throughout the movie on several levels with the primary one being, "How could a child actually make it out of a public school that bad?". No amount of pulling oneself up by the bootstraps could get a child out of a school district with such low graduation rates. The movie gives a strong impression that charter schools are the only answer to this epidemic, and President-elect Trump appears to agree with his recent appointment of Betsy DeVos, a charter school and school voucher advocate.

The movie gives a startling statistic mid-way through, however, that one in five charter schools perform the same or worse than public schools. Trump and DeVos, a billionaire and heir to Amway and an investment management group, with their extensive business backgrounds curiously fail to discuss this poor ROI in advocating for privatization of schools. Unless you examine it a bit more deeply and realize that, in this investment equation, the children and families themselves are not the investors (they are not monetary beneficiaries of these failing schools or charter programs) or the consumers (which implies families have a choice between low quality and better quality). The misleading title of "school choice" legislation is a misnomer for low-income neighborhoods with few quality options for school choice, either public or private.

One begins to wonder, with DeVos and Trump's clear understanding of how businesses are successful, why such a low rate of success would be satisfactory if they truly believe these charters and vouchers are the answer to failing schools . . . unless you frame the conversation exclusively from a business perspective. Privatized charter schools with a low-rate of return suck valuable funding from public schools but turn a quick profit for private companies before closing within three years (due to failing scores). Charter schools require low investment capital because they are staffed by inexperienced teachers (read: cheap) who have hopes and dreams of changing the world but are rapidly faced with the realities of teaching a population of children that require more skills and education to be successful, not less. Worse yet, the hopes and dreams are peddled to affluent young teachers as a line item for their resumes, no more than a way-station on their route to a more "serious" career.

From a business standpoint, charter schools and school vouchers are a profitable market. Morally, however, selling out low-income schools to the highest bidder is repugnant and incompatible with what makes America great, which is opportunity. Without quality public schools, many of our most vulnerable students will never be given the opportunity to rise above their circumstances to have the same chances as those in higher socio-economic income brackets. Even middle class families will have to cough up funding for transportation to private or out-of-district schools or move far away from their jobs and families to support a quality public education. The irony is that the picture perfect vision of the 1950s and 1960s painted by President-elect Trump requires public school education in order to be complete. His very vision marketed to many Americans is in jeopardy.

Rather than capitalizing on draining the rich coffers of our K-12 public education system, President-elect Trump would do well to shift the focus to match the changing demographic of Americans, particularly working Americans with families who are paying an exorbitant amount of money for early childhood education (from birth through ages five). Quality early childhood programs are in high demand yet hard to come by for an affordable price. And, as we learn more about the brain science of the first five years of life, we are learning how crucial these early years are to lifelong success. A child's brain grows rapidly in the first three to five years of life and vocabulary at age three is predictive of future literacy success. And it is not just preparing children for reading and math. Early childhood educators teach and model valuable lessons to children in the crucial early years around nutrition, health and physical fitness, social-emotional growth, communication that contributes to literacy (language), and early academics to a captive audience.

But more importantly, quality early childhood education can improve the epidemic of failing schools with a front-end investment. Better still, early childhood education research shows that quality education can mediate the negative effects of poverty. Early childhood education teachers can serve as a intermediary to families in need or in crisis by providing a stable, supportive environment. They are afforded the space to love and care for children, growing their brains in a positive way, without the stressors of assessments and testing that cripple K-12 teachers and prevent them from meeting all of the demands of vulnerable children growing up in poverty. Financial investment and improvements to the early childhood education system will create an immediate ROI for the families, eventually the K-12 system, and ultimately our country. Rather than fostering a system of catch-up once children arrive at school, where many children arrive lagging three or four years behind, teachers can simply continue a student's education on a strong trajectory towards educational success.

A radical approach to education is needed if the US ever hopes to move from the "middle of the pack" in the STEM fields to competing at an international level. President-elect Trump has proven himself to be up for radical change, and the DeVos appointment is no exception. But Trump's idealized vision of America must include a modern day approach to education that ultimately improves the system in the long term for future generations. An investment in early childhood education will ensure that Trump's education legacy is morally and financially sound.

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jessicaJessica Bergeron is Director of the Katherine Hamm Center at the Atlanta Speech School. The Katherine Hamm Center at the Atlanta Speech School serves children who are deaf and hard of hearing (DHH) and helps them realize their full potential in language and literacy through listening and talking. Dr. Bergeron received her Ph.D. in Special Education with an emphasis in Deaf Education from Georgia State University. Her research interests include emergent literacy with children who are deaf and hard of hearing (DHH), particularly related to the family’s role and strategies that contribute to successful outcomes in language and literacy development. While she was working on her doctorate, she worked as a research teacher for Georgia State University for four years. That collaborative project resulted in the development of the only early literacy curriculum designed for children who are DHH called Foundations for Literacy. 

Your Voice Needed for the Childhood Experiences Study for Adults

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Morning Zen Guest Blog Post ~ Dr. George Patrin ~

Researchers at Teachers College, Columbia University are seeking adults from diverse backgrounds, to participate in a study aimed at understanding both whether and when people experienced difficult or adverse events in the first 18 years of their life, as well as their mental health in adulthood.

It is important that we ask these questions...and then truly LISTEN to the responses. What won't be learned with this study is what factors helped an individual live with and then overcome negative thinking with dysfunctional behaviors to achieve (or not achieve) the level of success they have today. As a 'retired' pediatrician working child abuse and advocacy for 30 years, and now in my 'third career' (called "retirement") I believe the key is the presence of a 'team' of caring individuals, who all too often don't know each other, who take an interest in the child and put in energy, not because they have to, but because they can, and want to, to help that child achieve stability and personal happiness. It's called "Serendipity," part of the fabric of "The Universal Spirit." What we need to do, together, is stop letting it happen by 'chance,' and make it happen due to proactive vigilance as a society, certainly a hopeful outcome in conducting this survey. "History repeats itself, opportunity doesn't." On behalf of myself, a child and adult survivor, and others, thanks for asking.

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george patrinCOL (Ret) George Patrin, M.D., spent over 23 years as an Army Pediatrician and Healthcare Administrator concentrating on Family Advocacy and Healthcare Process Improvement. His final assignment was as Northern Regional Command Special Projects Officer for Patient-Family Centered Healthcare assisting in writing DoD Patient Centered Medical Home (PCMH) Guidelines and Training. He has been a staunch advocate for both soldier and family member readiness throughout is military career. He is a sought after speaker on parenting education, child abuse prevention, school learning and behavior problems, and healthcare administration optimization. Dr. Patrin is a member of the Children's Mental Health Network Advisory Council. He can be contacted at

Without Advocacy We Cannot Change a Damn Thing

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Morning Zen Guest Blog Post ~ Lisa Lambert ~

Without advocacy we cannot change a thing. Heaven knows there’s a lot that needs fixing, changing and bettering in our world today. Sometimes the changes are small and just need a little push. But many times, a small push won’t cut it. Big changes require big advocacy and advocacy requires boldness and bravery.

When I first started advocating for my son, I believed that the school and mental health systems were built to provide services for kids like him and that those services would be delivered quickly and match his needs. I paid – still do – a hefty sum each month for insurance (surely that would open doors?) and I knew I could make my case. I figured I could rely on the goodwill of the people who were concerned about him.  I absolutely knew in my heart that these were the necessary ingredients for success.

I know you’ll be just as surprised as I was to find out that’s not how it works.

I lived in Southern California when my kids were young. When my son was seven he was in a regular second grade classroom. He had already missed the second half of first grade because of phobias, depression and suicidal behavior. He had had one pretty lengthy inpatient stay. The school suggested that the school psychologist, Maryellen, evaluate him.

When Maryellen and I met, I felt nervous but sure that we would see eye to eye. She ran through the test results and agreed with his diagnoses. She added that he was very, very smart – his IQ was in the near genius range. She looked me in the eye and said, “High IQs tend to run in families. His father must be very smart.” I felt sucker punched and barely heard her say that she felt his high IQ more than compensated for his mental health challenges and therefore he didn’t need any help. Later I realized I had experienced disrespect as a tactic to change the meeting outcome. On that day an advocate was born.

Moments like these change things. You realize the world doesn’t work the way you thought, people don’t act the way you imagined and instead of a straight path from point A to point B, it’s more like a hiking trail over rocky stretches, across streams, in rain, sleet and snow. It can scare even the most intrepid hiker, but here you are taking the first step. You learn not just to advocate, but to become an advocate.

It’s unlikely that you’ll get what your child and family need in the mental health world without advocacy. People don’t rush to suggest services and insurance companies don’t agree matter-of-factly that you should get that treatment you identified. You find out you have to make it happen. You may become an advocate eagerly or reluctantly, by immersing yourself in knowledge or fighting every step of the way, but you change yourself. You change your expectations, you change your definition of success and most of all, you change who you are. As one mother said to me, “You become the parent your child needs, not the one you thought you’d be.”

Advocacy can be uncomfortable. For those of us who didn’t raise our hands for the teacher to call on (because then everyone would look at you) or make waves or dig in their heels as a matter of course, it doesn’t feel natural at first. Advocacy is something done publicly. It is played out in a setting that is very different from many other things we do. You do it in front of an audience, sometimes big, sometimes small. While some nod their heads along with the points you make, others assume a “show me” stance. When you get them to nod their heads too, even a little, you feel pretty fine.

You learn that advocacy does not have to be adversarial. It is sometimes, but many times it’s not. Lots of times it’s about being articulate, passionate, persistent and even patient. It’s also about being prepared and being stubborn. It’s about looking for options and sometimes creating them.

Without advocacy, people assume we are okay with the status quo. Without advocacy they don’t hear us or overlook our perspective. Without advocacy, we cannot make a difference for our family and for other families.

For many families, figuring out how to go about advocating is like playing a Jeopardy game. You know the answer you want and you try to figure out the right questions to get there. Advocacy is a skill, or set of skills, just like playing Jeopardy. If you hone those skills, you might get the jackpot instead of the smaller prizes. But even if you are a terrific player, there are still heartbreaking consequences if you make a misstep. You have to trust in your skills when you cannot trust in anything else. Unlike Jeopardy, there are days when you do everything right and you simply don’t win.

Advocacy is also about picking yourself up and going to the next meeting, the next discussion and bringing your A game one more time.

When I first began talking to other parents about my son and how we worked to get the services and treatment he needed, some would say, “I didn’t know you could say that” and a light bulb would go on. Others would share their own stories. Some would ask me to help. When I did, I learned that if you help one family, you only help one family. The barriers remain and the rocky stretches, treacherous streams and bad weather are there for the next person.

Individual advocacy for my family and other families was important, even crucial. But nothing changed for the families coming along after us – they were likely to hit the same snags and experience the same hazards. Systems advocacy – working to change policies, laws or practice – changes things for many more families. The first time I sat at a policy table, I realized that here was the place to bring all those family stories, the skills I had learned and the hard won expertise. Here too, you sometimes fight to have your perspective heard but when it is, it doesn’t echo anyone else in the room. It’s why you are there.

My son watched me advocate over the years first for him, later for families like our own. One day, he said, “I want to listen and watch. I think I can advocate, too.” Great, I told him. And he has. It’s a big undertaking to become a self advocate, with emotional fist pumping moments and moments of deep disappointment. He understands that, too. One day, when we were talking I told him, “Advocacy is our family business, you know. Some families have stores or restaurants or trades where the children learn a lot about the business from an early age. Just like you’ve learned about advocacy.” He grinned and nodded. “I’m okay with that,” he said.

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lisaLisa Lambert is the executive director of Parent/Professional Advocacy League (PPAL), a statewide, family-run, grassroots nonprofit organization based in Boston. Lisa became involved in children’s mental health as an advocate for her young son in 1989 through the CASSP family network in California. After moving back to Massachusetts, she began supporting families whose children and youth had behavioral health needs.  She became involved with PPAL, first on a regional level and then on a statewide level. Her areas of expertise include mental health policy, systems advocacy and family-driven research. Realizing that individual parent and youth stories need to be supported by data, Lisa authored several family-driven studies which highlighted the challenges families encountered when accessing services, their perspectives on psychotropic medications and the training needs of family partners. Lisa also authored a chronicle of PPAL’s Worcester-based youth group which highlighted how a strong youth-guided initiative had an impact on their community. Lisa has been instrumental in working with local and national media to highlight the concerns of families and youth. She is dedicated to ensuring that family voice is included in every state and national conversation about the policies, practices or services that impact them. 

Outrage Fatigue? Yeah, We’ve Got That

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Morning Zen Guest Blog Post ~ Lisa Lambert ~

Do you have outrage fatigue?  Yeah?  I think I do, too.  I’ve noticed that it feels a lot like the disbelief and exhaustion that comes with parenting a child with mental health problems.

Each day my inbox, Facebook and Twitter feeds, social media and most of all, the 24/7 news are filled with stories that are designed to outrage.  Much of the time they truly do. We have a presidential election going on that seems more like a reality show with way more than the usual sniping going on.  We hear the over the top comments, new twists on old scandals and on top of the television pundits, our friends and family are happy to post their opinions too.

Nearly every week I see (and you probably do, too) the video feed of a new shooting and many times (though not always) the police are involved.  In some cases it’s clear that racial bias plays a part in how events unfold and in other cases it’s less clear.  There are other times where the shooter may have significant mental health problems and has not received the treatment he needed.  Sometimes people with disabilities are the ones being shot. A few weeks ago, a deaf man was shot by police in North Carolina and earlier this week a woman threatening to kill herself was shot here in Massachusetts.  We are horrified and outraged and barely have time to hear the details before the next story grabs our attention.

We are not imagining it.  One study found that  “outrage discourse” was found in 100% of cable TV episodes, 98.8% of talk radio programs, and 82.8% of blog posts. On average, examples occurred once during every 90 to 100 seconds of political programming on TV and even more often on radio. Syndicated newspaper columnists used outrage discourse much less frequently than other media analyzed, but more frequently compared to columns from 1955 and 1975.

Only a few years ago, we talked about compassion fatigue.  The mood was different.  We saw abused animals in television ads.  We heard about the victims of diseases such as Ebola.  We saw the devastation caused by natural disasters and heard how it made people homeless and hungry and we were asked to take action and give.  Lots of us did.  For parents, the stories of children losing their homes and their families were particularly tough. Those heartrending stories came into our homes and social media often and while we felt sad, many of us also felt overwhelmed.

Then something shifted.  I can’t quite put my finger on when that happened but today we are told to be outraged (and much of the time we probably should be), not saddened.  We hear about the latest event, share the pictures, the stories and the comments.  We even add our own to the mix.  But the outrages come fast and furious and we barely have time to exclaim, post that emoji and comment before the next outrage appears.

Any parent of a child with mental health needs can tell you what is going to happen next.  We are going to get exhausted and overwhelmed.  We are on a constant cycle of reacting, figuring things out, moving on and starting over again. Voila!  Outrage fatigue.

When you parent a child who has multiple meltdowns and whose moods and behaviors are like a roller coaster, you shift your idea of what to react to.  You accommodate the slightly awful and save your energy for the truly terrible.  When you bang your already aching head against the wall of failed approaches, balky systems and waits that defy imagination, you learn to ignore the slightly shocking and save your determination for the jaw-dropping, I-can’t-believe-this-is happening events.

Social media, live streaming and 24/7 news lets us stay connected in ways that were not possible before now.  The good news is they can also be empowering, informing and entertaining.  But when what you hear is the same awful news or outrageous remark over and over, it loses its punch and ability to galvanize you into action.   We can’t maintain a state of intense moral outrage indefinitely.  What’s worse is that our barometer, or outrage-meter, begins to malfunction and it doesn’t register the only-somewhat-awful.  Just like ignoring that risky, over-the-top or unsafe behavior you’ve adjusted to managing at home.

Outrage should be a good thing and spur us into action.  Stories about climate change, the election, police shootings and terrorist attacks are intended to inform us but also motivate us to take action.  Sure we can give or donate, but the message encourages us to make a difference and act.  It might be to vote, sign a petition, join a protest or volunteer.  Outrage springs from a sense of basic decency and moral rightness and we know when that has been violated.  Like many uncomfortable emotions, it’s actually healthy.  We are engaged, fired up and we want to make a difference.

Children’s mental health advocacy relies on outrage.  There are children and teens waiting in emergency departments for elusive hospital beds.  One of the children who was waiting only a week or so ago was five.  We should all be outraged at that.  Waits for outpatient care can be weeks or even months and at the first appointment parents discover the clinicians are frequently new to the work.  Parenting a child with mental health needs is more like quilting, piecing together services paid for by insurers, schools, state agencies and often, out of pocket.  We have a system to try the patience of a saint, as if the child you are trying to help didn’t already stretch that patience thin.

But when we hear of 5, 10 or more outrageous things a day, it’s hard for the less outrageous to get traction.  People think they’ve already heard about stuck kids, waiting kids, struggling kids.  The quiet outrage families feel gets lost and doesn’t burn bright in others, the ones we hope will be the champions we need.

Outrage fatigue hurts us in several ways.  We begin to think outrageous events are epidemic.  They are everywhere and spreading rapidly.  We learn to look for the new ones and pay less attention to the ones we already know.  We can feel overwhelmed and tired and want to find a quiet space rather than jump in the fray to change things.  Different events and tragedies compete with one another and we try to prioritize them even though we are comparing apples, asparagus and armadillos.

While I admit to a self diagnosis of outrage fatigue, I am not saying that we should abandon telling each other about kids waiting for services or the harm stigma can do or the immense burden that families still haul around as they identify, coordinate and  (finally) access care for their children.  We need those stories.  We should feel appalled and want to change things.  That’s good because this is something we can fix in big and small ways.  Unlike a lot of other things in my inbox.

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lisaLisa Lambert is the executive director of Parent/Professional Advocacy League (PPAL) and a Children's Mental Health Network Advisory Council member. Lisa Lambert became involved in children’s mental health as an advocate for her young son in 1989 through the CASSP family network in California. After moving back to Massachusetts, she began supporting families whose children and youth had behavioral health needs. Her areas of expertise include mental health policy, systems advocacy and family-driven research. 

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