Changing the Conversation

The number of parents in recovery from mental illness, trauma, homelessness, and substance use is unclear because there is no standardized national data collection. This lack of data leads to a huge gap in service delivery to a sector of the population who is raising children.

This can be remedied by screening and assessing parents across our health care system to identify needs for specific education and support services--particularly in areas of mental illness, trauma, homelessness, and substance use. This would give families a good chance to receive critical support services to keep them intact and healthy. Children could escape the isolation and helplessness that comes with living with a parent who is ill, but without treatment. Interventions could occur before children are neglected or abused.

World AIDS Day--recognized every year on December 1 since 1988--is an occasion to reflect on the global impact of HIV and AIDS and health care inequities across world populations. On this day, HIV/AIDS organizations around the world affirm their commitment to eliminate stigma and expand testing and treatment to people living where rates of HIV and AIDS remain high.

The U.S. Global AIDS Coordinator--Ambassador Deborah Birx, M.D.--asserts, “We will only end the AIDS epidemic by 2030 if no one is left behind. It is unacceptable that key populations still face stigma, discrimination, and violence, which impede their ability to access quality HIV services.”

This year, the U.S. is working to control an epidemic in Scott County, Indiana that has a higher incidence of HIV than any country in sub-Saharan Africa. Austin--the county seat with a population of 4,200--has more cases of HIV than all of New York City. In this small, rural county, the forces of poverty, addiction, and politics drove an injection drug problem to cause the first-known HIV outbreak related to the current opioid crisis in America.

Have you ever watched an infant play? I mean really observed them? Try it some time, and while you watch, contemplate this...

At birth, we have 100 billion neurons, most of which are not connected. Infants form 700 new neural connections every second – tens of thousands of pathways that literally build the architecture of their brains. Through their senses and their relationships, they come to know the external world, and their brain begins to build the systems to understand it. The attention they receive (or don’t) from their primary caregivers, stimulation they receive from their environment, stress they experience and the responses to that stress by those around them reinforce or prune away at their neural connections and promote or hinder cognitive, physical, and social-emotional development.

Right before my eyes, I have seen the numbers of people asking for money increase in New Bedford, MA. Seven years ago, you might have seen two or three people a month. Now, there are four at a single intersection every day.

You may ask, how do I interact with these individuals? Do I give money, or will they just spend it on drugs and alcohol? Do I provide food? Do I put my head down and pretend I don’t see them at all? Are they even homeless? Am I being played? Depending on whom you ask, you will most likely get a different answer. The Center for Social Innovation and t3 have a wealth of knowledge about homelessness. So, I asked my colleagues, what do they do when someone asking for money approaches them? There were many different opinions, but five patterns arose.