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Impact
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said. “I’m a woman of faith myself.”
Another factor is the simple fact of how few therapists of
color are working today. Crenshaw’s team is largely women of color, but her practice is an exception — which is unfor- tunate because she knows people of color will often have an easier time trusting someone right off the bat when they can relate to them or see themselves in them.
This last factor might be a long-term struggle to over- come, she added, noting that she teaches classes in her field at Westfield State University, and none of the 17 students currently in one of her classes is a woman of color.
In fact, the mental-health and social-work fields in general are in need of more talent, said Jessica Collins, executive director of the Public Health Institute of Western Massachusetts (PHIWM). She agreed about the access is- sue as well, noting that mental health should be a basic sup- port, not something available only for people who can pay for it — especially when families who can’t pay are often in greater need of those supports.
Recognizing the importance of these issues among young people, before the pandemic even began, the Public Health Institute facilitated the formation of a youth mental-health coalition in Springfield — one that brings to the table direct service providers like BHN and Gándara, Springfield Public Schools, local therapists, and, critically, a group of 11 teenagers who meet regularly.
The question at the center of the initiative is simple, Collins said. “How do we best support kids? It might sound basic, but it’s fairly new; there has not been an emphasis on the mental health of kids except in extreme cases, where the kids have to go into inpatient care.”
One takeaway so far is that teens don’t feel fully heard by the distracted adults in their lives.
“What we’re hearing, loud and clear, from our young people is, when they talk to adults, adults are not skilled at supporting them,” Collins said. “Adults are stressed, adults are stretched, and that just adds to this epidemic of young people feeling hopeless and alone and unsupported.”
That’s why the Public Health Institute is talking about
what kind of training adults — those who work in pre- school and school programs, but also parents — might need to learn how to better listen to young people and work through and respond to what they’re hearing.
“These big direct-service providers are really competi- tive, so to get them in a room to talk about how can we work together to better support families, instead of just competing for them, that’s fairly new,” Collins said, add- ing that Daniel Warwick, Springfield’s superintendent of Schools, has also been on board with efforts like this for a long time.
For example, when he saw a 2017 report by PHIWM about the hopelessness felt by local teens who don’t identify as heterosexual, “he was so upset about that, a few years ago, he mandated some training for all Springfield public- school adults to better support kids who are LGBTQ+.”
Take It Seriously
That’s a good example of listening to young people and then taking them seriously — which is one way to normal- ize mental-health needs, Collins said. “If you can’t talk about it, you can’t figure out for yourself what you need.”
And one thing young people need right now is recon- nection. While many kids are tired of the technology-only avenues for connecting with friends, Crenshaw said, Zoom calls, text chats, and the like have been an overall positive in staying in touch. But she also encourages kids and families to take opportunities to see friends and loved ones in per- son, in a safe manner, when possible.
“You can go to the park; you can go outside with a soccer ball, wear your mask, and connect. Some families have said, ‘we can’t do this alone,’ and became part of each other’s bubble, taking turns doing homeschooling. We encourage these ways of connecting with each other.”
And don’t give up on trying to talk to your kids, Burgess said, even when they don’t feel like talking back.
“The most important thing any parent can do during these times is open a dialogue with their children and allow kids to have open communication,” she said. “What are they thinking? What are they feeling? Then we can guide them and help them through their own resiliency and make adjustments.”
Families can help combat their kids’ isolation, she said,
by planning quality family time, even if it’s just having din- ner together, around the table, every night, or scheduling a family game night every week. Those moments, she noted, can naturally help kids let their guards down.
“You want to have that quality time, that open commu- nication to talk and listen to your kids and ask, ‘how are you feeling? What’s going on? What can I do to help make things easier?’ Sometimes, as a parent, we’re not able to say ‘yes’ to everything, but we can look for compromises and help kids make some of the decisions.”
The problem in identifying signs of distress, Crenshaw said, is that teenagers, even on their best days, often prefer to be isolated, or present a sullen demeanor. So how can parents separate normal teen ‘attitude’ from real warning signs?
“Are they communicating as much with you, or are they isolating in their rooms moreso than normal? Are they eat- ing normally?” she asked. “Even prior to COVID, parents would say, ‘I didn’t know there was a problem — I thought that’s how kids are.’”
It doesn’t hurt for parents to simply ask their kids, directly, how they’re feeling, what’s working or not working in their lives, how school is going, and if they’re feeling more anxiety than usual. “If a teen is isolated in their room, that could be typical teen behavior, but maybe not.”
Physical signs may be visible, too, Crenshaw said, noting that cutting — what’s referred to in her field as ‘self-inju- rious behavior’ — and eating disorders are more common than some parents think.
But more often, the signs are subtler. “It’s just really knowing their disposition and what they’re involved in.”
Burgess said it’s important for parents not to go it alone if their gut tells them something is truly wrong.
“If you notice your kid struggling with severe signs of depression — really isolating, really struggling — definitely seek professional help. If your kid is talking about suicide or even just having a hard time getting back into interact- ing or adjusting, seeking professional help is always key.”
In the end, coming out on the other side mentally healthy — and that goes for parents and children alike — will take patience and resilience, Burgess added.
“There’s no guidebook for this. There’s no ‘COVID for Dummies’ book. We’re all doing the best we can to adapt. We’re all just going through an unprecedented time.” v
Joint
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as implemented all the necessary safety protocols to continue to see patients, Noel- Doubleday said. “COVID changed our routine, but it hasn’t stopped us from doing our jobs. We might work with patients in a different space or alter things slightly, but overall, we’ve made the necessary adjust- ments.”
As the world starts to emerge from pan- demic times, many people are concerned about the “COVID 15,” a popular expres- sion for the weight gained as a result of less activity during a year of being stuck inside. Maintaining a proper weight provides many health benefits, and lessening the wear and tear on the joints is one of them. Physical therapists say it’s a simple matter
of biomechanics: the more weight we carry, the more stress we put on our joints.
Snyder recently authored a whitepaper
the impact from recent weight gains during COVID, and it will probably be years from now until we do.”
the effort at physical-therapy appointments and, more importantly, at home with their independent program, they will most likely have a successful outcome.”
He noted that the success rate based on standard outcomes is much better today than it was even five years ago. In turn, most joint-replacement rehab patients these days expect to resume their activities at high levels after surgery. “If you look at walking, the goal is more than comfortably getting around, it’s being able to take a three-mile walk for exercise every day like they’ve done in the past.”
Noel-Doubleday said identifying specific activities patients want to return to is a change from past rehabilitation practices.
“For example, many patients want to re- sume playing golf or tennis, so we structure the rehab to help them do that again,” she said. “It’s been interesting to see how rehab has evolved like this, and it’s a lot of fun to beapartofit.”v
“If you look at walking, the goal is more than comfortably getting around, it’s being able to take a three-mile walk for exercise every day like they’ve done in the past.”
on treating knee arthritis and discussed the relationship between weight and our joints. In the data he cited, for every pound a per- son loses, the force on the knees is reduced by five to 10 pounds.
Jury said carrying too much weight over time can also throw off structural align- ments in the body, which exacerbates the stress on the joints. “We haven’t yet seen
When joint-replacement surgery is necessary, Noel-Doubleday makes it a goal to educate patients before the procedure so they know what is involved. Jury makes sure his patients understand what he termed as “a couple important things” to know about joint replacement.
“First, it’s not an easy rehab, by any means,” he said. “But if the patient puts in
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