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Editor’s Note: This story is part two of a three-part series on mental health in the Roaring Fork Valley. Read part one here.

Last year, Mental Health America — a non-profit dedicated to the promotion of mental health, well-being, and illness prevention — ranked Colorado as having the worst ratio of prevalence of mental illness to access to care in the country.

The relatively narrow portion of people accessing mental-health care — 53.6% of individuals with a mental illness received treatment in Colorado, according to 2022 MHA data — is partly due to workforce shortages in mental healthcare, cost of care, and ghost networks, according to Vincent Atchity, CEO and president of Mental Health Colorado.

The occurrence of ghost networks, according to him, happens when health-insurance providers ostensibly have a network of care providers for customers, but many of the care providers do not exist or are not accepting patients. Consequently, customers are left without access to quality care.

According to him, the Colorado Division of Insurance is tasked with identifying and addressing ghost networks but is struggling with enforcement due to the prevalence of the issue.

“It’s such a sprawling mess that it takes time to correct for, and the pipeline of folks going into providing care for mental health is not exactly a wild rushing geyser of people,” he said. “It’s tough work that is comparatively poorly compensated.”

In the Roaring Fork Valley, there are only three psychiatrists serving the region, according to Psychology Today’s database. And psychiatrists are not always accepting new patients.

A source who was under the age of 25 when searching for one in the Roaring Fork Valley said they faced difficulties associated with their age since the only psychiatrist available did not accept patients younger than 25.

“The big thing is going to be thinking about how we recruit providers to our area,” Aspen Outpatient Program Director at Mind Springs Health Kayla Bailey said. “The challenge that we consistently find here in our valley is that when we’re recruiting outside of this valley, the expectation is that the individual is going to have to find housing, which is very, very difficult.”

The 2022 Regional Health Assessment for Pitkin, Eagle, and Garfield counties also identified the lack of access to mental-health services in the area as a key issue. According to the report, there are 27.7 psychologists and 43 licensed clinical social workers per 100,000 people in the region. Statewide, there are 43.9 psychologists and 75.3 licensed clinical social workers per 100,000 people, although the state’s demand for mental-health services still exceeds the capacity of available resources.

After surmounting the challenge of finding a psychiatrist who is accepting patients, the cost of seeing a psychiatrist can be prohibitive — the initial appointment costs between $300 and $500 without insurance and subsequent appointments cost between $80 and $200 on average, according to K Health, a consumer health company.

HeadQuarters, a Basalt-based, mental-health organization focused on mental fitness, has a Mental Health Fund aimed at providing financial assistance for mental-health services. The fund allows local therapists to access subsidized therapy sessions for uninsured or underinsured clients, awarding up to 10 fully-funded therapy sessions.

The local requirement can present a challenge due to the limited availability of mental-health providers in the area. HeadQuarters Executive Director Angilina Taylor acknowledged that the mental-health landscape has evolved towards telehealth and said she hopes for the Mental Health Fund to eventually cover providers outside of the local region. However, she said that is not yet possible given the current funding available for the fund.

Atchity described a “non-system of a system” where Medicaid is set up to provide affordable care for eligible enrollees, but there are often long waitlists even if a client is eligible. Many providers also do not accept insurance at all, meaning that the cost of a session must come out of the patient’s pocket, according to him.

Bailey said that while most people who request services can be seen for mental-health counseling within a couple of weeks, the waiting period for psychiatric care can be much longer.

Navigating available mental health resources

Another major reason people are often discouraged from seeking help is due to the complexity of identifying and locating the proper care, according to Atchity. Scarce cultural competency, misdiagnosis, long waitlists, and a lack of inpatient psychiatric care contribute to the difficulty of accessing the appropriate resources.

The 2022 Pitkin Area Co-Responder Team annual report also found that multiple system involvement and a lack of communication among agencies and organizations can lead to confusion, creating a barrier to accessing mental-health services.

“When you’ve got a mental-health condition, regardless of acuity level, finding your pathway to care and supports and services is nowhere near as reliable and straightforward as finding your pathway to having an appendectomy or having a broken limb set or something like that,” Atchity said.

In April 2021, Gov. Jared Polis signed a bill into law establishing a statewide Behavioral Health Administration. The goal of the administration, according to Division Director of Policy and External Affairs Ryan Templeton, is to coordinate a cohesive and effective behavioral health system across Colorado.

Despite the duplicative efforts of behavioral health organizations, there are still many unaddressed gaps in the behavioral health system. He said the BHA is working on identifying and filling those gaps.

One of the issues he said the BHA has identified is a lack of access to services and a clear starting point for people seeking menta-health support. Termed a “front-door” or “no wrong door” approach, he said the BHA is exploring how to create a more straightforward pathway to accessing care. He said the BHA has anecdotally heard from Coloradoans that navigating the vast network of mental-health resources can act as a barrier to finding the right support services.

“If you go to a place to receive care, you should have access to the care that you need, whether it’s there directly or gets the coordination to or navigation where you need to go,” he said. Often, people report being discouraged after getting turned away from resources without any guidance on where to find the appropriate care they are seeking. “They just throw their hands up and say, ‘This isn’t a system for me.’ We can’t have that in Colorado. That’s how people die.”

Nowhere to go: Isolation in the Roaring Fork Valley

When Andrew Parrott was recently hospitalized at Aspen Valley Hospital for bipolar disorder, more than 40 hours passed before the hospital was able to locate a single available in-patient bed for him in the state of Colorado.

Once a bed was located, nearly a full two days later, he was transported five-and-a-half hours by a private security company to Colorado Springs. After receiving care in the hospital, he was discharged — still medicated — and left alone to face the task of getting home.

Parrott’s situation is not unique; in fact, the closest in-patient psychiatric care to Aspen is located in Grand Junction, still more than two hours away.

“We know that we’re lacking a lot of those beds in Colorado, a lot of those sites in Colorado, and access to those types of services,” Division Director of Policy and External Affairs at the Behavioral Health Administration Ryan Templeton said.

As of 2016, the Treatment Advocacy Center reported that there were 543 public psychiatric beds, or 10 beds per 100,000 people, in Colorado. That number is significantly less than the recommended minimum of 50 beds per 100,000 people to provide adequate treatment for individuals with severe mental illness.

According to Atchity, the in-patient bed shortage arose as the nation shifted away from asylums as people began to recognize they were not producing positive health outcomes, without implementing any alternative.

“As we closed those large warehousing environments, they were never replaced with anything to meet the needs of a critically ill population,” he said.

To address the shortage of in-patient beds, Templeton said the BHA is working on developing a reimbursement model that does not disincentivize higher acuity care. To do so, the funding streams must be associated with a certain level of care, complicating the funding plans.

Templeton said the BHA also plans to focus on ameliorating the insufficient availability of in-patient care by expanding “step-up” and “step-down” facilities, which refers to the continuum of care. 

“We’re missing some of those spots to keep people out of those highest levels of care,” he said.

Bolstering community-based facilities — shorter-term care, such as crisis stabilization units and residential care — could help reduce the demand for psychiatric hospitalizations, according to Templeton.

In addition, he stressed the need for “step-down” or “step-out” support to facilitate smooth release from in-patient hospitalizations, improving the rate of bed turnover by ensuring that beds are continuously opening up as people are released.  

While Parrott was eventually able to access the care he needed, the isolated nature of the Roaring Fork Valley can exacerbate mental health issues and impede access to supportive resources. 

According to Aspen Hope Center Executive Director Michelle Muething, many clients experience feelings of depression and isolation because they are far from family members. Only a few cities have direct flights to and from Aspen, resulting in expensive airfare. The high cost of travel in Aspen can be a deterrent to people planning visits to family members in Aspen, or to Aspen residents hoping to travel to visit family members.

In addition, the dispersed geography and extreme weather conditions of Colorado can make it more difficult to access care. 

“When somebody needs care, there is no local option,” Atchity said. “When somebody needs urgent crisis care, and it’s a blizzard outside, then your logistical obstacles are tremendous.”

Identifying gaps in care

Recognizing the sprawling network of resources and lack of coordination among them, Pitkin County Human Services created the Mental Health Access Program. Human Services Director Lindsay Maisch said a group of people in the mental health field have been working over the past few years to identify and fill gaps in the area’s system of care in order to reduce barriers to people accessing care.

MHAP was born out of that effort with the goal of establishing the infrastructure to collect cohesive community data. They accomplish that by partnering with Mind Springs Health, Recovery Resources, Aspen Hope Center, Mountain Family Health Center, and Aspen Valley Hospital to better understand how current funding is impacting the community.

“That’s a pretty good subset of who is accessing mental health services and at the community level,” she said.

The kind of collaboration facilitated by MHAP can help coordinate care across organizations addressing mental health and reduce redundancies in the work being done.

When Parrott found himself in the Aspen Valley Hospital, he said he noticed a lapse in communication between the Pitkin Area Co-Responder Team, which he had worked with previously, and the clinician he spoke with in the hospital.

Although he had already talked at length with PACT about his struggles with mental health, he had to go through the explanatory process again with another clinician as part of the intake process.

He said the people he spoke with from both PACT and at AVH were helpful and understanding, but the process could have been streamlined by coordination among responding agencies.

“I know that all of these organizations have the best intent … We can have people doing triplicate, if not quintuple the work, all overlapping with each other,” he said.

Creating opportunities for collaboration and communication among organizations through projects such as MHAP is one way to foster better communication.

In addition to collecting data, MHAP conducts weekly case conferencing to examine how referrals are made and where gaps in the system lie.

Through this work, Maisch said they have identified a “doughnut hole” in the care of individuals who are using substances and who are also suicidal.

“There’s not a place in our community for them to go because they can’t go to jail; the only other custodial place for them to go is the hospital; but typically, when somebody’s pretty heavily under the influence, it’s very hard to assess for suicidality,” she said. “It’s kind of this weird little doughnut hole that’s living in our community where we don’t know where people go, and it puts them at even higher risk and more barriers for them to have to overcome to get the treatment or care that they need.”

Addressing the root causes of mental illness

Regardless of the availability of mental-health services, people will continue to struggle with mental illness until its root causes are addressed, according to Atchity. The social determinants of mental health include environmental and behavioral factors such as access to childcare, affordable housing, and sustainable wages, among other factors.

“We’re going to be a state in crisis unless there is more emphasis on the bigger picture of human health and well-being,” he said. “All of these different social determinants of health … are stressors on human experience, and that there’s very little adequate provision for (them) in our communities. Clinicians are not going to solve our mental health crisis.”

He suggested that focusing on addressing the youth mental-health crisis, which begins in the perinatal ecosystem, is a good starting point in order to raise a healthy population from the ground up. That includes introducing a system of support for children and families that ensures basic needs are met and increasing access to mental health in schools.

“That’s how you build a system of care, is by building a healthy population because then you don’t have a system of care that is trying to react to a population that’s in a state of health distress,” he said. “You can’t build a system of care for a population that’s in a state of health distress. That’s exactly what our situation is right now in the United States.”

According to him, the current state of elevated tension that pervades American society introduces additional stressors to youth.

The American Psychological Association found that the increasingly devastating effects of climate change are disproportionately impacting the mental health of youth — nearly half of survey respondents between the ages of 18 and 34 said the stress they feel about climate change affects their daily lives.

In addition, Atchity said the pronounced political divisiveness prevents a commitment to improving the mental health and well-being of American communities.

“We’ve got a perfect storm of conditions leading to mental-health distress that there is no single clinical solution for,” he said. “It is a complex set of things that has a lot more to do with human communities getting their acts together, and realizing that prioritizing human health and well-being should be number one on everybody’s list.”

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Attendees of the Continuing Day Treatment Program in the Lower East Side stretching during their daily treatment sessions.
Photo: Rong Xiaoqing

Before he began attending the outpatient program at the Lower Eastside Service Center, Binzai* had bounced back and forth between hospitals and community rehab centers for nearly a decade. After watching his father die in a car accident in 2007, he had stopped working at a Chinatown bakery and shut himself in at home all day, where he would talk to the wall. In 2009, he tried to go outside with hardly any clothes on, claiming he was being chased by Japanese assassins. When his mother blocked the door, he grabbed a knife and tried to stab himself. That was the first time Binzai was hospitalized. During another hospitalization, he had kneeled down before a doctor and begged him to kill him with an injection because “life is too painful.”

Binzai’s mother, Yuping Huang, didn’t know how to help her son. Working a minimum-wage job at a day-care center and speaking no English, she couldn’t afford to care for him around the clock. The treatment programs he attended did not stave off his manic episodes, which would bring him right back to the hospital. His mother started taking antidepressants herself. “Those days, I prayed to God to let me die soon so I didn’t have to see my son suffer,” she said.

But ever since Binzai began participating in the Lower Eastside Service Center’s treatment program, he has not been hospitalized. It’s been seven years. Sitting hunched in a chair with a hard-to-read expression on his face, Binzai often looks sulky and bored. But he’s there at the center five days a week. Margaret Lai, the program’s director, has monitored him the entire time. “Whenever Binzai looks edgy, Ms. Lai would call me, and we’d discuss how to deal with it,” said his mother. “If not for her meticulous care, he wouldn’t have the life he has now.”

The program Lai runs in the 500-square-foot room on East Broadway is the only one like it left in the city that is designed specifically for Chinese-speaking patients with severe mental illnesses, including schizophrenia and bipolar disorder. Like Binzai, the dozen or so Chinese immigrants who are regulars had cycled between hospital and home and sometimes the streets before doctors referred them to the program. In the small room, decorated with red lanterns and cut-paper art, Chinese pop songs play in the background. Around the table, they practice t’ai chi–style exercise and take classes on getting along with family members, anger management, and other methods of coping with themselves and the world. But without enough Chinese-speaking social workers or funding from the state — which favors new, more flexible models of treatment — it’s at risk of closing down.

Messages that patients wrote down to encourage themselves are posted together with New Years decorations: ”The light will overcome darkness”; “Keep moving forward to a splendid future.”
Photo: Rong Xiaoqing

Lai, the 68-year-old director, is petite, barely five feet tall. She rarely raises her voice, and yet, when she speaks, it seems to have a calming effect on all the patients. She has worked at the Continuing Day Treatment program since graduating from Hunter College’s social-work program 40 years ago. After the other full-time social worker quit last year, she’s the only one left. When a patient begged Lai to expand the program to seven days a week, she mentioned that she should be considering retirement instead. But that made everyone very agitated. Some attendees can’t imagine their futures without Lai. She tells them, “I won’t leave without making sure you continue getting good care.”

But she doesn’t know how she’ll fulfill this promise. The center’s job opening for a bilingual social worker who speaks Chinese has been open for a year, but has attracted only three applicants so far. None has been a good fit. Most community-based mental-health services face this problem. “Workforce, that’s the No. 1 issue,” said Amy Dorin, president of the Coalition for Behavioral Health, which represents more than a hundred such providers in New York. “The salary is not high enough, so people are choosing other fields.” While Lai would not state the salary for the position, she did say that she does not make much more than the high end of the clinical social worker salary in the city, which is $76,200.

But finding staff who speak Cantonese or other Asian languages like Bengali is even more difficult. Elaine Ho, who coordinates the Asian Bi-Cultural Clinic for Behavioral Health at Gouverneur hospital in downtown Manhattan, says her program faces the same shortage. “If we offer sponsorship, it might be better, but we don’t,” said Ho — most nonprofit organizations cannot afford the thousands of dollars needed to sponsor the work visa and green card for newly graduated international students majoring in social work. She is now one of the only two social workers left to staff her program, down from a total of eight before the pandemic.

The biggest challenge, however, is that many Chinese immigrants with mental illness are extremely reluctant to begin treatment. Because of the stigma, many of the family members who take care of the patients in Lai’s program have never shared their situation with anyone outside the family. “I have a colleague who is functional but a little odd. I’ve seen other colleagues laughing at him behind his back,” said the sister of one of the attendees. “I cannot imagine how they would react if they knew my brother has schizophrenia.” By the time someone goes to see a psychiatrist, “most likely it’s going to be a very severe case,” said Xinlin Chen, the visiting psychiatrist for Lai’s program. When the illness is in a more moderate or early stage, “people try to keep it a secret.” Some in the older generation also resort to folk remedies, like swallowing the ashes of burned incense, which they believe will drive away the devil that has possessed one’s mind. Others consider mental illness to be a symptom of physical ailments and never think about visiting a psychiatrist until they are on the verge of being hospitalized.

Researchers have found that culturally competent mental-health services can help reduce the sense of stigma for patients and increase the possibility that they will look for treatment and see better outcomes. But helping patients find such services is still a challenge. A recent survey on the mental health of Asian American women in New York found that 84 percent of the respondents agreed that talking to a mental-health professional would positively impact their life, yet only 45 percent said they know a community-based organization that provided mental-health services in their preferred language.

Without other full-time staff, Lai must juggle running the program, filling out all the time-consuming paperwork required by government regulators, and fundraise, since state funds are not enough.

On a humid day in June, Lai started class by leading the group of adults in their 30s to their 60s in reading the goals listed on the whiteboard aloud. They included Confucian tenets like “Respect your elders” and practical tips like “Read newspapers to keep connected with the world.” The virtue she highlighted above all was being punctual — seeing your doctors and taking medicine on time.

“If you miss your pills, what will happen?” she asked the students in Cantonese.
“Being hospitalized.” they answered in unison.
“Do you want to be hospitalized?”
“No.”
“Then what do you need to do?”
“Take the pills on time.”

The lesson might sound frivolous or alarmist. But Lai believes that referencing Chinese culture and educational methods makes it easier for the patients, many of whom grew up in mainland China or Hong Kong, to absorb certain lessons. For example, she frames anger-management skills in terms of respecting one’s parents, rather than taking your frustration out on them, and she tries to boost the self-esteem of the members with lines from Tang-dynasty poems. As for taking pills on time, Lai repeats this goal every few days. For many of her students, skipping their medication has had catastrophic results: Some have attempted suicide, others have stormed out on family members, and a few ran away from home and spent the night on the streets. In the end, they’d all ended up involuntarily committed in hospitals, which none of them wanted to repeat.

Margaret Lai, the director of the Continuing Day Treatment program, has been working with patients at the center for 40 years.
Photo: Rong Xiaoqing

The goal of outpatient programs like Lai’s is to stabilize patients and keep them out of hospitals through daily, on-site treatment. These programs began gaining support in the 1980s, offered as a solution during the deinstitutionalization movement of the time which wanted to prevent the abuse of patients locked away in psychiatric wards. Better medicine also meant many patients could control their symptoms while living in their own communities, rather than in hospitals. Then, in the 2000s, the state turned away from the goal of stabilizing patients and focused instead on their recovery and reintegration into society. In 2010, the New York State Office of Mental Health prioritized a new program model called Personalized Recovery Oriented Services, or PROS.

Compared to the CDT treatment model, PROS offers patients greater flexibility in arranging their own services and aims for them to live independently. PROS patients are not required to attend treatment programs every day, and they can set their own goals, including finding a job (the employment rate of PROS patients is around 15 percent statewide), something a CDT program is not able to provide. Many providers say PROS also makes better financial sense for the government in the long run, since it pushes patients to wrap up treatment and reintegrate into society after a couple of years, while CDT programs might serve a patient for decades — the one who’s stayed the longest in Lai’s program has been there for 30 years.

Many service providers have switched to the PROS model — there are now up to 79 in the state, while the number of CDT programs has plummeted from 190 in 2005 to 11 across the state. The state has also launched several new service models after PROS, and it no longer issues new CDT licenses. In New York City, CDT programs serving Asian patients dropped from four to just the one run by Lai.

But even fans of PROS agree that it cannot completely replace CDT. Peter Yee, a former assistant executive director of behavioral health services at Hamilton Madison House on the Lower East Side, was involved in transitioning the organization’s CDT program to PROS about eight years ago. He likes the individualized services that PROS provides, but, he cautions that patients “have to function high enough to understand the concepts.” When Hamilton Madison House closed its CDT program, Yee said, some higher-need Asian patients who wouldn’t fit in PROS were referred to Lai’s program. However, a spokesperson for OMH said that the PROS model was designed to meet the needs of people with serious mental illness at any stage. “OMH strongly believes that all individuals have the capacity to recover and that decisions about the level of support any one individual needs should be made through a person-centered and recovery-oriented framework,” he said.

But Lai doesn’t plan to switch. The OMH “would like the patients to build function and be independent,” said Lai. “But for the patients we have, missing one day of the program could lead to a relapse.” She still remembers when a member who lived alone didn’t answer multiple phone calls during a period when they had paused in-person meetings because of the pandemic. Lai begged the manager of the building where he lived to check on him. He was found dead in bed. “This is how important it is to meet every day in person,” said Lai. “It’s not easy to know for sure whether someone is well over a phone call.”

This year, the state and the city announced a plan to add more psychiatric hospital beds, and Mayor Adams last November revealed a new policy that permitted police and emergency medical workers to involuntarily hospitalize mentally ill patients living on the streets who they determine might hurt themselves or others. To Lai, that plan looks like a step backward. Those who have family members in Lai’s program are even more concerned. “When Binzai was hospitalized before, I couldn’t even communicate with the doctors,” said Huang.

On the day I visited, two members were missing from class. One of them, Xiaoli, had called Lai in the morning to ask for a day off. Her mind was “chaotic,” she told Lai. The visiting psychiatrist to the program had recently increased the dosage of her medicine. Lai told her to do some breathing exercises, take a good rest, and drink a lot of water.

But no one had heard from Ah Wen, a former messenger in his 40s who occasionally put on a tie to read the newspaper aloud to everyone. When he didn’t pick up Lai’s calls, she called his brother to let him know. The members wondered aloud about whether he was sick, hospitalized, lost on the streets, or — the worst case — had died.

As the members talked, Lai’s phone rang. Xiaoli’s husband told her that Xiaoli had been hospitalized after developing hallucinations. The members gasped when they heard the news. Ah Wen’s brother called a few minutes later to report that Ah Wen had been tracked down. He had thrown a tantrum in his supportive housing unit and refused to talk to anyone. Everyone seemed relieved that no one was still missing.

Lai doesn’t want her patients to be cocooned in their own world. She encourages them to donate from their meager supplemental-security income to underserved children and to do volunteer work in the community to help them build self-esteem, one of the major tasks Lai gives to herself. But when Binzai went to a bakery in Chinatown to offer his skills for free, he was let go after half a day when the manager found out about his condition.

This can make it hard for Chinese immigrants with severe mental illness to live independently. “It’s not like Chinese patients do not want to find a job. But they don’t speak English, and employers in the Chinese community won’t hire them,” said Ho.

I asked Lai how she measures her accomplishments if the risk of relapse is permanent and if her patients may not ever be able to live independently. “Any progress they make, no matter how tiny, makes me happy. And you have to measure the progress by years, not by days,” Lai said.

Then she went to lead the class into their favorite session — singing. She placed a notebook on the table — a collection of 84 Chinese songs from the past several decades. They sang together, and some also took turns singing solos. When Lai placed the notebook in front of Binzai, he shook his head and his eyes darted away, which is how he usually reacted whenever he was asked to sing in the class. But that day, he picked up the notebook and slowly flipped the pages. In a quivering voice, he began to sing, “In a place far away, there is a fine maiden / When people pass her tent, they turn their head back and keep glancing …”

Lai cheered and applauded, as if Binzai, who had once damaged the bathroom door at the venue in one of his manic episodes, was a pop star. Then she turned away and dabbed the corners of her eyes. It was the first time he had sung in public.

* All patients named in the story are referred to by pseudonyms to protect their privacy.

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Camdyn Rider, left, and Riley Groover started a relationship in 2021, Groover’s mother said. She said they were “deeply in love,” but their volatile relationship ended with Groover fatally shooting Rider and then killing himself on July 21 in Winter Haven.

WINTER HAVEN — She happily anticipated becoming a grandmother next month, ready to welcome baby Oliver into her household.

Instead, the Winter Haven woman is now mourning the loss of her son and his partner, along with their unborn child. Yet she is unwilling to hold a funeral, afraid that “haters” would show up to ruin it.

Such is the aftermath of a July 21 murder-suicide in the Inwood area, just outside the boundaries of Winter Haven. The Polk County Sheriff’s Office said that Riley Groover, 26, shot and killed his fiancé, Camdyn Rider, 21, who was eight months pregnant, and then fatally shot himself.

Five days later, Groover’s mother stood on the front porch of the home she shared with her son and Rider, staring across the street to a neighbor’s yard, where the shootings occurred.

“I’m in so much shock,” she said. “Pieces of memories are coming back, when people are telling me what happened because I’m just totally devastated.”

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The woman asked to be identified only by her first name, Bonnie, for security reasons and to avoid possible harassment by others unaware of the lifelong struggles with serious mental illness that she said plagued her son. Bonnie is in her early 60s, and she uses a walker, as she is in need of double hip replacement surgery.

During a one-hour conversation, Bonnie gave a detailed history of Groover’s mental illness, talked openly about the couple’s loving but highly volatile relationship and said that Rider identified as a transgender man, a fact confirmed by their Facebook page and comments from friends.

And Bonnie repeatedly emphasized the need for those with psychological issues to pursue treatment.

“People don’t realize that mental illness needs to be treated,” she said. “People need counseling. I’m going to be going through grief counseling myself because I’m devastated. I lost my son. I sat by his bed, so many hospital beds, so many times after he tried to overdose and kill himself. But I loved him, no matter what. I love him. You always love your child. I’d rather him have gone to prison than to die.”

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A son’s troubled childhood

Bonnie said that her son showed signs of mental illness from at least the age of 4. He was diagnosed with borderline personality disorder, typified by difficulty managing emotions, with tendencies toward anger, impulsiveness and severe mood swings. Groover also suffered from anxiety, depression and post-traumatic stress disorder, his mother said, and had been diagnosed with Asperger Syndrome, a condition on the autism spectrum.

The family has a history of mental illness, Bonnie said, acknowledging that she tried to kill herself at age 22. She said counseling and medication helped her to become more stable.

Bonnie said her son had made multiple suicide attempts, starting at age 8. An undersized child with gaudy ginger hair, he was a target of bullying as a kindergartner and beaten up by a fellow student, she said.

When he was 6, he came home from school with an unexplained injury that turned out to be a broken arm. Bonnie said he suffered “a nervous breakdown” at age 7 while at school, leading to a police call and Groover being handcuffed and taken to a hospital for a psychiatric evaluation under Florida’s Baker Act.

Camdyn Rider, left, and Riley Groover held a baby shower in June and revealed that they planned to name their son Oliver John Lee. Groover fatally shot Rider and then killed himself on July 21 outside their home in Winter Haven.

She said her son was wrongly diagnosed with ADHD, his autism not recognized until he was 14.

Groover developed an intense fear of some teachers and desperately resisted going to classes at Inwood Elementary School. One on occasion, he scrambled under her car to avoid being taken to class. On another, he wrapped himself around a flagpole at school and “screamed like a banshee,” Bonnie said.

Groover first drew the attention of law enforcement in 2014, when he was 17. His mother said he had a dispute with a woman who then lived across the street, and he shot out a window of her house with a pellet gun.

The Polk County Sheriff’s Office charged Groover with shooting into an occupied dwelling, a felony, along with resisting arrest and battery on a law-enforcement officer. He spent time in a juvenile detention center in Tampa following the arrest. Bonnie said he received training in automotive work and earned a cooking certificate.

Though Bonnie said Groover was never violent toward her, court records show that in 2016 he was arrested on a domestic violence charge following an incident at the family’s home.

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According to the arrest report, Groover broke a bottle on the kitchen floor and used a hatchet to break several doors inside the house. As Groover left the house, a victim (whose name is redacted) saw him approach while holding what they thought was the hatchet. The victim swung at him with a broom in defense, and Groover grabbed their upper arm, causing a 3-inch gash, the report says. He was charged with domestic battery on a person over age 65, a felony, and violation of conditional release.

The State Attorney’s Office for the 10th Judicial Circuit later filed notice that it would not prosecute Groover.

Groover was arrested again in 2018 after an argument with his sister at their home turned violent. At one point, he approached his sister while holding a pocket knife, the arrest report says.

Groover’s mother moved between the two, and Groover’s sister ran into the house, taking refuge in a bedroom, the report says. Groover broke in and attempted to stab her with the knife, cutting her on the belly, the report says. He was charged with aggravated battery and aggravated assault.

Two years later, the State Attorney’s Office again filed a no-prosecution order. The notice said that Groover’s sister had signed a waiver, stating that she wanted him to continue taking medications and receive treatment. The order said Groover was receiving care in a group home.

Despite all the turmoil, Groover earned a high school diploma from Ridge Technical College in Winter Haven. Bonnie said he had a license as an HVAC technician but was working as a nighttime security guard, a position that did not involve carrying a gun.

Groover talked of working for a fish and wildlife service, and he also aspired to be a professional photographer, his mother said. He created a Facebook page titled Frosty Photos, posting his images of cars drift racing at Sebring International Raceway.

‘Deeply in love’

Groover and Rider began dating in early 2021, Bonnie said. At the time, Rider already identified as a transgender man, she said. Rider had stopped using their feminine given name and planned to change their name legally after marrying Groover, she said.

“Cam had told me personally that when he was younger, he was bisexual and had crushes on girls, but then he met somebody online and he identified with him, I guess, when they were talking about transgender and dysphoria and all that,” Bonnie said. “And so Cam decided he was a man and he honestly felt like he was a man. But you know, that’s neither here nor there. I accepted him as he was because he loved my son.” (See related story)

Bonnie said that Camryn planned to begin a physical transition after giving birth and finishing breastfeeding. Rider’s parents could not be reached. Bonnie said they lived in the Orlando area.

Riley Groover, 26, worked as a security guard but aspired to be a professional photographer, his mother said.

Not long after Groover and Rider started dating, Bonnie invited Rider to move into her Winter Haven home.

“And I loved Cam,” she said. “Cam called me ‘Mom.’ He never called me by my name.”

Bonnie said that Rider and her son were “deeply in love.” In April 2022, Rider posted a video snippet on Facebook showing the pair singing the line, “We found love right where we are,” from the Ed Sheeran song, “Thinking Out Loud,” followed by a loud smooch.

“Oh, it’s just heartbreaking to look at it,” Bonnie said. “But I watch it several times a day.”

In another post from April 2022, Rider wrote to Groover, whom they called “RJ”: “From the second I laid eyes on you I knew that I wanted you in my life. I didn’t know as what yet, but I knew I wanted you there. You showed me who I can be and you showed me what love is supposed to feel like. The more we talked and hung out the more I grew to like you. … I’m so happy to say that I’m gonna marry my best friend. Thank you for everything my love. And I can’t wait to spend the rest of my life with you.”

The couple decided to delay their wedding after Rider became pregnant, Bonnie said. They held a baby shower and gender reveal party in June with a Harry Potter theme, one of Rider’s fixations. The couple disclosed that they planned to name the baby, due Aug. 18, Oliver John Lee.

Rider wanted to be a tattoo artist and owned an ink gun, Bonnie said. She talked of letting Rider turn a back room of the house into a tattoo studio someday.

A fiery relationship

But Bonnie said the relationship also contained a combative strain, one that regularly led to loud arguments and, in some cases, physical fights. She allowed the couple to live rent-free in her 1960s-era block home but expected them to help with bills and housework, and Bonnie said her son criticized Rider for not doing enough.

“They would argue over stupid stuff — stupid stuff,” she said.

Neither Groover nor Rider ever reported violence committed by the other, the PCSO said.

During arguments, Rider would sometimes enter what Bonnie called a “catatonic state,” going silent and rigid, with a vacant stare.

Bonnie said pregnancy increased Rider’s sense of gender dysphoria, or discomfort with a female body, and she suspects the hormonal surges of pregnancy worsened Rider’s emotional volatility.

Riley Groover is shown in a jail booking shot taken after his arrest in 2018 on charges of domestic violence.

Bonnie suspected that Rider had traits of autism, like her son. She said Rider engaged in self-injury through cutting their arms and legs, a practice used to manage emotional pain, according to psychological experts.

“He got my son to start doing it,” Bonnie said. “When I found out my son was doing it, I told them if they didn’t stop that s— they had to leave, that they couldn’t stay here. And they stopped.”

Bonnie, a former nurse now on disability, has a heart condition. She warned Groover and Rider that their arguments sometimes caused her to have chest pain.

Bonnie said she urged Rider to seek psychological counseling, but Rider refused. She said Groover had resumed therapy, meeting with a counselor in a park because he didn’t like offices. But Bonnie said her son resisted taking psychiatric medications owing to bad memories of being overmedicated in childhood.

“He didn’t want to be drugged up,” she said. “He didn’t want to feel nothing.”

An unimaginable horror

Bonnie said she doesn’t know exactly what precipitated the tragedy of July 21, but she expects it was another argument over household chores. She said that around 7 p.m., the dispute moved outside, and at one point Rider drove their car toward Groover in the carport, possibly striking him.

Groover used something — Bonnie doesn’t know what — to break the driver’s-side window. As of Thursday, some broken glass remained under another vehicle in the carport, and the front porch floor bore dark splotches that Bonnie said were Groover’s dried blood.

Bonnie had obtained a handgun for protection on nights when Groover and Rider were away, and she kept it hidden in the house. After the clash in the carport, Groover darted into the house. He soon raced out, but Bonnie said she didn’t know he had seized her gun, a .380 pistol small enough to fit in a pants pocket.

As he ran past her, he called out, “I’m not going to jail,” Bonnie said.

Rider had retreated and run away down the long, straight street. Recalling those moments, Bonnie said she wished Rider had continued past the point where the street bends to the right, out of Groover’s sight. Instead, Rider turned and came back toward Bonnie’s house.

At that point, Groover chased after Rider, Bonnie said, and Rider ran across the street, seeking refuge in a neighbor’s house. But Groover caught up, “and they got into physically fighting on the ground. And then Cam got up and ran, and Riley shot him in the back several times.”

Camdyn Rider had identified as a transgender man since before they started dating Riley Groover in 2021, Groover’s mother said.

The Medical Examiner’s Office for the 10th Judicial Circuit has not yet released autopsy reports.

Bonnie could not see her son as he moved behind a large truck parked in the neighbors’ driveway and a tall bush. She went in that direction, moving as fast as she could with her walker. She found Rider dying, with a large wound in their chest.

Her son was on the ground, not far from Rider, his eyes still open. Bonnie asked if he had shot himself, and he said yes, pointing to the left side of his head, though he was right-handed. Bonnie picked up the gun so that Groover could not grab it and shoot himself again.

A neighbor had called 911, and a team of Polk County sheriff’s deputies soon arrived. A medical crew rushed Rider to Winter Haven Hospital, but they and the baby were soon pronounced dead. Groover died a short time later.

Bonnie’s hands trembled as she recalled that horrible evening. She said some of her description came not from her own memories but from what others told her, including the neighbors across the street, whose security cameras recorded video of the shootings.

“I know I’m stuttering because I have so much anxiety,” she said. “I’m just beside myself, just trying not to break out into tears. It just comes in waves.”

No appeals process Lakeland’s homeless are being trespassed from Munn Park

Adding to her distress, the PCSO Animal Control unit took away her dog, Wally, so that deputies could search her house after the shootings. She received the dog back after a few days, but she said Wally was showing signs of being traumatized by his time in the shelter, refusing to put his head in her lap or wag his tail. By Thursday, though, Wally was behaving more normally, she said.

Bonnie also said she has been receiving unwanted offers to buy her house following news reports about the murder-suicide.

‘Wasn’t in his right mind’

Bonnie has largely avoided social media since July 21, wary of seeing her son denounced by strangers.

“My friends and family are actually, like, ‘Riley was a terrorist’ because of what he did, but he wasn’t in his right mind,” she said. “And people do bad things when they’re not in their right mind, you know?”

Rider’s parents visited Winter Haven to claim their belongings, and Bonnie said they were understandably upset. They took all the baby items, planning to give them to a relative who is giving birth soon.

Asked about holding a service for her son, Bonnie said, “No, because I don’t want haters there taking pictures and stuff. I don’t want them because I couldn’t mentally handle it.”

Bonnie’s stepdaughter came to stay with her for a few days, and her brother is coming down from Massachusetts. She plans to have Groover cremated, and she will blend his ashes with those of her mother and her stepfather to be placed in a pendant for a necklace.

While acknowledging the inexplicable evil of her son’s final actions, Bonnie emphasized his loving tendencies and his many acts of kindness. She recalled that the night before the tragedy, Groover came in to kiss her good night and mentioned her upcoming appointment with a cardiologist.

“And he said, ‘I love you, Mom. You can’t die before me.’ ”

Gary White can be reached at gary.white@theledger.com or 863-802-7518. Follow on Twitter @garywhite13.

This article originally appeared on The Ledger: Mother urges mental-health treatment after Winter Haven murder-suicide

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With the county’s police director gravely wounded in a hospital from a self-inflicted gunshot wound, Miami-Dade Mayor Daniella Levine Cava on Wednesday emphasized the mental-health hazards of law enforcement.

“This incident is also a tragic reminder of the critical role that mental health plays in our law enforcement officers,” Levine Cava said at a morning press conference, flanked uniformed county police administrators and commanders. “The reality is that these jobs are very demanding, they’re stressful and they’re emotionally taxing.”

READ MORE: Before he shot himself, Miami-Dade’s police director offered to resign, source says

Levine Cava declined to say what Alfredo (Freddy) Ramirez, the county’s police director since 2020, told her in an anguished phone call the two had hours before he shot himself on a highway outside Tampa. He and his wife, Jody, left a convention hotel in the city following a reported altercation that drew the attention of police.

“He was very remorseful,” Levine Cava said of what she described as a brief conversation by phone as Ramirez was driving away from Tampa around 8:30 p.m. “I reassured him we would talk.”

Details remain sparse as to what happened that prompted Ramirez to leave a law enforcement convention Sunday.

As the Miami Herald reported before Wednesday’s press conference, Ramirez offered his resignation to Levine Cava during the call. She did not make a decision on the offer, saying the two needed to talk on Monday.

Police said Tampa officers were responding to a potential domestic dispute when they encountered the Ramirezes in their 12th-floor hotel room. Police also said there was a report of a man wielding a gun at the Tampa Marriott at the start of the Florida Sheriff Association event the two were attending.

Miami-Dade Police Director Alfredo “Freddy” Ramirez shot himself and survived on Sunday, July 23, 2023. Police haven’t characterized his mindset at the moment, but the county’s mayor, Daniella Levine Cava, on Wednesday said the incident is a reminder of mental-health risks for police officers. DAVID SANTIAGO/dsantiago@miamiherald.com

“I cannot speculate as to anything that was going on,” Levine Cava said.

She used the press conference to remind police officers they have access to the county’s mental-health services, and urged residents to call a suicide hot line in Miami-Dade by dialing 988 if they needed help.

Story continues

Ramirez, a Democratic candidate for sheriff in 2024, has been temporarily replaced by an interim police director and interim chief safety officer overseeing public safety under Levine Cava. He assumed both roles in 2022 under Levine Cava, a first-term Democrat.

Authorities have not yet characterized the self-inflicted gunshot wound by Ramirez after pulling over Sunday night on I-75. Jody Ramirez reportedly was in the car with him when he pulled over and shot himself with his gun.

READ MORE: ‘He’s stable and he’s talking.’ Miami-Dade’s top cop said to be recovering after shooting

Levine Cava also did not characterize Ramirez’s state of mind when he stopped his car. But she and Oliver Gilbert, the county commission chairman who also spoke, addressed mental-health issues in the context of Ramirez’s self-inflicted wound.

“There’s nothing wrong with seeking help,” said Gilbert, who joined Levine Cava in Tampa on Monday before returning to Miami. “It’s a sign of strength to seek help. We never want to be this sad again. We never want to be this broken.”

A visibly saddened Miami-Dade County Mayor Daniella Levine Cava,takes questions from reporters on the condition of Chief of Public Safety Alfredo “Freddy” Ramirez during a press conference at the Stephen P. Clark Government Center in downtown Miami on July 26, 2023. Jose A. Iglesias/jiglesias@elnuevoherald.com

In her comments, Levine Cava praised Ramirez as a stellar police leader who was appointed Miami-Dade police director under her Republican predecessor, Carlos Gimenez, and became one of her most trusted senior administrators .

“I love Freddy. He is an amazing human being,” she said. “He is the best of what law enforcement means. I have total trust in his leadership.”

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There’s no one right way to tend to your mental and emotional health. Some folks might want to carve out alone time for reflective activities like journaling, while others prefer an at-home movie night with friends, and still others would rather do something physical, like go for a walk or run—and all of these preferences are valid. But with advice for self care proliferating on social media and beyond, it can be difficult to know where to start. One option? Checking your birth chart, which could offer insight into mental-health tips optimal for your zodiac sign.

“Astrology can be a wonderful tool to use in mental health [especially as a means] to build a self-care routine that suits your zodiac energy,” says astrologer Lauren Ash. Along with your sun sign (aka the zodiac sign for which you’d read a horoscope), which reflects your core personality and nature, there are several facets of your birth chart that can shed light on ways to care for yourself.

“Astrology can be a wonderful tool to use in mental health [especially as a means] to build a self-care routine that suits your zodiac energy.” —Lauren Ash, astrologer

According to astrologer and tarot reader Nivedita Kapoor, one of the most salient elements to consider is your moon sign, or the sign that the moon was in when you were born. (Don’t know yours? Enter your birth date, time, and location into a chart generator like this one.) “Our moon sign tells us about our emotional landscape and our sense of safety, which reveals how we can nurture ourselves,” says Kapoor. And according to Ash, this internal side of who we are reflects “a crucial piece of working through whatever is plaguing [us] emotionally.”

Looking to dive deeper? Considering the zodiac signs of the sixth and 12th astrological houses in your birth chart (which reflect different areas of life) could lend further insight into the best mental-health tips for your personality. The sixth house governs habits, physical health, and schedules—all of which play into your willingness to adopt certain self-care strategies over others. And the 12th house encompasses the unconscious mind, all things repressed, and the figurative prisons we create for ourselves, revealing the deep shadows we might need to confront to feel truly whole.

With all of that said, it’s important to note that astrology can’t provide all the answers when it comes to how to nurture and support our mental health. Particularly in the case of mental illness, it’s always best to consult a mental-health practitioner—as astrology is not a replacement for a professional diagnosis or therapy, says Kapoor. Rather, we can use the various pieces of our birth chart “to better understand ourselves and our motivations as we forge ahead in our self-care journey,” says Ash.

To that end, read on for your sun and moon signs to get a fuller picture of your emotional landscape and gather star-sanctioned tips for taking care of yourself and improving your mental health.

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Mental-health tips for every zodiac sign, according to astrologers

Aries

You may feel the need to do something right now, especially if you’re in a tough place mentally, Aries. After all, you’re a cardinal sign—meaning you’re all for instigating and initiating, so long as it’s on your own terms. If you have an Aries moon, that could make you prone to emotional outbursts, which could be challenging for maintaining your mental and emotional health.

Mental-health tip: Kapoor suggests finding ways to release excess energy, perhaps “by doing a physical activity, such as running or dancing.” Opting for calmer activities that still engage your body, such as Pilates or Tai-Chi, can also help keep you grounded.

Taurus

You have a reputation for being stubborn, Taurus—but your steadfastness can certainly have an upside when wielded carefully. If you’re committed to a practice, be it for your mental health or otherwise, you’re likely to see it through, so long as you have a clear understanding of why you’re doing it.

That said, your preference for feeling deeply confident of any decision you make could also require you to sit and process emotions for a lengthy time before responding, particularly if you’re a Taurus moon. Though that’s generally a positive thing, getting caught in your feelings can also be draining.

Mental-health tip: One of the best things you can do is create a reliable sleep routine, which will fuel your desire for consistency and ensure you have your emotional wits about you. To cater to your Taurean love for sensory luxuries, make sure to also “spend time in nature and indulge in simple pleasures like good food and a warm blanket,” says Kapoor.

Gemini

You are characterized by your restlessness more than most, Gemini. You’re constantly acquiring information, processing it, and committing it to memory. In turn, you take in experiences and long to do everything at once—putting you at risk for both FOMO and burnout if you aren’t mindful.

If you’re a Gemini moon, it likely doesn’t help that you may also get lost in your thoughts and emotions or feel the need to talk about them repeatedly, often winding yourself into a ruminative spiral.

Mental-health tip: To avoid hyper-fixating on your thoughts, practice some healthy escapism. “Any form of media you consume can be a great way to take a break from your thoughts, whether that’s movies, TV shows, music, or podcasts,” says Kapoor.

Cancer

You’re known to be in tune with your emotions, Cancer—often to the point of deep sensitivity. Indeed, you may lean on your emotions as the dominant force in your decision-making and wear your heart on your sleeve when it comes to interactions with others (especially if you’re a Cancer moon). While transparency is admirable, it can also be depleting if you aren’t regularly refilling your cup.

Mental-health tip: Take time to sit with your emotions, and be gentle with yourself, suggests Kapoor. Simply resting—without any guilt or shame attached to it—can be a huge asset to your mental health. And when it comes to your relationships, be extra sure that you’re giving your energy to those who truly value it, adds Kapoor, so you don’t run the risk of overexerting to little effect.

Leo

You may be best known for your confidence, Leo, but that doesn’t mean you don’t struggle sometimes, too. You pride yourself on achieving goals and being acknowledged by others for doing so—but all of this can place plenty of unwarranted pressure on your everyday life. (As can seeking affirmation or appreciation from others, which is common among Leo moons, in particular.)

Mental-health tip: To you, life is a stage—and acting that way can give you a serious boost. Do not underestimate the power of expressing yourself shamelessly as a means to feel lighter, says Kapoor. “Singing, dancing, painting, or even re-enacting a favorite scene from a movie can help you unwind.”

Virgo

Ever the perfectionist, you tend to approach everyday tasks from a determined, detail-oriented lens, Virgo. But when the number of tasks on your list is high, this approach can quickly take a toll on your mental health. You may also struggle to be kind to yourself, if you’re a Virgo moon, and fail to give yourself grace if you don’t follow through on every single thing to which you’ve committed.

Mental-health tip: If you find yourself strapped with mundane tasks, as Virgos tend to be, find ways to make them more enjoyable, suggests Kapoor. Listening to a podcast while doing the dishes or playing upbeat music while sweeping the floor can make a huge difference in how you feel, she says.

While you love a good set of instructions or clear process to follow, it’s also important for you to remember that self care is not one-size-fits-all, so “don’t get stuck in the trap of following others’ advice about what worked for them,” says Ash. Give yourself the freedom to find what works for you.

Libra

You have a strong desire for balance and harmony in your life, Libra—which can cause issues when things fall outside of your expectations or control. That applies to the behaviors of other people in your life, too; you tend to focus more on the well-being and emotional stability of others than of yourself, even though, at the end of the day, you can’t control how others feel. Unlearning these tendencies may be a lifelong journey if you’re a Libra moon.

Mental-health tip: Beauty planet Venus is your planetary ruler, which could mean you gravitate toward forms of pampering for the ultimate relaxation; booking a massage or getting a manicure could work wonders for your mental health. According to Ash, you may also be drawn to slow-moving and spiritual practices as a means of self care, like meditation and yoga.

Scorpio

You’re known for your all-encompassing intensity, Scorpio. But deep-down, your sensitivity as a water sign makes protecting yourself emotionally a top priority. If you have a Scorpio moon, in particular, you may keep your guard up as a means of protection, refusing to show much vulnerability without establishing strong trust beforehand. Taken too far, this tendency might involve repressing your emotions—which could cause inner turmoil.

Mental-health tip: Kapoor suggests allowing the emotions you may be tempted to hold inside to come to the surface. “Find an expressive outlet like crying to truly feel your feelings,” she says. You can also look to communicating with a trusted therapist or confidant to help process your emotions in a safe setting.

Sagittarius

You skew toward total optimism… and sometimes to your detriment, Sagittarius. When negative emotions surface, you tend to quickly sidestep them so as not to feel weighed down—but repressing negative feelings doesn’t make them vanish. If you’re a Sagittarius moon, you may especially pretend as if nothing ever bothers you, refusing to fully acknowledge and process unpleasant situations (even if doing so would contribute to your growth).

Mental-health tip: One of the best ways for you to practice self care is to spend reflective time in nature—not to escape from pent-up emotions but to work through them in an environment that feels familiar and comfortable to you. “It is important for you to venture out into the world to feel free and joyful,” says Kapoor.

Capricorn

You crave stability and order, Capricorn, and as a result, you typically have an unwavering work ethic extending well beyond the tasks of your job. Indeed, the desire to endlessly achieve goals and succeed can take a toll on your mind and body. If you’re a Capricorn moon, you may also struggle with taking a beat to feel and process your emotions.

Mental-health tip: Given your desire to do everything to the best of your ability, managing your time is an essential part of caring for yourself. That means creating a realistic schedule for what you can feasibly accomplish as well as a functional routine for getting it all done. “Create structure in your day in order to feel stable and secure,” says Kapoor.

Aquarius

You tend to be a nebulous presence to others, Aquarius, and truthfully, you might have a hard time ascertaining what’s going on in your own mind, too. Chances are, you prefer analyzing your emotions over actually feeling them, especially if your moon is in Aquarius.

Mental-health tip: It’s important to make sure you don’t get stuck in your own head, trying to process all the elements of your day. Sure, you can grant yourself some much-needed time alone to parse your thoughts, but steer clear of self-isolation, says Kapoor. “Try to connect with loved ones regularly in one way or another.”

Pisces

You tend to be highly creative and intuitive, Pisces, and to see the best in people and circumstances. Generally, this is a good thing, but your affinity for idealism can also work against you if you stray too far from reality. If you’re a Pisces moon, in particular, you might have trouble taking off the rose-colored glasses when it comes to difficult circumstances, making for abrasive reality checks.

Mental-health tip: You don’t have to abandon your imaginative side to better care for yourself; allowing your mind to wander can help you find creative solutions for difficult moments. Just make sure to ground yourself with a walk in nature when you start to feel disconnected, says Kapoor. Reconnecting with your tangible senses can provide the balance you need.

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Editorials and other Opinion content offer perspectives on issues important to our community and are independent from the work of our newsroom reporters.

Children and youth in Florida are facing serious mental-health challenges, made worse by Florida law.

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The subject line of the email declared: “Protecting the health of Florida’s children is a priority for the department, we aspire to do all we can to ensure the well-being of every child.”

The irony of these words from the Florida Department of Health is disturbing and incomprehensible, for the department has repeatedly remained silent as state lawmakers atrociously attack youth. Even worse, the department has allowed misinformation to drive harmful policies and practices.

American youth are exhibiting unprecedented mental-health difficulties. Marginalized youth, already at increased risk for poor health outcomes, have been Florida’s target for detrimental policies. Specifically, girls, LGBTQ+ and Black youth are suffering. Given recently passed Florida laws that contradict every accredited medical and psychological association, one must ask, why has the Florida Department of Health remained silent?

LGBTQ+ youth are four times more likely to attempt suicide than their peers and experience substantial levels of psychological distress, homelessness and violence. State laws banning classroom discussions of gender identity and sexual orientation, criminalization of evidence-based gender-affirming care, discrimination of transgender and gender-diverse athletes, and increased vile rhetoric demonizing LGBTQ+ people are direct contraindications of “ensuring the well-being of every child.”

After Florida’s “Don’t say gay” law, anti-LGBTQ+ “grooming” rhetoric surged by 400% online. American youth spend approximately eight hours per day on screens, making exposure to shaming and potentially trauma-inducing language inevitable. Florida political leaders have spewed hateful rhetoric that has shaken the core of young LGBTQ+ people, as the majority of these youth report that laws restricting their rights have negatively affected their mental health.

Yet, silence.

For the first time in recent history, Black youth are nearly twice as likely to die by suicide as white youth, while suicide attempts among Black youth have risen faster than in any other racial or ethnic group over the past 20 years. In order to dismantle institutional and structural racism, which contributes to increased suicidal behavior among Black youth, students must learn about U.S. history, such as slavery and racial discrimination. Yet Florida’s Stop Woke Act prohibits ny discussion or teaching regarding critical race theory.

Silence.

Recent data from the Centers for Disease Control and Prevention shows that teen girls are experiencing record high levels of sadness, sexual violence and rape. Females are combating dismal levels of control over their own bodies, yet, Gov. Ron DeSantis signed a six-week abortion ban. Disturbingly, this law will require survivors to prove rape through documentation. No person should ever have to provide documentation to prove they endured heinous sexual violence. Instead of passing laws to improve health outcomes for girls, who we know are suffering tremendously, Florida’s law perpetuates their shaming and psychological harm.

Silence.

Gun violence has become innately pervasive within our society. In the United States, firearm-related injuries are the leading cause of death among children and adolescents, while suicide is the second-leading cause of death among young people. Youth firearm suicide has reached an all-time high, constituting 40% of youth suicides. It’s no surprise that states with weaker gun laws have higher rates of gun deaths. Florida is already home to two of the deadliest mass shootings in history, and soon it now is legal to purchase and carry a gun without a permit or training.

Silence.

Data drives policy. Through data collection, we learn the domains in which youth need increased support, then can develop policies to promote the well-being of children and adolescents. Yet, last year, the Florida Department of Education withdrew from the Centers for Disease Control and Prevention Youth Risk Behavior Survey. Florida has turned a blind eye to children and adolescents who are in crisis.

Silence.

Physicians and psychologists are at the forefront of ensuring youth well-being by abiding to respect all people and striving to do no harm. Healthcare providers in Florida can now deny care to patients based on their moral or ethical beliefs, per the Medical Conscience Act. In other words, healthcare workers and insurance companies can overtly discriminate and withhold life-saving care from children and their families due to personal bias.

Silence.

The odds of thriving have been stacked tremendously high against Florida’s youth because of the governor’s recent egregious acts. Laws and policies grounded in data and science are desperately needed across settings, such as healthcare and school, to ensure the health and well-being of Florida’s youth.

The silence from the Florida Department of Health is deafening.

Natasha L. Poulopoulos, Ph.D., and Melisa Oliva, PsyD are pediatric psychologists in Miami. They are members of the Society of Pediatric Psychology and have co-authored several peer-reviewed publications.

Poulopoulos

Oliva

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“Vanderpump Rules” star Raquel Leviss has reportedly left the mental health facility she checked into after the eruption of the so-called Scandoval affair last spring. And she’s making some major changes, including going back to using her birth name, Rachel.

The Bravo reality star left the Meadows in Arizona about two weeks ago after racking up a $200,000 bill while undergoing intensive therapy there for two months, TMZ reported Friday. A representative for Leviss did not immediately respond Friday to The Times’ requests for confirmation.

Leviss, 28, reportedly checked into the facility after taping the bombshell three-part “Vanderpump Rules” reunion in late March — but had planned to undergo treatment prior to the discovery of her affair with co-star and TomTom restaurateur Tom Sandoval. Their illicit romance, long suspected among their co-stars, upended Sandoval’s nearly nine-year relationship with Leviss’ friend and confidante Ariana Madix as cameras were rolling on Season 10 of the “Real Housewives of Beverly Hills” spinoff series.

“I have sought emotional validation through intimate connections that are not healthy without regard for my own well-being, sometimes negatively affecting others and often prioritizing the intimate connection over my friendships. I am taking steps to understand my behavior and make healthier choices,” Leviss said in an early March statement posted on Instagram.

Despite willingly partaking in a reality TV series, Leviss said that her privacy had been violated as a result and that she had been physically assaulted, lost friendships and received death threats and hate emails. But, she added, she did not “expect sympathy, understanding or forgiveness” and planned to learn from her mistakes as she worked on her mental health.

The former SUR waitress and pageant queen underwent “mental health and trauma therapy” — not rehab — in the wake of the public outcry over Scandoval, TMZ said. She has apologized for her actions on social media, to Madix directly, on the reality series and during the reunion. At the reunion, which aired in late May and early June, she revealed that she had been lying about her and Sandoval’s relationship timeline at his behest.

Tom Sandoval, left, Tom Schwartz and Raquel Leviss on their show’s reunion special.

(Nicole Weingart / Bravo)

Since leaving the facility, Leviss has been “holed up in a friend’s house, and is uneasy about venturing out,” TMZ reported, with a source telling the site that she is “like a totally different person.”

As for the name change, it comes in response to critics and viewers weaponizing her birth name during the scandal fallout. TMZ also reported Friday that Leviss’ decision to take back her given name will help neutralize people using it against her.

You’ll recall that in early March Leviss filed for a temporary restraining order against Madix’s bestie Scheana Shay after Shay allegedly threw a cellphone at her during a post-Scandoval altercation. The court documents filed in Los Angeles indicated that Leviss’ first name is Rachel not Raquel. (Raquel is a nickname given to her at a young age.)

“We obviously recognize mental health is an important issue and wish Rachel all the best in her recovery, but we’d also like her to own up to her false allegations and publicly come out and acknowledge that she lied,” Shay’s lawyer told The Times in an April statement.

According to legal documents obtained by The Times, a judge dismissed Leviss’ temporary restraining order against Shay, 37, in late March after Leviss failed to appear in court for a hearing. But the order had remained in place while the reunion was being filmed and disrupted the usual way Bravo shoots its explosive debriefing episodes. Shay and Leviss wound up seated in separate locations during the shoot: One woman at a time could join the rest of the cast onstage during the emotional sit-down while the other could only observe it from a trailer.

The dramatic season earned “Vanderpump Rules” two Primetime Emmy Award nominations on Thursday, the first in the docuseries’ 10-season run. Madix, who has emerged as a hero in the wake of Scandoval but reportedly still lives in Valley Village with her ex, has landed several brand deals and a spot on the upcoming season of ABC’s “Dancing With the Stars.”

Cameras have begun rolling on Season 11 of “Rules” without Leviss, who is still in negotiations with Bravo about her involvement in the upcoming season. Sources close to the reality star told TMZ that her mental health remains paramount.

Representatives for Bravo declined to comment Friday when reached by The Times.

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The post Raquel Leviss has left a mental-health facility — as Rachel appeared first on Minds Valley.