Ames Police officers are not ashamed to talk about their struggles with mental health. And they say you shouldn’t be ashamed either.

Several officers appear on camera in a promotional video for the Sept. 25 Story County Mental Health Expo to talk about their mental health diagnoses.

Ames Police Commander Jason Tuttle is among the personnel featured. As an early responder to the June 2, 2022, shooting at Ames’ Cornerstone Church, which left three people dead, Tuttle experienced physical and mental symptoms in the wake of the tragedy.

With his wife’s and fellow officers’ support, he sought professional help, which has made a difference.

“I’ve been in therapy for the last year,” Tuttle said in the video. “I feel much healthier, both physically and emotionally today.”

He shared his story so others wouldn’t feel alone in their struggles.

“It’s okay to not be okay,” he said.

More: Cornerstone Church first responder receives city’s highest honor with Award of Valor

Story County Mental Health Expo is free

The Story County Mental Health expo is entering its eighth year, which has grown annually. About 400 people attended in 2022, said Ames Police Department mental health advocate Julie Saxton.

“It’s free. It’s always free — admission, parking, food, everything,” she said. “We’ll have more than 35 vendors and keynote speaker Kai Roberts.”

The event runs from 6 p.m. to 8 p.m. Monday, Sept. 25 in the Great Room at the Iowa State Memorial Union.

Kai Roberts

Kai Roberts will perform “Mental Health Through Music” at 7 p.m. The Pennsylvania-based mental health advocate uses hip-hop to share how he has dealt with anxiety and panic attacks.

“We always have such amazing keynote speakers from different backgrounds, with different experience,” Saxton said. “I think Kai will really relate with college students, but also with all ages. I think we can all relate to having anxiety.”

Youth suicide numbers are ‘astronomical’

The annual Mental Health Expo is held in conjunction with suicide awareness month.

The number of people in mental health crises is overwhelming, Saxton said. Last year, she received 2,800 mental health calls for service and responded to 2,500.

“Twenty percent of those calls were people who were actively suicidal,” she said.

At least one person in her daily call log is suicidal, and it’s often more than one.

“The number of youth that have died by suicide in Story County is astronomical,” Saxton said. “And the numbers are higher than even reported, because sometimes the family members don’t want to admit that’s what it was.”

More: Iowa’s gender-affirming care ban is chasing transgender kids out of state for medical care

Saxton’s figures don’t include calls to Iowa State police, medical providers or social service organizations.

“There are many more people struggling that we don’t know about,” Saxton said. “Every therapist is full, the waiting lists are longer, especially if you’re a new patient.

“We’re also lacking medication providers, like psychiatrists — that’s countywide, statewide and nationwide.”

People on Medicaid take even longer to get treatment because “a lot of agencies and clinicians just don’t want to have to deal with it,” she said.

“It doesn’t make a lot of sense. It’s no different than being treated for a broken bone, going into the emergency room and being treated immediately,” Saxton said. “But it’s not at all the same for people who are struggling with mental health.”

Social media contributes to mental health issues

A combination of factors have contributed to the rise in mental illness, Saxton said.

The coronavirus pandemic forced many people to isolate, specifically having an effect on youth development.

“Our students don’t have coping skills and they are not resilient,” she said.

Social media can also play a role, which often is the root of anxiety and depression, Saxton said.

“We collectively are saying it’s okay to have a culture of hate. What I mean by that is: every community has a social media page, like Ames People,” Saxton said. “And if you are even looking at it, you are contributing to that.”

Although citizens have a right to free speech, she said, there are consequences. One of the consequences is a decline in mental health.

“It’s a cesspool of hate, misinformation, made up information, and that’s allowed,” Saxton said. “It’s a place for adults that are creating hate and anger, which we know as providers contributes to the decline of mental health.”

She said social media allows people to say whatever they want with no consequences, hiding behind their computer screens.

“My question to the community is, ‘Why is that okay?’” Saxton said.

The theme for the 2023 Story County Mental Health Expo is “Escape for overcoming anxiety and intrusive thoughts.”

A suicide prevention training is offered at 5:30 p.m. prior to next Monday’s expo. The hour-long class will give residents the skills to identify suicidal behavior and crisis.

As the Ames Police asks in their Mental Health Expo promo, “What’s preventing you from reaching out?”

If you or a loved one are having thoughts of suicide, call 988 or reach the 24-hour crisis line at 855-581-8111.

Ronna Faaborg is a reporter for the Ames Tribune. Reach her at rlawless@gannett.com.

This article originally appeared on Ames Tribune: Hip-hop artist is keynote for Story County Mental Health Expo

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“Sometimes, things between a player, a club and a manager don’t work, that’s football,” says Chelsea’s new No 1 Robert Sanchez.

The rise, fall and rise again of one of the Premier League’s most sought-after young goalkeepers has been fairly remarkable over the past 12 months.

Not so long ago Sanchez was talked about as one of the top-flight’s rising stars, a giant of a man with an excellent command of his box, a strong shot stopper and comfortable with the ball at his feet. The all-round modern goalkeeper.

But a poor spell at the Amex last season, tied in closely with the ultra-prescriptive style of incoming manager Roberto De Zerbi, brought everything tumbling down. Memories are short in football and within months, after losing his place to Jason Steele in March, the 25-year-old’s stock had collapsed.

The £25m offer Brighton accepted from Chelsea in August would have never been countenanced a year earlier. Bayern Munich were said to be stunned by the price tag and also sounded out a move.

Now thrust back into the spotlight under Mauricio Pochettino and surrounded by £1bn worth of players, it has given Sanchez a chance to rebuild the reputation he worked so hard to develop.

Between his first and his last Premier League appearance for Brighton, only seven goalkeepers kept more clean sheets. Only Alisson and Ederson completed more passes, and only Nick Pope and Emi Martinez made more catches.

Those aren’t the statistics of a bad goalkeeper. Others’ confidence in him dropped off, but Sanchez has long talked about the sense of self-belief which first helped him oust fan favourite Mat Ryan as Brighton No 1, and has now seen him through the other side of a tough few months before his London move.

“If you don’t believe in yourself, who else will?” He asks Sky Sports, half smiling, at Chelsea’s Cobham training base. “I think I did well last season.

“He [De Zerbi] had a view of the team, for one reason or another he didn’t count on me for the specifics of the kind of goalkeeper he wanted and decided to go with another [Jason Steele].

“He suited what he wanted to do better, and I’m happy for him, because he’d been supporting me for the two and a half years I’d been the goalkeeper and now he’s got his chance.”

De Zerbi hinted at similar when he first dropped Sanchez in March. Though the Italian never expanded on the details, Steele’s success on the ball in his press-baiting style made it clear.

Sunday 17th September 1:00pm

Sanchez’s form had suffered too before he lost his place. He conceded more than five goals over his expected tally last season, but he didn’t become a poor player overnight.

“I was pretty relaxed,” he adds. “I know my level as a goalkeeper. I know I’d play one way or another somewhere, so I relaxed and waited for my opportunity to come round.”

Could he have imagined sitting here as Chelsea’s No 1 at the start of the summer, though? “I probably couldn’t have seen that coming,” he laughs.

“You hear things as the transfer window goes on, and when Chelsea got in touch I couldn’t say no. What they presented for me, the plan that they had, it was unbelievable.”

It helped that Levi Colwill, a stalwart in the Brighton backline last season, had already returned to his parent club Chelsea and would be a familiar face waiting for him at Cobham.

He wasn’t the only one. Ben Roberts, Sanchez’s goalkeeping coach for his entire Brighton career, moved to Stamford Bridge with Graham Potter last year and stayed on after the head coach’s short-lived tenure. There was the lure of working under Mauricio Pochettino, too.

Image:
Sanchez and Levi Colwill have been reunited at Stamford Bridge after playing together at Brighton last season

“The whole thing just looked like a real family environment here,” he says. “There was Ben [Roberts] and the relationship I used to have with him, Moises Caicedo, [Marc] Cucurella, Levi [Colwill], a couple of Spanish talkers.

“Ben knows my level, he always thinks I’m one of the best and he helped with the move – he put a good word in and helped to get me to Chelsea. I love him, I’ve had an amazing relationship with him for seven years, and I wanted to come here and work with him.

“I’d played against a lot of the boys for a few years – and I also had a couple of chats with the manager, I know what kind of manager he is.

“He knows when to tell you that you need to do better, when to give you a hug, put his arm around you. He’s a great manager tactically, but especially managing players, he gets to know each player individually and everyone’s different, and he gets the best out of us.”

The rebuild of Sanchez’s reputation as one of the Premier League’s best will take longer than his return to first-team football. It is not helped by the expectation levels on a squad still finding its feet in front of the world’s glare and a line-up still being tinkered by Pochettino.

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Sanchez’s new side Chelsea were shocked by Nottm Forest in their last game before the international break

He has witnessed first hand the virtues of time and patience under Potter at the Amex though he knows, as the head coach found out for himself in April, those qualities are not often in great supply at Stamford Bridge.

“We’ve got a great manager, great staff, wonderful individual players, but it’s a young team,” he says. “People have heard this a lot of times but players have come in from a lot of different situations, it’s new to them, and we need time.

“We’re improving as quick as we can, we know we want to win but it does take time. Winning is the most important thing, it gives us the best feeling, but we’ll get there.”

An much-needed shot in the arm could come at the Vitality Stadium this Sunday, live on Sky Sports, against a Bournemouth side still without a win this season.

Whatever the outcome there, for Sanchez at least, it won’t be for a lack of belief.

Watch Bournemouth vs Chelsea live on Sky Sports Premier League from 1pm on Sunday, kick-off 2pm

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A new report by the University of Hawaii says many survivors will likely experience post-traumatic stress and depression in the fire’s aftermath and a lack of trust in public officials.

Two of the biggest challenges in the immediate and long-term aftermath of the Aug. 8 fire that destroyed most of Lahaina and killed at least 115 people will be the mental health of survivors and the need to ensure government transparency in the recovery, according to a new report from the University of Hawaii.

“The health effects of the disaster are profound. They go beyond the tragic loss of lives and the immediate injuries that many suffered,” according to the report released Thursday by the university’s Economic Research Organization.

The report, titled “After the Maui wildfires: The road ahead,” was prepared by 16 experts from a variety of disciplines including economics, environmental science, public health, finance and governance.

A brush fire razed Lahaina in West Maui, Aug. 8. (Nathan Eagle/Civil Beat/2023)

The experts said research conducted in the aftermath of the 2018 Camp Fire that killed 85 people and leveled the California community of Paradise, and other major wildfires, found a significant rise in post-traumatic stress, depression and anxiety disorders among survivors both right after the disaster and often years later.

Mental health impacts from fires can also trigger physiological damage to hormone regulation, the heart, and the brain, the report found.

While signifiant federal and state resources are being deployed to Lahaina, it’s imperative to find enough qualified mental health practitioners to care for fire survivors, and that will likely be a big challenge in the medium and long term, the report says.

It’s also important to have mental health practitioners with ties to the local community and culture.

That could be especially difficult given Hawaii’s severe shortage of psychiatrists, psychologists, licensed clinical social workers and mental health therapists, particularly on the neighbor islands.

The Maui Community Mental Health Center is offering to help those affected by the recent wildfires. (Kevin Fujii/Civil Beat/2023)

Besides that, there’s the logistical problems. Much of Lahaina’s healthcare infrastructure burned down and many people who might have driven to Central Maui for mental health care are now carless.

Given all that, it’s critical that services be made available close to survivors, whether they’re in Lahaina, Kula, where more than a dozen homes were destroyed in the Upcountry fires, or elsewhere on Maui, the report found.

The Hawaii Department of Health appears to be aware of the needs and is taking steps to meet them.

“We understand the behavioral health impacts from the Maui wildfires are severe and are likely to be long lasting,” said Marian Tsuji, the state’s deputy director of behavioral health, in a news release. “We also know that the impacts may not be revealed for weeks or even months after the disaster.”

Tsuji’s department is working with community partners to make sure that Maui residents have access to comprehensive and culturally sensitive behavioral health support. This includes a wellness navigator program for survivors staying in hotels. The navigators go door to door with carts containing toiletries, snacks, toys for children and other donated items, and they offer information about mental health services.

“There is a danger that post-disaster governance will be hobbled by bureaucratic turf battles and fragmented jurisdictions of authority.”

UHERO Report

The department is setting up telepsychiatry services and hiring local behavioral health clinicians to provide support to survivors for several months.

The U.S. Department of Health and Human Services has provided four federal behavioral health providers on Maui to assist, according to DOH.

Locations for in-person behavioral health visits include the Lahaina Comprehensive Health Center at Akoakoa Place below the Lahaina Civic Center and the Maui Community Mental Health Clinic at 121 Mahalani Street in Wailuku.

The Hawaii CARES Crisis Line is also available 24/7 by calling or texting 988 or visiting hicares.hawaii.gov.

The department plans to create peer support groups, increase telehealth services as communications are restored, and add additional crisis hotlines, according to the release.

Efficient government coordination and transparency will be key to the recovery from the Maui fires, the report found. (Nathan Eagle/Civil Beat/2023)

Meanwhile, as the recovery moves forward, the University of Hawaii report emphasized the need for efficient government coordination and transparency.

Effective governance of the recovery will involve state and county governments, local nonprofits, community groups, FEMA and other federal agencies.

“There is a danger that post-disaster governance will be hobbled by bureaucratic turf battles and fragmented jurisdictions of authority,” according to the report.

The other issue is regaining the community’s trust, said UH political science expert Colin Moore.

Colin Moore says rebuilding public trust in government will be a real challenge. (Courtesy: UHERO)

Post-disaster redevelopment environments often favor “big top-down strategies that leave the community feeling left out or not being consulted,” he said.

In West Maui, trust in government was already a problem even before the fire. It experiences one of the lowest voter turnouts of any place of the island, an indicator that people don’t feel invested in elected leaders, Moore said during a press conference.

It’s going to be a “real challenge” to rebuild that trust, Moore said. One way to approach that is to create as inclusive a governance system as possible, to involve community stakeholders “from day one,” he said.

That’s probably going to take many community meetings facilitated by outside professionals and it’s going to require lots of transparency on the part of government. All that’s necessary to make sure the public is heard, knows how decisions are being made, has a seat at the table, and is confident that the millions of dollars in relief aid is reaching the people who need it the most, Moore said.

Civil Beat’s coverage of Maui County is supported in part by a grant from the Nuestro Futuro Foundation.

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In four months, the gavel will fall, and the state’s first CARE Courts will be in session.

Seven counties opted for an Oct. 1 rollout of the law that orders each county to create special courts, whose judges have the authority to order voluntary treatment plans for individuals with untreated schizophrenia and related disorders.

The CARE Act, signed into law by Gov. Gavin Newsom last September, requires counties to come up with the bureaucratic mechanisms that will support the goal of easing an epidemic of severe mental illness on the streets and in communities.

“We’re deep in the weeds, thinking about what will be the daily lives of the people who engage in this work,” said Luke Bergmann, the behavioral health director for San Diego County.

Among the many challenges of the CARE Act is developing a manageable workflow for disparate groups.

For every individual appearing in the court, there will be the clerks who processed the petitions that initiated the proceedings, the outreach teams that found the individual and served the paperwork, the psychiatrists who prepared a treatment plan, defense attorneys who will represent the individual, behavioral health clinicians who will present the plan and the judges who will negotiate its implementation.

In addition, there will be insurance companies that pay for the plan, administrators who manage the paperwork associated with the plan and healthcare providers who execute the plan.

The first group — San Diego, Orange, Riverside, San Francisco, Stanislaus, Tuolumne and Glenn — reflects the geographic and demographic diversity of California. Their courts will serve as a template for Los Angeles and the 50 other counties. (L.A. County will open its court on Dec. 1; the rest of the state has until Oct. 1, 2024.)

Many counties will be playing catch-up with a crisis that has gone unchecked for decades. County supervisors and behavioral health directors describe a neglected system with an unknown number of people who may be eligible for a CARE Court.

The state has estimated that 7,000 to 12,000 people will qualify for a treatment plan. The range is so broad, officials say, in part because the law allows roommates or family members to initiate an assessment of a family member suspected of having a severe mental illness.

Some counties are concerned that they will be overwhelmed by families who have been unable to seek assistance caring for individuals with mental illness by laws that protect their rights and privacy.

They are braced as well for the frustration from families whose requests are denied for not meeting the criteria specified by the law. Those brought into a CARE Court must be 18 or older, diagnosed with “schizophrenia spectrum and other psychotic disorders” and not currently being treated.

“We’re just not sure who this law will bring to the door,” said Veronica Kelley, Orange County’s behavioral health director.

Orange County estimates it will receive petitions for about 1,500 people the first year, with about 1,000 of them meeting the court’s criteria. Of those, officials estimate, nearly 300 are expected to agree to a treatment plan without having to be brought into CARE Court, leaving 700 for the court to monitor for at least a year.

Family members demonstrating at the state Capitol in support of the CARE Court proposal.

(Anita Chabria / Los Angeles Times)

One of the smaller counties, Stanislaus, has identified 150 people who will qualify based on frequent emergency room visits. “Beyond that,” said county Supervisor Terry Withrow, “it’s anyone’s guess.”

Such estimates are critical for counties needing to hire staff at a time when the state is experiencing a shortage of behavioral health workers. Meeting that need will be harder on rural counties, which have fewer providers capable of working with people suffering from acute mental illness.

“In a small county, it’s not like staffing will grow to meet capacity, especially when it comes to administration and management,” said Joe Hallett, behavioral health director for Glenn County, 60 miles north of Sacramento. “Instead, we just add these new responsibilities to the existing workload.”

Health directors like Hallett are looking to lawmakers in Sacramento for continued advocacy and support. Glenn County will receive nearly $1.4 million in early allocations.

Startup funding for the CARE Act was $57 million. The state budgeted $26 million to be divided among the first group of counties as they work out whatever kinks arise in implementation. Another distribution of $31 million will be shared among all counties in advance of full implementation in 2024.

While Orange County received one of the highest allocations — $7.1 million — Kelley is concerned about lawmakers’ resolve keeping the CARE Act fully funded.

“That’s good for one year,” she said, “but for the ensuing year, we don’t know.”

Funding behavioral health services was one reason Riverside County signed up early, said Jeff Van Wagenen, the county’s chief executive officer, who argues that it has not received support from the state commensurate with its population growth. The first allocation of $6.6 million will help, but what comes after the first year is unknown.

“One of the concerns of CARE Court is that it could be the latest unfunded mandate from the state,” he said.

Reflected in Sacramento’s budget for CARE Court is the presumption that the initial counties will work out kinks in the legislation so that other counties can start up their courts at less expense. This means answering a number of mundane yet critical questions left unaddressed by the law itself.

For instance, who should serve the petition and transport individuals to the court?

While behavioral health departments may seem the logical choice, Bergmann is concerned that it creates a conflict of interest when the agency bringing the person to court represents the interests of the party who petitioned the court. Enlisting law enforcement for this task is equally problematic for encounters on the street that will likely require more trust than authority, he said.

Building that trust is one reason why Orange County is making provisions for its staff to help family members fill out the petitions that the court needs to initiate the intervention.

“We imagine a loved one at wit’s end — agitated, frustrated and tired — for all they have been through getting to this moment,” Kelley said. “So, the court staff has to be ready for that. We’re also trying to get the $433 filing fee waived. That’s a lot of money.”

To help families understand the process, Riverside County is developing an app that will chart individual progress through the CARE system. The county also might conduct remote civil hearings, so that someone living in Blythe, for instance, would not have to go to court in Riverside, 170 miles away.

“All we need is a table, chair and laptop,” Van Wagenen said. “So we could buy a van and convert it into a mobile courtroom. This would avoid the problem of having to store property or board pets for those who are experiencing homelessness.”

Homeless people create a unique dilemma for counties required to hold a case management hearing within two weeks of determining the validity of the applicant’s petition.

“We will need more than 14 days to find the person and to try to get them to agree to treatment,” Kelley said. “What if a person has moved to a different county? We can’t extend all our resources, trying to find them. We’re not investigators.”

“We’re deep in the weeds, thinking about what will be the daily lives of the people who engage in this work,” said Luke Bergmann, the behavioral health director for San Diego County.

(Kristian Carreon / For the San Diego Union-Tribune)

Hallett, with Glenn County, has similar concerns. The two-week window is “really, really fast to find someone, do outreach and process a report,” he said. “A month would be more reasonable.”

Yet lawmakers wrote the law with the intention of pressuring counties to act quickly, leaving counties to meet that timeline or pay a price.

“The CARE plan is like a settlement agreement between the county and the respondent,” said Jacqueline Wong-Hernandez, chief policy officer for the California State Assn. of Counties. “Once a plan is in place, the petitioner falls away, and an agreement to comply has to be struck between the county behavioral health department and participants in the court.”

The stakes for not meeting the 14-day deadline are high. If the court finds the county to be noncompliant, a $1,000-a-day sanction per case can be levied.

Dr. Mark Ghaly, secretary of the California Health and Human Services Agency, calls the counties’ efforts so far “very promising.”

Not only does the legislation hope to change “the arc of lives of some of the most vulnerable among us,” but it also represents “a culture shift in how we collectively as a system do business, which will take time and repetition.“

“Frankly,” he said, “it is our responsibility to do better.“

As much as behavioral health directors welcome the CARE Act, they emphasize that additional work is required to address broader and deeper problems in the state’s behavioral health system.

“We’re moving too quickly,” Kelley said. “Give us five years, which is how long the county needs in order to build anything. Without the infrastructure, these programs won’t be as successful as the Legislature wants, and we might lose people whom we could be serving in the process.”

Newsom hopes to address this deficiency by creating new revenue streams for housing and services, but his proposals are contingent on voters and will take years to put in place.

“We’re standing at the front door,” Bergmann said. “We’re painting it, we’re putting in windows, we’re outlining it with mother of pearl, and yet when we walk in, we find a building without a roof.”

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Tuesday, May 16, 2023 by Kali Bramble

With the wheels officially in motion for Travis County’s Mental Health Diversion Center, City Hall is doing its own work to scale up the mental health services that will be key to its success.

In honor of Mental Health Awareness Month, City Council’s Public Health Committee spent last week’s meeting hearing from Emergency Medical Services and the county’s Health and Human Services Department on existing crisis outreach and diversion programs. The committee also unanimously endorsed the Mental Health First Aid Initiative slated for a vote this Thursday, which directs the city to expand its cadre of certified mental health emergency specialists in Austin by 1,000 over the next year.

“People with mental health and substance use disorders too often land in the criminal legal system because of disruptive or erratic behaviors that lead them to get arrested,” said Travis County Judge Andy Brown, who noted misdemeanors like public trespassing as a common example. “As this body is all too aware, the state of Texas woefully underinvests in mental health care, and as a result our county jail is the largest mental health facility in the county.”

Since the county’s approval of the new facility, staffers have been working on the program’s design, looking to success stories in cities like Nashville, Miami and Tucson for inspiration. While Brown says the funding and bidding process to get a center up and running will likely take two to three years, staff members are acting now to form partnerships at all levels, hoping to build robust pre- and post-arrest programs with a focus on rehabilitation and housing.

In step with that vision, the city will lean into existing mental health diversion programs like Community Health’s Paramedic Mental Health Response Unit, which works in tandem with the 911 call center and EMS to provide specialized on-scene care for those experiencing a mental health crisis. Since 2021, 911 callers have had the option to request help specifically for a mental health emergency, utilizing partnerships with Integral Care specialists that have diverted thousands of calls from unnecessary police responses and ER visits.

Since the program’s inception, Division Chief of Integrated Services Stephen White says an average of 90 to 95 percent of mental health calls have been resolved without law enforcement, and over 75 percent without dispatching an ambulance. The team has also made headlines piloting on-site administration of olanzapine, a medication commonly used in emergency rooms that can help quickly stabilize those suffering a psychotic episode.

“What other EMS systems are doing is using olanzapine for treatment during transport to the ER, but we believe we’re the only ones (in the nation) treating them, staying with them and ensuring they’re safe, and leaving them in the community if that’s appropriate,” said paramedic field training officer Kenny Pailes. “We’ve had a lot of success, and a really important facet of the program is connecting them to follow-up care.”

If Thursday’s votes suffice, Council will also look forward to pushing forth the Mental Health First Aid Initiative, a citywide campaign to expand the number of certified mental health specialists in more community-facing roles. Around 700 city employees have already undergone training, and another 120 are in the pipeline. Staffers hope they can encourage training, which entails an eight-hour training course, via vouchers for exams and supervisor requirements, targeted outreach, and expanding language access. Executive Director of Community Advancement Network Raul Alvarez, who is spearheading the team, says research has shown that such training outside of clinical settings can be particularly useful to those struggling with mental health and substance abuse disorders.

Those interested in becoming certified can learn more at Integral Care’s website, or sign up for an upcoming free training session on May 23.

The Austin Monitor’s work is made possible by donations from the community. Though our reporting covers donors from time to time, we are careful to keep business and editorial efforts separate while maintaining transparency. A complete list of donors is available here, and our code of ethics is explained here.

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