New CA law takes aim at long wait times for mental health care : Shots

When Greta Christina heard that Kaiser Permanente mental health clinicians were staging a protest on Oct. 13, 2019, over long wait times for therapy, she made her own sign and showed up to support them. She’s had to wait up to six weeks between therapy appointments for her depression.

Ingrid Nelson


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Ingrid Nelson


When Greta Christina heard that Kaiser Permanente mental health clinicians were staging a protest on Oct. 13, 2019, over long wait times for therapy, she made her own sign and showed up to support them. She’s had to wait up to six weeks between therapy appointments for her depression.

Ingrid Nelson

When Greta Christina fell into a deep depression five years ago, she called up her therapist in San Francisco — someone she’d had a great connection with when she needed therapy in the past. And she was delighted to find out that he was now “in network” with her insurance company, meaning she wouldn’t have to pay out of pocket anymore to see him.

But her excitement was short-lived. Over time, Christina’s appointments with the therapist went from every two weeks, to every four weeks, to every five or six.

“To tell somebody with serious, chronic, disabling depression that they can only see their therapist every five or six weeks is like telling somebody with a broken leg that they can only see their physical therapist every five or six weeks,” she says. “It’s not enough. It’s not even close to enough.”

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Then, this summer, Christina was diagnosed with breast cancer. Everything related to her cancer care — her mammogram, biopsy, surgery appointments — happened promptly, like a “well-oiled machine,” she says, while her depression care stumbled along.

“It is a hot mess,” she says. “I need to be in therapy — I have cancer! And still nothing has changed.”

A new law signed by Gov. Gavin Newsom in October aims to fix this problem for Californians. Senate Bill 221, which passed the state Legislature with a nearly unanimous vote, requires health insurers across the state to reduce wait times for mental health care to no more than 10 business days. Six other states have similar laws limiting wait times, including Colorado, Maryland, and Texas.

Unequal access to behavioral health care is pervasive

Long waits for mental health treatment are a nationwide problem, with reports of patients waiting an average of five or six weeks for care in community clinics, at the VA, and in private offices from Maryland to Los Angeles County. Across California, half of residents surveyed said they have to wait too long to see a mental health provider when they need one.

At Kaiser Permanente, the state’s largest insurance company, 87% of therapists said weekly appointments were not available to patients who needed them, according to a survey by the National Union of Healthcare Workers, which represents Kaiser’s therapists — and was the main sponsor of the legislative bill.

“It just feels so unethical,”

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Men’s Health Fitness Editor Andrew Tracey Takes on 24 Hero WODs in 24 Hours

Photo Credit: Callum Tracey (IG: @sportsdaymedia)

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Men’s Health fitness editor Andrew Tracey is about to take on a monumental task. He will complete 24 CrossFit Hero WODs in a 24-hour timeframe for the fourth year, but he will add in an ultra-marathon as an extra challenge, according to a profile originally published in Men’s Health.

The details: Tracey will start the Herculean endeavor in rural Essex at 10 a.m. local time on Saturday, November 20. He will complete all 24 Hero WODs by 9 a.m. local time on Sunday, November 21. Tracey will tick off miles between each of the CrossFit workouts to reach his ultimate goal of completing an ultra-marathon. 

  • Tracey will not simply complete these workouts in a gym. Each portion of the ultra-marathon will continue a journey between Stansted and Stratford. His Hero WODs will take place at different locations along the route. 
  • Tracey’s final workout — Murph — will take place in East London’s Olympic Park. 

Tracey will start with the 100 muscle-ups of James Prosser before taking on Nate, which includes even more muscle-ups. The schedule continues with Hidalgo, Jerry, DT, Ricky, Mead, Bert, Joseva, Oz, Burgess McLaren, Bolger, Smudge, and Jordan.

Tracey will complete nine more Hero WODs on Sunday to cap off the schedule. The list is The Chief, Heidi, Jones, Jay, Sham, Jenny, Randy, Joseph Grzelak, and Murph. 

Raising money for charity: Tracey will complete this task to raise money for Pilgrim Bandits, the organization whose motto — “Always a little further” — originally inspired this task in 2018. Those who want to support Tracey as he takes on the Hero WODs can donate directly to Pilgrim Bandits.

Pacing is critical: Tracy’s past efforts to complete 24 Hero WODs in 24 hours have always included a mix of longer workouts and shorter, intense ones. The mix would provide him with extra time every few hours to refuel and recharge. The 2021 iteration is a different beast.

  • Tracey will have to complete two or three miles between each workout to chip away at the ultra-marathon distance. If a Hero WOD takes 50 minutes, he will only have 10 minutes to get this distance in before starting the next workout. 

“Discomfort is not found within the four walls of a gym,” Tracey told Men’s Health. “That’s just a little bit of hard work… This is about putting myself in an unknown situation where I can’t stop. And this year, more than ever, will reflect that, because there’ll be real consequences to slowing down. It’s s— or bust. You either make it to the next one, or you don’t.”

The WODs and schedule: Courtesy of Men’s Health.

10am: James Prosser

11am: Nate

  • 20-minute AMRAP:
    2 muscle-ups
    4 handstand press-ups
    8 kettlebell swings

12pm: Hidalgo

  • 2-mile run
    20 cleans
    20 box jumps
    20 walking lunges
    20 box jumps
    20 cleans
    2-mile run

1pm: Jerry

  • 1-mile run
    2000-metre row
    1 mile
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Why Health-Care Workers Are Quitting in Droves

The moment that broke Cassie Alexander came nine months into the pandemic. As an intensive-care-unit nurse of 14 years, Alexander had seen plenty of “Hellraiser stuff,” she told me. But when COVID-19 hit her Bay Area hospital, she witnessed “death on a scale I had never seen before.”

Last December, at the height of the winter surge, she cared for a patient who had caught the coronavirus after being pressured into a Thanksgiving dinner. Their lungs were so ruined that only a hand-pumped ventilation bag could supply enough oxygen. Alexander squeezed the bag every two seconds for 40 minutes straight to give the family time to say goodbye. Her hands cramped and blistered as the family screamed and prayed. When one of them said that a miracle might happen, Alexander found herself thinking, I am the miracle. I’m the only person keeping your loved one alive. (Cassie Alexander is a pseudonym that she has used when writing a book about these experiences. I agreed to use that pseudonym here.)

The senselessness of the death, and her guilt over her own resentment, messed her up. Weeks later, when the same family called to ask if the staff had really done everything they could, “it was like being punched in the gut,” she told me. She had given everything—to that patient, and to the stream of others who had died in the same room. She felt like a stranger to herself, a commodity to her hospital, and an outsider to her own relatives, who downplayed the pandemic despite everything she told them. In April, she texted her friends: “Nothing like feeling strongly suicidal at a job where you’re supposed to be keeping people alive.” Shortly after, she was diagnosed with post-traumatic stress disorder, and she left her job.

Since COVID-19 first pummeled the U.S., Americans have been told to flatten the curve lest hospitals be overwhelmed. But hospitals have been overwhelmed. The nation has avoided the most apocalyptic scenarios, such as ventilators running out by the thousands, but it’s still sleepwalked into repeated surges that have overrun the capacity of many hospitals, killed more than 762,000 people, and traumatized countless health-care workers. “It’s like it takes a piece of you every time you walk in,” says Ashley Harlow, a Virginia-based nurse practitioner who left her ICU after watching her grandmother Nellie die there in December. She and others have gotten through the surges on adrenaline and camaraderie, only to realize, once the ICUs are empty, that so too are they.

Some health-care workers have lost their jobs during the pandemic, while others have been forced to leave because they’ve contracted long COVID and can no longer work. But many choose to leave, including “people whom I thought would nurse patients until the day they died,” Amanda Bettencourt, the president-elect of the American Association of Critical-Care Nurses, told me. The U.S. Bureau of Labor Statistics estimates that the health-care sector has lost nearly half a million workers since February

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