Archive for the ‘Health’ category

Teen depression and suicide

May 14, 2019

In Hawaii, 11.97% of teens (ages 12-17) had a major depressive episode in the past year, according to the National Survey on Drug Use and Health, 2016-2017. Even more alarming, 16.0% of teens (ages 12-17) reported that they seriously considered attempting suicide in the past year, according to the Centers for Disease Control and Prevention’s Youth Risk Behavior Surveillance System (YRBSS) data, 2017.

Suicidal thoughts don’t have to be literal, but they’re always dangerous.

That’s one of the first things that I learned at a panel discussion about “Teenage Depression and Suicide” at the 2019 Hawai‘i Book and Music Festival.

Moderated by comedian Pashyn Santos, the discussion talked about how teens (and adults) can respond to sadness or depression. “Happiness is not defined by success or achievement,” Santos reminded us.

Psychiatrist Sonia Patel emphasized that “Suicidal thoughts really mean, ‘I want to feel better’ or ‘I need a break.’” We can help teens recognize their feelings by teaching them to be in the moment and slow down.

Clinical psychologist Sid Hermosura said that mindfulness can help us look at our thoughts, not just feel our thoughts. He emphasized the importance of social connection, relationships, and gratitude.

Associate professor Thao Le said that just as we eat healthy foods to feed our bodies, our thoughts are a form of “mental food.” For every negative thought we have, we need to bring up five positive thoughts to balance it!

Interfaith minster Rev. Bodhi Be challenged teens to identify their “core wound,” the hole that they are trying to fill. When we find out what we love, we can fill that hole and “forget about ourselves” by serving others.

Le shared a mindfulness practice that can help us feel compassion and strengthen our relationships with others. Think of a person (or yourself) and wish them well by saying, “May you be happy, peaceful, and free from suffering.”

What are your happiness tips? Who can you reach out to when you feel sad or depressed?

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A better work-life balance

May 7, 2019

Working for a growing nonprofit, I struggle with balancing the things I should do, but can’t do within a “normal” workday; and taking work home. Sometimes it means that my work-life balance is more work than home, and that’s okay – but only if it’s an occasional thing. It’s not okay if it becomes the new normal.

Taking work home is easier than ever because technology and social media are 24/7. It has an even greater impact on millennials, because this is the world they grew up in.

So I was really interested to attend a panel discussion about “Millennial Work/Life Balance” at the Hawai‘i Book and Music Festival last weekend.

Moderated by comedian Pashyn Santos, the discussion centered on how panelists “escape” from social media, their favorite “failure” story, and some of the initiatives that companies are doing to create a better work-life balance.

Psychiatrist Sonia Patel shared that she is no longer on social media at all. She stressed the importance of having structure outside of social media, like getting enough sleep and healthy meals. We have to learn to be advocates for ourselves and our time.

Clinical psychologist Jeff Stern suggested that we use social media as a reward after completing a task or achievement, rather than using it as an escape or avoidance. We need to learn to manage our time, or companies will try to manage it for us. He wondered if companies will start requiring employees to leave their phones at the door.

Stern mentioned an intriguing idea: some companies are offering a pre-cation, a vacation before the first day of work as a way to give employees breathing space before starting a new job.

Jade Snow of Jade Snow Media admitted that “I only realized my [social media] addiction when I experienced burnout and reminded us that we need to set healthy boundaries. She said that we need to appreciate being with people in the moment, and then be more intentional about the time we spend on social media. We should practice gratitude and surround ourselves with people who are like-minded.

Snow speculated that perhaps we are not looking for a work-life balance, but a work-life integration. The goal is to incorporate healthy practices into our daily lives.

KHON2 TV personality Mikey Moniz stated that we need to stop comparing ourselves with who we think we should be. “Have a strong group of friends,” he said. “You become who you surround yourself with.” Moniz added that when going out to eat, he and his friends are trying something new: they put their cell phones in the middle of the table, and the first person who touches their phone has to pay the bill.

Is social media a “reward” or an “escape” for you? Do you think about work at home and think about home at work?

Hope, help, and healing to prevent suicide

April 16, 2019

Anyone can be at risk for suicide. We all have sources of strength. And it’s strong to get help.

These messages of hope, help, and healing are what I took away from the Prevent Suicide Hawai‘i Statewide Conference last week, April 11-12, 2019.

Organized by the Prevent Suicide Hawai‘i Taskforce (PSHTF), the Conference was sponsored by organizations such as EMS and Injury Prevention System Branch of the Hawai‘i State Department of Health, the Department of Psychiatry under the John A. Burns School of Medicine, and the American Foundation for Suicide Prevention (AFSP) Hawai‘i Chapter.

I work for a local mental health nonprofit, and I was fortunate to be a resource table volunteer. During the Conference, I spoke with passionate advocates, educators, and service providers. I learned about the resources that are available for people in crisis. And I was inspired by West Oahu and neighbor island youth who are committed to prevent suicide in their schools and communities.

The Conference opened with a keynote by Dr. Christine Moutier, Chief Medical Officer of the American Foundation for Suicide Prevention. Dr. Moutier emphasized that the stigma of mental distress is going down and talk saves lives – for those at risk and for survivors of suicide loss. “Everyone struggles,” she stated. “It’s strong to get help.”

There were five breakout sessions and five different “tracks,” covering Hope (primary prevention), Help (intervention and treatment), Healing (postvention and survivor supports), Special Topics and Populations (Micronesian, Military, Filipino, and LGBTQ populations), and Culture (Hawaii and Pacific Islands).

For me, the most moving point came at the Fight For Each Other (F4EO) break-out session. Speakers for the F4EO Project share how suicide affects the lives of military members, their friends, family, and co-workers. Col. Robert Swanson shared his personal story of healing and recovery. “It always gets better – but only if you stick around,” he asserted.

The most impressive part of the Conference was the Youth Leadership Council. These motivated youth shared some of the results of their training, including identifying sources of strengths – such as family support, positive friends, and healthy activities. Youth facilitator Deborah Goebert, DrPH summed it up when she said, “Go out and inspire each other.”

The Conference closed with an address by Lieutenant Governor Dr. Josh Green, who shared his personal story as a survivor of suicide loss. “It took us years to realize we shouldn’t blame ourselves for missing the signs,” he revealed. Dr. Green concluded with words of encouragement: “We have an incredible capacity to help each other.”

Suicide Prevention Resources:

  • ANYONE in crisis can call the 24-hour National the National Suicide Prevention Lifeline at 800-273-TALK (8255).
  • Veterans, call 800-273-TALK (8255) and press “1” to reach the Veterans Crisis Line or text to 838255.
  • Teens in Hawaii can text ALOHA to 741741or call 832-3100 for 24-hour crisis support.

Healthy in Hawaii

April 2, 2019

How healthy are we in Hawaii?

“Health is a state of complete physical, mental, and social well-being and not merely the absence of disease or infirmity,” according to the World Health Organization.

America’s Health Rankings follows this definition of health when it presents its annual report, evaluating 35 markers of health that cover behaviors, community and environment, policy, clinical care and outcomes data.

Their 2018 America’s Health Rankings Annual Report helps counties understand what influences how healthy residents are and how long they will live. Hawaii ranked #1 for overall health in 2018. This is the 9th time that Hawaii has been ranked #1 since the health rankings were first published in 1990.

Hawaii’s strengths. Our strengths include a low prevalence of obesity and a low prevalence of frequent mental distress.

“Low prevalence” is a relative term – 23.8% of adults are obese (compared to 31.3% nationally) and 9.5% of adults report frequent mental distress (compared to 12.4% nationally). For a state with temperate weather and a wealth of outdoor activities, 23.5% of adults are physically inactive.

Hawaii’s challenges. Our challenges include high prevalence of excessive drinking, which increased 7% from 19.7% to 21.1% of adults (compared to 19.0% nationally); and high prevalence of diabetes, which increased 40% from 7.8% to 10.9% of adults (compared with 10.5% nationally).

These “strengths” and “challenges” are to some extent within our control.

Obesity and diabetes are influenced by genetics and medical history, but can be managed by addressing contributing factors such as diet and physical activity. Mental distress and anxiety are a part of life, but prolonged and serious episodes are treatable and preventable through early intervention and access to care.

Excessive drinking is another matter. “Unlike other health behaviors, higher educational attainment is associated with a greater prevalence of this negative health behavior on average,” the report concludes.

Overall, the good news is that in the past five years, the percentage of uninsured people in Hawaii decreased 53% from 7.8% to 3.7% of the population (compared to 8.7% nationally). And on a related note, we have a relatively low prevalence of health disparity or access to health care based on education – 13.3% of adults (compared to 29.9% nationally).

The most alarming news is that the number of children living in poverty has increased 14.0% from 10.1% to 11.5% in 2017 (compared to 18.4% nationally). Children in poverty have little control over their lives, but they may suffer from chronic stress, unreliable access to food and healthcare, and lack of stable housing.

How healthy are you – physically, mentally, and socially? What changes can you make in your life today to become healthier – and help make Hawaii a little healthier?

Climate change, home, and mental health

March 12, 2019

I’ve been thinking about home recently. The land I grew up on is still there, but the home is gone, replaced by a house that overwhelms the land. Though I didn’t live there anymore, it still makes me feel a sense of loss whenever I’m in the neighborhood.

And how much stronger would that sense of loss be if the land were gone?

The 2018 “Sea Level Rise and Climate Change” Final White Paper, prepared by the University of Hawai‘i Sea Grant College Program, is an alarming summary of the effects of climate change on Hawaii’s environment, communities, and overall well-being.

There are environmental impacts, like more frequent heat waves, worsening air and water quality, rising sea levels, changes in rainfall patterns, changing ecosystems, and more frequent weather effects.

There are corresponding health impacts, like increased respiratory illness, heatstroke, and cardiovascular and kidney disease. And climate change impacts us as neighborhoods and communities, like our ability to travel within and without the islands and our access to food and freshwater.

Beyond the environment and our physical survival, climate change affects our mental health.

How can we thrive with the threat of displacement, the threat of losing our homes and our connection to the ‘aina? How can we address mental health concerns in our disaster planning and community resilience efforts?

In 2018, 700 homes on Hawaii Island were destroyed during the Kilauea eruption, and over 2,000 people had registered to receive aid from the Federal Emergency Management Agency (FEMA), according to Pacific Business News (7/9/18).

Also in 2018, more than 100 people lost their lives, and over 17,000 homes were destroyed by California wildfires, according to the California Department of Forestry and Fire Protection, reported The Weather Channel (3/11/19).

As small Pacific island nations become inhabitable due to sea level rise, lack of fresh water, or other factors, an increasing number of climate change migrants may come to Hawaii because it is similar to the home they left behind. How can we help them thrive in Hawaii? What can we learn from their experiences with the loss of place and loss of their connection to the past?

I’m feeling a little nostalgic about my childhood home. What are your thoughts about maintaining or regaining mental well-being in the face of losing a home?

How connected do you feel to your home? Do you live in a flood or tsunami zone? Are you prepared for a sudden disaster or a slow rise in sea level?

Practicing gratitude at the airport

November 6, 2018

When I was young, family and friends walked us to the airport gate and waved goodbye. When we returned, they met us at the gate with flower lei and hugs.

Today, to pass airport security, we carefully measure liquid toiletries, stand in line like cattle, open our bags for inspection, and take off our shoes. We walk through full-body scanners and are subject to random searches.

All of this doesn’t make me feel safer or welcome. It made me feel like a criminal before I even reach the airport gate – anxious, stressed, and powerless.

But after participating in an online course, “The Science of Happiness,” for a few weeks, I realized that I didn’t have to feel that way. While I don’t have the power to change the Transportation Security Administration (TSA) procedures, I can change how I react to them.

I have the power to change my attitude.

I can acknowledge that there is a positive outcome for me personally by going through airport security. I can appreciate that TSA representatives are trying to act in my best interests.

So the next time I had to go to the airport, I tried to put myself in a grateful mindset.

Grateful that TSA is working hard to keep us safe in airports.

Grateful that TSA is professional, competent, and courteous.

Grateful that we pass through security with rules and rights.

Grateful that we have clean, air-conditioned check-points.

Grateful that all of my belongings are returned to me intact.

Grateful that we have the privilege to fly by airplane.

On my last trip, I thought about the things I was grateful for. I felt calmer as I approached the security check-point. I was able to breathe easier and felt less anxious.

By changing my mindset to one of gratitude, I had a more relaxed and pleasant airport experience.

How often do you travel by airplane? How would you describe your experiences with airport security? What can you do to improve those experiences?

Health insurance hunter: secondary claims

May 15, 2018

I work for a small nonprofit organization in Hawaii, and it was eye-opening to enter the mysterious world of health insurance coding and billing. I gained a new appreciation for my doctor (aka primary care physician), my son’s pediatrician, my dentist, and my optometrist.

Earlier this year, I shared some stories about the sometimes confusing and frustrating health insurance claims process. But it doesn’t end there.

Some people have multiple health insurance policies. These secondary claims are tricky. The secondary plans often, but not always, pay the copayment or coinsurance (aka the “patient’s responsibility”). The secondary plans sometimes, but not always, pay for services that the primary plan does not cover.

Healthcare providers have to verify which insurance is primary. We have to verify which claims are forwarded (“crossover”) automatically, and which must be submitted manually. Sometimes we have to identify that there is a secondary plan, to avoid duplicate billing.

Some days I have to be a health insurance hunter, and other days I have to be a secondary claims health insurance hunter. Here are a few stories…

Why is there a payment and denial? The best insurance plans are the ones that automatically forward claims to the secondary plan – and let you know it upfront. We submitted a claim to Payer A1, and received a payment. Then we submitted a secondary claim to PayerA2, and received a payment – as well as a denial notice. Why? Because we sent a duplicate claim. That’s when we found out that Payer A1 automatically forwards claims to Payer A2.

The two copayments. We submitted a claim to Payer B1, and received a payment, along with a notice that the client had a copayment. The client paid the copayment. Then we received a payment from Payer B2. We didn’t know that the client had a secondary plan and we didn’t know that Payer B1 automatically forwarded claims to Payer B2. We refunded the client, with our apologies.

Why did they pay? We submitted a secondary claim to Payer C2, and received more than we expected. We immediately called Payer C2 to let them know about the overpayment, and set the check aside. Three months later, we received a letter saying that an “audit” uncovered the overpayment. Payer C2 demanded repayment – even though we never deposited the check – and threatened to deduct the amount from future payments, without apologizing for their mistake.

Why didn’t they pay? We submitted a claim to Payer D1, and received a payment, along with a notice that the client had a copayment. We submitted a secondary claim to Payer D2 for the copayment, but received a denial letter. Their explanation: the amount Payer D1 paid was more than the amount Payer D2 would have paid as the primary plan (even though Payer D2 is not the primary plan).

Are you satisfied with your health insurance plan(s)? Are your health care premiums affordable? What about your copayments or coinsurance?

 

Artwork courtesy of All-Free-Download.com.