WHAT'S HAPPENING

APA: CONGRESS SHOULD INCREASE CHILD AND ADOLESCENT MENTAL HEALTHCARE

The COVID-19 pandemic is putting enormous stress on children's mental health, which is why Congress should act now to protect our nation's youth over the long term by addressing shortages of mental health providers and increasing access to school-based behavioral and physical health care, according to the chief executive officer of the American Psychological Association (APA). 

STRESSED STUDENTS: The mental health of children is tied to the health of their communities, their schools and their homes.

"Children and adolescents have been especially affected by the COVID-19 pandemic, experiencing higher rates of stress, anxiety and fear. Social isolation, financial uncertainty and disrupted routines place considerable stress on children and their families," APA CEO Arthur C. Evans Jr., PhD, told the House Energy and Commerce House Energy and Commerce Subcommittee on Oversight and Investigations. "While APA appreciates Congress' significant investments in mental health during the COVID-19 pandemic, part of the problem is that such funding is temporary, which often inhibits the ability of states and school systems to make long-term investments in their mental health workforce and infrastructure. New investments must be made with the understanding that a long-term commitment is needed."

Evans cited psychological research showing that the mental health of children is frequently tied to the health of their surroundings, including their communities, their schools and their homes. "If traumatic events are occurring in these settings, they almost always have a downstream impact on children's well-being," he said.

Failing to treat children's mental health needs can have an impact on the overall trajectory of their lives, he said. "This can include a greater likelihood of difficulties with learning, addiction to substances, lower employment prospects and involvement with the criminal justice system," he told the subcommittee. "This concern is amplified for individuals from underserved communities and communities of color, who have long struggled with the social determinants that lead to behavioral health concerns and inadequate access to behavioral health services."

Evans called for moving away from the over reliance on acute care and crisis services for children and adolescents toward a population health approach that emphasizes prevention and treatment and moves services into the places where people live, work and play, thus reaching more children at their earliest point of need. This involves a multi-tiered approach, including: 1) effective and efficient clinical care for those experiencing behavioral health disorders; 2) mitigating the impact of risk factors for those individuals who have elevated risk for behavioral health disorders and intervening early if those efforts are not successful; and 3) providing tools and resources that promote wellness for those who are relatively healthy, according to Evans.

“Communities – when properly empowered – play a pivotal role in shaping solutions to their unique challenge,” Evans said. “Research on children’s mental health is urgently needed as we see how the pandemic has uniquely and disproportionately affected children. Scientific research is our best tool for improving public health and educational systems to help children overcome the challenges of the pandemic and ensuring preparedness for subsequent crises.”

Evans called on Congress to pass legislation that would increase the number of psychologists and other mental health providers, including school-based mental health professionals, who are in very short supply, with only one school psychologist for every 1,400 students. He also called on the panel to increase Medicaid funding to schools and to permanently extend the Children’s Health Insurance Program.

“Federal, state and local governments should be working in concert to ensure that all children continue to have access to equitable education and support services, while staying mentally and physically healthy,” he said.

 

ABOUT THE APA

The American Psychological Association, in Washington, D.C., is the largest scientific and professional organization representing psychology in the United States. APA's membership includes nearly 122,000 researchers, educators, clinicians, consultants and students. Through its divisions in 54 subfields of psychology and affiliations with 60 state, territorial and Canadian provincial associations, APA works to advance the creation, communication and application of psychological knowledge to benefit society and improve people's lives.

STUTTERING ASSOCIATION SHINES A SPOTLIGHT ON KIDS WHO STUTTER IN NEW PSA

SPACE TO SPEAK: This powerful PSA from SAY aims to ignite an overdue national conversation around stuttering to educate viewers about how to supportively listen to people who stutter — by giving them as much time as they need to speak. 

For the over 70 million people who stutter, every conversation can feel like speaking in front of a crowd: all eyes on you as you know what to say but cannot seem to get the words out fast enough.

"I n the Spotlight," a powerful PSA from the Stuttering Association for the Young (SAY) and BBDO, portrays the emotional weight of young people living with a stutter to ignite a conversation and bring awareness to this common yet stigmatized speech disorder. With the incredible challenges faced by kids who stutter after a year of home learning, "In the Spotlight" educates viewers on how to treat their peers who stutter, stressing empathy and patience. View the "In the Spotlight" PSA at youtube.com/watch?v=mp9voC0QymU

"Too often we hear people speak about stuttering in a negative light," says Noah Cornman, Executive Director of SAY. "There's a common misconception that people stutter because they are nervous, when in reality, they might be nervous out of fear for how the public will react to their stutter."

Stuttering is common, yet young people are often taught that it is something they should be ashamed of, or fix. "In the Spotlight" changes the narrative around youth who stutter by featuring real members of the SAY community in public speaking scenarios. But instead of giving a presentation or belting into song, they deliver speech from everyday interactions – such as asking for a job application or ordering food at a restaurant. This helps viewers understand what ordinary conversations can feel like for youth who stutter, where finishing one sentence can sometimes take as much courage as public speaking. It also tells them to give young people who stutter time to share their voices, as every voice deserves to be heard and respected.

BBDO NY was inspired to partner with SAY to produce “In the Spotlight” after their own Junior Copywriter Aaron Marshall shared his experience of growing up with a stutter and brought attention to the struggles that kids who stutter face. Young people who stutter can get discouraged to speak up and often purposely stay quiet out of fear of others' reactions to how they speak, even when they know the answer, and have so much to offer and share.  In Marshall's experience, there were times he would order something at a restaurant that he did not want, just to avoid stuttering. He believes this PSA will shift the narrative from fixing stutters to accepting and celebrating all voices, so that a child never has to compromise again. 

For 20 years, SAY has empowered kids to own their voice and teach them that there is nothing wrong with the way they speak. SAY's leadership team works year-round to provide kids with access to arts programs, speech therapy, and summer camp, regardless of a family's ability to pay. The annual two-week sleepaway camp builds a community of acceptance, friendship, and encouragement where young people who stutter can develop the confidence and communication skills they need to thrive. To learn more about SAY, their programs, and how to support, visit SAY.org. SAY is a national 501(c)(3) non-profit organization that provides support, advocacy and life-changing experiences for young people who stutter. SAY grants access to its valuable programs, which include year-round arts programs, speech therapy, and summer camp – regardless of a family's ability to pay. SAY believes that every voice matters and hopes to educate those who are unaffected. 

ABOUT SAY: SAY: The Stuttering Association for the Young is a national non-profit organization that provides support, advocacy, and life-changing experiences for young people who stutter, ages 3-18. Since 2001, SAY has offered comprehensive and innovative programs that address the physical, social, and emotional impacts of stuttering. Through summer camp, regional day camps, speech therapy, and creative arts programming, SAY builds a community of acceptance, friendship, and encouragement where kids and teens who stutter can develop the confidence and communication skills they need to thrive.

SALK TEAMS ADVANCE EFFORTS TO TREAT, PREVENT AND CURE BRAIN DISORDERS VIA NIH BRAIN ATLAS

ARTICLE IN BRIEF

It takes billions of cells to make a human brain, and scientists have long struggled to map this complex network of neurons.

Now, dozens of research teams around the country, led in part by Salk scientists, have made inroads into creating an atlas of the mouse brain as a first step toward a human brain atlas.

The researchers, collaborating as part of the National Institute of Health's BRAIN Initiative Cell Census Network (BICCN), report the new data today in a special issue of the journal Nature. The results describe how different cell types are organized and connected throughout the mouse brain.

"Our first goal is to use the mouse brain as a model to really understand the diversity of cells in the brain and how they're regulated," says Salk Professor and Howard Hughes Medical Institute Investigator Joseph Ecker, codirector of the BICCN. "Once we've established tools to do this, we can move to working on primate and human brains."

The NIH Brain Research through Advancing Innovative Neurotechnologies® (BRAIN) Initiative is "a large-scale effort that seeks to deepen understanding of the inner workings of the human mind and to improve how we treat, prevent and cure disorders of the brain." Since its initial funding in 2014, the BRAIN Initiative has awarded more than $1.8 billion in research awards.

The BICCN, one subset of the BRAIN Initiative, specifically focuses on creating brain atlases that describe the full plethora of cells—as characterized by many different techniques—in mammalian brains. Salk is one of three institutions that were given U19 awards to act as central players in generating data for the BICCN.

"This is not just a phone book for the brain," says Margarita Behrens, a Salk associate research professor who helped lead the new BICCN papers. "In the long run, to treat brain diseases, we need to be able to hone in on exactly which cell types are having trouble."

The special issue of Nature has 17 total BICCN articles, includ ing five co-authored by Salk researchers that describe approaches to studying brain cells and new characterizations of subtypes of brain cells in mice. Some highlights include:

DNA METHYLATION ANALYSIS

While other papers in the special issue relate to the function or structure of mouse brain cells, the work led by Ecker, Behrens and their colleagues largely focuses on the epigenomics of brain cells in mice. Every cell in a mouse brain contains the same sequence of DNA, but variations in how this DNA is regulated – its so-called "epigenome" – give cells their unique identity. The arrangement of methyl chemical groups on the cytosine base in DNA (known as "cytosine methylation"), which specifies when genes are to be turned on or off, are one form of epigenomic regulation that may highly influence disease and health in the brain.

In one of the new papers, the Salk team analyzed 103,982 mouse brain cells using single-cell DNA methylation sequencing. This approach, developed in the Ecker lab, lets researchers study the pattern of methyl chemical groups on each strand of DNA in brain cells.

When they applied the technique to the thousands of cells collected from 45 different regions of the mouse brain, they were able to identify 161 clusters of cell types, each distinguished by their pattern of methylation.

"Before now, there have been a handful of ways to describe brain cells based on their location or their electrical activity," says Hanqing Liu, a graduate student in the Ecker lab and co-first author of the paper. "We've really extended the definition of cell type here and used epigenomics to define hundreds of potential cell types." The team went on to show that the methylation patterns could be used to predict where in the brain any given cell came from— not just within broad regions but down to specific layers of cells within a region. This means that eventually, drugs could be developed that act only on small groups of cells, by targeting their unique epigenomics.

NEURON DESTINATION PATTERNS

In another paper, co-authored by Ecker and Salk Professor Edward Callaway, researchers studied the association between DNA methylation and neural connections. The team developed a new way of isolating cells that connect regions of the brain, then studying their methylation. They used the approach on 11,827 individual mouse neurons, all extending outward from the mouse cortex. The patterns of methylation in the cells, they discovered, correlated with cells' projection (destination) patterns. Neurons that led from the motor cortex to the striatum, for instance, had distinct epigenomics from neurons that connected the primary visual cortex and the thalamus.

"Neurons don't function in isolation, they function by communicating with each other, so understanding how these connections are established and how they work is really fundamental to understanding the brain," says Zhuzhu Zhang, a Salk postdoctoral fellow and a co-first author of the paper with graduate student Jingtian Zhou, both members of Ecker's laboratory. The researchers say that the new data on the mouse brain cells is merely the first step in creating a complete atlas of the mouse brain – let alone the human brain. But understanding what differentiates cell types is critical to future research and future brain therapeutics.

"In these foundational studies, we're describing the 'parts list' for the brain," says Callaway. "Having this parts list is revolutionary, and will open up a whole new set of opportunities for studying the brain." •

DNA Methylation Atlas of the Mouse Brain at Single-Cell Resolution A comprehensive cell census and atlas of the mammalian primary motor cortex, a region of the brain responsible for movement. The atlas integrates information from various sources to define the molecular, anatomical and physiological identities of specific cell types, while also revealing where they reside in the motor cortex tissue. A significant number of cell types are conserved across mice, marmosets and humans, suggesting those cell types play important roles in cortical circuitry and function in mammals. nature.com/articles/s41586-020-03182-8