The tragic story of the young Latino leader from the Southwest Side of Chicago who died by suicide (“‘Did he really not know how loved he was?,'” Jan. 24) highlights the ongoing issue of mental health among our youths. As a Latina pediatrician serving children from the Southwest Side, this issue is important to me; I believe that providing more access to mental health services will not only be beneficial from a medical perspective but also will help decrease stigma.
The issue of mental health is so large, encompassing family dynamics, school settings, social media and health care, that it is difficult to focus on just one aspect that can be improved; as a pediatrician, how mental health is recognized and treated in the health care setting is my priority. Studies have found that depression rates among adolescents can range from 13% to 25%.
Genetic predisposition and environmental factors like low educational and socioeconomic standing contribute to the development of depressive episodes. Screening for depression among 12-to-18-year-olds is recommended by the U.S. Preventive Services Task Force.
There is agreement that screening for depression among adolescents is essential and that the course of treatment for a teenager with moderate or severe depression is referral to a mental health clinician. Even mild-to-moderate depression requires cognitive behavioral therapy and interpersonal therapy. Pediatricians can prescribe antidepressants, but therapy alone or therapy combined with medications can be effective for mild-to-moderate depression.
This leads to the question of how families will pay for mental health services, including therapy.
As highlighted by a letter from many health organizations to the U.S. Senate Committee on Finance regarding how to improve mental health care for children who have Medicaid insurance, reimbursement for mental and behavioral health services is low to nonexistent. Medicaid agencies pay less for these services than Medicare and private payers.
With the recognition of mental health as a legitimate health issue and the process of diagnosis and treatment with health care providers and insurance reimbursement occurring in the same way as any other disease, there is hope that stigma against mental health issues may decrease.
— Dr. Nicole Salach, Chicago
Tension between tradition, technology
Among history’s recurring rivalries is tradition versus technology. Ever since the invention of the wheel, traditionalists have had their doubts about newfangled innovations. Frankly, the technologists have eventually carried the day.
However, there are times — as recently as the Iowa caucuses — when the traditionalists get to crow in the wake of the technologists’ mistake — in this case, Shadow Inc.’s spiffy new phone app. Designed to improve ballot counting, the little app generated some big problems.
All this will be sorted out in due time. But here’s the point. No matter the results, this technical flop will rekindle the hearts of all the skeptics who love to live by the shibboleth: If it ain’t broke, don’t fix it.
Assuming we take good citizenship seriously, we get to make two important decisions. First, whom should we elect to be our leader. Second, what mix of tradition and technology should be our guide.
— Jack Spatafora, Park Ridge
Nostalgia for simpler times
In these troubled and often unsettling times, it may be therapeutic to think back to simpler days and remember a time when:
Drivers kept their eyes on the road — not on their phones. Virtual reality was known as a dream. Our president was a respected leader of the free world. Climate change was the changing of the seasons. People didn’t feel so entitled. Republican senators stood against corruption. Honey Bears roamed the sidelines. Our president wasn’t easily manipulated by a Russian leader. It wasn’t trendy to be offended by everything. Winter in Chicago meant cold and snow. Liberal wasn’t a derogatory term. Pot was illegal. The federal government tried to reduce pollution. People weren’t so inconsiderate as to think their dogs belong in stores and planes.
And lastly: Our president and the village idiot weren’t the same person.
— Bryan Bradley, Buffalo Grove
Editor’s note: Another letter was merged with writer Bryan Bradley’s letter. His letter now appears in its proper form. The Tribune regrets the error.
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