Jessie Diggins made history winning the first U.S. Olympic gold medal in cross country skiing in 2018. She and skiers at a season kickoff welcome the U.S.’s first World Cup race since 2001.
Hokyoung Kim for NPR and KHN
Nothing Jenn and Jason learned in parenting class prepared them for the challenges they’ve faced raising a child prone to violent outbursts.
The couple are parents to two siblings whom they first fostered as toddlers and later adopted. (NPR has agreed not to use the children’s names or the couple’s last names because of the sensitive nature of the family’s story.)
In some ways, the family today seems like many others. Jenn and Jason’s 12-year-old daughter is into pop star Taylor Swift and loves playing outside with her older brother. He’s 15, and his hobbies include running track and drawing pictures of superheroes. The family lives on a quiet street in central Illinois, with three cats and a rescued pit bull named Sailor.
Jenn describes their teenage son as a “kind, funny and smart kid,” most of the time.
Drawings made by Jenn and Jason’s 15-year-old son lie on the family’s dining room table in their home in central Illinois. Though his angry outbursts reveal a violent side, his parents say that most of the time he is “kind, funny and smart” — a teen who enjoys drawing pictures of superheroes.
Christine Herman/Illinois Public Media
hide caption
toggle caption
Christine Herman/Illinois Public Media
But starting when he was around 3 or 4 years old, even the smallest things — like being told to put on his swimsuit when he wanted to go to the pool — could set off an hours-long rage.
“In his room, his dresser would be pushed across the other side of the room,” Jason says. “His bed would be flipped up on the side. So, I mean, very violent. We’ve always said it was kind of like a light switch: It clicked on and clicked off.”
Jenn and Jason say their son’s behavior has gotten more dangerous as he has gotten older. Today he’s 6 feet tall — bigger than both of his parents.
Most of the time, Jenn says, her son directs his initial anger and aggression toward her. But when the 15-year-old has threatened to hit her, and Jason has intervened, the teen has hit his father or thrown things at him.
“The way he will look at me is just evil,” Jenn says. “He has threatened to slap me in the face. He’s called me all sorts of horrible names. After an incident like that, it’s hard to go to sleep, thinking, ‘Is he going to come in and attack us while we’re sleeping?’ “
Help Is Available
If you are experiencing abuse and need help, you can call the National Domestic Violence Hotline at 1-800-799-7233 or visit its page for an online chat.
People who are victims of domestic violence are advised to seek help. But when the abuse comes from your own child, some parents say, there’s a lack of support, understanding and effective interventions to keep the entire family safe.
While research is limited, a 2017 review of the literature found child-on-parent violence is likely a major problem that’s underreported.
Jenn says she’s concerned about everyone’s safety and worries about her 12-year-old daughter being exposed to constant violence in their home.
The stress has taken a significant mental and emotional toll on Jenn. She sees a therapist to cope with the abuse at home and to deal with her anxiety.
“There are days when it’s hard to breathe,” Jenn says. “You just feel it in your chest — like, I need a breath of air, I’m drowning. We say to each other all the time, ‘This is insanity. How can we live like this? This is out of control.’ “
Parents feel blamed and shamed into silence
It’s hard to know exactly how common Jenn and Jason’s experience is, since research is sparse. In one nationally representative survey in the mid-1970s of roughly 600 U.S. families, about 1 in 11 reported at least one incident of an adolescent child acting violently toward a parent in the previous year. In about a third of those cases, the violence was severe — ranging from punching, kicking or biting to the use of a knife or gun.
Other more recent estimates of the prevalence of child-on-parent violence range from 5% to 22% of families, which means several million U.S. families could be affected.
A 2008 study by the U.S. Justice Department found that while most domestic assault offenders are adults, about 1 in 12 who come to the attention of law enforcement are minors. In half of those cases, the victim was a parent, most often the mother.
While most children who are abused or witness domestic violence do not go on to become violent themselves, and while most people with mental illness are not violent, those life experiences have been identified as risk factors for children who abuse their parents.
Lily Anderson is a clinical social worker in the Seattle area who has worked with hundreds of families dealing with a violent child. Along with her colleague Gregory Routt, she developed a family violence intervention program for the juvenile court in King County, Wash., called Step-Up.
Anderson says, in her experience, many parents feel ashamed about their situation.
“They don’t want to tell their friends or their family members,” Anderson says. “They do feel a lot of self-blame around it: ‘I should be able to handle my child. I should be able to control this behavior.’ “
Anderson says many of the incidents take place at home, where the assaults are hidden from the public eye. That contributes to the lack of public awareness about the issue and makes it even harder for affected parents to find support.
“The whole issue becomes perceived as being the parent’s problem and the parent is to blame for the youth’s behavior,” Anderson says. “I think the main issue is that we need to talk about this. We need to talk — be willing to put it out there and make it an important issue and bring resources together for it.”
When therapy doesn’t fix it
Jenn says that she has talked to her son’s therapists about why he has such trouble regulating his emotions, and they’ve told her it could be linked to the severe trauma he experienced as a baby and toddler.
When the couple began fostering the siblings in late 2007, the boy was 3 and his sister younger than 1. They had been removed from the home of their birth parents, where police were regularly called for drug and domestic violence issues. Jenn says her son remembers being beaten by men in his home and watching as his biological mom cut herself.
Jenn, Jason and their kids together at home last spring. Before they were adopted, the kids experienced or witnessed significant abuse in their birth family, Jenn says. That severe trauma, according to therapists, is likely a source of their son’s difficulty in regulating his emotions.
Christine Herman/Illinois Public Media
hide caption
toggle caption
Christine Herman/Illinois Public Media
Jenn and Jason started their son in therapy at a young age, and he has been diagnosed with reactive attachment disorder, PTSD, ADHD and autism.
The teen has attended art therapy and equine therapy regularly for years. He also participated in a mentorship program and attended a school designed for children with behavioral health needs. Jenn and Jason participated in family therapy sessions with their son, where they learned coping skills and practiced de-escalating situations at home.
The teen was also prescribed medication to help regulate his emotions.
Jenn says her son enjoyed going to therapy and seemed to be making some progress, but his anger remained unpredictable.
During the worst of the conflicts, the teen has kicked holes in walls and broken appliances. He has attempted to run away from home and even created weapons to try to hurt his parents and himself. About once a month, in recent years, Jenn and Jason have had to call police to their house for help restraining their son and sometimes had to have him admitted to the hospital for a brief psychiatric stay.
“Seems like it’s not enough”
Keri Williams is a writer in North Carolina who advocates for parents raising children who have trauma-related behavioral issues, including attachment disorders that can manifest as intentional violence directed toward parents.
Williams’ own son became so violent that her family had to place him in a residential facility at age 10. He’s now 18.
“I actually thought I was the only person going through it,” Williams says. “I had no idea that this was actually a larger issue than myself.”
Williams manages a blog and Facebook page where she says parents like herself, who are often isolated and unsure of where to turn, can find others who can relate.
Many parents she meets online struggle to accept that they’re dealing with a serious domestic violence issue, she says.
“You just don’t want to think like that,” Williams says. “That’s just not how our culture is and how parents perceive things. And that denial actually is what keeps parents from getting their kids help.”
Jenn — the mother of the 15-year-old in Illinois — says parenting her son often feels like being stuck in an abusive relationship.
“But it’s different when it’s your son,” she says. “I don’t have a choice. I can’t just, you know, shove him away or break up with him.”
Jenn says any time she sees a news story about a child who has killed a parent, she worries. Such events are extremely rare, and Jenn doesn’t want to think her son is capable of that.
“But, unfortunately, the reality is, when he is in those rages and in those meltdowns, he really isn’t thinking straight, and he’s very impulsive,” Jenn says. “So, it’s very scary.”
Despite all the challenges, she and her husband both say that adopting their son has brought them a lot of joy.
“It’s made me a better, stronger person, a better and stronger wife and teacher,” Jenn says.
But, she adds, she wishes there were more effective treatments that could help kids like her son live safely in the community and more places where traumatized parents could turn to find help.
“I feel like we’re doing everything that we can for him, but it just seems like it’s not enough,” Jenn says.
A difficult decision
Right before the current school year started, Jenn and Jason made the difficult decision to send their son to a residential facility for children with severe behavioral health issues. He’s living there now.
The couple wrestled with that choice for some time. The boy had already spent almost three years in residential treatment all told, starting when he was 10. He’d moved back home last year because they thought he was ready.
But the family continued to deal with almost-daily standoffs involving verbal threats, angry outbursts and property destruction.
The boy’s 12-year-old sister says she has mixed feelings about her brother leaving home again to reenter residential treatment.
“It makes me feel happy and sad,” she says, “because, well, I love my brother. And I know he’ll be getting the help he needs.”
She’s comforted knowing her parents will be safe but says she’ll miss her brother a lot.
“I just love him,” she says. “And I don’t want to see him go through that.”
This story is part of NPR’s reporting partnership with Side Effects Public Media, Illinois Public Media and Kaiser Health News. Christine Herman is a recipient of a Rosalynn Carter Fellowship for Mental Health Journalism. Follow her on Twitter: @CTHerman.
The suspension of a NHL coach for a past use of a racist slur is raising questions in Canada about the sport’s ability to reflect the nation’s increasingly multicultural makeup.
Years ago, Portia Smith (center) suffered postpartum depression and feared seeking care because of child welfare involvement. She and her daughters Shanell Smith (right), 19, and Najai Jones Smith (left), 15, pose for a selfie after makeup artist Najai madeup everyone as they were getting ready at home on Feb. 6, 2019, to go to a movie together.
Tom Gralish/Philadelphia Inquirer
hide caption
toggle caption
Tom Gralish/Philadelphia Inquirer
Portia Smith’s most vivid memories of her daughter’s first year are of tears. Not the baby’s. Her own.
“I would just hold her and cry all day,” Smith recalls.
At 18, Smith was caring for two children, 4-year-old Kelaiah and newborn Nelly, with little help from her abusive relationship. The circumstances were difficult, but she knew the tears were more than that.
“I really didn’t have a connection for her,” says Smith, now a 36-year-old motivational speaker and mother of three living in Philadelphia. “I didn’t even want to breastfeed because I didn’t want that closeness with her.”
The emotions were overwhelming, but Smith couldn’t bring herself to ask for help.
“You’re afraid to say it because you think the next step is to take your children away from you,” she says. “You’re young and you’re African-American so it’s like [people are thinking] ‘she’s going to be a bad mom.'”
Smith’s concern was echoed by several women of color interviewed for this story. Maternal health experts say women often choose to struggle on their own rather than seek care and risk having their families torn apart by child welfare services.
Nationally, postpartum depression affects one in seven mothers. Medical guidelines recommend counseling for all women experiencing postpartum depression, and many women also find relief by taking general antidepressants such as fluoxetine (Prozac) and sertraline (Zoloft). In March, the Food and Drug Administration approved the first drug specifically for the treatment of postpartum depression.
But those advances help only if women in need are identified in the first place — a particular challenge for women of color and low-income moms, as they are several times more likely to suffer from postpartum mental illness, but less likely to receive treatment.
The consequences of untreated postpartum depression can be serious. A report from nine maternal mortality review committees in the United States found that mental health problems, ranging from depression to substance use or trauma, went unidentified in many cases and were a contributing factor in pregnancy-related deaths. Although rare, deaths of new moms by suicide have also been reported across the country.
Babies can suffer too, struggling to form a secure attachment with their mothers and becoming more likely to develop behavioral issues and have lower cognitive abilities.
‘I was lying to you’
For many women of color, the fear of child welfare services comes from seeing real incidents in their community, says Ayesha Uqdah, a community health worker who conducts home visits for pregnant and postpartum women in Philadelphia through the nonprofit Maternity Care Coalition.
News reports in several states and studies at the national level have found child welfare workers deem black mothers unfit at a higher rate than white mothers, even when controlling for factors like education and poverty.
During home visits, Uqdah asks clients the 10 questions on the Edinburgh Postnatal Depression Scale survey, one of the most commonly used tools to identify women at risk. The survey asks women to rate things like how often they’ve laughed or had trouble sleeping in the past week. The answers are tallied for a score out of 30, and anyone who scores above a 10 is referred for a formal clinical assessment.
Ayesha Uqdah, a community health worker with Maternity Care Coalition, meets with her client, Chaffon Williams at the Maternity Care Coalition Office in the Mantua neighborhood of Philadelphia on March 13, 2019. Uqdah helps women with high-risk pregnancies in getting the care and education that they need.
Heather Khalifa/Philadelphia Inquirer
hide caption
toggle caption
Heather Khalifa/Philadelphia Inquirer
Uqdah remembers conducting the survey with one pregnant client, who scored a 22. The woman decided not to go for the mental-health services Uqdah recommended.
A week after having her baby, the same woman’s answers netted her a score of zero: perfect mental health.
“I knew there was something going on,” Uqdah says. “But our job isn’t to push our clients to do something they’re not comfortable doing.”
About a month later, the woman broke down and told Uqdah, “I was lying to you. I really did need services, but I didn’t want to admit it to you or myself.”
The woman’s first child had been taken into child welfare custody and ended up with her grandfather, Uqdah says. The young mother didn’t want that to happen again.
Screening tools are not one-size-fits-all
Another hurdle for women of color comes from the tools clinicians use to screen for postpartum depression.
The tools were developed based on mostly white research participants, says Alfiee Breland-Noble, an associate professor of psychiatry at Georgetown University Medical Center. Often those screening tools are less relevant for women of color.
Research shows that different cultures talk about mental illness in different ways. African-Americans are less likely to use the term “depression,” but may say they don’t feel like themselves, Breland-Noble says.
It’s also more common for people in minority communities to experience mental illness as physical symptoms. Depression can show up as headaches, for example, or anxiety as gastrointestinal issues.
Studies evaluating screening tools used with low-income, African-American mothers found they don’t catch as many women as they should. Researchers recommend lower cutoff scores for women of color, because women who need help may not be scoring high enough to trigger a follow-up under current guidelines.
Bringing treatment home
It took Portia Smith six months after her daughter Nelly’s birth to work up the courage to see a doctor about her postpartum depression.
Even then, she encountered the typical barriers faced by new moms: Therapy is expensive, wait times are long, and coordinating transportation and child care can be difficult, especially for someone struggling with depression.
But Smith was determined. She visited two different clinics until she found a good fit. After several months of therapy and medication, she began feeling better. Today, Smith and her three daughters go to weekly $5 movies and do their makeup together before each major outing.
But many moms never receive care. A recent study from the Children’s Hospital of Philadelphia found that only one in 10 women who screened positive for postpartum depression at the hospital’s urban medical practice sites sought any kind of treatment in the following six months. A study examining three years’ worth of New Jersey Medicaid claims found white women were nearly twice as likely to receive treatment as women of color.
Noticing that gap, the Maternity Care Coalition in Philadelphia decided to try something new.
In 2018, the nonprofit started a pilot program that pairs mothers with Drexel University graduate students training to be marriage and family counselors. The student counselors visit the women an hour a week and provide free in-home counseling for as many weeks as the women need. Last year the program served 30 clients. This year, the organization plans to expand the program to multiple counties in the region, and hire professional therapists.
It was a gamechanger for Stephanie Lee, a 39-year-old woman who had postpartum depression after the birth of her second child in 2017.
“It was so rough, like I was a mess, I was crying,” Lee says. “I just felt like nobody understood me.”
She felt shame asking for help, and thought it made her look weak. Lee’s mother had already helped her raise her older son when Lee was a teenager, and many members of her family had raised multiple kids close in age.
Stephanie Lee remembers the period after her son Santeno Adams, 2, was born.
Kimberly Paynter/WHYY
hide caption
toggle caption
Kimberly Paynter/WHYY
“The black community don’t know postpartum,” Lee says. “There’s this expectation on us as women of color that we have to be these superhero strong, that we’re not allowed to be vulnerable.”
But with in-home therapy, no one had to know Lee was seeking treatment.
The counselors helped Lee get back to work and learn how to make time for herself — even just a few minutes in the morning to say a prayer or do some positive affirmations.
“If this is the only time I have,” Lee says, “from the time I get the shower, the time to do my hair, quiet time to myself — use it. Just use it.”
This story was reported as a partnership between The Philadelphia Inquirer, for which Aneri Pattani reports, and WHYY. You can read the original version here.
The summer kicked off with a blitz of government activity to end surprise medical billing, but lobbying, impeachment, and policy arguments have left the future of the legislation up in the air.
If you don’t have a steady source of healthy food, it’s hard to manage chronic conditions. That’s why health care providers are setting up food pantries — right in hospitals and clinics.
mixetto/Getty Images
hide caption
toggle caption
mixetto/Getty Images
There’s a new question that anti-hunger advocates want doctors and nurses to ask patients: Do you have enough food?
Public health officials say the answer often is “not really.” So clinics and hospitals have begun stocking their own food pantries in recent years.
One of the latest additions is Connectus Health, a federally funded clinic in Nashville, Tenn. This month, the rear of LaShika Taylor’s office transformed into a community cupboard.
“It’s a lot of nonperishables right now, just because we’re just starting out,” she says, but the clinic is working on refrigeration.
It’s not that patients are starving, Connectus co-director Suzanne Hurley says. It’s that they may have a lot of food one day and none the next. That’s no way to manage a disease like diabetes, she says.
“I can prescribe medications all day, but if they can’t do the other piece — which is a decent diet and just knowing they’re not going to have to miss meals,” she says, “medications have to be managed around all of those things.”
Second Harvest Food Bank of Middle Tennessee, a local food bank, is encouraging more health care providers to consider on-site pantries. The food bank also wants every patient — not just those suspected of being low income — asked about their food situation.
“We’re really pushing for universal screening, so you’re not picking who you’re asking that question to. The doctor already asks you really personal questions, and we don’t think twice about it,” says Caroline Pullen, Second Harvest’s nutrition manager. “I think people have always been scared to ask this question because they didn’t really have the resources of where to send them.”
“Food insecurity,” as it’s known, has become a particular concern among seniors. The anti-hunger group Feeding America found that more than 5 million older Americans don’t have enough food to lead a healthy life — a figure that has doubled in the last two decades.
Nashville General Hospital’s “food pharmacy” opened in February. Some shelves have high-calorie superfoods for cancer patients. Other foods are low sugar for patients with diabetes or low sodium for those with hypertension. The pantry recently added fresh garlic to help patients trying to lower the salt in their diet but maintain some flavor.
Blake Farmer/Nashville Public Radio
hide caption
toggle caption
Blake Farmer/Nashville Public Radio
In response, food banks are increasingly meeting seniors where they get their health care. Hospitals from Utah to Massachusetts are sending patients home with food.
Trudy Hoffman now gets free groceries at her monthly visits to Nashville General Hospital.
“They just asked me, did I want a bag of food to carry home?” she recalls. “And I said, ‘Yeah.’ “
The city-funded hospital started its pantry just for cancer patients in recent years but opened it to all patients this year and received a $100,000 grant in October to fund its expansion.
Organizers call it a “food pharmacy,” following the lead of places like Children’s Hospital of Philadelphia, with patients getting a “prescription” for what to pick up. Some shelves have high-calorie superfoods for cancer patients to keep their weight up. Others have low-sugar staples for people with diabetes or low-sodium items for patients with hypertension.
Vernon Rose, who oversees the Nashville General Hospital Foundation, says no one is surprised to see dozens of patients using the pantry each day.
“Because when you’re in a place like ours, where 40% of the folks can’t even afford their health care, you can imagine the choices they’re making,” she says — such as deciding whether to pay for food or pharmaceuticals.
The pantry operates mostly with grant funding. So Rose says the biggest challenge now is keeping it fully stocked with important but more expensive items like fresh produce and spices, which can be used to help patients keep some flavor while reducing salt in their diet.
This story is part of NPR’s reporting partnership with WPLN and Kaiser Health News.
Stephen F. Austin University beat No. 1 ranked Duke in one of the biggest men’s college basketball upsets ever on Tuesday night.
Stephen F. Austin forward Nathan Bain (23) and guard David Kachelries (4) celebrate Bain’s game-winning shot against Duke in overtime Tuesday in Durham, N.C.
Gerry Broome/AP
hide caption
toggle caption
Gerry Broome/AP
There were two sure bets heading into Tuesday night’s basketball matchup between perennial powerhouse Duke University and Stephen F. Austin State University. One: Duke would dominate. Two: Few people outside of Nacogdoches, Texas, could confidently say where the smaller school’s campus is located.
But after a stunning overtime buzzer-beating layup, not only did the unranked Lumberjacks shock the No.1 Blue Devils in a nail biting 85-83 finish, but Stephen F. Austin did something no other college basketball program outside the Atlantic Coast Conference has done in nearly two decades — beat Duke on its home floor.
The final sequence unfolded in dramatic fashion. With the game tied at 83 and 14 seconds left in overtime, Duke corralled a rebound after a missed shot from the wing. Duke swung the ball out to top of the 3-point line to set up for the final shot.
? UPSET ALERT ?
Stephen F. Austin ends No. 1 Duke’s 150-straight non-conference home game win streak! #AxeEm pic.twitter.com/6HkBavqEB0
— NCAA March Madness (@marchmadness) November 27, 2019
Duke drove toward the basket, and a bounce pass got deflected. Players scrambled for the loose ball.
The Lumberjacks’ Gavin Kensmil dived for it, wrested control and, from the seat of his pants, flipped the ball to his teammate Nathan Bain. With 3.1 seconds left, Bain sprinted the three-quarters of the court toward his hoop with nothing but open floor in front of him.
With .07 seconds left, Bain elevated with Duke’s Jack White leaping virtually simultaneously to try to swat away his layup from behind. By the time the two men came crashing down to the floor, it was over. Bain’s layup was good and the Lumberjacks had a win for the ages.
Stephen F. Austin’s Bain watches the game-winning basket as Duke forward Jack White attempts to defend.
Gerry Broome/AP
hide caption
toggle caption
Gerry Broome/AP
The faces of Duke fans crumpled in unison.
The Blue Devils were projected to win by more than 27 points, ESPN reports. The sports network also adds that Stephen F. Austin was at one point trailing by 15 points, when it fought back and tied the game with under 20 seconds remaining in regulation. After the game Bain explained how the final seconds of overtime unfolded from his vantage point, according to ESPN:
“I saw my teammate grab it, and I looked up at the clock. We had about 2.6 seconds,” Bain told the network. “I was like, ‘I have to get on my horse.’ I went as fast as I can to try to lay it up. It’s like a layup drill. I could feel the dude on my back, and I just prayed it [would] go in.”
Duke forward Matthew Hurt (21) and guard Cassius Stanley (2) react following the team’s loss to Stephen F. Austin in overtime.
Gerry Broome/AP
hide caption
toggle caption
Gerry Broome/AP
The win over Duke is easily the most significant win in Stephen F. Austin’s history, according to The Associated Press. It adds:
“This Duke team didn’t have the feeling of invincibility that some of its predecessors had, in part because it committed at least 16 turnovers in three of its first six games. The Blue Devils’ offense was completely flummoxed at times by the Lumberjacks’ unrelenting pressure, and as a result, their run at No. 1 will end after two weeks.”
With Tuesday’ loss, Duke is the third top-ranked team to lose this season. And it’s not even Thanksgiving.
Duke has one of the most storied programs in all of men’s college basketball. That didn’t matter Tuesday night when the Blue Devils were beaten by unranked Steven F. Austin State University.
RACHEL MARTIN, HOST:
Good morning. I’m Rachel Martin. Duke has one of the most storied programs in all of men’s college basketball; they’ve won the national championship five times. The Lumberjacks from Stephen F. Austin State University in Texas have only won two games ever during March Madness. They really had no hope of beating the nation’s No. 1 team last night, but…
(SOUNDBITE OF ARCHIVED RECORDING)
ERIC COLLINS: Yes, the Lumberjacks have done it.
MARTIN: In overtime, Nathan Bain stole the ball and hit a layup at the buzzer to topple the mighty Blue Devils.
Copyright © 2019 NPR. All rights reserved. Visit our website terms of use and permissions pages at www.npr.org for further information.
NPR transcripts are created on a rush deadline by Verb8tm, Inc., an NPR contractor, and produced using a proprietary transcription process developed with NPR. This text may not be in its final form and may be updated or revised in the future. Accuracy and availability may vary. The authoritative record of NPR’s programming is the audio record.
A 4-year-old girl was playing with her dolls and next thing you know, she had two tiny doll shoes stuck in her nose. A trip to urgent care, then the emergency room left her parents with a giant bill.
