Pediatric Meltdown

Welcome to Pediatric Meltdown, the podcast where we discuss the unique challenges parents face when it comes to their child's mental health. Host Dr. Lia Gaggino teams up with guest Dr. Cynthia Ewell-Foster to tackle the pressing issue of suicide prevention and support for families. Learn how parents can better navigate this challenging terrain as they uncover the importance of community engagement, clear communication, and empowering parents to implement discharge recommendations effectively. You’ll hear about the vital role of caregivers, the role of firearm safety, and the remarkable impact of a supportive network in times of crisis. It is crucial for parents to be vigilant and proactive when it comes to their child's mental health. By utilizing the resources available, such as the toolkit provided by the Macomb County crisis center and participating in support groups like NAMI Washtenaw County parents group, parents can navigate the challenges with more confidence. Let's take action, reduce stigma, and create a world where every child feels heard, supported, and loved. Together, we can make a difference and save lives.      

TRIGGER WARNING: Please note that this episode contains a discussion of suicide, self-injurious behavior, depression and/or reference of other mental health disorders that may act as triggers.

[05:34 -15:13] Building Self-Efficacy and Capacity in Suicide Prevention

• communication between systems create a seamless environment for providing comprehensive care to at-risk children.
• initiatives should prioritize empowering parents, healthcare professionals, and stakeholders in suicide prevention.
• Suicide prevention requires a multi-system approach involving emergency departments, therapists, and pediatricians.
• Efforts should focus on building self-efficacy and capacity in different systems to address suicidal ideation in children.

[15:14 - 25:13]  Cultivating Confidence and Empowerment within the Family Unit

• Provide clear directions and support to help families believe in themselves
• Encourage families to have confidence in their abilities to overcome challenges
• Offer resources and tools to assist families in achieving their goals
• Promote self-belief and resilience in families facing difficult situations

[25:14 - 37:25]  Importance of Emotional Support for Parents After a Suicide Crisis

• Establish a network of trusted adults who can provide emotional support to parents on a regular basis.
• Encourage open communication and create a safe space for parents to express their feelings and concerns.
• Provide resources and information about coping strategies and self-care to help parents navigate the emotional aftermath.
• Offer professional counseling or therapy services to parents to address their own mental health needs.

[37:26 - 48:24] Strategies for Clinicians to Promote Safety and Mental Health 

• Secure firearms or remove them from homes.
• Address medication safety and storage.
• Manage access to dangerous objects.
• Help patients connect with mental health professionals. 

[48:25 - 57:27]  Closing segment Takeaway

Links to resources mentioned on the show

Holding On To Life Toolkit:  https://medicine.umich.edu/sites/default/files/content/downloads/macomb-county-cmh-holding-on-to-life-toolkit.pdf

NAMI support group:

TRIGGER WARNING: Please note that this episode contains a discussion of suicide, self-injurious behavior, depression and/or reference of other mental health disorders that may act as triggers.

Welcome to the Pediatric Meltdown podcast, where Dr. Lia Gaggino will take you into the world of pediatric care to tackle the most important topics that impact the well-being of our little ones. In today's episode, Dr. Gaggino and her guest, Dr. Alejandra Arango, explore the critical role of safety planning in preventing child suicides. Their heartfelt conversation takes a deep dive into the intricacies of safety planning within various settings, highlighting the effectiveness of individualized plans, coping strategies, and community crisis resources. Creating a meaningful safety plan in just 20 minutes is not only realistic, but essential in a primary care setting. By involving all staff, from doctors to nurses to administrators, we can truly make a difference in the lives of our children. Standardized screening protocols and readily accessible safety plans in medical records make the process more feasible. Remember, a safety plan is part of a comprehensive suicide prevention approach that includes screening, assessment, evidence-based interventions, and crisis support. A unified team will provide the support and resources needed to guide our young ones through the darkest times. So, grab your headphones and get ready to learn invaluable insights that will empower you to create safe environments for our young ones, ensuring their well-being and building a brighter future.      

[05:58 -17:27] Importance of Tailoring Safety Plans to Individuals

• The effectiveness of a safety plan is enhanced when the person themselves contributes ideas on how to distract or cope with distressing thoughts.
• Safety plans should go beyond simply checking off boxes and should encourage open discussions about strategies for managing difficult situations.
• Providers should actively engage with patients to understand their unique warning signs and triggers.
• Safety plans should be regularly updated and revised to ensure they remain relevant and effective.

[17:28 - 28:24]  Specificity in distraction strategies  

• Consider options like watching videos of cats, playing a specific video game, or listening to a certain song
• Encourage team members to be specific about what engages them personally
• Highlight the importance of finding activities that pull the brain's attention
• Suggest coloring or other activities that require focus and concentration

[28:25 - 43:57]  Safe Storage of Firearms and Medications

• Proper storage methods for firearms, such as gunlocks or safes
• Separating ammunition from firearms and keeping them in secure locations
• Educating families on safe storage practices
• Discussing potential barriers and feelings associated with safe storage
• Including over-the-counter medications in safe storage practices

[43:58 - 55:06]  Integrating Safety Plans into Medical Records 

• Standardized screening and assessment protocols for providers
• Incorporating safety plans into the medical record system
• Easy accessibility of safety plans for healthcare professionals
• Streamlining the process of pulling up safety plans during consultations
• Ensuring safety plans are readily available for problem-solving with the youth

[55:07 - 01:04:09]  Closing segment Takeaway

Links to resources mentioned on the show

Stanley Brown Safety Plan Template:

https://swiy.co/WhatAreYourThoughts

TRIGGER WARNING: Please note that this episode contains a discussion of suicide, self-injurious behavior, depression and/or reference of other mental health disorders that may act as triggers.

In this thought-provoking episode, Dr. Lia Gaggino invites Dr. Lisa Horowitz back to the mic to discuss important aspects of suicide prevention programs and validation studies. They specifically focus on the role of pediatricians in identifying and supporting young people who may be at risk. They introduce the Brief Suicide Safety Assessment (BSSA), a tool that can help in these situations. Dr. Horowitz emphasizes the importance of using appropriate language when discussing suicidality with parents, offering a valuable perspective that can change how we approach this sensitive topic. This episode serves as a reminder of how crucial it is for caregivers to provide guidance, support, and reassurance to children, and to make them aware of available resources when facing challenges. Just like we talk to our children about topics such as safe sex or drugs and alcohol, discussing resilience should also be an ongoing conversation. Caregivers must equip children with coping mechanisms rooted in resilience to prepare them for the future. So together, let's create a community where children feel safe to ask questions, without fear of judgment or stigma. By investing time today in building resilient kids, we can nurture a generation capable of overcoming any hurdles they may encounter tomorrow.       

[02:37 -12:30] Screening Practices and Feasibility Studies

• Several studies demonstrate the feasibility of screening practices.
• Screening can be effective in identifying acute and non-acute cases.
• The fifth question in the screening process determines the acuity of the situation.
• Comprehensive toolkits provide scripts and guidance for medical professionals.

[12:31- 23:41]  Brief Suicide Safety Assessment (BSSA)  

• Specifically created with pediatricians in mind to aid in suicide risk assessment.
• Aims to remind pediatricians about essential elements of the BSSA.
• Serves as a middle step in the pathway of suicide screening programs.
• Offers a triage of the screening process to further assess and prioritize patients.

[23:42 -31:52]  Practical Next Steps

• Determine urgency: Assess immediate need for intervention based on the frequency and severity of the thoughts 
• Provide support: Offer a listening ear and a calm presence to help the individual express their feelings and thoughts comfortably.
• Safety measures: Talk about the importance of safety, including lethal means safety, especially when firearms are involved, to prevent any potential harm.
• What’s next: Based on the assessment and discussion, determine the appropriate disposition or action plan to address the individual's needs effectively.

[31:53- 39:49]  Importance of Taking Action and Finding Support 

• Emphasize the difference between doing nothing and doing something.
• Stress that it is acceptable for plans to change if the initial approach is not working.
• Assure individuals that there is a process and plan in place to keep them safe.
• Offer the option for a follow-up call from your staff to inquire about their well-being, providing a sense of reassurance and support for parents.

[39:50 - 48:05]  Closing segment Takeaway

Links to resources mentioned on the show

• NIMH ASQ Toolkit:

https://swiy.co/WhatAreYourThoughts

In this abbreviated episode of Pediatric Meltdown, Dr. Lia Gaggino celebrates 3 years of the Pediatric Meltdown podcast and opens up about the challenges and uncertainties that come with transitioning from a daily pediatric practice. Join her as she explores the psychological grief and identity crisis she faced when stepping away from patient care. Dr. Gaggino shares the realization that being a pediatrician goes beyond simply seeing patients in an office, reminding us that purpose and impact can take various forms. From her involvement with the American Academy of Pediatrics to her role as a consultant in a Child Psychiatry access program, she finds new avenues to make a difference in children's lives, and last but never least, this podcast that has reached listeners worldwide. The Heart of Pediatric Meltdown is the passionate conversations with all the high-profile experts that share time with Dr. Gaggino. They remind us that even in the face of uncertainty, we can find purpose, make a difference, and bring hope to the lives of our children. Dr. Gaggino wants to thank you so much for joining her on this incredible journey, and together, let's continue to create a world where every child's mental and emotional well-being is prioritized.

Other episodes you may like:

For all episodes, go to Pediatric Meltdown

107 Suicide Prevention That Works: The Zero Suicide Framework

114 Palliative and Hospice Care: A Conversation on Grief and Joy

Key quotes for Twitter:

 "Not that I love social media so much, but I really want to spread the word about pediatric meltdown, and I hope you can help me do that.".... Dr. Lia Gaggino on the challenges of social media

"I want this podcast to be for all of you who take care of children."... Dr. Lia Gaggino on who would get the most out of the podcast.

THANK YOU FOR YOUR SUPPORT!

Pediatric Meltdown was listed as a Top 20 Pediatric Podcast on FeedSpot.

If you’d like to connect with me, you can Tap the “What Are Your Thoughts” button at the top of the notes or you can find me on LinkedIn, Facebook, Instagram, and Twitter, or email me at [email protected] or [email protected]. To learn more about me visit https://www.medicalbhs.com/

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https://swiy.co/WhatAreYourThoughts

In this thought-provoking episode of Pediatric Meltdown, host Dr. Gaggino welcomes special guest Dr. Polly Y. Gipson Allen as they do a deep dive into the world of trauma-informed care and its impact on primary care settings. Reflecting on personal experiences and societal awakenings brought about by the pandemic, they shed light on the psychological, physical, and spiritual effects of racial trauma and discrimination. From trauma-informed care to enhancing organizational capacity, the duo explores the various strategies and policies that can be implemented to create a culture of soul and self-care not only in clinical facilities, but also in schools as well. Join them as they share insights on building resilience, integrating mental health support, and the role of integrated care models in providing holistic patient care. It is time to prioritize the mental wellbeing of our patients and students and ensure that they have access to the resources and support they need. Let us be the voice that advocates for school-based mental health services and screenings, because every child deserves a caring and nurturing environment where they can thrive and grow. Together, we can transform our primary care settings into spaces that heal not just the body, but also the soul.

[00:33 -13:07]  Trauma Prevalence and the 5 R's of Trauma Informed Care

• The 1st R:  Realizing the widespread impact of trauma and the potential paths for recovery
• The 2nd R: Recognizing the signs and symptoms of trauma in patients and families
• The 3rd R:  Responding by integrating trauma knowledge into policies, practices, and procedures
• The 4th R:  Resisting re-traumatization within primary care settings
• The 5th R:  Promoting resilience and the ability to cope, adapt, and recover from trauma and stress

[13:08- 21:28]  Identifying Trauma in Primary Care Settings  

• Assign champions within the clinic to facilitate the implementation of trauma screenings.
• Ask a question like "Since the last time I saw you, has anything really scary or upsetting happened to you or your family?" to initiate the conversation on trauma.
• Conduct brief screenings that take around 5 to 10 minutes to identify traumatic exposure or stress symptoms.
• The purpose of universal screening is to guide clinical decision making and determine if further trauma assessment is required.

[21:29 -32:19]  Integrated Care Models

• Collaborating with clinical colleagues, behavioral health professionals, and social workers
• Warm handoff process for seamless care transitions
• Identifying primary care or behavioral health as the initiator of the brief screen
• Focusing on holistic well-being and integrating mental and physical health

[32:20 - 43:30]  Engaging the Community

• Organize focus groups or community events to gather input and feedback on improving care
• Collaborate with community members and leaders to form a planning committee for implementing changes
• Address barriers to access such as transportation or lack of resources
• Leverage community traumatic events to bring people together, raise awareness, and promote community support and resilience

[43:31 - 47:45]  Closing segment Takeaways

Links to resources mentioned on the show

• Resources:
• https://www.nctsn.org/
• https://seekwellbeing.org/

https://swiy.co/WhatAreYourThoughts

Get ready for another thought-provoking episode of Pediatric Meltdown, the podcast that explores the untold stories and groundbreaking developments in pediatrics. Host Dr. Lia Gaggino sits down with Dr. Wendy Hunter, a remarkable pediatrician who has revolutionized the way pediatric care is delivered. Reflecting on Wendy's inspiring journey, we are reminded of the profound impact that social determinants of health have on pediatric patients' lives. As healthcare professionals, it is our duty to not only treat their physical symptoms but also understand their unique experiences and address the underlying issues. By incorporating trauma screening and fostering community partnerships, we can create a healthcare system that truly supports the holistic well-being of our patients. Let Dr. Hunter's story be a call to action for all of us to champion, change and prioritize the social determinants of health in our own practices. Let us all be inspired to make a difference in our own professions, and remember that even amidst the chaos, there is incredible power in staying true to our passions and values.       

[00:33 -17:40] Community Outreach Programs on Trauma Awareness

• Community-based organizations as partners in spreading health literacy and trauma information.
• Bringing pediatricians to low-income housing communities, homeless shelters, and maternity shelters.
• Using interactive sessions with families to discuss health topics and model reading practices.
• Breaking down communication barriers and fostering trust by engaging with families in their own communities.

[17:41- 26:51]  Training and Preparation for Asking ACEs Questions 

• Presentation on ACEs and specific scripting for introducing and discussing the screener
• Utilization of Epic EMR with smart phrase scripting for easy reference during conversations
• Orientation and training for office staff by the training staff
• Front office trained on patient self-administered ACEs questionnaire on tablets or mobile devices

[26:52 -37:45]  Workflow Process for Screening a Four-Year-Old

• Introduce the pearls questionnaire as part of the routine well visits for children at the appropriate age.
• Ensure the questionnaire is integrated into the EMR system to streamline the process.
• Provide a comfortable and confidential environment for the family to fill out the questionnaire.
• Use identified scores to facilitate a discussion with the family, providing appropriate guidance and support.

[37:46 - 45:34]  Managing Wellness and Work-Life Balance 

• Importance of having a basic level of competence in mental health for everyone
• Grant opportunities for physicians to receive training in managing ADHD, anxiety, and depression
• The Pediatrician Next Door podcast as a platform to educate and entertain families and pediatricians
• Personal values and rituals as a guide for managing well-being and making decisions

[45:35 - 50:59]  Closing segment Takeaway

You can reach Dr. Wendy Hunter

Website: www.drwendyhunter.com

Facebook: Dr. Wendy Hunter | Facebook

Instagram  the_pediatrician_next_door

Twitter:...

https://swiy.co/WhatAreYourThoughts

Welcome to the Pediatric Meltdown podcast, where we delve into the challenges and triumphs of pediatric healthcare. Today, host Lia Gaggino has the pleasure of introducing her guest, (and self-proclaimed “superfan” of Pediatric Meltdown), Dr. Alisa Minkin, a trailblazing pediatrician and host of the JOWMA Podcast, a show dedicated to health education for the Orthodox Jewish community. In today’s episode, Dr. Minkin shares her inspiring journey as a pediatrician and her unwavering commitment to mental health awareness. Drawing from her experiences as a parent to a child with special needs, as well as her advocacy for mental health screenings, Dr. Minkin's story is one of passion, resilience, and making a difference in the lives of children and families. Despite the barriers of time and limited resources, she has embraced telehealth as a double-edged sword and implemented crucial mental health screenings in her practice. Her desire to hear more voices of lived experiences, particularly from autistic and neurodivergent individuals and family partners, reminds us of the importance of inclusion and diverse perspectives in approaching pediatric care. Her journey serves as an inspiration for healthcare professionals and parents alike. With her passion and determination, she is indeed a true mental health warrior. So, grab your headphones and tune in to this episode – you don't want to miss this thought-provoking episode.

The Spoons Theory:  The spoon theory is a metaphor describing the amount of physical and/or mental energy that a person has available for daily activities and tasks, and how it can become limited. It was coined by writer and blogger Christine Miserandino in 2003 as a way to express how it felt to have lupus; explaining the viewpoint in a diner, she gave her friend a handful of spoons and described them as units of energy to be spent performing everyday actions, representing how chronic illness forced her to plan out days and actions in advance so as to not run out of energy.

The metaphor has since been used to describe a wide range of disabilities, mental health issues, forms of marginalization, and other factors that might place an extra and often unseen burden on people living with them. From Spoon theory - Wikipedia

[03:10 - 09:01] Barriers to meeting mental health needs

• Limited time for pediatricians to address mental health concerns during appointments.
• Lack of resources, especially for those who accept insurance or Medicaid.
• Challenges in finding qualified therapists and mental health resources.
• Disparities between Medicaid and private insurance coverage for mental health services.

[09:02 - 14:24]  Training Programs and Resources  

• Case reviews and phone calls as part of the Reach program
• Utilizing Project Teach, a child psychiatry access program
• Listening to podcasts, including the Joma and Pediatric Meltdown podcasts
• Learning from personal experiences and emotionally resonant stories

[14:25 - 22:34]  Personal Reflections and Advocacy

• Highlighting the importance of suicide prevention and her sister's experience with it.
• Discussing the journey of implementing suicide prevention screening in her practice and allied supergroup.
• Expressing gratitude for the support received from experts in the field.
• Describing the introduction of combined ASQ Gad and PHQ screening tools in her practice.

[22:35 - 32:47]  The Importance of Advocacy and Creativity in...

https://swiy.co/WhatAreYourThoughts

Welcome back to Pediatric Meltdown. In this week’s episode, host, Dr. Lia Gaggino welcomes Dr. Lee Beers and Dr. Binny Chokshi, where they discuss the often-overlooked topic of military families and the unique challenges they face. As a military pediatrician, Dr. Beers shares her personal journey and experiences taking care of military-associated families. Dr. Chokshi, a civilian pediatrician who provides care to military families, also shares her role in researching the impact of military life on children's mental health and overall well-being. Together, they highlight the importance of understanding the demographics and specific stressors of military families, such as parental deployments, frequent moves, and potential injuries or PTSD. They also emphasize the strengths and resources available to military families, including the strong sense of community and access to specialized support services. The subject of military children and mental health can no longer hide in the shadows. These extraordinary young individuals sacrifice so much in service to our nation, so let us continue to advocate, educate, and empower our military families so that they receive the care, understanding, and support they truly deserve.      

[00:33 -17:03] Opportunities for Pediatricians in the Military

• Military scholarships available that cover medical school expenses and provide additional funds.
• Unique clinical opportunities, such as working with military families in Guantanamo Bay.
• Opportunities for leadership roles within the armed forces and military treatment facilities.
• Ability to serve an important group of children and families while practicing medicine.
• Access to resources and support specifically tailored to military families.

[17:04 - 23:16]  Considerations for Caring for Military Children and Families  

• Asking specific questions to understand the stress and uncertainty of deployments
• Recognizing the strength and support from military communities
• Being creative in helping families navigate disruptions caused by deployments
• Utilizing innovative programs like video calls for deployed service members and their children
• Addressing the challenges of living in the moment due to uncertainties and stressors 

[23:17 - 36:44] Impact on Mental Health of Children in Military Families

• High prevalence of mental health struggles among military children
• Factors impacting mental health moves, deployments, transitions, and caregiving for injured parents
• Importance of recognizing and addressing the mental health needs of military children
• Protective factors: positive childhood experiences, peer support, and a sense of community
• Collaborative efforts to provide support for hidden helpers and families of injured service members

[36:45 - 46:50]  The Role of Pediatricians 

• Pediatricians can advocate for military families, recognizing and addressing their unique challenges and life stressors.
• Pediatricians can play a role in normalizing the act of seeking help and support for military kids and their families.
• Pediatricians are in a unique position to support military families, utilizing their knowledge and expertise in pediatric care.
• Serving as a military pediatrician offers opportunities for growth, leadership, and learning in the field of pediatrics.
• Pediatricians can deepen their gratitude towards military families and appreciate the sacrifices they make for the nation.

[46:51 - 51:01]  Closing...

https://swiy.co/WhatAreYourThoughts

Welcome to this week's Pediatric Meltdown Podcast, where host Dr. Lia Gaggino invites guests Dr. Bruno Chumpatazi and Dr. Amanda Deacy to unravel the mysteries behind chronic symptoms in children. Together, they delve into the complexities of post infectious IBS, highlighting the multifaceted causes that contribute to these symptoms. From altered pain perception and processing to the potential role of inflammation, the experts leave no stone unturned. Discover how food sensitivities, the microbiome, and seasonal allergies come into play in shaping the experience of chronic symptoms. Join us as we explore the multidisciplinary treatment plans, focusing on non-pharmacological interventions like relaxation training and cognitive behavioral therapy. It's time to gain a better understanding and listen, learn, and advocate for the multidisciplinary support and resources that these children and their families desperately need. Together, we can make a profound impact on their journey towards wellness.      

[09:24 -21:07] Impact and Contributing Causes

• Disorders of gut-brain interactions (DGBI) affect 25% or more of school children worldwide.
• Early life events, such as being born prematurely or having a nasogastric tube placed, can increase the risk of developing DGBI.
• Sensitizing medical events, like inflammation or infection, can trigger or exacerbate DGBI symptoms.
• Psychosocial factors, including depression, anxiety, family stress, and abuse, can also contribute to the development and severity of DGBI symptoms.

[21:08 - 34:35]  Preliminary testing for evaluating abdominal pain  

• Acknowledge that the symptoms are real and not imagined
• Avoid dichotomizing symptoms as either physical or psychological
• Emphasize the biopsychosocial nature of the condition
• Avoid giving families the impression that medication is a quick fix
• Inform families that the treatment may take time and require attention and coping strategies

[34:36 - 48:43]  Golden Rules in DGBI Treatment

• Acknowledge that the symptoms are real and not imagined
• Avoid dichotomizing symptoms as either physical or psychological
• Emphasize the biopsychosocial nature of the condition
• Avoid giving families the impression that medication is a quick fix
• Inform families that the treatment may take time and require attention and coping strategies

[48:44 - 01:02:02]  Non-pharmacological interventions for pediatric abdominal pain 

• Importance of attention and cognitive processing in pain management
• Gradual physical rehabilitation to improve strength and stamina
• Relaxation training as a mechanism to decrease overall nervous system activation
• Various techniques under relaxation training, including hypnotherapy and biofeedback training
• Educating adults (parents, teachers) on therapeutic approaches to influence the child's environment

[1:02:03 - 01:08:11]  Closing segment Takeaway

You can reach Dr. Bruno Chumpatazi

Twitter:  @‌Dr_BrunoC

You can reach Dr. Amanda Deacy

Twitter: @‌ADeacyPhD

Links to resources mentioned on the show

Hyams J et al. Functional Disorders: Children and Adolescents 

Gastroenterol 2016; 150:1456-1468. PMID: 27144632

https://302.buzz/PM-WhatAreYourThoughts

As the only pediatrician in her Native American community, Dr. Empey’s insights and first-hand experiences offer a valuable perspective on the need for better representation and improved healthcare access. Dr. Gaggino and Dr. Empey urge all of the listeners, (especially all you early career physicians), to step up and take leadership roles at every level within the medical community. We cannot afford to ignore the health inequities faced by marginalized populations, including American Indian and Alaska Native children. Let us learn from the historical traumas that have shaped their communities and continue to impact their well-being. Through cultural competency, collaboration, and advocacy, we can prioritize their unique needs and ensure that their voices are heard. It is our call to action to dismantle systemic barriers and work towards healing and justice. The journey may be challenging, but the rewards of creating a more equitable and inclusive healthcare system for all are immeasurable. Together, we can pave the way for a brighter future, leaving no child behind.       

[03:20-10:21] Challenges and Strengths of American Indian and Alaskan Native Children and Youth

• Many pediatricians may not realize they have children from tribal communities in their practices
• Consider the cultural, religious, and spiritual practices of these children and their families in providing care
• Majority of American Indian and Alaskan Native population live off reservations, in urban centers
• Urban population seeks care at children's hospitals due to limited IHS or tribal facilities
• Language, cultural, and historical diversity among different tribes need to be acknowledged and respected

[10:22- 16:14]  Historical Trauma and Health Inequities  

• Contextualizing health inequities within the historical traumas faced by American Indian and Alaskan Native communities
• Impact of colonization, diseases, boarding schools, termination of tribes, and relocations on communities
• Examples of personal and intergenerational traumas, such as the Trail of Tears and Indian boarding schools
• Loss of culture, language, and family connectedness due to boarding school experiences
• Effects of relocations on access to traditional foods, opportunities for employment, and increased poverty levels

[16:15 -21:25]  Health Outcomes and Concerns for Kids

• Mental health concerns, including an increased risk of suicide
• Obesity and type 2 diabetes
• Cardiovascular risk factors and hypertension
• Lack of safe places for kids to play in some communities
• Limited access to fresh fruits and vegetables due to food deserts

[21:26 - 27:17]  Methods for Stress Reduction 

• Practicing mindfulness and meditation
• Engaging in regular physical activity
• Socializing and spending time with loved ones
• Engaging in hobbies and recreational activities
• Seeking professional help or therapy when needed

[27:18 - 31:44]  Closing segment Takeaway

Links to resources mentioned on the show

• AAP Caring For American Indian and Alaskan Native 2021 Policy Statement: