#new york medical behavioral health services

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[nicklloydnow]

“One need not be a Marxist to acknowledge the logic behind Karl Marx’s observation: “The ideas of the ruling class are in every epoch the ruling ideas.” It is especially important for the ruling class that the general public’s ideas about our emotional suffering and behavioral disturbances be the ideas of the ruling class.

Twenty years ago, one would have been labeled as “anti-psychiatry” for acknowledging that: (1) psychiatry’s treatment outcomes are “abysmal” and “not getting any better”; (2) the serotonin imbalance theory of depression is untrue; and (3) psychiatry’s diagnostic manual, the DSM, is scientifically invalid. Yet today, these acknowledgements—which don’t threaten the ruling class—are stated by the psychiatry establishment and reported by the mainstream media.

There are, however, critiques that continue to be too taboo for the mainstream media to report. Such critiques are existential threats to establishment psychiatry, and these critiques are financial threats to both Big Pharma and a mainstream media dependent on Big Pharma advertising dollars. Even more importantly, these critiques are political threats to the ruling class which prefers medical “individual defect” explanations for emotional suffering and behavioral disturbances rather than explanations that challenge the societal status quo.

(…)

In 2011, Thomas Insel, director of the National Institute of Mental Health (NIMH) from 2002-2015, acknowledged: “Whatever we’ve been doing for five de­cades, it ain’t working. When I look at the numbers—the number of suicides, the number of disabilities, the mortality data—it’s abysmal, and it’s not getting any better.” In 2017, Insel told Wired: “I spent 13 years at NIMH really pushing on the neuroscience and genetics of mental disorders, and when I look back on that I realize that while I think I succeeded at getting lots of really cool papers published by cool scientists at fairly large costs—I think $20 billion—I don’t think we moved the needle in reducing suicide, reducing hospitalizations, improving recovery for the tens of millions of people who have mental illness.” In 2021, New York Times reporter Benedict Carey, after covering psychiatry for twenty years, concluded that psychiatry had done “little to improve the lives of the millions of people living with persistent mental distress. Almost every measure of our collective mental health—rates of suicide, anxiety, depression, addiction deaths, psychiatric prescription use—went the wrong direc­tion, even as access to services expanded greatly.” While twenty years ago, it would have been radical to state that psychiatry is making no progress, today it is not taboo to report that our collective mental health has gone in “the wrong direction” despite increased treatment.

(…)

In 2022, CBS reported: “Depression is Not Caused by Low Levels of Serotonin, New Study Suggests.” Receiving widespread attention in the mainstream media was the July 2022 research review article “The Serotonin Theory of Depression: A Systematic Umbrella Review of the Evidence,” published in the journal Molecular Psychiatry. In it, Joanna Moncrieff, co-chairperson of the Critical Psychiatry Network, and her co-researchers examined hundreds of different types of studies that attempted to detect a relationship between depression and serotonin, and concluded that there is no evidence of a link between low levels of serotonin and depression, stating: “We suggest it is time to acknowledge that the serotonin theory of depression is not empirically substantiated.” Leading establishment psychiatrists, rather than disputing these finding, tried to convince the general public that Moncrieff’s findings were not newsworthy.

(…)

What remains taboo is criticism of psychiatry that calls into question its fundamental paradigm of care. Specifically, this means it is taboo to ask this question: Has viewing our emotional suffering and behavioral disturbances as medical disorders and illnesses been helpful or harmful? Thus, the mainstream media rarely reports the empirical research that challenges psychiatry’s essential paradigm—its so-called “medical model.”

In psychiatry’s medical model, mental illnesses and their symptoms are voted in by the American Psychiatric Association (APA), and then listed in the DSM, published by the APA. DSM mental illnesses such as attention deficit hyperactivity disorder (AHDH) and schizophrenia are—like gonorrhea and cancer—seen as pathological conditions. While psychiatry generally views mental illnesses as biological in nature—be it chemical imbalances (now a discarded theory) or other theories involving brain and genetic defects—its medical model, as in much of the rest of medicine, does not preclude the effect of psychological and social factors on biological functioning. (Just as oncologists embrace the idea that genetics predisposes a person to cancer but recognize that psychological and social variables can trigger it, so too does psychiatry’s medical model recognize that psychosocial variables can trigger DSM mental illnesses.)

In contrast to psychiatry’s medical model, other models of emotional suffering and behavioral disturbances don’t assume that a medical illness is causing emotional suffering or disturbing behaviors. Non-medical models conclude that there are many reasons that have nothing to do with medical illness as to why, for example, a child does not pay attention and is disruptive; and such non-medical models conclude there are many reasons that have nothing to do with brain defects as to why an individual may be hearing voices and having bizarre beliefs. Before examining the research that casts doubt on the neurobiological validity of psychiatry’s medical model, first the empirical research that examines whether or not the medical model creates more or less stigma.

(…)

Published in the journal Neuron in 2022, Raymond Dolan—considered one of the most influential neuroscientists in the world—co-authored “Functional Neuroimaging in Psychiatry and the Case for Failing Better,” concluding, “Despite three decades of intense neuroimaging research, we still lack a neurobiological account for any psychiatric condition.” Reflecting on the more than 16,000 neuroimaging articles published during the last 30 years, Dolan and his co-authors concluded: “It remains difficult to refute a critique that psychiatry’s most fundamental characteristic is its ignorance. . . . Casting a cold eye on the psychiatric neuroimaging literature invites a conclusion that despite 30 years of intense research and considerable technological advances, this enterprise has not delivered a neurobiological account (i.e., a mechanistic explanation) for any psychiatric disorder, nor has it provided a credible imaging-based biomarker of clinical utility.”

What about genetic correlates to “serious mental illnesses”? A 2020 study in Schizophrenia Bulletin reported that no genetic variants have been found to predict schizophrenia; as no significant difference was found in the genetic variance of people with a diagnosis of schizophrenia and people without such a diagnosis. Similarly, examining mood disorders, a 2021 investigation published in the Journal of Affective Disorders (that included 5,872 cases and 43,862 controls, and examined 22,028 genes), reported that the study “fails to identify genes influencing the probability of developing a mood disorder” and “no gene or gene set produced a statistically significant result.”

Thus, despite the fact that researchers have not found any neuro-chemical-biological-genetic evidence for any psychiatric condition, it remains taboo to challenge psychiatry’s medical model and brain disease ideas about emotional suffering and behavioral disturbances.

(…)

While it is not taboo to report psychiatry’s poor treatment outcomes, it is taboo to blame these poor outcomes on psychiatry. Former NIMH director Insel has repeatedly acknowledged psychiatry’s poor treatment outcomes, but he does not blame psychiatry for it in his 2022 book Healing. He states, “First, most people who would and should benefit from treatment are not receiving care.” However, more people are in treatment than ever, and as the New York Times reported in 2021, outcomes have gone in the “wrong direction.” Insel also tells us that “although individual treatments work, they are rarely combined to provide the kind of comprehensive care that most people need.” However, nobody, including Insel, argues that such “comprehensive care” has worsened, yet outcomes have worsened with more treatment. Why is it not taboo for the mainstream media to report treatment outcome failure, the jettisoning of the serotonin imbalance theory of depression, and the invalidity of psychiatry’s DSM diagnostic manual? The public is simply being prepared for new treatments, new theories, and new diagnostic manuals—none of which fundamentally threatens the ruling class and ruling institutions of society.

However, it remains taboo to challenge whether or not medicalizing our emotional suffering and behavioral disturbances is the best model of care. Such a challenge, as noted, is not only an existential threat to establishment psychiatry but a financial threat to Big Pharma and a mainstream media dependent on Big Pharma advertising dollars. Even more significantly, such a challenge is a political threat to the ruling class which prefers “individual defect” explanations for emotional suffering and behavioral disturbances—rather than explanations that take seriously the direct and indirect effect of an alienating and dehumanizing society. While researchers have not linked any psychiatric condition to neurobiological variables, there are many links between these conditions and socioeconomic variables. Results from a 2013 national survey, issued by the U.S. government’s Substance Abuse and Mental Health Services Administration (SAMHSA), provide extensive evidence that unemployment, poverty, and involvement in the criminal justice system are highly associated with depression and suicidality.

Moreover, in the late 1990s, the Adverse Childhood Experiences (ACE) study revealed a powerful relationship between childhood trauma (including physical and emotional abuse) with later adult emotional difficulties and behavioral disturbances. An alienating and dehumanizing society such as ours that creates extensive anxiety, powerlessness, resentment, and rage is a society that creates adults who, in their interactions with children, have little frustration tolerance; and this lack of frustration tolerance makes abuse and trauma of children more likely—resulting in the adverse childhood experiences that create later adult emotional difficulties and behavioral disturbances.

The ruling class could not care less whether psychiatric treatment consists of bloodletting, lobotomy, electroshock, SSRI antidepressants, or psychedelic microdosing. As long as the “ruling idea” of society is that our emotional difficulties and behavioral disturbances are caused by our medical defects, this keeps us diverted from just how much shit we have to eat in order to survive and how extraordinary our good luck need be for us to find joy. As Marx stated, “The ideas of the ruling class are in every epoch the ruling ideas,” and you would have to be an especially stupid member of the ruling class not to see the value of the “ruling idea” that emotional suffering and behavioral disturbances are the result of medical individual defects—and not the result of a society that is a good deal for the ruling class but is alienating and traumatizing for many of the rest of us.”

“Drug retailer CVS and health insurer Aetna announced a $69-billion merger. Walgreens made a $5.2-billion investment in primary care provider VillageMD and took a $330-million stake in home care provider CareCentrix, giving it control of both firms. Rite Aid wasn’t as aggressive, but still built up its national footprint to 5,000 stores before cutting back to about 2,100.

The companies talked about evolving into one-stop medical providers so that “patients discharged from the hospital … will be able to stop at a health hub location to access services such as medication evaluations, home monitoring and use of durable medical equipment, as needed” (according to the merger announcement by CVS and Aetna).

(…)

That wasn’t so long ago. The CVS/Aetna merger was in 2017. Walgreens took over VillageMD in 2021 and CareCentrix just last year.

Now, however, their dream of playing a central role in a restructured nationwide healthcare system seems to be fading.

The pharmacy chains have discovered that taking a larger role in the healthcare system than simply dispensing prescriptions and selling over-the-counter notions is more complicated and costlier than they expected.

“It has taken us longer than anticipated to realize the cost synergies across the combined assets,” John P. Driscoll, the head of Walgreens’ U.S. Healthcare division, told investment analysts at the company’s fourth-quarter earnings conference call on Oct. 12.

He said VillageMD would be focusing on “our highest opportunity markets” — evidently affluent urban areas — by shutting down in five markets and closing 60 VillageMD clinics over the coming year.

(…)

At CVS, executives paint the effort to remake the company into an integrated healthcare provider as very much a work in progress.

“If you think about what’s happening in America relative to healthcare,” Chief Executive Karen Sue Lynch told investment analysts at a Morgan Stanley healthcare conference in September, “it’s ... very hard for people to access care.”

She said the company’s goal is “to make sure that people have seamless connected experiences across the spectrum of healthcare. And I would argue that the businesses that we’re creating will enhance the value of consumer experience.”

The tendency of the American healthcare system to confound promises and expectations was underscored in 2021. That’s when billionaires Warren Buffett, Jeff Bezos and Jamie Dimon had to admit that their plan to solve the system’s problems, as if by sheer star power — well, to be fair, through “technology solutions” — had been obliterated.

The trio had announced their venture in 2018 to a blast of worldwide fanfare. If they couldn’t succeed, it was said, no one could. The idea was that there was some magic bullet for reducing healthcare costs that had evaded everyone for years, but that they could discover.

Less than three years later, they had been subjected to a ritual mortification. Their joint venture, christened Haven, shut down. For all their efforts, primary care had not become easier for millions of Americans to access, insurance benefits were as opaque and arcane as ever, and prescription drug pricing was still a public scandal.

The drug chains’ expansion strategies have exposed them to complexities in American healthcare — political controversies, Medicare regulations, issues of prescription drug pricing — that they had not faced in the their core businesses and have led to a string of unpleasant surprises.

Walgreens became embroiled in abortion politics in March, when it said it would not distribute or ship a drug used for medication abortions in at least 21 red states, including at least four where abortions were still legal.

The company made the announcement after a group of red state attorneys general threatened it with unspecified “consequences” for shipping the drug, mifepristone, the long-assumed legality of which had been challenged in federal court.

Walgreens’ national footprint made it vulnerable to the threat — and to a backlash from blue states such as California, where Gov. Gavin Newsom said he would stop the state from doing business with the company, or any other “that cowers to the extremists and puts women’s lives at risk.”

CVS ran into the buzzsaw of Medicare politics in August, when a New York state judge blocked the transfer of 250,000 Medicare patients to Aetna’s Medicare Advantage plan. The transfer was part of a contract worth $15 billion to Aetna over five years. Medicare Advantage plans provide more benefits to enrollees than traditional Medicare but have come under fire for costing the government too much for too scanty patient gains.

The company also disclosed a potential hit of $800 million to $1 billion in its 2024 operating income from a downgrade by government authorities in its Medicare quality rankings, known as “star ratings.”

The move of CVS into the pharmacy benefit manager business through its $24-billion acquisition of the Caremark PBM in 2007 also may not have worked out as it expected.

PBMs originated as middlemen to help health insurance plans process prescription claims, steer doctors and hospitals to the cheapest drug alternatives, and allow insurers to combine their customer bases for greater leverage in negotiations with drug manufacturers. Eventually they got blamed for driving up drug costs by extracting their own profits without producing sufficient discounts for their clients.

In August, Blue Shield of California rattled Caremark by cutting most of its ties with the PBM and turning over most of its responsibilities to four competitors, in a strategy aimed at cutting its prescription costs, which come to more than $600 billion annually, by as much as $500 million a year.

That was the second blow to Caremark in a year; in November managed care insurer Centene said it was turning pharmacy benefits for its 20 million enrollees over to Express Scripts starting next year, on a $35-billion contract.

The Blue Shield announcement drove the CVS stock price down by about 9%, a reaction that CEO Lynch called “overblown” at the Morgan Stanley conference. She also cast doubt on Blue Shield’s assertion that the PBM change would save it $500 million. “We’re not earning that kind of money on that account,” she said.

As for Rite Aid, that chain has problems all its own. The firm filed for bankruptcy protection on Oct. 16, citing a crushing debt load and excessive rent for underperforming stores. The company subsequently announced plans to close 154 stores, including 31 in California.

Rite Aid is also facing a federal lawsuit for allegedly filling unlawful prescriptions, mostly for opioids. It isn’t alone in being accused of complicity in the opioid crisis: In a 2022 legal settlement with state attorneys general, CVS agreed to pay as much as $4.9 billion over 10 years, Walgreens up to $5.52 billion over 15 years, and Walmart, which has become a major competitor in the pharmacy business, up to $2.74 billion within six years.

At this moment, it’s clear that pharmacy services remain overwhelmingly the drivers of revenue and profit for the drugstore chains. At CVS last year, pharmacy services and other retail sales provided $14 billion in operating profit on $275.8 billion in revenue, versus $6 billion in operating profit on $91.4 billion in revenue from healthcare benefits.

At Walgreens, retail pharmacy sales provided $3.7 billion in operating profit on $110.3 billion in revenue in the fiscal year ended Aug. 31, 2023, while U.S. healthcare generated a loss of $556 million on $6.6 billion in revenue.

One other factor stands between the drugstore chains and their ambitions to cast a wider net over American healthcare: The presence of well-heeled rivals with ideas of their own. Walmart, the nation’s largest retailer, offers customers low-priced prescriptions and telehealth services, and has been opening walk-in clinics around the country.

Then there’s Amazon, which may have felt burned by the failure of Haven, but acquired concierge care provider One Medical in February for $3.9 billion and offers its Amazon Prime members access to scores of generic medicines for a monthly fee.

(…)

They and their rivals in retailing and clinical services may well change the course of American healthcare in the future, but it should not be forgotten that they’re all fundamentally in it for the money. Their promises of cheaper, more efficient and more effective healthcare for the average American should be treated with the all-purpose medicine of a healthy skepticism.”

“Many pharmacy employees at some of the largest U.S. drugstore chains say they’re reaching a breaking point.

On top of verifying, filling and dispensing prescriptions, pharmacists and support staff are responsible for administering vaccines, fixing insurance issues, transferring prescriptions to other pharmacies and tending to dozens of patients in stores and over the phone, among other tasks. Those workers have said they are concerned that companies like Walgreens and CVS are placing unreasonable demands on them, without providing enough staffing or resources to safely execute tasks.

Frustrated by what they describe as increasing workloads, understaffing and cuts to their hours, pharmacy staff from Walgreens locations around the country and CVS stores in the Kansas City area have walked off the job in recent weeks — and some employees are planning to walk out again from Oct. 30 to Nov. 1.

(…)

The two companies were the biggest pharmacies in the U.S. based on prescription drug market share in 2022. Both CVS and Walgreens operate around 9,000 retail store locations across the U.S.

CVS has more than 30,000 pharmacists and 70,000 pharmacy technicians, while rival Walgreens has more than 86,000 health-care service providers, including pharmacists, pharmacy technicians and other health-related professionals.”

[dontmeantobepoliticalbut]

Since Russia launched its invasion of Ukraine in late February, speculation about Russian President Vladimir Putin's health has implied that he is battling an array of illnesses, including cancer and Parkinson's disease.

The most recent rumor, posted by the General SVR's Telegram channel, alleges after a difficult day of leadership earlier this week, Putin fell down five steps on a staircase and landed on his coccyx, or tailbone. The jarring fall caused the Russian leader to then "defecate involuntarily," according to the Telegram channel.

General SVR has repeatedly touted claims that Putin is sick, with many media outlets citing its Telegram channel as people worldwide look for proof that Putin's leadership is cracking. Previous General SVR Telegram posts have been widely reported in Europe and the United States, with organizations like the New York Post, United Kingdom's daily newspaper The Mirror and various other media organizations citing the channel's claims in articles.

WHAT CAUSED THE FALL?

General SVR is reportedly operated by a former Russian Foreign Intelligence Service official with inside access to Putin and his staff, although the channel's owner has not been named, according to a fact check report by Newsweek. Many of the claims made by the channel are not substantiated with proof, and fact-checking journalists such as those at Snopes and Newsweek have urged caution when using the channel as a source for truth.

Most recently, the channel started its post about Putin's failing health by saying the president had engaged with leadership about the state of Russia's economy. Although the alleged meeting can't be proven, it is true that the country's economy has suffered a devastating blow from Western sanctions imposed against Russian products, such as oil, in response to the Russia-Ukraine war.

General SVR also said as a result of the discussion and of Russia's difficulties on the battlefield, Putin was "upset" and alleged that nerves caused Putin to slip down the "safe" stairs even while wearing his non-slip shoes.

Rumors have previously circulated online that the Russian leader is battling pancreatic cancer and has received surgery for it. However, Telegram offers anonymity to its public channels, which makes it prone to misinformation from both pro- and anti-Kremlin channels.

In May, General SVR posted on Telegram that Putin had undergone surgery, possibly for his alleged cancer diagnosis. Putin and his leadership have repeatedly said that the president is not sick, but media outlets such as one article by the New York Post have started sharing photos of Putin with alleged IV marks on his hand as he gripped a Russian soldier's arm and clips of his foot shaking during meetings.

Newsweek previously reported that some medical experts have examined clips of the president and provided conflicting opinions on whether or not he suffers from Parkinson's disease or not.

Other insider information alleges in addition to Parkinson's disease, Putin suffers from prostate cancer, according to an article from The Mirror. According to the newspaper, General SVR has also claimed Putin suffers from a mental health illness called schizoaffective disorder, which can affect one's thoughts, mood and behavior.

According to the General SVR Telegram, Putin's anti-slip shoes didn't prevent his fall on Wednesday, and that his security officers rushed to his aid and called for medics on duty at Putin's residence.

"Putin suffers from [cancer] of the organs of the gastrointestinal tract, as a result of which he is already experiencing serious digestive problems, and as a result of the fall, ... the main blow fell on the coccyx, probably causing sharp pain, provoking involuntary defection," an English translation of the post said, which added that Putin suffered a bruised tailbone as a result of the fall.

Newsweek reached out to Putin's press office and the Embassy of the Russian Federation in the U.S. for comment.

[melissalwatkins]

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[mariacallous]

Exposure to poverty is deeply intertwined with the deterioration of emotional health. This linkage is often exacerbated by a lack of coordinated social support for individuals and families. To appreciate this connection and how efforts in some communities suggest ways to address it, consider three public health issues and their impact on mental health: homelessness, food insecurity, and hygiene poverty (i.e., a lack of resources to maintain personal hygiene).

Homelessness

There is a close connection between homelessness and mental health. Since the start of the COVID-19 pandemic, homelessness and associated behavioral health issues have increased. While there are widely differing estimates of the prevalence of mental disorders among individuals experiencing homelessness, a review of the research by the Substance Abuse and Mental Health Services Administration (SAMHSA) suggests that between 20% and 50% have serious mental illness. Research suggests, moreover, that the experience of being homeless often intensifies the condition of individuals with poor mental health, with factors such as increased stress aggravating previous mental illness through heightened anxiety, fear, substance use, etc.

Some believe that the best course of action for those experiencing homelessness and mental illness is to provide treatment and services first so that homeless individuals are stabilized and “housing ready,” and only then can live successfully in permanent housing. Under this approach, placement in housing would follow initial treatment. However, many jurisdictions now use a Housing First model. In this approach, an individual is placed into permanent supported housing as the first step, followed swiftly with treatment and social service supports to start addressing the individual’s physical and mental health, education, employment, and substance use issues. Studies suggest this is an improvement on “treatment first” approaches.

How communities are addressing the challenge

Philadelphia, Pennsylvania – Pathways to Housing: Pathways to Housing works with individuals experiencing homelessness to provide housing without treatment preconditions and, once participants are housed, goes on immediately to address underlying issues involving mental health, substance use, medical care, and education. After arranging housing, Pathways manages an integrated care clinic to ensure that “participants have access to a low-barrier, person-centered approach that emphasizes recovery, wellness, trauma-informed care, and the integration of physical and behavioral health care.”

Denver, Colorado – Colorado Coalition for the Homeless: The Colorado Coalition for the Homeless (CCH) operates twenty permanent supportive housing and affordable housing properties and administers housing vouchers nearly 1,300 households in the Denver area. Like Pathways, the Coalition takes steps to ensure that, once housed, residents immediately receive the physical and behavioral health services they need to be able to achieve stability. CCH provides integrated medical and behavioral health care, substance use treatment, dental, vision, and pharmacy services through an on-site Federally Qualified Health Center.

New York City, New York – Breaking Ground: Breaking Ground provides permanent supportive housing for individuals who have experienced chronic homelessness in New York City. Housing is co-located with wraparound services such as on-site medical care, psychiatric care, substance use referrals, and skills-building/employment programs. In addition to a focus on housing, Breaking Ground provides New Yorkers who remain unhoused with Street to Home services, which include 24/7 engagement and outdoor counseling and connections with available medical and social supports. Programs like this are likely to be particularly important in the context of New York City’s new plan to involuntarily hospitalize unhoused individuals with mental health conditions despite a chronic psychiatric bed shortage in city hospitals.

What else could be done to help?

Expand Housing First models to encompass more communities, including those in rural areas. As illustrated in the examples above, Housing First programs show that providing stable housing can improve the efficacy of psychiatric and substance abuse treatment as well as aid in connecting individuals to social services. A 2018 study on the effects of housing stability service use among homeless adults with mental illness found that participants who achieved housing stability had decreased use of inpatient psychiatric hospitals and emergency departments. Currently the severe shortage of affordable housing makes it very difficult in many jurisdictions to provide immediate housing for homeless individuals. Moreover, although the federal Department of Housing and Urban Development distributes emergency Section 8 housing vouchers to jurisdictions for unhoused individuals and people attempting to flee domestic violence, it is common for people to wait years for voucher assistance. Achieving the goal of stable housing for people with mental health conditions will therefore require ramped-up investment in housing as well as health and social service supports for residents.

Utilize mobile crisis intervention teams to address social and behavioral health needs of individuals experiencing homelessness that are at risk for a mental health crisis. Breakthroughs in mental health services are often the result of multi-agency partnerships. One such breakthrough has been the development of local crisis intervention teams, which use a co-response model between law enforcement, emergency medical services, and mental health providers. In a previous publication, we highlighted several successful programs using this model. Since the full launch of the 988 suicide and crisis lifeline in June of 2022, many jurisdictions are working to deploy crisis intervention teams for behavioral health emergencies in a way that is most beneficial to those in need, including those experiencing homelessness. Moreover, states can now receive an enhanced federal medical assistance percentage (FMAP) for mental health crisis systems.

Improve the coordination and continuation of services for people experiencing homelessness. Departments at all levels of government often fail people with housing and mental health problems because of administrative obstacles and budget silos. Fortunately, there have been some steps to tackle these challenges. California, Arkansas and other states, for instance, have received federal Medicaid 1115 Waivers that allow them to better coordinate housing, health care, and other services for vulnerable populations. In February 2023, Congresswoman Madeleine Dean reintroduced legislation through The Homelessness and Behavioral Health Care Coordination Act to the House of Representatives, which would authorize a Housing and Urban Development (HUD) grant to enable state/local/tribal entities to coordinate care for individuals simultaneously experiencing homelessness, behavioral health, and substance use disorders.

Food Insecurity

The U.S. Department of Agriculture (USDA) estimates that in 2021 over 34 million people—including 9 million children—were living in households that did not have enough to eat. Many of these families do not qualify for federal nutrition programs such as Supplemental Nutrition Assistance (SNAP) or the National School Lunch Program (NSLP) and are dependent on food banks or community donations.  A national study found that food insecurity was associated with a 257% higher risk of anxiety and a 253% higher risk of depression among low-income families. Mothers and children appear to be at an especially high risk of mental health distress associated with food insecurity. For instance, food insecurity can exacerbate postpartum depression, and food insecurity has been found to be associated with increased behavioral and emotional dysregulation during infancy and adolescence. Food insecurity has also been associated with maternal depression and increased developmental risk in children such as decreased psychosocial function, elevated aggression, anxiety, depression, hyperactivity, and difficulties interacting with peers. In another study conducted to analyze the relationship between food insecurity and poor mental health, researchers discovered that food insecurity correlates to depression, anxiety, shame, and acute psychological stress.

What is being done in some communities?

Maryland – Frustrated by the lack of food access and overburdened charity models, the Black Church Food Security Network (BCFSN) created a self-sustaining food system at Pleasant Hope Baptist Church in Baltimore, MD. Using the community garden at the church, the organization created a pipeline for fresh food from the garden directly to community members experiencing food insecurity. The organization has grown into a partnership of Black churches across the country to provide health-related, environmental, and economic benefits to those most vulnerable.

Connecticut – Recognizing that the quality of a diet can serve as either a risk factor or protective factor to mental health, Mental Health Connecticut (MHC) partnered with the Healing Meals Community Project to deliver nutritious meals to food-insecure individuals experiencing mental illness. A 2020 small-scale pilot study conducted by the University of Hartford examined the partnership. It found the program to be effective and Healthy Meals to be “a highly workable intervention approach,” and recommended expanded community collaboration to promote nutrition education and improve food access.

California – Food Equity Round Table: Los Angeles County’s Food Equity Roundtable is comprised of a coalition of county officials and Los Angeles-area philanthropic organizations dedicated to addressing food insecurity. The goal of the Round Table is to promote cross-sector collaboration to improve access to and affordability of healthy foods, support supply chain/food system resilience, and enhance county-wide nutrition education.

What else could be done to help?

Strengthen government safety net programs to better respond to food insecurity. During the COVID-19 public health emergency, Congress extended flexibility and increased benefit levels of federal nutrition programs such as SNAP. To continue these programs and make them permanent, several bills have been introduced in Congress in the last few years, including the Closing the Meal Gap Act of 2021. Such measures would prevent millions of people from falling into food insecurity and the associated mental and physical health implications by permanently raising the baseline benefits for SNAP households, particularly for families with large medical or housing expenses. Another approach, included in the Improving Access to Nutrition Act of 2021, would eliminate time limits on SNAP eligibility. Currently, the time limit restricts many working-age adults to only three months of benefits in a three-year period unless they document sufficient hours of work. But, of course, for those with mental and behavioral health conditions, staying in the workforce can be difficult.

Improve cross-sector coordination to allow for increased support for food insecurity across the public and private sectors as well as nonprofits and philanthropic organizations. In September 2022, the Biden administration released a National Strategy on hunger, nutrition, and health. This included steps to permit Medicaid to include nutrition education and supports and other proposed actions to address hunger, reduce diet-related diseases (including mental illnesses), and nutritional disparities.

Hygiene Poverty

Inequitable access to personal care and hygiene products is an overlooked public health crisis. In the United States, data is limited on the mental health implications of what is widely described as “hygiene poverty.” Most research focuses on what is known as “period poverty,” with a 2021 study finding an association between women struggling to afford menstrual products and depression. In fact, the study found that two-thirds of the 16.9 million low-income women in the U.S. could not afford menstrual products. Meanwhile, in homeless and low-income households, chronic absenteeism in schools has been attributed in part to the mental health impacts of poor hygiene (often involving increased anxiety, bullying, and isolation). More research is certainly needed to fully establish the relationship between hygiene poverty and behavioral health in women, but for young women in low-income households, this added stress in their daily lives is a significant factor in their behavioral health.

As an example of state efforts to help support such students, the Oregon legislature allocated $700,000 to support youth-led projects designed to help tackle factors that affect mental health. One of the funded projects was for “caring closets,” within schools; these are locations with supplies of hygiene products, underwear, and other basic supplies for children from low-income families.

Unlike the public programs available to help families obtain healthcare, food, and housing, there are generally no public supports for families in need of hygiene products. The most commonly used public  benefit programs (Medicaid, SNAP, and the Special Supplemental Nutrition Program for Women, Infants, and Children (WIC)) do not cover essential hygiene items such as laundry detergent, toilet paper, diapers, feminine hygiene products, toothpaste, shampoo, and deodorant.

What is being done in some communities?

Washington State – Essentials First seeks to fill in a critical gap that food banks, homeless shelters, schools, and refugee resettlement agencies across the state generally do not have the capacity to fill for critical hygiene items.  Recognizing that household and personal care items were among the top tier of items Washingtonians had difficulty paying for during the COVID-19 pandemic, the organization focuses on the procuring large quantities of hygiene supplies that are distributed through existing social service networks across the state.

Massachusetts – Hope & Comfort addresses youth hygiene insecurity by providing supplies to youth-serving community organizations such as schools, Boys & Girls clubs, YMCAs, and food pantries in the greater Boston area. In a published pilot study from year one of the organization’s operations, 46% of surveyed youth said they had less stress, and another 19% said they had more confidence when given consistent and easy access to hygiene products.

What else could be done to help?

While local organizations are working to address hygiene poverty in their communities, they have limited capacity. Thus, it is important for policymakers at the state and federal level to recognize that hygiene poverty remains largely overlooked in health and social service programs and to take steps to include those needs in appropriate federal and state programs. Steps that could be taken include:

Increase flexibility for EBT cards. In late 2021 and early 2022, some states, such as Illinois, passed new laws permitting public benefits to be used to purchase diapers and menstrual hygiene products. This step does not require new programs or a new program infrastructure but is limited in that it does not provide dedicated funds specifically for hygiene products. A more complete solution would be to provide new funds under the existing program to cover essential hygiene needs.

Enable certain federal grant recipients to purchase hygiene products. Federal grant recipients providing services and supports, such as schools and homeless shelters, receive funds for a variety of uses. However, these funds typically come with tight requirements that often do not allow for the coverage of essential hygiene items, even where such coverage might further the objectives of the program. That usually forces organizations to purchase and distribute products using resources from private contributions, state and local grants, or in-kind donations.

There have been efforts in Congress to address these limitations on federal grants. In 2021, for instance, the Menstrual Equity for All Act was introduced in the House. If enacted, this would allow states to have the option to use federal grant dollars to provide students with free menstrual products in schools (currently only 15 states and DC have enacted requirements making it possible for students to access free state-funded menstrual hygiene products in schools). The legislation would, among other things, also fund pilot programs in colleges/universities for free menstrual hygiene products, allow homeless assistance providers to use grant funds that cover shelter necessities (e.g., bedding and toilet paper) to also use that money to purchase menstrual products, and require Medicaid to cover the cost of menstrual products.

Our understanding of behavioral and mental health conditions is gradually improving. This has led to advances in the development of treatment and support for populations experiencing these conditions, as well as the identification of circumstances that cause or exacerbate them. For instance, we have seen progress in dealing with the impact of warfare on many servicemen and servicewomen. There is also a greater understanding that law enforcement officers are not usually the best responders to someone experiencing a mental health crisis. Similarly, there is now greater attention being given to the effects of neighborhood violence and other sources of stress on school-aged children.

With these advances in mind, it is important for the health of individuals and communities that we continue to examine relationships between social conditions, the policies that shape them, and the impacts on behavioral health. The connection—in many cases the two-way connection—between behavioral health and homelessness, food insecurity, hygiene poverty, and other conditions needs to be studied and policies realigned to fit our increasing understanding of these relationships.

[freedomhypnosisnyc]

A Guide to Understanding and Healing: Hypnotherapy in New York City

Hypnotherapy is a form of alternative medicine that uses hypnosis to create a state of deep relaxation in a person's mind, allowing access to the subconscious. This state can be used to address a variety of issues, such as anxiety, addiction, phobias, and depression. Hypnotherapy has become increasingly popular in recent years, and if you're looking for a hypnotherapist in New York City, you're in luck.

New York City is a bustling metropolis that offers a wide variety of resources for anyone looking to improve their mental health. Hypnotherapy is no exception, and there are plenty of qualified practitioners who can help you achieve your goals.

In this blog, we will explore the world of hypnotherapy, from its history and origins to its modern applications and benefits. We will also discuss the process of hypnotherapy, the different types of hypnosis, and what to expect in a typical session.

The History of Hypnotherapy

Hypnotherapy has been used for centuries as a healing tool, with its roots in ancient cultures such as the Greeks and Egyptians. However, it wasn't until the 18th century that hypnosis as we know it today was developed, with the work of Franz Mesmer, a German physician who believed that the power of suggestion could cure illnesses.

Mesmerism, as it was called, was popularized in the 19th century by James Braid, a Scottish physician who coined the term "hypnosis" and wrote extensively on the subject. From there, hypnotherapy continued to evolve and gain acceptance in the medical community as a valid form of therapy.

The Benefits of Hypnotherapy

Hypnotherapy can be used to address a wide range of issues, from anxiety and depression to phobias and addictions. By accessing the subconscious mind, hypnotherapy can help people gain insight into their thoughts and behaviors, overcome negative patterns, and create positive change in their lives.

Research has shown that hypnotherapy can be effective in treating a variety of conditions, including:

Anxiety and stress

Depression

Insomnia

Pain management

Addiction

Phobias and fears

Weight loss

Smoking cessation

Performance enhancement

The Process of Hypnotherapy

The process of hypnotherapy typically involves an initial consultation where the therapist assesses the individual's needs and determines the goals of the therapy. The individual is then guided into a relaxed state through the use of guided imagery and suggestion. The therapist may use various techniques to address specific issues such as anxiety, phobias, or addiction. Hypnotherapy sessions typically last between 60 to 90 minutes and may require several sessions to achieve the desired results. Throughout the process, the individual remains in control and aware of their surroundings.

Overall, Hypnotherapy NYC is a powerful tool that can help you achieve your goals and improve your mental health. It's important to do your research and find a hypnotherapist who is qualified, experienced, and has a track record of success. You should also make sure that you feel comfortable with your therapist and that they understand your unique needs and goals.

For those looking for a more holistic approach to hypnotherapy NYC, the Freedom Hypnosis is the perfect fit. Freedom Hypnosis provides live online sessions to help with a variety of issues, including smoking cessation, stress and anxiety relief, weight loss, confidence and self-esteem, overcoming fears, breaking bad habits, focus, motivation, and test preparation, sleep problems and pain relief, public speaking and shyness, memory enhancement, and improving sports performance. Other popular services include grief counseling, undesired behaviors, procrastination, business development, obsessions, and many more. We give a cutting-edge platform where we emphasize the inner self, achieving self-confidence, and having the freedom to be your best self.

Conclusion

Hypnotherapy New York City is a vital tool that may assist you in overcoming a wide range of mental health concerns. Anybody interested in exploring this sort of treatment will discover a multitude of resources in New York City, and with a little investigation, you may locate a hypnotherapist who can help you reach your objectives and enhance your quality of life.

Freedom Hypnosis 34–18 Northern Blvd Long Island City, NY 11101 (917) 300–1809 https://freedomhypnosisnyc.com/

[tallmantall]

#JamesDonaldsononMentalHealth - The NFL’s Latest Approaches To #MentalHealth

By JENNY VRENTAS Photo by Pixabay on Pexels.com One of the first questions asked was a simple but important one: Where do you put the office of your team’s mental health clinician? In a conference room with about 100 medical professionals and NFL team employees, one club shared its answer: On the first floor of team headquarters, near the locker room and the cafeteria, where the players spend much of their time. It’s the only office in the building without windows, for privacy. Another attendee raised his hand and asked about tips for how to connect players with the help they need, while also maintaining their privacy? A different NFL team’s director of player engagement explained that once he shares the cell phone number of the team clinician with a player, he doesn’t ask for or receive any further information, unless the player signs a release form. He also tells players he has a list of several other names, including clinicians of multiple genders and races, so they can talk to whomever they are most comfortable with. JamesDonaldson notes:  Welcome to the “next chapter” of my life… being a voice and an advocate for #mentalhealthawarenessandsuicideprevention, especially pertaining to our younger generation of students and student-athletes. Getting men to speak up and reach out for help and assistance is one of my passions. Us men need to not suffer in silence or drown our sorrows in alcohol, hang out at bars and strip joints, or get involved with drug use. Having gone through a recent bout of #depression and #suicidalthoughts myself, I realize now, that I can make a huge difference in the lives of so many by sharing my story, and by sharing various resources I come across as I work in this space.  #http://bit.ly/JamesMentalHealthArticle www.celebratingyourgiftoflife.com One morning last week, Nyaka NiiLampti—a licensed psychologist hired in December as the NFL’s vice president of wellness clinical services, after three years working for the players union—was leading this discussion about how to address the mental health needs of the NFL’s 2,000 players. The agenda for this day-long Player Health Summit, hosted by the NFL and the NFL Players Association in New York, included hot topics like a 25-minute “CBD Update” and a session on concussion treatments. But the primary focus was implementing the new measures to address behavioral health and pain management that the league and the players agreed to in May. The summit gathered head team physicians, head athletic trainers and directors of player engagement. Also present were the behavioral health team clinicians and pain management specialists that new joint agreements between the league and the players require each team to retain before the start of the 2019 season. As of last week, Allen Sills, the NFL’s chief medical officer, said “virtually everyone” had filled both positions. In the context of the ongoing labor negotiations toward a new collective bargaining agreement this summer, the fact that new provisions to protect player health were added to the current CBA in May reflects the two sides’ ability to work together. In introductory remarks at last week’s summit, Sills introduced his counterpart at the players union, Thom Mayer, as “a real partner.” In turn, Mayer pointed to the meeting as a sign of progress over the last few years. “The idea that we would have had this meeting previously,” Mayer told the room, “is inconceivable.” Solomon Thomas was also in New York last week, spending part of the summer break from the #NFL calendar on a media tour along with Christine Moutier, the chief medical officer for the #AmericaFoundationforSuicidePrevention. After Thomas’s older sister, Ella, died by #suicide in January 2018, the 49ers defensive end began to use his voice to speak about #mentalhealthandsuicideprevention. About five months after losing Ella, Thomas and his family participated in an overnight walk for the AFSP in Dallas, one of his first steps in becoming a #mentalhealthadvocate. “I realized what I can say can really help other people, or really help myself, or get a conversation started,” Thomas says. He’s been part of a growing conversation about #mentalhealth beyond the #NFL, but also within it. Last season, Vikings defensive end Everson Griffen spent five weeks away from the team to focus on his #mentalhealth. Thomas’s 49ers teammate, Marquise Goodwin, sat out for two weeks as he and his wife, Morgan, processed the grief of losing twin baby boys 19 weeks into her pregnancy. And midway through last season, the 49ers helped Thomas address his own #mentalhealth in the wake of losing his sister. GM John Lynch, who drafted Thomas and once took a class with him at Stanford, told him that if he needed some help, they could connect him with a therapist. “He could kind of tell, I was probably putting a mask on in front of my teammates,” Thomas says. “That was really helpful, really powerful for me, to have John reach out to me like that and help me continue to get mentally healthy and to continue my walk through my grief process.” The increased spotlight on both #mentalhealth and the use of painkillers, both inside and outside the #NFL, played a role in the new guidelines being adopted for the 2019 season. Over the past several years, the NFL and the Players Association have worked to establish #mentalhealth resources for both current and former players, but these have varied team to team and many players have said they aren’t aware of everything that is available. Now with regulations written into the CBA, which could thus be grieved or penalized if they are not met, the bar has been raised. About 90 percent of teams were already working with a clinician in some capacity, NiiLampti said, but those clinicians were at the clubs an average of three hours per week. The new agreement mandates they must be available to players at the team facility a minimum of twice per week, for at least 8 to 12 hours—a significant increase. And while past education included steps like an hour-long module for rookies or a slide-and-a-half during training camp, clinicians will now conduct at least two #mentalhealth education sessions per season. Teams have emergency action plans for other serious health concerns—cardiac emergencies, heat illness and severe neck and spine injuries—and now they will each create a plan for #mentalhealth emergencies, to be reviewed and rehearsed annually. The question about office location is a common one, because teams are trying to work through the best way to fully integrate the presence of the clinician, most of whom have not been listed among the “medical staff” on team websites. One team at the summit in New York said that the clinician is the first meeting rookies take as part of their orientation; another club said that they make sure the clinician is visible, on the practice field, on the team plane and in the lunchroom, to normalize his presence. At an identical summit in Las Vegas—teams picked one of the two to attend—one club said its head coach put his arm around the clinician while meeting with players and said, “I use this person. My family uses this person.” But even with these steps, there are hurdles in getting some players to feel comfortable seeking them out. “Some guys won’t sit at the same lunch table as our team therapist, because they are like, I don’t want anyone to think something is wrong with me,” Thomas says. “I have heard guys say out loud, ‘Oh, I can’t sit at that table.’ I’m just like, why? There’s a huge #stigma about that; people are still afraid of therapists, still afraid of getting help, because they don’t want anyone to know that anything is wrong with them.” Men overall are less likely to seek out #mentalhealth resources than women, studies have shown, but there are specific stressors in the #NFL compounding that. Players are taught not to trust fully anyone in the building, because they can be cut or traded at any time. “Guys are fighting for their job every day,” Thomas adds. “So they don’t want to have anything seen as a disadvantage or a reason to not be the one chosen. ‘Oh, both of them have the same amount of yards and TDs, but he has #mentalhealth problems.’ That’s scary to some guys, I guess. But, it’s something that needs to change.” For these reasons, during the #mentalhealth discussion at the summit, NiiLampti described confidentiality as the “lynchpin” to making the program work. One team clinician described how he keeps a case file totally separate from the team for every player he sees, as if they were a patient at his private practice. Another clinician said he has never been asked by management about any interactions with players, which is why he continues to work for his team. It’s customary in clinical medicine for mental health records to be separate from all other medical records, and the joint mental health agreement includes stipulations for that, according to Sills: The only #mentalhealth information that should be entered into a player’s electronic medical record is any psychotrophic medicine he is taking, to avoid his being prescribed a drug that could interact. Teams were also encouraged to have a referral network of multiple #mentalhealthprofessionals, both to address specific topics such as substance abuse or family counseling, and to ensure that players have options beyond the team clinician. One team’s director of player engagement simply posts their names and contact information on a bulletin board outside his office, so players don’t even have to ask him for a referral. Thomas says he chose to see a therapist who is outsourced by the 49ers, rather than an in-house employee, which made him more comfortable talking about both on- and off-the-field stressors. He started meeting with her once a week in a room at the team’s headquarters in Santa Clara, Calif. Before he started working with her, Thomas says he didn’t know how to talk, who to talk to, or where to start. She worked with him on acknowledging all the emotions he was feeling after losing his sister, how to release his anger and different coping mechanisms and outlets for his grief. By the end of the season, Thomas began to see a difference in his play on the field, too. He began to recognize the player he was watching on film again. “I honestly felt like I was running in sand sometimes, or running in mud,” he says. “Then just being able to feel that twitchiness again, that explosiveness. … That’s all due to my head clearing up, or being able to freely live, I guess.” During OTAs this spring, 49ers coach Kyle Shanahan brought in a group of Navy SEALs for a training session focused on the mental side of the game. After a team-wide discussion about how to cope with stress, they opened up to the floor to anyone who wanted to talk. Thomas stood up and talked about how mental health affects physical health, and that he deals with his mental #stress through seeing a therapist. If his teammates see him coming back from a session with his therapist or finishing up a phone call with her, he’s open about telling them what he was doing, hoping they can see it as he does—just a normal part of his routine. “If our brain’s not working, our bodies aren’t going to work. I said one way I dealt with that was through therapy, and so I hope that motivates guys … Just trying to let them know that nothing's wrong with it—it’s a good thing, it’s for help,” Thomas says. “If guys do it more openly, and the culture of #mentalhealth changes in the NFL, I think that is going to change a lot. Because we are a very masculine, tough sport. If we start that change, it will echo throughout the whole league and society as well.” When Sills was hired by the #NFL two years ago, he says Roger Goodell asked him for the major health issues he believed needed to be addressed. After concussions, Sills listed behavioral health and pain management. Around the same time, in the spring of 2017, the players union filed a grievance alleging that the #NFL and its teams conspired to violate the terms of the CBA regarding the use and dispensation of opioids and other prescription painkillers; it cited a federal lawsuit filed by the widow of former #NFL fullback Charles Evans. “We had significant concerns,” Mayer says, “but I truly feel this is a great example of something good coming out of a disagreement.” What stole the headlines when the health and safety agreements were announced in May is that the #NFL and the players union agreed for the first time to work together on studying alternative pain management therapies for players, including marijuana. They’ll do so as part of two new joint medical committees that will make recommendations on policies and practices for pain management and #mentalhealthandwellness. A new prescription drug monitoring program will also track all prescriptions issued to players, reviewed by both the league and the union. At last week’s summit, team employees listened to a 15-minute presentation on alternatives to opioids, followed by the CBD update led by Kevin Hill, an addiction psychiatrist and author of Marijuana: The Unbiased Truth About The World’s Most Popular Weed. (The MMQB was only invited to sit in on the first hour of the summit, including introductory remarks and a session on the behavioral health practices.) Sills said the joint pain management committee has already met with a couple of experts about the current state of research and will explore ways they might be able to further ongoing research into marijuana and its derivatives. Several players have advocated for the NFL to change its policies to permit marijuana use for pain management, but Goodell and medical advisors on both sides continue to indicate that more information is needed. “My opinion, and there are a lot of us who share it, is that opinions and attitudes are far outstretching the science behind CBD right now,” Mayer said. Added Sills: “We are open-minded to look at every aspect of how we can better treat pain, but it’s from a data-driven perspective. … We will let the science take us where we need to go.” As players begin reporting to training camps this month, teams will start sharing information on the new #mentalhealth and pain management rules. It’s not a coincidence they’ll be addressed together; one affects the other. The goal, NiiLampti said, is to work with players to prevent an emergency or crisis stage, and that these services can help in optimizing player health and performance. Some clubs, like the one that has a “prevention team,” to this end, are farther along. Others are still figuring out the clinician’s office location. “Guys care about that,” Thomas says. “I think we will have some … where there’ll be some players who maybe are held out, or missed games or practices for ‘medical reasons,’ That'll just be the end of it,” Sills says. “And we should all be comfortable with that reality.” • Question or comment? Email us at talkback@themmqb.com. Photo by Pixabay on Pexels.com Read the full article

[gointelligenthealth]

Discovering the Best Anxiety Treatment Solutions in NYC

Anxiety has become one of the most prevalent mental health issues in the modern world, especially in bustling cities like New York. The fast-paced lifestyle, combined with work stress, social pressures, and personal challenges, often leads individuals to experience overwhelming anxiety. Fortunately, a wide range of effective anxiety treatment options are available in New York to meet the needs of a wide range of people. If you’re searching for the best anxiety treatment solutions in NYC, this blog will guide you through the most effective strategies, including traditional therapy, telehealth services, and holistic approaches.

Understanding Anxiety and Its Impact

Anxiety can manifest in various ways, from mild nervousness to debilitating panic attacks. Both mental and physical health are affected. Individuals may experience symptoms such as constant worry, insomnia, muscle tension, and even digestive issues. Without proper treatment, anxiety can negatively impact every aspect of a person’s life, from relationships to job performance.

Common Anxiety Treatment Solutions in NYC

In New York City, a range of treatment options is available to help those suffering from anxiety. These include therapy, medication, and lifestyle changes. The following are the solutions that work best:

1. Traditional Therapy and Counseling One of the most widely recommended treatment methods for anxiety is therapy. Anxiety disorders respond especially well to cognitive behavioral therapy (CBT). Through therapy, patients learn to identify and manage triggers, develop coping mechanisms, and change harmful thought patterns. Seeking a local psychiatrist near me or a therapist can be the first step towards finding a personalized treatment plan.

2. Telehealth Services for Anxiety Treatment In today’s digital age, accessing mental health care from the comfort of your own home has never been easier. Anxiety Telehealth Services Hoboken NJ provides the convenience of virtual therapy sessions for individuals unable to attend in-person appointments. These services allow individuals to connect with qualified professionals through video calls, making it easy to get help from anywhere, including busy cities like NYC.

Many find Anxiety Telehealth Hoboken NJ to be a game-changer. It offers flexibility, reduces travel stress, and allows for more consistent treatment, which is crucial for managing anxiety effectively. Plus, telehealth platforms are often more affordable than traditional in-office visits.

3. Medication Management Therapy on its own may not always be sufficient to alleviate severe anxiety symptoms. Anxiety can be lessened by taking medication prescribed by a trained psychiatrist, allowing patients to better participate in therapy and daily life. It’s essential to consult a mental health expert or psychiatrist who specializes in anxiety treatment to determine the right medication plan.

4. Holistic and Lifestyle Approaches Many individuals are turning to holistic approaches, such as meditation, yoga, and mindfulness exercises, to manage anxiety. In NYC, there is a growing trend towards integrating traditional treatment methods with alternative therapies to provide a well-rounded approach to mental health. Practices like acupuncture and aromatherapy, combined with therapy, can help reduce anxiety and promote overall well-being.

5. Depression Treatment Hoboken It’s not uncommon for anxiety and depression to occur together, which makes it crucial to seek comprehensive care. If you’re in NYC or nearby areas like Hoboken, services like Depression Treatment Hoboken offer dual treatment options for both anxiety and depression. Addressing both conditions simultaneously can lead to a more effective and faster recovery process.

How Intelligent Health and Wellness Services Stand Out

Intelligent Health and Intelligent Wellness is a great place to start when trying to find the right treatment. They provide a holistic approach to mental health, combining traditional and alternative treatments. Their services prioritize patient-centered care, focusing on individual needs, which is essential when addressing something as personal as anxiety.

Why Choose Anxiety Telehealth Services in Hoboken, NJ?

If you’re living in or near Hoboken, Anxiety Telehealth Hoboken NJ is an ideal solution for those seeking accessible and convenient care. Telehealth services offer the flexibility of receiving treatment from home, which can be particularly beneficial for individuals whose anxiety may prevent them from leaving the house. These services are designed to provide the same quality care as in-office visits but with added convenience and accessibility.

Telehealth is also a great solution for busy New Yorkers who struggle to find time for in-person visits amidst their hectic schedules. It offers privacy, ease of access, and effective treatment for individuals looking to manage their anxiety efficiently.

How to Choose the Right Treatment

When considering anxiety treatment, it’s essential to take into account factors like your personal comfort level, the severity of your anxiety, and your availability. Some may prefer in-person sessions, while others find telehealth more convenient. For those in or near Hoboken, Anxiety Telehealth Services Hoboken NJ could be the perfect match. Additionally, if you need treatment for co-occurring conditions like depression, it’s important to choose a provider that can address all aspects of your mental health, such as Depression Treatment Hoboken.

Consulting with a local psychiatrist near me is another excellent first step. They can assess your condition and recommend the most effective treatment plan tailored to your specific needs.

Final Thoughts: Embracing Mental Wellness

Anxiety is treatable, and living in NYC means having access to some of the best mental health resources in the world. Whether you choose in-person therapy, telehealth options like Anxiety Telehealth Hoboken NJ, or alternative therapies, the most important step is to seek help. Don’t wait until anxiety takes over your life — start exploring your treatment options today.

Gointelligenthealth.com is a good place to start if you’re looking for reliable mental health services. They offer comprehensive care, including Intelligent Health and Intelligent Wellness services, ensuring you receive the best possible care for your anxiety in NYC and beyond.

By choosing the right treatment and provider, you can regain control of your mental health and start living a more balanced, anxiety-free life.

[awsomebloggersblog]

Job Opening For Registered Nurse (RN) - (Sign-On Bonus for Full-Time & Part-Time Positions, Shift-Differentials) Intuitive Health Services Job title: Registered Nurse (RN) - (Sign-On Bonus for Full-Time & Part-Time Positions, Shift-Differentials) Job description: The Impact You Can MakeGlens Falls Hospital is seeking dedicated and compassionate Registered Nurses to join our team! This opportunity will allow you to make a positive impact on the lives of our patients while advancing your career in a supportive and collaborative environment.Team ImpactIn this position, you will be an important member of the patient care team. The Registered Nurse (RN) is accountable for management and delivery of patient care to assigned patients in collaboration with the interdisciplinary team, and within the scope of practice delineated in the New York State Nurse Practice Act. Provides direct patient care, delegates/assigns responsibility as appropriate to others, and serves as leader of the interdisciplinary team in collaboration with and under the direction of the attending physician. The patient care team identifies desired outcomes for each patient based on assessment data, and plan of care and completes ongoing assessments to facilitative achievement of desired outcomes. Some highlights about this opportunity include: Full time, part time, and per diem positions available. Shifts include days, evenings, overnights, and weekend tracks. 8 and 12 hour shifts available Specialty areas include but are not limited to: Med Surge, OB, ED, ICU, PACU, OR, Telemetry, Oncology, Behavioral Health, Vascular Access, Medical Imaging, and Physicians Practice Mentorship programs and career growth pathways to support your professional aspiration Professional development and continuing education tuition reimbursement to advance your clinical skills Clinical Ladder that supports professional growth Sign on bonus Shift differentials Certification bonus The Glens Falls Hospital ImpactMissionOur Mission is to improve the health of people in our region by providing access to exceptional, affordable, and patient-centered care every day and in every setting.Glens Falls Hospital NursingGlens Falls Hospital is proud to be a Magnet designated organization, joining only 8% of all hospitals in the United States to currently hold this distinction. Magnet Recognition is the gold standard for nursing excellence.When you join Magnet Designated nursing excellence team, you will experience shared governance, engaged leadership, and skilled team members all in a family - like atmosphere.QualificationsEducation/Accredited Programs· Graduation from a Registered Professional Nursing Program.· Current Registered Nurse (RN) license in the state of New York.· Bachelor's degree in Nursing is preferred; new hires will be required to complete their BSN within 5 years of hire (RNs with 20+ years of experience may be eligible to opt for certification completion rather than BSN).Experience/Abilities· Excellent communication and interpersonal skills· Maintains competency in professional nursing practices· Knowledge of standard health care reporting measures required· Ability to recognize patient care problems and to react appropriately in patient care emergenciesCommunities We ServeLocated in the foothills of the beautiful Adirondack mountains, Glens Falls is conveniently located a short drive away from the capital region and Lake George. Work at the top of your profession and jumpstart your next career here at Glens Falls Hospital!All qualified applicants will receive consideration for employment without regard to race, color, religious creed, national origin, sex, age, gender identity, disability, sexual orientation, military service, genetic information, and/or other status protected under law.Salary Range The expected base rate for this Glens Falls, New York, United States-based position is $34.00 to $58.

74 per hour. Exact rate is determined on a case-by-case basis commensurate with exp­­erience level, as well as education and certifications pertaining to each position which may be above the listed job requirements.Benefits Glens Falls Hospital is committed to providing our people with valuable and competitive benefits offerings, as it is a core part of providing a strong overall employee experience. A summary of these offerings, which are available to active, full-time and part-­time employees who work at least 30 hours per week, can be found .. Apply for the job Registered Nurse (RN) - (Sign-On Bonus for Full-Time & Part-Time Positions, Shift-Differentials) At Intuitive Health Services, our goal is to make healthcare better for everyone. We help hospitals, clinics, and other healthcare places find the right doctors, nurses, and other healthcare workers. For over 15 years, we have been doing this important job. We work with places like state hospitals and correctional facilities to make sure they have the best people to take care of patients. We don’t just connect people with jobs; we also support them throughout their journey. We help with things like improving resumes, preparing for interviews, and finding the job that fits best. We work in over 50 different locations and have over 900 professionals who trust us to help them. If you are looking for a job in healthcare, we are here to guide you. If you are a healthcare facility needing to hire someone, we can find the best person for you. Our team is always ready to help, and we believe that by working together, we can make healthcare stronger and better for everyone. If you need to contact us, you can find us at: Address: 520 West Lacey Blvd, Hanford, CA 93230 Email: jobs@intuitivehealthservices.com Phone:+1 (805) 703-3729 We’re here to help you with all your healthcare staffing needs! https://intuitivehealthservices.com/register

[newsmarketreports]

In-Depth Financial Analysis of Rite Aid Corp.

Rite Aid Corp. is one of the largest retail pharmacy chains in the United States, with a rich history dating back to its founding in 1962. Headquartered in Camp Hill, Pennsylvania, Rite Aid operates thousands of retail pharmacies across the nation, providing a wide range of pharmaceutical services, health and wellness products, and other retail offerings. The company is listed on the New York Stock Exchange and is a significant player in the healthcare and retail sectors.

Financial Performance Overview

Rite Aid’s financial performance reflects the challenges and opportunities in the retail pharmacy industry. The company has navigated through a highly competitive market, adapting its business model to meet changing consumer needs and regulatory environments.

To know about the assumptions considered for the study, Download for Free Sample Report

Revenue Breakdown

Rite Aid’s revenue is primarily generated from its pharmacy services and front-end retail sales. The company’s revenue streams are diversified across several key areas:

Pharmacy Sales: The largest portion of Rite Aid’s revenue comes from prescription drug sales, driven by a broad network of retail pharmacies and pharmacy benefit management (PBM) services.

Front-End Retail Sales: This segment includes sales of over-the-counter medications, health and beauty products, personal care items, and general merchandise.

Healthcare Services: Rite Aid has expanded its offerings to include various healthcare services, such as immunizations, wellness programs, and telehealth services, contributing to its overall revenue.

Profitability Analysis

Rite Aid’s profitability has been influenced by a mix of factors, including healthcare regulations, competitive pressures, and shifts in consumer behavior. The company’s financial metrics provide insights into its operational efficiency and profitability.

Gross Margin: Rite Aid’s gross margin is a key indicator of its ability to manage costs and pricing strategies effectively. The company’s focus on optimizing its supply chain and inventory management contributes to maintaining stable gross margins.

Operating Margin: The operating margin reflects Rite Aid’s operational efficiency and cost management across its pharmacy and retail operations.

Net Profit Margin: The net profit margin is impacted by various factors, including interest expenses, tax rates, and extraordinary items. Rite Aid has implemented cost-saving initiatives to improve its net profitability.

Financial Ratios and Indicators

An analysis of Rite Aid’s key financial ratios provides a clearer picture of the company’s financial health and operational performance.

Liquidity Ratios

Current Ratio: The current ratio indicates Rite Aid’s ability to meet its short-term obligations with its short-term assets, highlighting its liquidity position.

Quick Ratio: The quick ratio, which excludes inventory from current assets, provides a more conservative measure of the company’s ability to cover immediate liabilities.

Solvency Ratios

Debt-to-Equity Ratio: Rite Aid’s debt-to-equity ratio is a critical indicator of its financial leverage. The company’s reliance on debt financing to support its operations and growth initiatives is reflected in this ratio.

Interest Coverage Ratio: The interest coverage ratio measures Rite Aid’s ability to cover its interest expenses with its operating income, indicating the company’s capacity to manage its debt obligations.

Efficiency Ratios

Inventory Turnover Ratio: This ratio indicates how efficiently Rite Aid manages its inventory levels. A higher turnover rate suggests efficient inventory management, reducing the risk of overstocking or obsolescence.

Asset Turnover Ratio: The asset turnover ratio measures how effectively Rite Aid utilizes its assets to generate revenue, providing insights into the company’s operational efficiency.

Strategic Investments and Capital Expenditure

Rite Aid’s strategic investments and capital expenditures are focused on enhancing its retail pharmacy network, expanding healthcare services, and improving digital capabilities.

Retail Pharmacy Expansion

Store Modernization: Rite Aid has invested in modernizing its stores, including upgrades to its pharmacy counters, customer service areas, and in-store technology. These enhancements aim to improve the customer experience and drive sales growth.

Pharmacy Automation: The company has also invested in pharmacy automation technologies to streamline prescription processing, reduce wait times, and improve service accuracy.

Digital Transformation

E-Commerce and Mobile Integration: Rite Aid has accelerated its digital transformation efforts, integrating e-commerce and mobile platforms to meet the growing demand for online shopping and prescription delivery services.

Telehealth Services: The expansion of telehealth services is a key component of Rite Aid’s strategy to offer convenient healthcare options to its customers, particularly in underserved areas.

Future Financial Outlook

Rite Aid’s future financial outlook is shaped by its strategic initiatives aimed at strengthening its core pharmacy business, expanding healthcare services, and enhancing its digital presence. The company’s ability to adapt to changing market conditions and consumer preferences will be crucial in driving its financial performance.

Growth Drivers

Pharmacy and Healthcare Services: Continued growth in pharmacy sales, driven by an aging population and increased healthcare needs, is expected to be a significant driver of Rite Aid’s revenue.

Digital and Online Sales: The shift towards digital and online sales, accelerated by changing consumer behavior, presents an opportunity for Rite Aid to capture market share and enhance customer loyalty.

Cost Management Initiatives: Ongoing cost management initiatives, including supply chain optimization and operational efficiencies, are expected to improve profitability and support long-term growth.

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[elitedisability]

Community Access Support Services

Community access support services help people with disabilities overcome the barriers to getting around their communities. They provide assistance with daily tasks and support them to participate in recreational and leisure activities.

These programs offer a variety of services, from food education to care coordination. They also work with individuals to pursue their dreams and goals.

Affordable health care

Access to affordable health care is a vital component of a fulfilling life for individuals with disabilities. Community access support services facilitate independence in several ways, including offering transportation assistance to help people with disabilities travel to and from work or other destinations. They also provide training and skill development opportunities that help individuals learn how to live independently.

Community access support services can also promote social connections for individuals with disabilities. This can help combat feelings of isolation and improve mental health. For example, some programs offer peer support groups where people can share their experiences and receive emotional support from others who have similar issues.

Other services offered by community access support include assisting people with disabilities to attend events and participate in chosen recreational activities. They can also help with running errands and assist with daily living tasks. These programs can be a great help for those with physical, sensory or cognitive disabilities.

Public housing

Public housing provides affordable living for low-income families and individuals. It is designed to give tenants a safe place to live and provide access to basic services, such as child care, transportation, and food. These programs can help individuals who are in need of social support and community engagement, as well as those with a mental health concern.

Some community access programs offer single-site housing that combines affordable living with support services, while others may provide congregate housing. These programs can also offer assistance with job skills and employment opportunities. They can also help individuals with disabilities to maintain their independence and connect to community organizations, such as the New York City Mental Health Film Festival or Changing Minds Young Filmmaker Festival.

Those who qualify for public housing can apply in person at their local public housing agency (PHA). The PHA will evaluate your application and check your references to make sure you are eligible.

Employment

One of the most important components of a person’s health is their ability to earn money and work to meet their needs. To do so, they need access to affordable housing, employment, and social support. Community access programs can help individuals with these basic needs, as well as screen for underlying issues that may be contributing to their health problems.

These programs can also provide job training, support to find a job, and navigation assistance. They can also connect individuals to healthcare and mental health services. This helps them avoid costly trips to the emergency room.

Community Access is committed to promoting the full inclusion of people with disabilities in their communities. This is achieved through research, policy advocacy, and training. Their team of highly trained and dedicated staff members works together to bring about the changes they seek. Their values include trust, innovation, humility and respect for every individual they serve. They call their work “heart work” and are tenacious in defending their clients’ rights.

Social determinants of health

The social determinants of health are the non-medical factors that shape people’s ability to pursue healthy behaviors. These include education, housing, employment, and the community environment. They also include the broader set of forces and systems that shape everyday life, including economic policies, development agendas, racism, climate change, and social norms.

While many efforts to improve healthcare have focused on medical care, there is growing recognition that achieving better health requires addressing social and environmental issues as well. As a result, new initiatives are emerging to increase attention to these social determinants of health.

These programs range from providing food education to facilitating access to affordable health insurance and mental health services. They also offer opportunities for individuals with disabilities to connect with others, which can alleviate feelings of isolation and loneliness. In addition, these programs provide a variety of other person-centered services that help individuals pursue their goals and dreams. For example, some programs organize inclusive sports leagues and other recreational activities.

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We develop a personalized depression treatment plan based on the root causes identified during our assessment. Our experienced physician prescribes antidepressant medication tailored to the severity of your depression, carefully considering your current medication list to minimize side effects. We offer referral services to specialists such as psychologists, psychiatrists, or licensed therapists if your depression requires advanced treatment. 

Contact Jahanara Reza MD PC today to schedule your consultation. Located in Washingtonville, we also offer primary care services to manage your physical health needs, including chronic disease management. We provide both online appointment and walk-in appointments for your convenience.

[zelda-larsson]

Healthcare Initiatives in New York. Access and Equity for All

New York has long been a pioneer in addressing healthcare challenges and ensuring that all residents have access to high-quality medical services. In 2024, the state continues to build on this legacy with a range of innovative healthcare initiatives designed to improve health outcomes, reduce disparities, and enhance the overall well-being of its diverse population. Michael Shvartsman, a businessman and advocate for equitable healthcare, highlights the importance of these initiatives and the positive impact they are having on communities across New York.

Expansion of Community Health Centers.

Community health centers play a crucial role in providing accessible and affordable healthcare to underserved populations. New York has significantly expanded these centers, increasing their capacity to serve low-income residents, immigrants, and uninsured individuals. These centers offer comprehensive services, including primary care, dental care, mental health services, and preventive care. “Community health centers are the backbone of our healthcare system,” says Michael Shvartsman. “They ensure that even the most vulnerable members of our society have access to essential medical services.”

Telehealth Services.

The COVID-19 pandemic accelerated the adoption of telehealth, and New York has continued to invest in this technology to improve access to healthcare. Telehealth services enable patients to consult with healthcare providers remotely, reducing the need for travel and increasing convenience. This is particularly beneficial for individuals in rural areas or those with mobility issues. “Telehealth has transformed the way we deliver healthcare,” notes Michael Shvartsman. “It breaks down barriers and makes it easier for people to receive timely medical advice and treatment.”

Mental Health Support.

Recognizing the critical importance of mental health, New York has launched several initiatives to expand access to mental health services. These include increasing funding for mental health clinics, integrating mental health support into primary care settings, and launching awareness campaigns to reduce the stigma associated with mental health issues. “Mental health is just as important as physical health,” emphasizes Michael Shvartsman. “By providing comprehensive mental health support, we can improve the quality of life for countless individuals.”

Addressing Health Disparities.

Health disparities based on race, ethnicity, and socioeconomic status remain a significant challenge. New York is actively working to address these disparities through targeted programs that focus on preventive care, education, and community outreach. Initiatives such as the Healthy Neighborhoods Program aim to improve health outcomes in historically marginalized communities by addressing social determinants of health. “Equity in healthcare is essential,” states Michael Shvartsman. “We must ensure that everyone, regardless of their background, has access to the care they need.”

Innovative Public Health Campaigns.

Public health campaigns are a vital tool in promoting healthy behaviors and preventing disease. New York has implemented several innovative campaigns to tackle issues such as smoking, obesity, and infectious diseases. These campaigns use a mix of traditional media, social media, and community events to reach diverse audiences and encourage positive health behaviors. “Public health campaigns are crucial for educating the public and promoting healthier lifestyles,” says Michael Shvartsman. “They can lead to significant improvements in community health.”

Support for Healthcare Workers.

Healthcare workers are the foundation of the healthcare system, and New York has launched initiatives to support and retain these essential workers. This includes providing additional training opportunities, mental health support, and financial incentives for those working in underserved areas. “Our healthcare workers are heroes,” remarks Michael Shvartsman. “We must do everything we can to support them and ensure they have the resources they need to provide excellent care.”

New York’s healthcare initiatives in 2024 reflect a comprehensive approach to improving health outcomes for all residents. By expanding access to community health centers, embracing telehealth, enhancing mental health support, addressing health disparities, launching public health campaigns, and supporting healthcare workers, the state is making significant strides towards a more equitable and effective healthcare system. As Michael Shvartsman highlights, “These initiatives are not just about healthcare; they are about building a healthier, more inclusive society for everyone.”

Read more:

[brian-mccann]

Addiction Policy and Social Constructs Fail Many Americans

Nearly 50 million Americans are estimated to live with substance use disorders, with only around five percent receiving the help that they need. A major issue is social barriers that prevent ready access to support, such as behavioral therapies and medications.

As explored in a December 2023 New York Times article, one root cause is that a majority of medical professionals lack familiarity or comfort with addiction medicine topics. This also holds for probation officers, judges, and wardens, who often control the options available to those with use disorders.

Many people who could be helped never receive meaningful essential services as they pass through a barrage of institutions such as courts, hospitals, and prisons. Compounding this, they often cannot see the problem or are ashamed to admit it. Purchasing illicit substances for a short-term high is much easier than accessing quality addiction care through trained providers and committing to a program of personal rehabilitation that can take years to complete.

To solve this persistent and urgent issue, the article suggests that addiction be treated like a chronic medical condition that has periods of remission and relapse. Like any disease, addiction can be fatal, but with proper treatment and support, it is also often manageable. Achieving such a change requires eliminating the stigmas that come with admitting to addiction, including potentially losing a job or custody of children. Only if policymakers and physicians treat addiction as a health condition rather than as a criminal justice system matter can society devise impactful solutions.

[marryslittlelambs]

What Is Kinder Care?

kinder care is a type of child care that involves a paid caregiver taking responsibility for children's health, safety and learning. The caregiver may be a family member, professional or community volunteer.

Within one year after the effective date of this Agreement, KinderCare will train teachers and other staff who work at its facilities about its disability nondiscrimination obligations.

History

The Great Depression and kinder care II altered the nature of child care. Federal programs favored the expansion of private, for-profit centers and the development of vouchers, which shifted public subsidies from low-income families to middle- and high-income households.

In 1969, Portland-based Kinder-Care Nursery Schools opened its first center, which featured a Humpty Dumpty motif and the red bell tower that would later be trademarked. The company aimed to build brand recognition through centers with easily identifiable exteriors, similar to the approach used by McDonald’s restaurants and Holiday Inn hotels.

Chief Executive Officer Tull Gearreald took over the company with the goal of returning Kinder-Care to its core mission. The new strategy was not an easy one. Grassgreen had led the company on an ill-conceived diversification plan, investing in shoe stores, photo studios and even a foreign fertilizer manufacturer.

Locations

Currently, KinderCare Learning Centers operates more than 1,165 locations throughout the country. It is the largest chain of childcare facilities in the United States. It is headquartered in Montgomery, Maryland. The company offers preschool and before and after school child care services for children six weeks to twelve years of age.

To help the company recover from its financial troubles, Kinder-Care began focusing on niche markets. It created Kid’s Choice centers and established Kinder-Care at Work on-site corporate facilities for working parents. It also began publishing activity books and calendars for children and introduced a health and safety coordinator program for staff members.

Lalaine Oropeza-Aclao is the executive director at KinderCare FiDi NYC in New York,

NY. She has a son who is 9, a daughter who is 8, and a newborn. She earned her Master's Degree in Elementary Reading and Math and her Post Baccalaureate Certificate in Applied Behavior Analysis.

Fees

The high price of child care forces working families to make difficult choices. It can also strain the budgets of childcare providers trying to keep their doors open and hire a skilled staff to provide quality, safe early learning.

The cost of KinderCare varies based on location, child’s age, and how many days per week they attend. Generally, daycare rates range from $170 to $2,400 per month or $680 to $2,400 annually.

Recruit and retain your best talent with flexible child care solutions. Bundle Tuition Benefit+ with back-up care and priority waitlist to offer your team a full-range of family-friendly benefits they’ll love. It’s the perfect complement to any remote or hybrid work model. Your employees will appreciate that you’re giving them the confidence and flexibility they need to be their most productive selves.

Insurance

Many child day care providers rely on insurance as a vital safety net against thirdparty claims and damages. These include general liability and professional liability.

The first type of policy covers claims resulting from bodily injury and property damage to children or visitors at the facility. It may also include medical payments coverage. Some policies also offer abuse and molestation coverage.

The second type of policy protects the provider if a parent sues over a failure to meet expectations set out in marketing material. Errors and omissions coverage is available separately or as an add-on to a standard liability or package policy. Business interruption coverage shields the facility against financial losses from operational halts due to unforeseen events. Commercial auto liability insurance is also necessary for facilities that use vehicles to transport kids or staff.

Contact

For more information about child care subsidies and locating child care solutions in your area, contact the regional kinder Care about Childcare agency. You can also find out about public pre-K partnerships that work with child care programs to provide early learning opportunities for children.

KinderCare’s centers are clean and safe, with teachers that are friendly and caring. They follow strict safety and sanitation guidelines and have keypad entry to prevent unauthorized pick-ups. They also send parents pictures and updates throughout the day on the KinderCare app, so they can see who their child played with, how much they ate, and what they learned. They have a wide variety of locations in Long Island, Tribeca, Brooklyn, and across New Jersey. The company is a for-profit, publicly traded operator of child care and early childhood education facilities.