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Why We Run: To Boost Mental Health, Raise Awareness, & Combat Stigmas

Exercise is a great way for people to take mental health improvement into their own hands. Don’t get us wrong: working out is not a cure-all for mental illness and is not a definitive treatment option. But it allows people who suffer from mental health disorders to be proactive, to take control of a potentially dangerous situation. Perhaps most importantly, it sets into motion chemicals in the brain that induce feelings of euphoria which combat feelings of despair.

The notion that exercise is a constructive way to counterbalance feelings of, for example, depression or anxiety is rooted in evidence-based science. Studies have been published that show a relationship between increased physical activity and low rates of major depressive disorder.

One such recent study was co-authored by Karmel W. Choi, PhD, a postdoctoral fellow at the Harvard T.H. Chan School of Public Health and Massachusetts General Hospital, and Jordan Smoller, MD, ScD, director of the Mass. General Hospital Psychiatric and Neurodevelopmental Genetics Unit and a professor of Psychiatry at Harvard Medical School.

“On average, doing more physical activity appears to protect against developing depression,” Dr. Choi said in a statement. “Any activity appears to be better than none; our rough calculations suggest that replacing sitting with 15 minutes of a heart-pumping activity like running, or with an hour of moderately vigorous activity, is enough to produce the average increase in accelerometer data that was linked to a lower depression risk.”

Related: Save the Date: Our 5th Annual Frozen Yogurt 5K is on August 25

According to Yale scientist Adam Mourad Chekroud, PhD, exercise is a key opportunity for individuals to develop protective factors against depression, maybe even more so than prescription medications. In fact, he says “Antidepressants are not universally effective, and many patients undergo a trial-and-error process to find the right regimen. Psychological therapies are about equally effective and can be expensive and difficult to access.”

A big part of this is the so-called runner’s high. This sensation is caused by a rush of pleasure-causing endorphins in the brain, in addition to endocannabinoids, a chemical that acts like naturally synthesized THC (the main chemical component in marijuana).

Cardio workouts can also generate new brain cells and improve cognitive performance, which has been linked to low rates of Alzheimer’s. It also has the added benefit of providing an outlet for stress, a time for self-reflection, and, especially on sunny days, an opportunity for your body to produce Vitamin D.

For these reasons and more, Gándara has hosted a 5K road race in Northampton for the past four years. This year, on August 25, will be our 5th annual Frozen Yogurt 5K.

We run to not only give participants the chance to experience all the health benefits that accompany running, but also to raise awareness around mental illness, substance use disorders, their stigmas, and the various services and treatments available to those in need.

Register today! Kids 12 and under run for free, and all runners—and walkers—get a free GoBerry Frozen Yogurt. Sign up by August 14 and you’ll be receive a free t-shirt. Registration on race day will be available beginning at 8:00 a. m. Credit and debit cards will be accepted. The staging area is on the Courthouse Lawn across from the Calvin Theater. For GPS purposes please use 19 King Street Northampton, MA.

Leashed pets are also welcome to run for free.

Our 5K is officially timed by RaceWire. Medals will be awarded to the top three finishers in each of the following categories: Male, Female, 12 and under and 50 and over.

For any questions regarding the event—or for those interested in having their business sponsor this year’s race­—please contact Lisa Brecher at 413-296-5256 or lbrecher@gandaracenter.org.

Por |enero 31, 2019|Eventos, Noticias, Ciencia|Comentarios desactivados on Why We Run: To Boost Mental Health, Raise Awareness, & Combat Stigmas

De-escalation & Crisis Management Training: How to Defuse the Situation

Mark Huntington likes to begin training sessions by explaining why everyone calls him Mark H. It’s really quite simple. When he started at Gándara, there were two other Marks and so as a point of clarification, he adopted the name Mark H and it stuck. He tells this story because it helps create a connection with him and his trainees, a mutual understanding. They don’t feel like they’re sitting through a lecture. Connection is an important part of Mark H.’s de-escalation and crisis management training sessions, one of which he held on viernes, enero 4. Empathy is a necessity.

De-escalation prevents confrontational situations from becoming aggressive and violent. “It’s not about trying to fix the situation,” said Mark H., “It’s about trying to survive the situation.” What he means is sometimes when we put a lot of energy into trying to fix a situation, that energy can increase the tension between you and the other person. He added: our actions and attitudes have an impact on the actions and attitudes of others. Sometimes your approach can be a part of the problem.

verbal agitation scale

Mark H. has of 25 years of experience in the field. Much of that has been focused on de-escalation. From his time working with inner-city gang youths to being yelled at by Green Berets, State Police, and corrections officers (to name just a few), Mark H. has found that de-escalation is as much about science as it is about intuition. People who suffer trauma, for example, have difficulty with logic and coping because that part of their brain—the part that triggers the fight, flight, freeze, submit, or cry for help reflex—has been deeply affected.

“Be what you want to see,” said Mark H. If you want someone to calm down, be calm; if you want them to listen, be a listener. It’s what he calls an integrated exercise, and he uses a scale to assess and respond to different types of verbal agitation.

At the low end of the scale, you might encounter someone who’s verbally spontaneous, intermittently silent, or talking to his/herself. In that instance, you should communicate your concern and express empathy. You might have someone who’s inquisitive, suspicious, or doubting (e.g., “Why would they do that? What’s their problem? Are they after me?”). Instead of simply communicating concern, try to provide them with answers to their questions while you acknowledge their feelings. At the high end of the scale, if the person is challenging or verbally threatening, it’s best to disengage and to seek safety and/or support from fellow staff members; sometimes a co-worker brings a different attitude or perspective to the situation that helps defuse it.

If such a situation arises at the workplace, the most important thing to do is to remain calm. You need to be able to think rationally, to analyze the situation and determine best approaches. Always, too, be empathetic to the person. You never know what they’ve been through and how it’s affected them.

Por |enero 07, 2019|Eventos, People, Ciencia|Comentarios desactivados on De-escalation & Crisis Management Training: How to Defuse the Situation

4 New Years Resolution Ideas to Improve Your Mental Health [Infographic]

New Years resolutions can seem daunting. They’re a set of goals or ideals to aspire to, but sometimes even the attainable ones can feel out of reach. This is especially true if you suffer from mental health disorders, like depression or anxiety, for example.

Don’t let the new year get you down. We want to help you kick off 2019 with confidence and hope. Let’s use this as an opportunity to take small steps towards self improvement. These can be coupled with therapy, counseling, or whichever treatment service works best for you. So take a look at some of the New Years resolution ideas below; they’re tied together by the themes of self-reflection, neurological balance, and finding value in people and/or activities.

Happy New Year, everyone.

 

New Years resolutions ideas_mental health

Por |diciembre 28, 2018|Ciencia|Comentarios desactivados on 4 New Years Resolution Ideas to Improve Your Mental Health [Infographic]

Co-Occurring Mental Health & Substance Use Disorders, and Patriots WR Josh Gordon

On Thursday, New England Patriots wide receiver Josh Gordon announced on Twitter that he is stepping away from the game to focus on his mental health. According to a report, Gordon also violated the terms of the NFL’s substance use policy. His decision brings up an important conversation about co-occurring mental health and substance use disorders.

We applaud Gordon’s decision and support him as he seeks long-lasting recovery. Earlier this year, Gordon missed training camp while he sought counseling for anxiety. It’s quite common for someone with mental health issues to also have substance use issues. Gordon has been suspended in the past for repeated violation of the league’s substance use policy.

Co-occurring mental health and substance use disorders affect approximately 8 million people in the United States. They’re especially dangerous because one disorder can mask the symptoms of the other, and too often people will seek treatment for only one of them. According to the Substance Abuse and Mental Health Services Administration (SAMHSA), “the consequences of undiagnosed, untreated, or undertreated co-occurring disorders can lead to a higher likelihood of experiencing homelessness, incarceration, medical illnesses, suicide, or even early death.”

The following are signs and symptoms to look out for, but these can vary from person to person:

  • Withdrawal from friends and family
  • Sudden changes in behavior
  • Using substances under dangerous conditions
  • Engaging in risky behaviors
  • Loss of control over use of substances
  • Developing a high tolerance and withdrawal symptoms
  • Feeling like you need a drug to be able to function

Treatment options will also vary from person to person, but there are ways to treat both a mental health issue and substance use issue.

El National Alliance on Mental Illness (NAMI) suggests the following services, as per consultation with a therapist, counselor, or doctor:

  • Detox
  • Inpatient rehab
  • Residential housing
  • Psychotherapy
  • grupos de apoyo;
  • Medications

We at the Gándara Center understand the immediate need for treating co-occurring disorders. We’re currently hiring to staff a 16-bed enhanced residential rehabilitation services program for women with co-occurring mental health and substance use disorders.

The program, based in Ludlow, will take a multi-disciplinary approach to treatment, employing evidence-based and peer support methods including community, clinical, psychiatric, and medication-assisted treatment services. Wellness resources and activities will help patients build protective measures against co-occurring mental health and substance abuse disorders, and expose them to social skill-building opportunities as a pathway to achieving long-term recovery. These may include art, music, and fitness events; community fellowships; and mental health support groups.

We identified 14 Chestnut Place, the former location of the HealthSouth Rehabilitation Hospital of Western Massachusetts, as the site for the program. The opening date has yet to be determined.

 

Featured image via Erik Drost(CC BY 2.0)
Por |diciembre 20, 2018|Noticias, People|Comentarios desactivados on Co-Occurring Mental Health & Substance Use Disorders, and Patriots WR Josh Gordon

3 Reasons You Should Donate to Aventura!, our Western Mass Summer Camp Program [Infographic]

El testimonials we’ve heard from parents and kids who spent time at our Western Mass summer camp program are heartwarming. There are so many benefits to supporting an experience like this. It’s all about providing our local youth with an opportunity to grow in different ways. Kids can meet new friends, make new memories, and enjoy a level of self-confidence and self-esteem they may not usually get to at home. Since 2016, we’ve had the privilege to send almost 145 kids to camp.

Last year, we gave camp scholarships to 40 kids. This year with your help, we think we can do better.  Here are 3 big reasons you should donate to our Aventura! Summer Camp Scholarship program:

3 reasons to donate

Por |diciembre 19, 2018|Eventos|Comentarios desactivados on 3 Reasons You Should Donate to Aventura!, our Western Mass Summer Camp Program [Infographic]

Not Just Winter Blues: What is Seasonal Affective Disorder & What Are the Treatments?

People and media will tell you the holiday season is supposed to be a time for celebrating and good cheer. But it doesn’t always feel that way. The holidays can be stressful and put a strain on your physical and emotional wellbeing. For many, this is made worse by seasonal affective disorder—sometimes referred to as seasonal depression. Because it can be as distressing as other disorders, and shouldn’t be characterized as just winter blues, we put together this guide to answer some of your most important questions: what is seasonal affective disorder? Do I suffer from seasonal affective disorder? What causes seasonal affective disorder?

What is Seasonal Affective Disorder (SAD)?

SAD is a form of depression, so it doesn’t have its own standalone entry in the DSM-5. That doesn’t mean it should be taken lightly, though. According to the National Institute of Mental Health, in order to be diagnosed with SAD a person must meet the full criteria for major depression during specific seasons for at least two years. It’s caused by a chemical imbalance in the brain due to shorter days and less sunlight, which is why SAD tends to be seen more in the wintertime. This causes a person’s internal clock, or circadian rhythm, to shift out of sync.

Recognizing SAD Symptoms

Depression can manifest itself in many ways. Symptoms of major depression can include the following:

  • Feeling depressed most of the day, nearly every day
  • Feeling hopeless or worthless
  • Having low energy
  • Losing interest in activities you once enjoyed
  • Having problems with sleep
  • Experiencing changes in your appetite or weight
  • Feeling sluggish or agitated
  • Having difficulty concentrating
  • Having frequent thoughts of death or suicide.

Because SAD symptoms can vary as the seasons change, the following symptoms can include the following for winter and summer:

Light box therapy / Image via Lou Sander (CC BY SA 4.0)

Light box therapy / Image via Lou Sander (CC BY SA 4.0)

Winter

  • Having low energy
  • Hypersomnia
  • Overeating
  • Weight gain
  • Craving for carbohydrates
  • Social Withdrawal

Summer

  • Poor appetite with associated weight loss
  • Insomnia
  • Agitation
  • Restlessness
  • Anxiety
  • Episodes of violent behavior

Treatment for SAD

There are four primary ways of treating SAD: light therapy, Vitamin D, medication, and psychotherapy. Medication dosages and psychotherapy sessions should be discussed with your primary care physician, therapist, or clinician.

Light therapy is exactly as it sounds. According to Harvard Health Publishing, light therapy “entails sitting close to a special ‘light box’ for 30 minutes a day, usually as soon after waking up as possible. These boxes provide 10,000 lux… That’s about 100 times brighter than usual indoor lighting; a bright sunny day is 50,000 lux or more. You need to have your eyes open, but don’t look at the light.”

Light therapy isn’t a one-size-fits-all treatment. The amount of light people need varies on an individual basis. Some people are more sensitive to light than others.

Vitamin D therapy works on the same principle as light therapy; people who suffer from SAD tend to have lower levels of Vitamin D, and so a method of treatment is to provide more Vitamin D. Not surprisingly either, a good source of Vitamin D is sunlight intake.

From a scientific perspective, the jury’s still out on Vitamin D therapy. Studies have shown mixed results and correlations, though there is no definitive evidence that a Vitamin D supplement can effectively treat SAD.

Facts and Stats

  • Between 50–80% of light therapy users have complete remissions of symptoms
  • Seasonal affective disorder occurs four times more often in women than in men and the age of onset is estimated to be between 18–30 years
  • Those living farthest from the equator in northern latitudes are most susceptible: In the United States, 1% of those who live in Florida and 9% who live in Alaska experience SAD.
  • SAD can co-occur with other depressive, bipolar, attention deficit, alcoholism, and eating disorders, making it difficult to diagnose.
Por |diciembre 04, 2018|Noticias, Ciencia|Comentarios desactivados on Not Just Winter Blues: What is Seasonal Affective Disorder & What Are the Treatments?

The Massachusetts Good Samaritan Law: Protection for Overdose Victims & Witnesses

Studies show the Latinx and African-American communities are losing trust in law enforcement. This is because of a number of different reasons, such as societal stigmatization and prejudicial rhetoric against minorities. While in some cases it’s understandable why this erosion of trust is taking place, it makes things difficult for combatting the opioid crisis. Mutual trust between police and the community at large is necessary for harm reduction services to act as they should. This is where the Massachusetts Good Samaritan Law comes into play.

El Good Samaritan Law is the common name for a state law that protects substance users experiencing overdose symptoms from being arrested. It’s meant to encourage people to seek medical attention if they overdose by calling 9-1-1, protecting them from prosecution for illegal acts such as possession of an illicit substance.

The rule also extends to people with the overdose victim; so if they witness an overdose, they, too, will not be arrested.

Related: Opioid Overdose Deaths Among Black Males, Fentanyl Use Increase [Report]

The point of the law is not to arrest substance users, but instead to urge them to seek sustainable, long-lasting treatment and recovery services. Responders on the scene may administer the overdose-reversal drug naloxone (aka Narcan), and provide users with dosages to carry on themselves if medical assistance is unavailable.

Now, the law can also be a bit tricky to understand. It doesn’t exactly guarantee full immunity from prosecution. For example, if someone at the scene calls the police under the Good Samaritan Law and the caller has prior warrants or is intending to distribute substances, the protection goes away.

Here’s a breakdown:

What the Good Samaritan Law does:

  • Protects people from prosecution for possession of controlled substances when calling 9-1-1
  • Empowers witnesses to call 9-1-1 during an overdose
  • Saves lives and gives people who use opioids a chance to seek recovery and treatment services
  • Provides legal protection for medical professionals who prescribe naloxone, or people who possess and/or administer naloxone to someone appearing to suffer an opioid-related overdose
  • Builds trust between law enforcement and members of the community

What the Good Samaritan Law does not do:

  • Does not interfere with law enforcement securing the scene at an overdose
  • Does not prevent prosecution for drug trafficking
  • Does not prevent prosecution for outstanding warrants
Holyoke Police

Holyoke Police

The Gándara Center hosted two Spanish-speaking Narcan training events in November. Here we provided attendees with step-by-step instructions on how to act if they encounter an overdose. These included techniques for giving rescue breathing to overdose victims and best practices for administering Narcan. We believe everyone—Everyone!—should possess, know how to use, and be prepared to use Narcan. It could save a life.

We also enlisted the help of officers from the Springfield and Holyoke police departments to help residents restore trust with law enforcement. The officers explained the Good Samaritan Law from their perspective. They reminded everyone that their primary job is to maintain a safe community and it’s not their intention to simply go around locking people up on drug charges; rather, they want to help people recovery from their substance use and/or mental health disorders.

Por |noviembre 26, 2018|Noticias, Política, Ciencia|Comentarios desactivados on The Massachusetts Good Samaritan Law: Protection for Overdose Victims & Witnesses

Opioid Overdose Deaths Among Black Males, Fentanyl Use Increase [Report]

New data has been released that show overall opioid-related overdose deaths in Massachusetts are on the decline. Between Q2 and Q3 of this year, 49 fewer people suffered fatal overdoses. If this trend continues through 2018, Massachusetts will see two consecutive years of overdose death decreases after six consecutive years of increases from 2010–2016. This is good news. But there’s also bad news. Overdose deaths among black males are on the rise, as are deaths in certain counties, and fentanyl use.

11.16.18 opioid stats MassDPH_demographics

The Department of Public Health (DPH) uses three race and ethnicity identifiers to break down statewide demographic information: white, non-Hispanic; black, non-Hispanic; and Hispanic. Each group has suffered traumatically from the opioid crisis in their own way.

For example, more than three quarters of the state’s population identifies as white and statistically more whites have died over overdose than black, non-Hispanics and Hispanics. Hispanics saw the most dramatic increase in overdose deaths from 2014–2016, when the number of fatal overdoses nearly doubled. From 2016–2017, both groups saw a decline.

Opioid Overdose Deaths Among Black Males

Overdose deaths in the black, non-Hispanic community have steadily increased since 2014. But from 2016–2017, overdose deaths declined among black women—they increased among black men by more than 10 per 100,000.

“There is an increase in opioid-related overdose deaths among black males and we are focusing our efforts on tailoring our services to the needs of these communities,” said Public Health Commissioner Monica Bharel, MD, MPH. “We are also targeting public awareness campaigns to black communities in the Commonwealth, including a campaign to raise awareness about the importance of carrying naloxone, the opioid reversal medication.”

The African-American community faces a number of societal challenges that play into this increase, especially for men. These include stigmatization and bias when treating African-Americans, which can lead to breakdown of trust between the substance user and the medical professional; the lack of access to information and treatment services for African-Americans; and an over-reliance on faith as a spiritual form of treatment.

Fentanyl on the Rise

For overdose victims who received a toxicology screen, presence of the synthetic opioid fentanyl was found in 90% of cases. The DPH suspects that the majority of fentanyl found in Massachusetts is illicitly produced, meaning most of it does not come from pharmaceutical prescriptions and is either created illegally or smuggled into the state.

“The opioid epidemic, fueled by an all-time high level of fentanyl, remains a tragic public health crisis responsible for taking too many lives in Massachusetts,” said Governor Charlie Baker.

Fentanyl is estimated to be 25–50 times stronger than heroin and 50–100 times stronger than morphine. About 2–3 milligrams of fentanyl can be lethal. That’s roughly the size of 5–7 grains of salt.

Counties

Of the 14 counties in Massachusetts, 5 saw increases in overdose deaths from 2016–2017: Essex, Nantucket, Plymouth, Suffolk, and Worcester counties. Overdose deaths are up in Boston and Worcester, the two most populated cities in New England. In Boston, though, fewer residents died over overdose while more non-residents died of overdose, indicating people are traveling to urban centers and overdosing there in higher numbers. In Worcester, increases occurred among both residents and non-residents.

In addition, all these counties except Worcester County are contain significant port cities and towns, making it easier to import substances by boat.

11.16.18 opioid stats MassDPH_county

Combating the Opioid Crisis

The state has undertaken several initiatives to combat the opioid crisis. In addition to targeted public awareness campaigns (as seen above), Massachusetts secured $36 million in new federal funding to expand overdose education and naloxone (aka Narcan) distribution, office-based opioid treatment, access to medication-assisted treatment, and recovery support services.

The Gándara Center is also committed to supporting at-risk populations ravaged by the opioid crisis. We’ve hosted Spanish-speaking Narcan training events with Tapestry Health and will continue to put on training sessions in the future. We analyze data, like those provided by DPH, to determine effective long-lasting solutions for the communities we serve.

In addition, the various addiction recovery centers we operate are designed to serve people in different stages of addiction and recovery. We provide services for women, residential services for young women, short-term residential services for men, long-term residential services for Spanish-speaking men, and more.

Por |noviembre 16, 2018|Noticias, People, Ciencia|Comentarios desactivados on Opioid Overdose Deaths Among Black Males, Fentanyl Use Increase [Report]

What is Carfentanil: The Synthetic Opioid 10,000 Times Stronger Than Morphine

The latest available data show a decline in opioid-related overdose deaths in Massachusetts from 2016–2017. That’s reason to be optimistic. If this trend continues, the state could make serious strides to reduce the severe effects of the opioid crisis. But there’s also reason to worry. While toxicology analyses indicate a decline in the presence of heroin in opioid-related overdose deaths, fentanyl is on the rise. Even scarier is the emergence of a substance related to, and more potent than, fentanyl: carfentanil. So what is carfentanil?

Carfentanil is a Schedule II substance under the Controlled Substances Act (which includes substances like cocaine, opium, and oxycodone) and is used as an elephant tranquilizer. It’s a synthetic opioid much more powerful than fentanyl. Fentanyl is estimated to be 25–50 times stronger than heroin and 50–100 times stronger than morphine. About 2–3 milligrams of fentanyl can be lethal. That’s roughly the size of 5–7 grains of salt. (See image above.)

Image via DEA

Carfentanil, however, is estimated to be 100 times stronger than fentanyl, or 10,000 times stronger than morphine. As little as .00002 grams can kill a person.

Let that sink in a moment.

According to the Center for Disease Control, carfentanil deaths nearly doubled from 421 in the last half of 2016 to 815 in the first half of 2017. Like fentanyl, which turned up in 89% of toxicology reports among overdose victims in Massachusetts this year, other illicit substances can be laced with carfentanil. For example, a Cincinnati man plead guilty to attempting to murder a witness by selling him heroin cut with carfentanil; in Indianapolis, supposed prescription pills were found to be counterfeit, some of which contained carfentanil.

The arrival of carfentanil in the commonwealth was confirmed by Massachusetts State Police in 2017. At the time, State Police were unaware of any overdose deaths connected with carfentanil. Since then, “The state’s drug lab has detected carfentanil in at least 40 samples of heroin and other opioids seized during arrests” and “as detected in autopsies in at least four overdose cases last year,” as reported in abril 2018. The manufacture, possession, and distribution of carfentanil has been explicitly outlawed by the state legislature.

Overdose deaths caused by carfentanil have also been reported in New Hampshire.

On the other side of the continent, harm reduction methods are in development. Scientists in Vancouver, British Columbia have created a paper testing strip that recognizes the presence of fentanyl or carfentanil in a given substance. The hope is this will lead scientists to build “a compact mass spectrometer the size of a small microwave, that could be used in overdose prevention sites, in community health centres [sic] and by mobile harm reduction teams.”

Vancouver, hit extremely hard by the opioid crisis is an international leader in combating it, from offering extreme users clean prescription heroin to the formation of safe injection sites—the idea being you can’t provide treatment people for substance use if they aren’t alive to receive it.

Increased access to naloxone (aka Narcan) has helped reduce opioid-related overdose deaths nationwide. With fentanyl and carfentanil, though, it’s unclear how effective naloxone is. Naloxone reverses the symptoms of overdose in a matter minutes and has been credited with combating overdose deaths. Because of the sheer potency of carfentanil, scientists have seen a resistance to standard doses naloxone, such as an injection or nasal spray, though data remains inconclusive.

The Gándara Center is committed to empowering everyone to learn about naloxone and how to use it. We partnered up with Tapestry Health to hold two Spanish-speaking Narcan training sessions, in Holyoke and Springfield, to provide information and free dosages of Narcan to at-risk populations.

We will continue to work with Tapestry to host more training sessions in the future, and get Narcan in the hands of as many people as possible.

Por |noviembre 15, 2018|Noticias, Ciencia|Comentarios desactivados on What is Carfentanil: The Synthetic Opioid 10,000 Times Stronger Than Morphine

4 Questions for a Psychiatric/Mental Health Nurse Practitioner, Trans & Queer Specialist [Q&A]

Andrew Taylor is a Psychiatric/Mental Health Nurse Practitioner and a recent addition to the Gándara team. He started in early September, and he prescribes psychiatric medications to patients across the lifespan. His main area of expertise is working with the trans and queer community, and in addition to prescribing at Gándara, he will help expand the available services for that population at the outpatient clinic.

1. What are the dangers of the Trump Administration’s attempt to classify gender based on anatomy?

It’s hard to know where to begin with this question because of the gravity of damage that would be done if Trump is successful in this endeavor. Gender is by definition NOT based on anatomy. If you are cis-identified, meaning your gender identity coincides with your sex assigned at birth, you may think this definition is accurate, but for trans people across the spectrum, a change in this definition would effectively make the whole community invisible, as it cuts to the core of what trans identity is.

It seems to me that people will be affected by this change in a variety of ways. For the trans kids of the world who are in the contemplative phase of transition, they may be less likely to come forward with essential parts of their identity because the adults around them may refuse to, or not know how to, recognize them. A denial or avoidance of such a central component of identity does long lasting damage to the mind, heart, and body of a child. So often trans people say they always knew their identity to be different from the mainstream, but did not have the language to explain it. If the language is taken away, then what? Kids and adults will then have to rely on the subset of the population still acknowledging this identity as real and valid, and that community may be harder to find.

“If they are hoping we will give up, they should reconsider the power of our persistence and our fury.”

For people of all ages who are already in transition, and who are attempting to change their legal documentation, they will now encounter barriers that will drastically affect the future of their lives. It puts safety at risk when documentation does not line up. Driver’s licenses, state IDs, and passports will not accurately reflect identity, potentially putting safety at risk both inside and outside the bounds of the United States. People may struggle to get married, adopt children, and get basic services, if not all documentation lines up. Healthcare coverage could be in jeopardy if people have some documents changed but not others. The list actually is endless and creates incredible complications for people within this community.

2. What are the dangers of voting no on Question 3, repealing the law allowing individuals to use bathrooms/locker rooms based on identity?

First we need to take a step back here and widen our understanding of this law, what it covers, and what a repeal of the existing law would mean. Opponents call it the “bathroom bill,” but that grossly under-represents the scope of this law, and instead addresses only a tiny portion of what it covers. The law is about Public Accommodations, meaning any and all PUBLIC SPACES. Sure bathrooms and locker rooms are public spaces, but so are hospitals, pharmacies, libraries, highways, public parks, restaurants, bars, banks, any kind of retail shop, gas stations, sports stadiums, concert venues, amusement parks, grocery stores, liquor stores, gyms, coffee shops, ice cream shops, public beaches, tattoo shops, veterinarian clinics, craft stores, hardware stores, etc. A yes on 3 vote continues to ensure protections for trans people in all of those spaces, not simply bathrooms and locker rooms. A no on 3 vote repeals legal protections in all of these spaces and does damage far beyond pulling coverage within restrooms and locker rooms.

But second, it’s also very important to address the fact that a repeal of this law would put a whole group of non trans-identified people at risk as well. Really anyone who does not look like one end of the gender binary or the other would be targeted and policed. For example, someone who was assigned female at birth, and who identifies as a woman, but who dresses in clothing traditionally deemed masculine, she is now at risk as well even though she is a woman using a woman’s restroom. It would be immensely problematic and will continue to jeopardize the safety of the trans population because people, both of authority and not, people will begin to police the use of restrooms in an unproductive and damaging way.

Related: Transgender Governor Candidate Helps Focus Attention on LGBTQI+ Substance Use & Mental Health

It seems opponents are waging the same war that was waged against gay men several decades ago, painting trans people–especially trans women–as predators, pedophiles, and criminals. But not once have opponents mentioned that trans people are far more likely to be the victims of violence in these spaces than the perpetrators. It’s an essential component of this dialogue, and opponents are choosing not to include it at all, which is quite simply, not in keeping with reality.

In moments when I am feeling low, I look at all the people who are supporting ballot question 3 here in Mass. The list of those in support goes on and on, requiring several scrolls through the webpage. There is only one group not in support, and the representation pales in comparison.

Ultimately, my hope would be that those in favor and those opposed could instead focus on our common ground, and work towards societal goals that carry more weight. A focus on policing restrooms is a distraction from much larger issues that this country is dealing with.

3. Why do you think these movements have gained traction?

I think people reflect what they see in leadership and when those actions are backed by a tremendous degree of power, the results can be very dangerous. Perhaps hate was lying dormant, and it has found a home in Trump’s leadership, and since Trump does very little to condone the acts of violence we see escalating in our country, the hate continues. If I were working with a patient who was telling me about this kind of rhetoric, I would not hesitate to call it emotional abuse. It’s destabilizing, and it is creating a traumatized society. And with one of the main symptoms of trauma being anger, it’s not surprising that we see the world around us growing angrier by the day.

4. What advice would you give to the LGBTQI+ community about living happy, healthy lives in a climate that feels increasingly prejudiced towards them?

In the face of trauma, there are several actionable steps that improve outcomes:

  1. Find a community who sees you, validates you, and wholly honors your identity; do not isolate, as it increases depression symptoms.
  2. Keep breathing, keep moving your body, keep drinking water, and do not let your self-care slip by the wayside.
  3. The powers that be are hoping for minority communities to crumble so power can be maintained by the elite few, but we must persist and remember that this is not normal. In addition, if changing legal documentation is part of a person’s transition goals, the time to act is now.
  4. Do not delay, but rather reach out to people who can help.

When I recently heard of the changes attempting to be made to the definition of gender, I read a response piece by Mara Keisling, who is the Executive Director of the National Center for Transgender Equality that I found incredibly helpful. She ends the response with the statement, “If they are hoping we will give up, they should reconsider the power of our persistence and our fury.” That quotation now hangs on the wall next to my desk as a reminder to keep moving forward, and spread as much love and positivity as I can muster.

 

Featured image via Creative Commons/ Ted Eytan (CC BY-SA 2.0)
Por |noviembre 05, 2018|Gándara en las noticias, Noticias, People, Política|Comentarios desactivados on 4 Questions for a Psychiatric/Mental Health Nurse Practitioner, Trans & Queer Specialist [Q&A]
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