TeenScreen Truth

Mental health screening when in matters most.

Hiring The Best Blog Hosting Service

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bbhsPeople who are trying to find out how to start a blog usually have no idea where to start, and hiring a hosting provider can be very confusing. One sure thing is that hosting is a must, but the question is, how do you find the right provider? There are exclusive blog companies, web hosting and web hosting resellers, and the first two groups can be either free or paid.

Before making any choices, every blogger should know what exactly they need, because there are people who want to create blogs in order to share their point of view, while others want to earn money. There are bloggers who have no knowledge on encoding, so they need a provider who offers simple interfaces. On the other hand, professionals want to control their blogs, so they search for unlimited features. Choosing the web hosting services over blog hosts, and vice versa, usually depends on blogger, how much he knows about technical stuff, and how dedicated he can be. People who wish to make money through their blogs should turn to blog hosting providers, especially because they have better chance to be seen by everyone. After figuring this out, one can move on to the “how to start a blog” process, and start making quality content.

The Battle Of Blogging Platforms

Those who have realized how much benefits blogging can bring along usually want to learn how to start a blog immediately. This takes more than good writing skills and passion, and the first thing is probably choosing the right platform. The Blogger and the WordPress as the most popular ones are usually compared but they both have pros and cons that must be considered.

Blogger was created by Google, and it is a great choice for beginners in this area, because it is easy to use and set up. It goes great with various Google applications, and for just $10 a year, one can get a domain name and hosting service as he needs. The major reason people choose WordPress over Blogger is the so-called unprofessional look of Blogger. WordPress is a great idea for those who consider creating a business blog, and it is constantly updated. There are many templates offered by WordPress, and they may be free or paid. When it comes to hosting, the WordPress suggests some of the best providers, for the best price. After making the choice, comes the process of learning how to start a blog and how to write engaging articles that will attract the audience.

25

January
2014
Time: 6:27

Back Tax Help Issues

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bthsWith technological advances, there are highly orchestrated scams within each public and private sector. In other words, fraudsters have invaded literally every part of the economy where money is generated. One of the sectors affected is the tax department. Many con people have perfected the art of stealing from unsuspecting individuals, often posing as professionals. Many people have lost a lot of money due to these scams. This therefore calls for absolute caution when one is seeking tax back help. It is hard to identify the fraudsters, but there are some tips to help one avoid falling victim to scams.

When seeking back tax help, it is necessary to use only experts who sign the returns they prepare and enter their Preparer Tax Identification Number (PTIN). The IRS has provided guidelines and tips about choosing a preparer, details on how to obtain preparer information and how and when to make a complaint. At the same time, the IRS has created a web page to help taxpayers. One fact tax payers have to be aware of is that they are legally responsible for whatever appears on their tax return, it does not matter whoever prepares it. Therefore, whoever needs back tax help must be wary of those they hire to file their tax returns.

Factors To Consider When Seeking Tax Relief Help

When one has a big tax debt to cater for, say more than $25,000, it may be important to seek a tax professional. The professional should be a certified public accountant, an enrolled agent or a tax attorney. It is important to seek more information about a certain professional as the IRS only recognizes approved tax professionals to handle tax related cases for their clients. At the same time, it is imperative to keep costs under control. Most tax professionals charge for their services on hourly rates. Others charge a flat rate. To minimize the fee to be paid, the tax professional should be able to advice on the paperwork that a client can handle on their own. This way, a client can get tax relief help without spending more on professional services.

Another way of benefiting from tax relief help is by filing for tax returns late. This is advantageous as it offers one the opportunity to take every tax deduction one is legally entitled to so that they can reduce their tax liability. When one has already filed for taxes, the tax professional can review the returns to check if they are accurate and if there are deductions that might have been overlooked yet a client is entitled to. After checking the tax situation, the professional may advice if one needs to file for tax amendment. Read about this at http://taxdebtrelief.biz/.

06

October
2013
Time: 6:47

The Need Of RAID 10 Recovery Techniques

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nr10rTo understand the process of RAID 10 recovery and find out other details, people must first know what the actual reasons of RAID 10 disk failure are. When this fact is known, the process becomes easier. The first reason would be the controller failure of RAID 10. Another reason is the corrupted and lost array configuration of RAID 10. Sometimes the data is lost or it gets damaged. If the formatting is done by mistake, such methods of recovery helps in getting back the lost data and bringing the disk to its original position.

Intermittent disk failure is the other reason that results in RAID 10 recovery. Sometimes the wrong attempts of drive markings result in the disk failure. For rebuilding the errors such techniques of RAID recovery are helpful. For different levels of RAID, different techniques and methods are designed. Conflicts in hardware is another reason that requires the techniques of RAID recovery. The method of RAID 10 recovery is completed by several ways. People can use software or do it manually. The RAID recovery is successful the size and location of volume is known. The method file system algorithm is a recovery process that works perfectly when disk is divided on a logical disk.

Different Types Of RAID

RAID has become very popular tool that is used in order to store more data, especially for small businesses. In this case, many hard disks are connected in one hard drive, but they can perfectly work separately, when needed. Therefore, in case of RAID repair need, it is recommended to check each disk, and there are experts specialized for this. However, there are various types of RAID drive, and it is better to know performances of all before purchasing.

The RAID 0 or so-called Stripe is larger that has a great size, and its speed is very good. It consists of two or more drives, and if one gets damaged, the information can be lost for good. The RAID 1 or Mirror is the reliable one, and its speed and size are not the advantage in this case. The RAID 0+1 or Mirrored Stripe is some kind of combination of previous two and it has it all – it is reliable, has a great speed and size. The RAID 5 or Stripe with Redundancy is also very reliable and has suitable speed and size, and it has very popular Redundancy Information feature. They are all created to various users, and in many cases, the RAID repair depends only on the type of the drive.

01

October
2013
Time: 17:30

Gaining Control With Stop Snoring Devices

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snoringdeviceIt is always better to control snoring as early as possible because once the snoring goes wild, you cannot control it effectively. It is very negative to take snoring lightly because after few years, you can develop some other more complex sleeping disorders and those disorders will disturb your life a lot. People are very reluctant to use stop snoring devices but if you see the situation realistically then you will see that these devices are the only way out of snoring. There are hundreds of remedies and tricks to control snoring but very few of those things are actually effective against snoring. Stop snoring devices are always effective and all you need to do is to find a more effective device that helps your case of snoring. Different devices address different issues and to choose best possible device, you should consult your doctor first. He will tell you the real reason of snoring and will help you find the most appropriate and most effective device. Addiction of these devices should be avoided as well because once you become addicted, you will find it tough to sleep outside your home because you cannot carry these devices everywhere with you. There are many stop snoring devices reviewed at stopsnoringmouthpiecereviews.org, of course.

Snoring can be handled very properly with stop snoring devices but some people are not comfortable with using these devices. Especially when it comes to using advanced devices like CPAP. Most of the devices, that are used to control snoring, come with a mask that sufferer has to wear during night while this mask can be uncomfortable for lots of people. The best way to minimize the struggle is to order a mask that suits your mouth size and fits you comfortably. There are very few methods to control snoring and using stop snoring devices is one of those methods. Modern stop snoring devices are not very complex and these devices are also very easy to wear. You just need to make sure that you are purchasing the right kind of device that addresses the real cause of your snoring. Some devices address the problem of nasal blockage while some address breathing issues. You need to consult your doctor first and determine the cause of snoring first. You should also take care of the addiction of these devices because some people get addicted to these devices and cannot sleep without these devices even for one night.

10

August
2013
Time: 0:25

What To Check Out For Before You Enroll In A Medical Billing Course

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Before you enroll for a medical billing course, there are several things that you will need to check out on one, you must keenly go through the school profile. Does it have trained medical billers? If so, how experienced are they?  Remember, you need to get value for your money as well as maximum proficiency. In this case, proficiency comes in after being taught by a well experienced medical biller. Secondly, the school must offer you the opportunity of interacting with other students. Taking up a medical billing course is not reason for you not to interact with members from other courses.

Additionally, the school must be in a position to offer you with enough referrals. A school which does not offer you referrals is questionable and you should never enroll in such. There should also be several payment options. This accommodates a variety of students from different towns and even other parts of the world. You must also be careful about the time limit offered by the school. A good school does not take more than two years to complete a medical billing course unless one is under special instructions. It is important for you to go through the school requirements before you can enroll for this course. Read about this at www.medical-billing.net

20

July
2013
Time: 15:55

NYC Politics Leaves Scars

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You want to talk about stress? Picture this. You are sitting in the first row of the cavernous hail in Brooklyn where the New York City Board of Education meets.

At your feet lies a hoard of news media types, cameras in hand, clicking away as if they need to use up all the cheap film in their expensive cameras. The hot television lights are reminiscent of those in your favorite tanning salon. Reporters feverishly scrawl notes on their pads, and you wonder what facial expression or body language they are reading and recording for their stories. The house is packed, standing room only.

The big hullabaloo is the culmination of my two-week roller coaster ride.

nycboard

Finalist Status

It all started with a phone call from a consultant wanting to know if I was interested in becoming the chancellor of the New York City public school system. Two years earlier I had been a finalist for the same position and my name had become indelibly etched in the computer banks for future reference. New York City chancellors tend to have short tenures and therefore are urged not to buy green bananas.

A list of more than 70 candidates quickly was pared down to 30, then to 15. I read in the newspapers that I had survived the cut and I was part of the final 10. In chancellor searches you learn about your status by reading the dailies.

I was in the company of several candidates who also had been part of the final 10 several years earlier. One of the tabloids handicapped the field and gave me the second best odds to win the job. I did not know whether to snort or smile.

The mayor of New York City, like many of his Republican counterparts in city halls and governors’ mansions around the country, wanted control of the school system’s finances. Because of his election campaign promise to reduce crime, he also wanted control of the schools’ security operation. Mayor Rudolph Giuliani, early on in the search process, had decided he wanted to hand-pick the next chancellor of the school system.

The mayor quickly announced his choice for the job. I was not that person. However, the person selected by the mayor came under severe attack by the press, which raised some serious allegations about his character and past dealings. Within several days, that individual withdrew his name from contention.

By this time, Bud Spillane, the superintendent from Fairfax County, Va., and I had survived a rigorous screening process that included one of the most in-depth background checks I have ever endured. We also had to subject ourselves to a comprehensive physical examination and a live two-hour television debate. That was followed by a two-hour grilling by reporters and editors at The New York Times, interviews with parent groups, community leaders, and assorted politicians. The last hurdle was a final interview with the school board.

Mounting Strain

Throughout this process I had been plagued by an old back injury. Sitting through countless interviews and walking up and down the streets of New York City were not doing my herniated discs much good. Adding to the pressure were the rigors of my current job as district superintendent in western Suffolk County.

In addition, I recently had been given responsibility by the state board of education for the first-ever intervention by the state education department in a failing school district. Expectations were high and everyone was looking for immediate changes and a miraculous turnaround for that school system.

Being a school superintendent is like being an athlete. Peak performance requires both physical and mental stamina.

Twelve-hour workdays are the rule, and we often are expected to be at our best during board of education meetings, after we already have put in a full day. Add to the physical demands the mental and emotional strain that accompanies the job and you have the ingredients for a lack of wellness.

Most superintendents fail to recognize the stress they work under. Such physical manifestations as headaches, back pain, stomach problems, and high blood pressure frequently are ignored. Also overlooked is the impact on personal and family life. Divorce among superintendents runs at a fairly high rate.

The short tenure of the superintendency–a national average of six years on the job and even less for urban superintendencies–makes for a great deal of mobility, another stress inducer. Alcoholism and substance abuse are addictions seldom discussed among superintendents, but I know of colleagues who have succumbed to these problems, often after losing jobs or splitting from their spouses.

Unfortunately, any thought of superintendents participating in workshops designed to train them to be physically fit and mentally tough is met with considerable skepticism. Superintendents themselves do not want to admit they need such help. While it is acceptable to attend a workshop on curriculum or administrative strategies, admitting to a need for stress reduction or conflict management training is akin to publicly flaunting a personal weakness. The superintendent must forever be the paragon of strength. Any show of weakness is an open invitation for our detractors to attack our Achilles heel.

The fact is that it is often the pressure of the job, and the inability of the superintendent to effectively cope with that pressure, that proves fatal. When was the last time you heard of a superintendent being fired for his or her lack of knowledge in curriculum and instruction? Sadly, the demise of most superintendents centers around political and governance issues and the superintendent’s inability to effectively manage conflict.

The majority of superintendents who retire as soon as they reach the qualifying age do so not because they feel unprepared to deal with the educational changes, but because they no longer want to deal with the political hassle and the pressures of the job.

We can improve the qualities of our lives and contribute significantly to our professional success by exercising regularly, being mindful of our weight and what we eat, and becoming proficient in stress reduction and relaxation techniques.

Survival Training

As stressful as my New York City experience may have been, I enjoyed every minute of it. I was physically and mentally ready for the job. I relished all the interviews with the media. I saw them as opportunities to advertise myself to the community I thought I would be serving. I looked forward to every interview with the board as another chance to express my views and gain their confidence.

I practiced my deep breathing techniques to help me relax before every major encounter with the press. I took advantage of “down time” to listen to relaxing music and allow my batteries to recharge. I continued my exercise and stretching program to minimize my back pain and maintain a high energy level.

My last meeting with the board clinched the deal. As I was driving home from the interview, I heard on the radio that the board had decided to offer me the job. Why should I have been the first to know?

On the evening that I sat before the New York City Board of Education awaiting their ratification vote on my contract, I was ready. I realized the mayor had done everything in his power to overturn the board’s decision the previous day to offer me a contract. That morning my picture had appeared on the front page of every major newspaper in the metropolitan area as the new chancellor.

However, a board member who had supported my candidacy the night before had succumbed to political arm twisting and had agreed to change his vote. I was about to be done in. My wife and son sat with me, ready for the inevitable. There would be no celebration in the Domenech household that evening.

I fell victim to New York City politics. I was chancellor for a day. But I was not cowed by the experience. I would not agree to the mayor’s intrusion into an area that was clearly the province of the chancellor and the board of education. The welfare of children is much too important an issue for it to become political fodder. There is no room for compromise in this regard.

22

June
2013
Time: 17:35

The Philippines Changed Him Forever

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One of the greatest gifts I received during my three-year stay in the Philippines was the display of love, hospitality, laughter and warmth that is so typical of the Philippine people. When I went to celebrate Mass in the barrios or visit families and friends or meet with students and coworkers at the seminary or at Maryknoll Women’s College (where I also taught literature), people always had time for me and were most personable and cordial.

Social events did not always start on time because people and their needs were always more important than schedules or the job at hand. This made me realize how task-oriented and time-conscious–and often impersonal–Americans can be by contrast. I began to discover how I, as an American, was always so serious about checking my watch and getting down to business. The Filipinos were the first to teach me the meaning of the Oriental expression: “We don’t have watches; we have time.” They taught me to lighten up and laugh and take time for human interchange and affection.

Comparing Asian and American Values

After my first year of teaching at Our Lady of the Angels, I was asked to be chaplain for a small group of Franciscan college students who were going to Cebu City, the Philippines’ second largest city. These students would be taking summer courses at the University of San Carlos in that bustling port city, situated on the island of Cebu.

This gave me the opportunity to take some classes myself at that university. One of the courses was Filipino Literature in English, a course that was itself an insightful journey into the Filipino culture. (I would be teaching it myself the next semester back at the seminary. There I would have the perfect opportunity to learn about the culture from students who grew up in it.) The other was Filipino Values, taught by Lourdes Quisumbing, Ph.D., a well-known sociologist who later became Secretary of Education for the Philippines under President Corazon Aquino.

Professor Quisumbing’s class was largely a comparison of Asian-Filipino cultural values with those of the United States. I found her course spellbinding. Scales seemed to fall from my eyes as she explained the different sets of presumptions upon which American and Filipino approaches to life were based.

Here is just one example. Professor Quisumbing explained that in the Philippine culture–and in Asia generally–people grow up learning to face life together. Families are close-knit. They are expected to be emotionally interdependent–to meet life’s problems as a social unit. American culture, on the other hand, typically teaches its children to become emotionally independent as early as possible, so individuals can face life’s difficulties on their own. The American ideal is to prevail on your own–like so many of the heroes in our movies.

How true this rang to me! As I grew up in the United States, I was seldom pampered by parents, relatives or teachers. Theirs was a kind of tough love that taught me to face life with a stiff upper lip. I learned rather early to go hunting and fishing by myself In U.S. society it would not seem strange for me to go to the swimming pool or gym to work out on my own. There were frequently times in the Philippines, however, when I went somewhere on my own and was asked, “Where is your companion?” The cultural assumption behind the question was that human beings should be facing life together, not alone.

Thus my Philippine experience was teaching me to test and question my own cultural presuppositions. I actually learned to be less of a loner, to be more personable and openly affectionate and to see the value of family closeness and emotional support. I saw how the Philippine approach reflected the Christian ideal of being one body and bearing one another’s burdens. At the same time, I could still see the need for emotional independence, like that exhibited by the prophets and Jesus when they had to stand up against the crowd, even when abandoned by their own.

Without judging, Professor Quisumbing gave a multitude of examples of how American and Asian perspectives differ. Day after day this great teacher enlarged our cultural vision and understanding. She taught us, above all, to revere the different ways of the earth’s peoples. “To judge other cultures by your standards is insult,” she used to say. “To judge them by their standards is insight.”

Other Memories and Goodbyes.

I experienced both hardships and blessings during my three-year stint in the Philippines. Among the blessings, certainly, was the friendship and love of many Franciscan brothers and sisters, native Filipinos as well as colleagues from other countries.

One American friar, Max Hottle, O.F.M., of the California Franciscans, and I became fast friends and confidants. We were roughly the same age and of the same mischievous temperament. Max had a head start on me in understanding the cultural background of the Philippines. Trained in sociology at Manila’s Jesuit university, he had already been teaching social studies at the seminary for several years before I arrived. His often humorous and wry observations were always full of light, wit and fraternal warmth and were a medicine for my soul.

One of the highlights of our camaraderie was taking a motorbike vacation in the summer of 1971 through the mountains of Luzon to visit the famous Banawe rice terraces and other wonderful places. We fancied ourselves Asia’s answer to the American movie “Easy Rider,” a big hit all around the world at the time. The image of the film’s two hippies on motorbikes quickly became the running joke of our adventures!

As I look back on my time in Asia, I see it as a gift of providence and a preparation for my future work as a writer and editor with an interest in global issues. High on the list of things I discovered in the Philippines was this: Cross-cultural experience is another word for light.

Even before I went to the Philippines and was wondering, with some trepidation, what the future would bring, I had latched on to Psalm 121 as a consoling prayer for God’s protection. It often brought me comfort in my wanderings so far from home. Here is an abridged and adapted version of that psalm for all those who are anxious about what is coming next in their life’s journey. It’s also my prayer that God may always be your constant traveling companion:

YOUR GUARDIAN NEVER SLEEPS

God will not suffer your foot to slip; for the God who guards you does not slumber. The guardian of Israel neither slumbers nor sleeps. The Lord is your guardian and your shade, a faithful protector at your side. The sun shall not harm you by day, nor the moon by night. God will guard you from all evil; God will guard your life. God will guard your coming and your going both now andforever.

PRAYER FOR OPENNESS

God of all nations, do not slumber in your love for the Philippines and all the peoples of the earth.

Forgive the sins that we, shaped by different cultures, commit against each other through ignorance, weakness and inexperience.

Fill us with your all-embracing love and goodness that we may carry your kind of love to all races and peoples. Amen.

I LEFT THE PHILIPPINES with mixed feelings. It was difficult leaving a country that had given me so much and separating from friends whom I had come to love. On the other hand, I was looking forward to reuniting with family and friends in the United States after a three-year absence. I was also eager to begin a new phase in my Franciscan journey as a writer and religious journalist.

Well, being a writer was not entirely new. As a student, I had always been attracted–if not driven–to write for our Franciscan seminary publications. I had also studied creative writing at the University of Louisville and at Notre Dame and journalism one summer at Marquette. I had even experienced the excitement of seeing a few free-lance articles of mine appear in Catholic magazines, including St. Anthony Messenger, a national magazine published by my Franciscan province in Cincinnati.

In fact, during my last year in the Philippines, I had written an article on Pope Paul VI’s 1971 visit to Manila and on the state of the church in that country. The magazine’s young, visionary editor at the time was Jeremy Harrington, O.F.M., whom I knew personally, a fellow Franciscan of the Cincinnati province. He wrote me a few months before I was to finish my time in the Philippines and invited me to join the staff of St. Anthony Messenger. It all seemed providential.

The Journey Home.

The pain of leaving the Philippines was also muted by the excitement of the long trip home with stops in Thailand, India, the Holy Land, Greece, Italy, Austria, Germany, Spain, France, England and Ireland. The trip was exciting. Enough soul-expanding things happened to fill a book. I will just share one little out-of-the-way incident from that trip which had a special impact on me. It took place at the shrine of Our Lady in Lourdes, France. From my earliest years as a Roman Catholic, I had heard about this famous shrine and was drawn to it as toward a magnet.

As a young boy, I had seen the movie “Song of Bernadette,” which dramatized the appearances of the Virgin Mary at Lourdes. I still remember the scene where the young visionary, Bernadette, digs into the ground at the lady’s instruction only to see a miraculous spring of water issue forth.

A few weeks before my stop at Lourdes, a Catholic traveler told me to be sure to take in the bathing pools at the shrine. I had thought that only people with serious illness or disabilities were lowered into the spring-fed pools in the hope of being cured. “No,” she told me, “every visitor should experience these baths.”

My first night at Lourdes, I felt like a lonely pilgrim reaching out for the healing presence of Mother Mary’s love. What I was yearning for, I believe, and somehow sensed there in the darkness, was the maternal love of God, such as Yahweh promised through Isaiah: “As a mother comforts her child, so I will comfort you” (Is. 66:13a). I had always seen such love embodied in Mary, whom Catholics revere as the mother of God and the mother of the church.

It was damp, cold and drizzly the next morning when I went to the shrine’s bathing pools. An attendant kindly showed me to a small dressing room next to one of the pools where I could remove my clothes and wrap around my waist the denim cloth they handed me. Two attendants greeted me at the pool. The water, which came up to my knees, was cold. After reciting a gentle prayer, they carefully lowered me, back first, into the water. I expected the water to feel shockingly cold, but it seemed remarkably comfortable. They helped me stand up again and led me dripping out of the pool.

I was invited to get dressed and leave. It was not necessary to dry off, they told me. My clothes would not get wet. Strangely enough, after I got dressed, my clothes seemed perfectly dry. On more than one occasion since that event, other visitors to Lourdes shared with me this same experience of their clothes not getting wet.

But that is not my most vibrant memory of the experience. I can’t explain it, but after I got dressed and was walking away from the baths, I had an amazing feeling of innocence and new life. It was as if I was cleansed of all my sins. I felt whiter than snow! Although this experience happened more than 23 years ago, it remains as fresh in my memory as if it just happened yesterday. It was an inexplicable moment of light.

Whatever mixed feelings I still had about leaving the Philippines, whatever darkness or failure or guilt I felt in my heart, they were now replaced by healing and light–at least for the time being. I felt like a little child whose bruises or hurts had been kissed by an unseen yet loving mother. I was suddenly healed, and ready to resume my journey with a lighter step.

Home, But not Really Home.

I arrived back in the United States in the middle of the summer, 1972. I was home again. But I did not really feel at home. Yes, I felt happy to be reunited with family and friends. It was exciting visiting the offices at St. Anthony Messenger in downtown Cincinnati, meeting the staff and seeing my new work space. I had an inkling that I had found the right niche for myself and that I would ultimately be very happy in this new world of religious journalism.

Deep inside, however, I felt lost and broken. I had entered a dark place of emotional pain which, I suppose, had been put on hold during my meandering trip home as I moved from one distraction to another. Now I felt alienated from myself. Though I could enjoy my assignments, I felt that a core part of me was just going through empty motions.

A strong image kept coming back to me as a symbol of my emotional state at the time. It was the image of my heart as a broken stained-glass window. Though once standing secure and glowing with light, or so I thought, it now lay shattered and spread out in dark pieces on the cold ground. My identity seemed fallen apart, with no comfort in sight.

For one thing, I was suffering what they call “reverse culture shock.” I was no longer the same person who left the States three years earlier. My perspectives and identity had changed because of my Asian experience. I did not feel fully at home in my own culture.

I had also imbibed, I believe, the turmoil of a Catholic Church still rocking in the wake of the Second Vatican Council. The roles of religious men and women were evolving. Priests and sisters were leaving their religious communities to get married. Church rituals, traditions and outlooks were changing. All the familiar points of reference were gone.

Most of all, perhaps, I felt cut off and so far away from the love and support I had come to know from dear friends in the Philippines. On the American side, too, I felt abandoned by a special friend who I thought would be an emotional stay for me. My heart and self-esteem felt crushed and battered.

Sources of Comfort and Light

Fortunately, I could pour out my heartache and confusion before my confrere and confidant, Murray Bodo, whose wise and brotherly affirmation has always been a healing balm. Behind a mask of nonchalance, I carried on. Day after day, however, I kept tasting my cup of darkness and brokenness.

Somehow, I clung to the Good News that light and goodness are the ultimate reality, not darkness. Despite my pain I found joy in my writing, support in my Franciscan community as well as from coworkers, friends old and new, and family. I had to trust–on blind faith–that God’s light and goodness were still there above the dark fog surrounding my soul. Some day the fog would lift and the light would break through.

I recall finding light in the words of various authors and friends who seemed able to pluck hope from the ashes of suffering. I took heart, for example, in a line remembered from Ernest Hemingway. He had written that broken hearts are like broken bones: They get stronger in the broken places.

A quote in a letter from a dear friend in the Philippines also offered me the kind of light and comfort that helps one carry on: “Our human choice is not between pain and no pain,” she wrote, “but between the pain of loving and the pain of not loving.” I found hope in her caring words and in the truth they conveyed: As human beings we are not always free to escape suffering, but we are free to take a stand toward that suffering.

Like my dear friend, I, too, wanted to make my pain a “pain of loving,” which alone can give it meaning. On the other hand, nothing seemed worse to me than to choose “the pain of not loving,” that is, to undergo pain without any love or meaning in sight.

Another quotation that testified to the existence of hope in the dark pit of suffering was that of French writer Leon Bloy: “There are places in the human heart which do not yet exist, and into them enters suffering that they may have existence.” Bloy’s words helped me to hold on to the Christian belief that suffering can be redemptive.

18

June
2013
Time: 17:34

Big Companies Must Pay Their Federal Mental Health Bills

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Federal law will soon mandate more generous mental health care benefits and end drive-through deliveries, but the cost is expected to be modest.

Congressional conferees agreed last week to accept two amendments to a broader measure appropriating funds for two federal agencies.

Those amendments will  require:

* Employers with more than 50 employees to offer in their group medical plans the same annual and lifetime limits for treatment of mental illness and disorders as they provide for physical problems.

healthinsGroup plans, though, could continue to offer different and higher deductibles and coinsurance requirements for mental disorders than for physical problems, while parity would not be required for treatment of substance abuse and chemical dependency.

In addition, employers would be exempt from this new, but limited mental health care benefits parity requirement if they can prove that parity will increase plan costs by at least 1%. There are questions, though, on how employers would have to prove that they are entitled to such an exemption.

The federal mental health care benefit mandate itself would expire on Sept. 30, 2001.

* Group health care plans to offer at least 48 hours of inpatient coverage for mothers and their newborns after a normal vaginal delivery and 96 hours of coverage after a Caesarean section.

Patients would be free to leave a hospital sooner, but that decision would have to be a mutual one of the physician and mother rather than required by an insurer or employer.

These amendments were included as part of a broader measure that appropriates funds for the U.S. Veterans Administration and the Department of Housing and Urban Development. Final passage of the measure was expected late last week or this week. President Clinton is expected to sign the bill.

Last week’s action ended weeks of suspense and an unsuccessful employer lobbying campaign that began after the two amendments were added to the appropriations bills on the Senate floor.

For some employer lobbying groups, there was bitterness over the passage of the amendments and fear on what it portends.

“What is disturbing is that Congress is willing to entertain legislation of this scope in the absence of hearings, or written records. It spells out an extraordinary danger to the employer community regardless of who controls the Congress,” said Mark Ugoretz, president of the ERISA Industry Committee in Washington.

The congressional action, Mr. Ugoretz said, is election-year politics. “This is election survival. This is typical of the feeding frenzy that occurs at the end of a session,” he added.

But advocates of the amendments put a different spin on the congressional action.

Sen. Pete Domenici, R-N.M., the chief Senate sponsor of the mental health care benefits amendment, said its passage “begins to move us out of the Dark Ages. . .and beyond the discrimination. It gets rid of a terrible stigma. It is a breakthrough for the mentally ill.”

Mental health care advocates also were jubilant. “This is a step toward elimination of discrimination” in coverage of mental health care services, said Russ Newman, executive director for professional practice at the American Psychological Assn. in Washington.

Backers of expanded hospital coverage for mothers and their newborns said its enactment will – appropriately so – leave medical decisions with the patient and her physician.

“The decision is appropriately placed where it should be and that is with the physician and the mother,” said Rep. Bill Thomas, R-Calif., chairman of the House Ways and Means Health subcommittee.

While employer lobbying failed to stop the amendments, it succeeded in narrowing the scope of the mental health care amendment. Sen. Domenici had originally pressed for legislation that would have mandated coverage equity for physical and mental health care benefits. Such a mandate would have increased group health care plan costs from between 4% to 9%, according to various studies.

The amendment agreed to by conferees falls far short of that. Employers still will be able to offer different cost-sharing arrangements for mental health care services compared with coverage for physical medical problems.

For example, employers will be able, as many now do, to require employees obtaining mental health care services to pay 50% of each bill, while requiring employees obtaining services for physical medical care to pay only 20% of the bill.

In addition, employers still will be able to direct employees to managed mental health care networks so that employees using the network will have lower out-of-pocket costs than those who go outside the network.

The legislation does however, bar the common practice of imposing lower annual and lifetime benefits for mental health care services compared to those for physical problems.

So long as employers can continue to manage utilization through networks, there should be little, if any, cost increase, said Joan Pearson, a principal in the Seattle office of Towers Perrin.

Congressional backers of mental health care benefits parity have said plan costs could increase anywhere between .16% and .4%.

Mental health care costs, which a decade ago were soaring, have been decreasing sharply in recent years as care has been better managed through medication and expanded use of day treatment rather than hospitalization, said Ms. Pearson.

The legislation does, however, exempt group plans from the mandate if they can prove that mental health care benefits parity increases plan costs by at least 1%.

While regulations will have to be developed to lay out how such proof or certification could be supplied, a congressional staffer said it wouldn’t be enough for an employer to provide a statement from an actuary saying plan costs would increase 1%.

Benefit consultants say the cost of the maternity provision also should be modest.

More than two dozen states already have imposed such requirements on commercial insurance companies and health maintenance organizations. HMOs, especially in California, led the drive – and triggered the public backlash – for shorter hospital stays, often dubbed drive-through deliveries.

“This will have only a negligible impact on health care costs,” said Woody McDonald, a Towers Perrin principal in Overland Park, Kan.

“Because the cost impact is so negligible, logic would dictate that this would not result in rate increases for HMOs in competitive markets,” he added.

01

June
2013
Time: 17:31

The Mental Health Industry Could Use Some Work

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Righting the wrongs of the mental health system is what earned Wesley Alcorn, who is president of the National Association for the Mentally Ill (NAMI) Consumer Council, the NAMI Wolf Award for 1998. The NAMI Wolf Awards were instituted six years ago to recognize those citizens who spoke up and challenged the mental healthcare system’s status quo.

Alcorn was in the audience when Dr. E. Fuller Torrey, director of the Stanley Research Institute, first explained the concept of the NAMI Wolf Awards. Named after the aggressive animal, says Torrey, it is awarded to a NAMI member who has been particularly effective and outspoken in trying to improve services for people with serious mental illness. It goes to one who has “raised hell,” says Torrey, rather than maintain a sheeplike demeanor.

getting-mentalThat description befits Alcorn. In 1991, at the age of 32, he first entered the mental health system with a serious depression and panic disorder and was hospitalized at a public health facility for 18 days. He went on Social Security to get Medicaid coverage for his illness and was then released to day treatment at Montana House, a Medicaid-funded community treatment center. He describes the experience as like being in a dog kennel. Despite an $8 million annual budget, which he had to fight to see, he says, the place could not provide services as simple as a glass of milk; a lack of screen doors allowed patients to entertain themselves by counting fly kills, Alcorn quips. Alcorn pursued the problems of Montana House in the media, eventually getting the state to investigate the situation. The place went out of business, and the contract was given to another service provider. “It was a worst case scenario,” says Alcorn. “Disastrous. People died.”

Montana in 1991, says Alcorn, was a bad place and time to become mentally ill. The state had just deinstitutionalized its mentally ill, the last state in the Union to do so, and many patients were “dumped” into such community facilities. Indeed, says Alcorn, it was as recently as 1995 that services for the mentally ill were removed from the bailiwick of the state’s department of corrections. Today, Alcorn himself couldn’t get into the public hospital where his life was saved as they no longer take patients, and the only state asylum hospital has a completely involuntary patient roster which is tied to the penal system.

In response to these problems, Alcorn began putting pressure on the state’s federally funded advocacy group, Protection and Advocacy for Individuals with Mental Illness, whose role is to investigate allegations of abuse of people with disabilities. His stance, that the group is not protecting those that they were supposed to protect, got him kicked off the group’s board, and the ongoing struggle has produced several lawsuits. But his actions to publicize the problem also contributed to his winning NAMI’s Wolf Award, according to Dr. Torrey.

At the beginning of his struggles, Alcorn became aware of the state AMI association, becoming a rank-and-file member. He also used his background as a library clerk to volunteer to put together a library on mental illness to be made available throughout the state. He went to his first national NAMI conference in 1991, where Dr. Torrey gave him the motivation to become more aggressive. From there, he worked his way up until he ran the state AMI office for five years, still as a volunteer. Later, in 1995, he ran for vice-president of NAMI’s Consumer Council, composed of one consumer representative from each state, and the world’s largest group of mental health service consumers. He has, since 1997, been president of that council. Now, he serves as an inspirational speaker encouraging others to get involved in direct action.

According to Alcorn, the mental health system is so bad throughout the country that Montana can be seen to represent a microcosm of America in its treatment of the mentally ill. What has happened in Montana since 1991, he notes, only mirrors what has happened in the country at large in the last half of the century:

* The closing down of aging institutions without development of a community-based system.

* The closing of single-room occupancy residences due to gentrification, with the resultant rise of homelessness.

* The gutting of the public health system under the Reagan Administration, and the treatment of mental illness as a crime.

The rise of managed care, with the corporate sector privatizing care, using cost-benefit formulas that express threadbare human values.

From here on, says Alcorn, we are moving into the second generation of mental health advocacy, following the generation that saw the demise of the asylums and the first brave group of parents who formed NAMI. The next generation, he says, needs to turn to the strategies that produced the great social reforms of the 20th century, such as the civil rights and the women’s movements. Mental illness, says Alcorn, is the last bastion of discrimination, a biological condition as treatable and with the same recovery rates as physical illnesses if treatment is continued. Yet these patients have been frozen out of the healthcare insurance complex. It is much like the discrimination that affected African-Americans, he says, with the mentally ill denied access to mobility, education and credit; being routinely ghettoized; and made a collective receptacle of people’s fears. Taking as his role model Dr. Martin Luther King, Jr., Alcorn calls for nonviolent civil disobedience, such as marches, sit-ins, candlelight vigils and symbolic boycotts of the drug industry and of mental health facilities.

A good time to begin? Alcorn says October: Mental Illness Awareness month. Among steps he is calling for to completely remake the system: Recognition that there are gradations of mental health consumers, all with different needs.

Perhaps some 20% of mental health consumers need some form of long-term care and housing, with some way to monitor their therapy. For these, Alcorn recommends that all 50 states have PACT programs, or Program for Assertive Community Therapy, a caregiving approach that started in 1974 in Madison, WI, where consumers are given housing and receive daily monitoring visits. For the 3% who need a great deal of oversight, the need is for a treatment system, not a jail.

Alcorn finds himself in the middle ground of the debate on coercion, believing in the need for some forms of coercive methodology but stopping short of absolute control–i.e., to continue trying to balance the civil rights of the individual with the community’s need for safety. To those clamoring for tightening commitment laws, Alcorn acknowledges the need, but only if there is somewhere to send this population where they can be assured of receiving treatment and postdischarge assistance.

Alcorn hopes to use the Consumers Council to facilitate the integration of patients with their families, to get both groups working together on the same page. “It’s the best thing I can do for America, for NAMI and for consumers,” he says, considering it a part of the healing process that got interrupted when mental illness hit the family. But integration is harder than it might seem, says Alcorn, because the disease that strikes the patient strikes the family, and scars everyone. The family/consumer dyad in the council represents but an expanded dynamic of the entire parent/child relationship. It is especially hard on parents, he says, because it is their job to make the child autonomous, but it is also their duty to keep him safe–“a dilemma.”

28

April
2013
Time: 17:06