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Federal Communications Commission and Media Must Combat Black Mental Health Crisis

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Screenshot of Rep. Bonnie Watson Coleman from the webcast

July 13, 2020 — Recent data from a survey launched by the federal government, originally intended to trace the effects of the coronavirus, has revealed that anxiety and depression rates among Black Americans have spiked disproportionately in the weeks following the widely-circulated video of George Floyd’s death.

The proportion of Black Americans battling anxiety and depression has risen from 36 percent to 41 percent, an increase amounting to roughly 1.4 million individuals.

Demonstrations and civic unrest, as well as the ongoing pandemic’s disproportionate toll on minority communities, have exacerbated existing disparities in mental health, as rates of anxiety and depression have remained relatively stable among white Americans.

In a virtual event on Monday, entitled “Thriving While Black: The Role of Media and Communications Technology in Addressing Black Mental Health,” panelists called attention to the growing Black mental health crisis in America.

Federal Communications Commissioner Geoffrey Starks opened the event, speaking of the trauma shared by members of the Black American community and describing common “emotions of fear, frustration, and most of all, hope.”

Rep. Bonnie Watson Coleman, D-N.J., chair of the Congressional Black Caucus Emergency Task Force on Black Youth Suicide and Mental Health, noted that the task at hand is a challenging one because “mental health in general has had a stigma in our communities.”

This stigma is one that the panelists are working diligently to overcome.

As the FCC is set to vote on finalizing a three-digit National Suicide Hotline on Thursday, it is clear that there is a distinct for the agency to play in conversations regarding universal access and content creation, panelists said.

Communities that lack access to electronic devices and broadband connections lack the resources necessary for critical mental telehealth services.

Panelists noted that minority groups are disproportionately vulnerable to both mental health conditions and internet inequality.

The telecommunications sector is uniquely situated to not only connect Black Americans to vital health resources, but also to educate the masses about Black experiences.

Screenshot of Nicol Turner-Lee, director of the Center of Technology Innovation at the Brookings Institution

Constant exposure to images of Black individuals being harassed and murdered can cause great trauma for Black Americans, said Nicol Turner-Lee, senior fellow in governance studies and director of the Center of Technology Innovation at the Brookings Institution.

Media lacks images of Black men and women simply existing, she said.

As individuals look to media to make sense of the world around them, Noopur Agarwal, vice president of social impact at ViacomCBS, argued that media and entertainment companies have crucial roles in providing diverse representations and working to destigmatize mental health in Black communities.

She detailed the effects of one scene from a popular VH1 series, which follows the journey of a predominantly Black cast.

In the episode, a cast member opens up to his loved ones about his battle with depression and suicidal thoughts. His friends and family rally around him, offering their support. The character goes on to seek professional help.

This kind of representation has positive effects, Agarwal said.

“It helped normalize the experience of depression and it showed viewers dealing with mental health that they are not alone,” she explained.

The night the episode aired, it inspired 20,000 people to immediately seek help, she said.

“Social media posts related to the story generated 5 million video views and 200,000 engagements outpouring support,” said Agarwal, adding that this is just one example of the powerful impact entertainment media can have in formulating ideology.

David Johns, executive director of the National Black Justice Coalition, attributed increasing depression and suicide rates among Black LGBTQ+ youth to a lack of representation, stating that “young people rely upon seeing reflections of themselves through media.”

“What we know about Black LGBTQ+ youth in particular is that 70 percent have reported having depression in the last 12 months, 35 percent have considered suicide, and 19 percent reported having attempted suicide in the past year,” he said.

Screenshot of David Johns, executive director of the National Black Justice Coalition

A further explanation for these statistics is that mental health care providers aren’t trained to respond to intersectional trauma, Johns added.

Yet another contributing factor is the criminalization of Black youth, said Michael Lindsey, executive director of the NYU McSilver Institute for Poverty Policy and Research.

“Often Black children are suspended from school because of behavior that is addressable through mental health treatment,” he said.

Lindsey referenced the “push-out phenomena,” or how young Black girls are disproportionately expelled from schools due to their behavior being perceived as more aggressive and defiant than similar actions from their white counterparts, resulting from ingrained racist prejudices.

Lindsey found that in lieu of being treated for mental health concerns, Black children are often disproportionately suspended, which only exacerbates existing conditions.

The number of mental health providers in schools should be proportionate to the number of students, he suggested.

“It is often the case that in communities of color [that] there is not an available mental health professional,” he said.

In conclusion, Turner-Lee called for panelists to utilize social media in order to “have conversations with people that would not typically come to these tables.”

Starks pledged to continue fighting to expand the FCC’s Lifeline Program, which works to subsidize phones for low income individuals, and could potentially help many Black Americans access mental health resources.

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States Lagging on Bills to Implement 988 Suicide Hotline Mandate as Deadline Approaches

As of June 7, 20 states have passed legislation to implement the 988 suicide hotline mandate, according to FCC data.

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Screenshot from the FCBA event on June 8

WASHINGTON, June 15, 2022 – Only 20 out of the 35 states that have introduced legislation for a new suicide hotline have made the legislation law as of June 7, according to information from the Federal Communications Commission, as the July 16 implementation deadline nears.

States are required to implement the infrastructure and the funding for a 988 number that will go to the National Suicide Hotline, but only four states have passed bills to finance it, Emily Caditz, attorney advisor of the Wireline Competition Bureau under the FCC, said at a Federal Communication Bar Association event last week. Those states – Colorado, Nevada, Virginia, and Washington – fund the implementation from fees on cellphone lines.

James Wright, chief of crisis center operations at the federal Substance Abuse and Mental Health Services Administration, suggested that “key partnerships between state and local governments” will be necessary to help states meet this deadline.

Laura Evans, director of national and state policy at Vibrant Emotional Health, said this funding will “make sure we have robust capacity for the anticipated 9-12 million contacts we expect to come in that first year.”

The commission ordered the adoption of the nationwide line nearly two years ago, on July 16, 2020.

According to the National Suicide Hotline Designation Act of 2020, “988 is designated as the universal telephone number within the United States for the purpose of the national suicide prevention and mental health crisis hotline system operated through the National Suicide Prevention Lifeline.”

“America’s suicide rate is at its highest since World War II,” said former FCC Chairman Ajit Pai at an FCC event in December of 2019. “A simple three-digit code for a suicide hotline can reduce the mental stigma surrounding mental health and ultimately save lives.

Caditz said the implementation of text messaging “is especially popular with groups that are at heightened risk of suicide or mental health crises, including teenagers and young adults and individuals who are deaf, hard of hearing, deafblind, or speech disabled.”

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Health

Digital Literacy Training Needed for Optimal Telehealth Outcomes, Healthcare Reps Say

Digital literacy should be a priority to unlock telehealth’s potential, a telehealth event heard.

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Photo of telehealth consultation from Healthcare IT News

WASHINGTON, May 18, 2022 – Digital literacy training should be a priority for providers and consumers to improve telehealth outcomes, experts said at a conference Tuesday.

Digital literacy training will unlock telehealth’s potential to improve health outcomes, according to the event’s experts, including improving treatment for chronic diseases, improving patient-doctor relationships, and providing easier medical access for those without access to transportation.

Julia Skapik of the National Association of Community Health Centers said at the National Telehealth Conference on Tuesday that both patients and clinicians need to be trained on how to use tools that allow both parties to communicate remotely.

Skapik said her association has plans to implement training for providers to utilize tech opportunities, such as patient portals to best engage patients.

Ann Mond Johnson from the American Telemedicine Association agreed that telehealth will improve health outcomes by giving proper training to utilize the technology to offer the services.

The Federal Communications Commission announced its telehealth program in April 2021, which set aside $200 million for health institutions to provide remote care for patients.

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Expert Opinion

Craig Settles and Sean Gonsalves: Telehealth For All is a ‘Stroke of Genius’

Without access to a secure broadband connection, the co-author of this Expert Opinion would have died.

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Craig Settles (left) and Sean Gonsalves are the authors of this Expert Opinion.

My colleague Craig Settles likes to say he had a “stroke of genius” when writing his last book about building the gigabit city. “I literally had an ischemic stroke at 10:30 p.m. on a Saturday night,” he recalls. “If I had been in a low-income urban community with poor communication infrastructure, or in a rural area with bad broadband, I’d probably be dead.”

The “genius” part was realizing broadband is magic that directly or indirectly enables us to perform minor and major miracles that we could not do before, but faster and easier.

When Craig moved to Alameda, California, situated less than five miles from the heart of Silicon Valley, he could not get cell service without a signal booster, and even then it was sketchy. Several years later the service was better, which allowed him to speed-dial his best friend who called 9-1-1.

The neurologist who set up the stroke center in Alameda Hospital had mirrored much of its technology and servers in her home so she could see everything the ER staff was seeing as they administered life-saving procedures within 25 minutes of Craig’s gurney hitting the ER door.

While Craig counts his blessings, over 14 million urban households do not have broadband in their home – 75 percent of whom are African American and other people of color. Millions more technically have home Internet service but don’t have the connection speeds and capacity to use the applications needed for remote work and school, or telehealth.

And don’t forget the 4 million rural homes that do not have broadband subscriptions.

Broadband as Social Determinant of Health

The essential nature of broadband came to the fore with the onset of the pandemic. And it compelled states and local communities across the nation to take the connectivity crisis far more seriously, especially with the influx of federal funds from the American Rescue Plan Act and the Infrastructure Investment and Jobs Act.

Although advocates commonly, and understandably, tout the importance of broadband access in the context of remote work and schooling, what often gets overlooked are the transformative powers of telehealth and its potential to drive broadband adoption.

It’s no exaggeration to say that broadband is a major social determinant of individual health as it enables access to virtual healthcare and facilitates a host of other things critical to health, such as education, employment, housing, and social services, all of which require broadband, most especially for telehealth applications.

More than video chats with your doctor, telehealth uses high-speed Internet connectivity to observe, diagnose, initiate or otherwise medically intervene, administer, monitor, record, and/or report on the continuum of care. Public health, in particular, can leverage telehealth to a great advantage.

Yes, healthcare providers are increasingly integrating telehealth into the delivery of care. But, if the patients most in need of better access to healthcare do not have access to broadband, as well as computing devices and digital skills, tremendous healthcare benefits and cost-savings will be needlessly missed.

This suggests that “fiscally conservative” elected officials, many of whom claim to support universal access to broadband while lamenting the high cost of healthcare, have been thinking about this whole thing backwards. Instead of wailing about the cost of building universal robust broadband infrastructure that could be used for telehealth, why not flip the script?

Achieving universal broadband infrastructure that would last a lifetime would cost on the order of $100 billion, which is just two and a half percent of what we spend on healthcare in this country every single year. Hundreds of academic and industry studies say that even the most conservative telehealth initiatives save more than two and a half percent of system costs.

Talk about a return-on-investment! A hint of this can be seen in a study done by the National Center for Biotechnology Information which found there were as many as 3.5 million potential preventable adult inpatient hospital stays in 2017 alone. That amounted to $33.7 billion in health care costs just for that year.

Telehealth can eliminate many of those stays. And in terms of improving health outcomes, the study further found that the elderly, men, Black communities, and those insured with Medicaid would reap the biggest benefits.

So why not exploit the math, and pay for broadband using healthcare savings? Let’s connect every home, hospital, and community anchor institution in the country to robust broadband, and transform healthcare while bringing it into the 21st century. The municipal broadband model in which local communities build and own the infrastructure is ideal.

Telehealth Can Drive Broadband Adoption

Looking at it this way, universal access to telehealth has the potential to simultaneously solve the connectivity crisis and ensure that millions of families can lead healthier lives.

Here are six tactical ways of using telehealth to maximize public health in a community along with increasing broadband adoption.

  1. Re-inventing the doctor’s office visit for a variety of healthcare practices

Understanding telehealth, all you need are four walls, an Internet connection, a computer, a healthcare partner, and a healthy imagination to create a range of practical telehealth solutions.

Transform barbershops and hair salons into Covid vaccination and hypertension screening centers. The school nurse’s office can now become school telehealth centers. Libraries are starting to add telehealth kiosks.

Libraries Without Borders uses interactive Web health content, laptops, and wireless gear to outfit intercity laundromats on Saturdays. Tucson used ARPA funds to build out a wireless network on top of the city’s fiber infrastructure and gave 5,000 low-income homes the ability to have telehealth resources.

  1.  Telehealth can marry chronic healthcare, home care, and public health

Frederick Memorial now distributes hundreds of tablet computers for remote patient monitoring  in patients homes to check their vital signs, changing medical conditions and treatments, with data that goes to the hospital daily.

Urban hospitals should partner with ISPs to leverage the FCC’s Affordable Connectivity Program subsidy of up to $30 per month for Internet service and up to $75/month for households on Tribal lands. ACP also offers a $100 discount on computing devices.

  1. Enhance the emergency response and Emergency Department to save more lives and money.

African Americans and other populations of color have the highest rates of strokes, heart attacks, and other medical trauma. We could reverse the trend of hospitals that abandon poor urban communities and replace them with city telestroke or telehealth critical care “broadband subnetworks” that are hosted by major hospitals and linked to Federally Qualified Health Center, clinics, and other facilities.

  1. Expand efficiency of mental healthcare delivery

Mental health professionals getting to see patients in their homes and therefore providing an alternative to needing to go to a therapist’s office can not only eliminate no-show appointments but can provide those most in need of therapy with broader access to a variety of specialists.

Leveraging telehealth can be especially empowering for underserved communities in which approximately 30% of African American adults with mental illness receive treatment each year, compared to the U.S. average of 43%, according to the National Alliance on Mental Illness.

But as Carly McCord, Director of Clinical Services at the Texas A&M Telehealth Counseling Clinic, rightly points out: “Often we’re talking about intensive therapy, like treating PTSD, which you can’t do with crappy Internet connections. When your patient’s disclosing a trauma and your connection glitches, or you miss a word and have to say, ‘I’m sorry. Can you repeat that? ‘This is a huge problem.”

  1. Improving senior care and facilitating aging in place for our nearly 60 million seniors

Three-in-four older Americans want to stay in their homes and age in place, according to a AARP survey. And, if offered a choice, about 53 percent of respondents say they would prefer to have their health care needs managed by a mix of medical staff and healthcare technology.

A key broadband element in this telehealth equation is “smart home” technologies that include wirelessly-controlled sensors. Some sensors now can determine whether a person sat up in bed or actually fell on the floor, if patients are eating regularly, or if they are taking their medications on time.

  1. Re-imagining what hospital care can be

In areas prone to natural disasters, make prior arrangements with hotels, college dorms, warehouses, and other facilities where you can bring in generators, computers, telehealth equipment, and wireless intranets.

Use these buildings for seniors with health conditions who have been displaced: people with chronic illnesses and patients with non-serious injuries from the disaster should those people not have easy access to other residential or healthcare facilities.

Building and subsidizing access to robust community-owned broadband networks is a wise investment because it will improve health outcomes and return significant community savings for decades to come.

And with a flood of federal funds available to build broadband infrastructure and advance digital equity, we have a once-in-a-life opportunity to stitch this all together and deliver telehealth for all.

Sean Gonsalves is a Senior Reporter, Editor and Communication Team Lead for the Institute for Local Self Reliance’s Community Broadband Networks Initiative. Saved from a stroke by telehealth, Craig Settles pays it forward by uniting community broadband teams and healthcare stakeholders through telehealth-broadband integration initiatives. This piece is exclusive to Broadband Breakfast.

Broadband Breakfast accepts commentary from informed observers of the broadband scene. Please send pieces to commentary@breakfast.media. The views reflected in Expert Opinion pieces do not necessarily reflect the views of Broadband Breakfast and Breakfast Media LLC.

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