Latest / Millennial Mental Health Channel / 30+ Years of the ADA: Progress, Setbacks, and the Fight Ahead

Transcript

30+ Years of the ADA: Progress, Setbacks, and the Fight Ahead · Millennial Mental Health Channel

0:00
Speaker 1: O o OI. This is Millennial Mental Health Channel. I'm
0:07
Speaker 1: doctor Justin Romano, a child adolescent psychiatry fellow.
0:10
Speaker 2: And I'm Adi Koreo, a licensed clinical therapist. Our podcast
0:13
Speaker 2: is here because we wanted to start a much neater
0:15
Speaker 2: conversation about mental health.
0:17
Speaker 1: Our goal is to teach you as much as we
0:19
Speaker 1: can by sharing our own experiences and interviewing experts in
0:22
Speaker 1: the mental health field. We will discuss topics like mood disorders,
0:25
Speaker 1: psychotic disorders, substance use, personality disorders, and many more.
0:29
Speaker 2: Millennial Mental Health Channel buy Millennials for everyone. We hope
0:33
Speaker 2: you enjoyed today's episode.
0:36
Speaker 1: MMHC is a production of Speaker from iHeartMedia, I heartmer
0:43
Speaker 1: Good Eye. Welcome back to MMHC, and as a raison,
0:47
Speaker 1: I'm talking like this for today and it's because we've
0:49
Speaker 1: actually gotten a lot of Australian listeners on this show recently,
0:54
Speaker 1: and i want to give a big old down under
0:56
Speaker 1: shout out because I'm sure that's how every sounds in Australia.
1:02
Speaker 2: And our downloads are gone.
1:04
Speaker 1: All right, We're sorry, and we'd talking also about a
1:07
Speaker 1: very American topic today.
1:09
Speaker 2: So yeah, well again, shout out to Australia. Before we start,
1:16
Speaker 2: I will give my one shout out, and my shoutout
1:18
Speaker 2: is going to be to my students this semester. I
1:22
Speaker 2: don't even know if I've talked about it on the show,
1:23
Speaker 2: but this semester I'm teaching cultural Foundations. It has been
1:28
Speaker 2: a whirlwind. It has been tough, it has been good,
1:31
Speaker 2: it's been all of the above. It's a new class
1:33
Speaker 2: for me, new curriculum, had to come up with it.
1:37
Speaker 2: I think we had the textbooks to go off of,
1:38
Speaker 2: but pretty much had to build it on my own.
1:42
Speaker 2: I should say on my own. I did get help
1:44
Speaker 2: from the previous professor, but I kind of had just
1:47
Speaker 2: build it in the way that I wanted to. So
1:48
Speaker 2: I've been doing that and just shout out to them.
1:50
Speaker 2: They've really taken the curriculum and the discussions and they've
1:54
Speaker 2: really gone with it. We've had a lot of good talks.
1:56
Speaker 2: As you can imagine if you are in the United States.
1:59
Speaker 2: Jan until now has felt like six years. There's been
2:02
Speaker 2: a lot of shit going on daily every hour, just
2:05
Speaker 2: a lot of stuff going on. So I think the
2:08
Speaker 2: topic's really important. I'm glad it's a required class for
2:12
Speaker 2: counselors and therapists and training. We've had a lot to
2:15
Speaker 2: talk about. One of my favorite parts of the class though,
2:18
Speaker 2: has been and maybe it's my favorite because I came
2:20
Speaker 2: up with the idea, but one of my favorite parts
2:22
Speaker 2: has been we're doing current events every week, so two
2:25
Speaker 2: to three students and then myself included, I present a
2:27
Speaker 2: current event every single week, but two to three students
2:29
Speaker 2: every week will present some kind of current event on
2:32
Speaker 2: what's going on in the world related to the topic.
2:35
Speaker 2: And a few weeks ago we our topic was disabilities,
2:38
Speaker 2: so developmental and acquired disabilities. So we talked about that
2:42
Speaker 2: a lot of great stuff, not great things in the news,
2:46
Speaker 2: but a lot of great discussion, a lot of great
2:48
Speaker 2: things for us to be aware. I've came up in it,
2:51
Speaker 2: so I figured, why not share it with our audience
2:53
Speaker 2: and talk about, you know, the intersection of disabilities and
2:57
Speaker 2: mental health, both acquired and developmental topic.
3:00
Speaker 1: This is something that I'm really proud of the United
3:03
Speaker 1: States for doing, is recognizing that people need extra help
3:07
Speaker 1: in certain areas and getting them extra help in school,
3:10
Speaker 1: putting the funding forward to make sure that people who
3:14
Speaker 1: have disabilities are taken care of and given the advantages
3:18
Speaker 1: that they should get in live. So before we get
3:23
Speaker 1: to some history, we want to define a couple of things,
3:27
Speaker 1: and we're going to be using the word developmental and acquired.
3:30
Speaker 1: Developmental meaning present from early development and often life long.
3:36
Speaker 1: So some examples of a developmental disability are things like
3:40
Speaker 1: down syndrome, fetal alcohol syndrome, muscular dystrophy ADHD, autism, spectrum disorders,
3:47
Speaker 1: and spine of bithida.
3:48
Speaker 2: And for acquired, these are typically things that occur due
3:51
Speaker 2: to events or conditions after the developmental phase. So that
3:55
Speaker 2: can be things like a TBI, a traumatic brain injury,
3:58
Speaker 2: stroke related disabilities SPUN, a cord injury, diabetes, PTSD, things
4:03
Speaker 2: like that. So we just give a couple of examples,
4:06
Speaker 2: and there's definitely things that like can be either or
4:09
Speaker 2: it could be like yeah, there's like things that could
4:12
Speaker 2: be one or the other. Things with like your eyesight,
4:15
Speaker 2: you're hearing things like that that could either be a
4:17
Speaker 2: developmental thing or something that you acquire later in life.
4:20
Speaker 2: So just important that we have that definition. So with
4:23
Speaker 2: some history, and this was as I was getting my
4:25
Speaker 2: lecture slides together, I learned a lot and I think
4:29
Speaker 2: I didn't even take I didn't even say this part.
4:31
Speaker 2: I've learned a shit ton in this class. We are
4:33
Speaker 2: like halfway through and I am the quote unquote like
4:36
Speaker 2: expert and like the one in charge. But I feel
4:38
Speaker 2: like I learned so much shit every week it's pretty
4:40
Speaker 2: fucking cool. So anyway, as I was getting ready for
4:44
Speaker 2: that lecture, I was like, well, we should probably talk
4:45
Speaker 2: about some history if we're gonna talk about disabilities, so
4:47
Speaker 2: why not start with the Americans with Disabilities Act. So
4:50
Speaker 2: this was something that was enacted in nineteen ninety. It
4:53
Speaker 2: was a landmark civil rights law that protects individuals with
4:57
Speaker 2: disabilities from discrimination and ensures that they have equal rights
5:00
Speaker 2: and opportunities in various areas of their life. Essentially, it
5:04
Speaker 2: aimed to promote inclusion for people with physical, mental, or
5:08
Speaker 2: sensory disabilities. I will say this is great. I'm glad
5:11
Speaker 2: our country did this in the nineteen nineties. Is kind
5:14
Speaker 2: of move forward with it. It doesn't mean everyone gets
5:17
Speaker 2: exactly what they deserve or should be getting. We're not
5:20
Speaker 2: always the greatest of that, but we at least have
5:22
Speaker 2: something in place that should help with that.
5:25
Speaker 1: So breaking it down into the different areas that people
5:27
Speaker 1: get assistance with, so Number one employment, this is Title one.
5:32
Speaker 1: It protects qualified individuals with disabilities from discrimination in employment.
5:38
Speaker 2: Title II relates to public services, same thing. It protects
5:42
Speaker 2: qualified individuals with disabilities from discrimination in public services public accommodations.
5:48
Speaker 1: Title IIE protects qualified individuals with disabilities from discrimination in
5:53
Speaker 1: public accommodations and services operated by private entities.
5:58
Speaker 2: Title IOUR is telecommunication, so protects qualified individuals with disabilities
6:02
Speaker 2: from discrimination in telecommunications. You can kind of see there's
6:05
Speaker 2: a pattern here, but it's important that we talk about it.
6:08
Speaker 1: Yeah, and it's important to just go over what the
6:10
Speaker 1: basics are on this stuff because most people have never
6:13
Speaker 1: gone over this. And then the last one is Miscellaneous Provisions.
6:17
Speaker 1: Title VE addresses issues such as retaliation against individuals who
6:22
Speaker 1: enforce their ADA rights and relationships to other laws.
6:27
Speaker 2: So, as you can imagine, in nineteen ninety it wasn't
6:30
Speaker 2: the end all, be all, final ADA law that we're
6:35
Speaker 2: going to have where they act right. There's always things
6:37
Speaker 2: that you can make better. Very rarely is there a law,
6:40
Speaker 2: at least I think in my humble opinion, I feel like,
6:42
Speaker 2: very rarely there's a law that comes into play that
6:45
Speaker 2: meets everybody's needs the best possible. There has to be
6:48
Speaker 2: some things that get added. So in two thousand and eight,
6:52
Speaker 2: the ADA Amendments Act was enacted to broaden and clarify
6:55
Speaker 2: the definition of disability under the original ADA. So essentially
7:00
Speaker 2: it made it easier to apply and focus less on
7:02
Speaker 2: defining what is a disability as a means to not
7:05
Speaker 2: accommodate an individual and more on making sure individuals are
7:08
Speaker 2: not being discriminated against. So I think it broadened it
7:11
Speaker 2: so it's not like, well, you got to meet there's
7:13
Speaker 2: this criteria. It made it more a little more subjective,
7:17
Speaker 2: which I think was better for people looking to get
7:21
Speaker 2: resources and supports. It made the definition so it could
7:24
Speaker 2: be interpreted more broadly, distinguished, and defined that an impairment
7:29
Speaker 2: that limits one major life activity is a disability, even
7:32
Speaker 2: if it doesn't limit other major life activities, which is
7:35
Speaker 2: really important for a lot of people. There's just certain
7:38
Speaker 2: things that they are impacted, either it's like school or
7:41
Speaker 2: work or mobility things like that. So it's important that
7:45
Speaker 2: just being able to have one major life activity impacted
7:48
Speaker 2: helps them qualify for a disability. And then the last
7:51
Speaker 2: thing that I added is that an impairment that's episodic
7:53
Speaker 2: or in remission is a disability if it would limit
7:56
Speaker 2: a major life activity when active. So I think of
7:59
Speaker 2: that as someone who maybe has some pretty severe depression,
8:02
Speaker 2: some pretty severe episodes of depression. Even when it does
8:06
Speaker 2: go on remission, it doesn't mean that they no longer
8:08
Speaker 2: have the disability. They can still be impacted by it.
8:11
Speaker 1: So let's talk about some actual conditions covered under the ADA.
8:16
Speaker 1: So here's some of the physical impairments that are covered.
8:20
Speaker 1: Visual impairments, speech hearing impairments, loss of body parts, mobility impairments,
8:27
Speaker 1: and orthopedic conditions.
8:29
Speaker 2: In terms of mental impairments, there's things like specific learning
8:32
Speaker 2: disabilities and psychological disorders. That's really important to put out
8:37
Speaker 2: there someone, And really where it intersects with us is
8:39
Speaker 2: that a mental health condition can be a disability for
8:43
Speaker 2: some people.
8:43
Speaker 1: And then some other conditions too, like HIV AIDS. We've
8:47
Speaker 1: got asthma, cancer, cerebral palsy, diabetes, epilepsy, heart disease, migraine, headaches.
8:53
Speaker 1: And I didn't know I might be able to qualify
8:55
Speaker 1: here muscular dystrophy and thyroid disorders.
9:00
Speaker 2: Remember the impairment of at least one major life activity.
9:03
Speaker 2: Fill it out there.
9:05
Speaker 1: Thank you for clarifying and I don't think I do.
9:07
Speaker 2: Yeah, that's why it's so good that, like I'm telling you, man,
9:10
Speaker 2: like there's been so many times like even we have
9:14
Speaker 2: next week's class. Spoiler alert if somehow any of my
9:16
Speaker 2: students have found the podcast. Next week is about well
9:19
Speaker 2: you should know anyway because you have the syllabus. Okay, anyway,
9:22
Speaker 2: next week's topic is about Indigenous heritage. There's if I
9:26
Speaker 2: take a couple of steps back, a lot of the
9:28
Speaker 2: classes focusing on doctor Pamela Hayes and her addressing model.
9:32
Speaker 2: Do you know what that is? Have you ever heard
9:33
Speaker 2: of that?
9:33
Speaker 1: Not coming to mind?
9:35
Speaker 2: So addressing is it's an acronym. I'm gonna do my
9:38
Speaker 2: best to get them all in order. I might not
9:40
Speaker 2: be able to spell addressing correctly, but addressing stands for
9:43
Speaker 2: A is for age and generational differences. D is for
9:47
Speaker 2: both developmental and acquired disabilities. OURS for religion and spirituality.
9:52
Speaker 2: What's next. E is for ethnicity or racial identity. S
9:58
Speaker 2: is for sexual orientation. Their SS four socioeconomic status. I
10:02
Speaker 2: is for indigenous heritage, and is for nation of origin,
10:06
Speaker 2: and then G is for gender. So a lot of
10:08
Speaker 2: our classes focusing on that, like different pieces of the
10:10
Speaker 2: addressing model. So we've been talking about it every week,
10:13
Speaker 2: and so next week is about the Indigenous heritage. And
10:17
Speaker 2: as I still remember as I was reading through all
10:19
Speaker 2: the chapters and stuff, just learning stuff like even like
10:21
Speaker 2: Alaska Natives and how there was I can't remember the
10:24
Speaker 2: exact company, but it was like an excellent company where
10:28
Speaker 2: there was an oil spill in Alaska, and I talked
10:30
Speaker 2: about the importance of understanding like how that traumatic event
10:34
Speaker 2: impacted Alaska Natives more than other people because of their
10:37
Speaker 2: relationship to the lands. So we're gonna talk about that
10:38
Speaker 2: next week. But yeah, just I've learned so much shit, man,
10:41
Speaker 2: Like I learned a lot.
10:43
Speaker 1: And I also want to point out that you just
10:45
Speaker 1: rattled off that entire mnemonic that wasn't even in the notes.
10:48
Speaker 1: That was just off the top of here.
10:50
Speaker 2: Fucking oh big.
10:50
Speaker 3: I'm telling you, I'm back, impress, appreciate it. I do
10:57
Speaker 3: want to give a story, And honestly, I think this
10:58
Speaker 3: might be maybe the reason why I thought, I'm like, man,
11:01
Speaker 3: we can really talk about this topic was that one
11:04
Speaker 3: of my students shout out, LEXI, this was her current events.
11:07
Speaker 3: I'm going to share a little bit about it. So
11:09
Speaker 3: have you ever heard of the Zagat Guide or yeah,
11:12
Speaker 3: Zagat Guide.
11:12
Speaker 2: Have you ever heard of that?
11:14
Speaker 1: Oh? Yes, popular in the early two thousands.
11:17
Speaker 2: Yeah, so back in twenty eleven, the guide, which basically
11:20
Speaker 2: aimed to rank the best restaurants in New York City,
11:24
Speaker 2: led to eighty A compliance issues for Kat's Delhi. It's
11:28
Speaker 2: a very famous like Deli diner in New York. Basically
11:32
Speaker 2: the guide was used as a starting point to check
11:35
Speaker 2: that businesses were in compliance with the ADA, which was
11:38
Speaker 2: not the intended use, but that's what it ended up
11:40
Speaker 2: being used for. And over the last there was the
11:45
Speaker 2: last fourteen years. So well maybe they started in twenty eleven,
11:49
Speaker 2: but over the last chunk of time, as they've been
11:51
Speaker 2: trying to get Kat's Delhi and Eightya compliance, Kat's Deli
11:55
Speaker 2: has really dug their feet in. They've basically said, like,
11:57
Speaker 2: we're not making these changes. We're basically you know, twelve thirteen, fourteen,
12:01
Speaker 2: fifteen years And this article that my student cited and
12:05
Speaker 2: presented was from a month ago, like literally it was
12:08
Speaker 2: like the week before she presented on disabilities as their
12:11
Speaker 2: current event. It had just they just posted it like that.
12:14
Speaker 2: Kat's Deli is still refusing to be an eighty eight compliance,
12:18
Speaker 2: and I think part of it ends up being like
12:19
Speaker 2: whatever the finds are, and stuff just seem cheaper than
12:23
Speaker 2: fixing things. So some things that they cited were things
12:25
Speaker 2: like the main entrance, accessible tables and bathrooms, and they
12:29
Speaker 2: even did a remodel in like mid twenty tens. Did
12:33
Speaker 2: not fix anything to make it a complain Yeah, but
12:37
Speaker 2: from the article, it basically sounds like CATS has reached
12:39
Speaker 2: the settlement to just kind of keep stuff the way
12:42
Speaker 2: there it is. But really it highlights what people with
12:44
Speaker 2: disabilities have to deal with on a daily basis, stuff
12:48
Speaker 2: that you and I don't even really think about. You know,
12:50
Speaker 2: when I this is probably just a coincidence, but when
12:54
Speaker 2: I the week that I was doing the notes for
12:57
Speaker 2: this class for the disabilities topic, we'd gone Kevin. I
13:00
Speaker 2: had gone to a plant shop in Portland. We were
13:03
Speaker 2: out there for probably like we're eating somewhere or whatever,
13:05
Speaker 2: and we went to this plant shop that we'd been
13:07
Speaker 2: to before. So we went to it and as we
13:09
Speaker 2: walked in, I saw a sign that said, like ADA
13:12
Speaker 2: compliant entrance this way. And I don't know if I
13:16
Speaker 2: would have realized that if you know, we hadn't been.
13:18
Speaker 2: I hadn't been getting ready for this topic. So just
13:20
Speaker 2: stuff that we just don't think about unless you think
13:23
Speaker 2: about it. It's just not something that impacts us every day.
13:26
Speaker 1: I didn't really ever start thinking about this stuff, and
13:28
Speaker 1: I know it's a very different situation. But the thing
13:31
Speaker 1: that got me to think about it more was having
13:34
Speaker 1: a baby and having a stroller. And it's nice to
13:38
Speaker 1: have ADA entrances for the stroller so you don't have
13:42
Speaker 1: to like lift the stroller. But I realized how many
13:45
Speaker 1: places still are not ADA compliant, how many places that
13:48
Speaker 1: you can't roll up onto with the stroller. And I thought,
13:52
Speaker 1: I thought we fixed this. I thought we had entrances
13:55
Speaker 1: for everyone, accessibility for everyone, but there's still a ton
13:58
Speaker 1: of places that I was like, wow, Wow, this is
14:00
Speaker 1: a huge asshole for a lot of people.
14:02
Speaker 2: And if it's not something that impacts you, then then
14:05
Speaker 2: it doesn't You don't know, yeah, you don't.
14:07
Speaker 1: Think about it. And surprisingly enough too this week, on
14:11
Speaker 1: one of my drive homes from work, I was sitting
14:15
Speaker 1: at a stoplight and a woman in a wheelchair was
14:18
Speaker 1: trying to cross the street. But it was really snowy
14:22
Speaker 1: out and so of course everyone shoveled their sidewalks. Everyone
14:26
Speaker 1: shoveled their what's right in front of their businesses, all
14:30
Speaker 1: onto the street and all onto the crosswalk. So this
14:33
Speaker 1: poor woman was in em manual wheelchair just trying to
14:36
Speaker 1: trudge through the snow and then got up and was like,
14:41
Speaker 1: couldn't get over the street curb on. So she's just
14:45
Speaker 1: like in the street struggling. So I started getting out
14:48
Speaker 1: of my car to go try and help her, but
14:51
Speaker 1: before I could, she flipped her wheelchair around and started
14:56
Speaker 1: going backwards up the curb and like fighting her way
14:59
Speaker 1: through through the snow and did it on her own.
15:02
Speaker 1: And I just thought that was so resourceful. She's obviously
15:05
Speaker 1: done this before and trying to live a world in
15:09
Speaker 1: a wheelchair. And you know, more power Tour for having
15:12
Speaker 1: some good strategies. But all those little things throughout life
15:15
Speaker 1: that most people take for granted, people struggle with on
15:18
Speaker 1: a daily basis. So since we both primarily work with teens,
15:25
Speaker 1: we also have to consider what's being done in schools
15:28
Speaker 1: to protect kids and teens with disabilities. So this is
15:31
Speaker 1: really where our jobs have the most to do with
15:34
Speaker 1: this subject. And this mostly comes in two different things
15:39
Speaker 1: and individualized education Plans i EPs and five oh fours.
15:45
Speaker 1: So people with a disability are entitled to extra help
15:50
Speaker 1: in school through either an IEP or a five oh four.
15:54
Speaker 1: So we want to go through what those specifically are.
15:57
Speaker 1: So for an IEP. So, for a long time, students
16:00
Speaker 1: with disabilities were not given any additional supports in schools
16:04
Speaker 1: and historically were not allowed to attend public schools, which
16:08
Speaker 1: limited their educational options to private school or home instruction.
16:13
Speaker 1: But following Brown versus the Board of Education in nineteen
16:15
Speaker 1: fifty four, parents of students with disabilities began to bring
16:19
Speaker 1: lawsuits against their schools districts for excluding and segregating children
16:24
Speaker 1: with disabilities. What an unintended consequences of such a major
16:29
Speaker 1: lawsuit in our country. In nineteen sixty five, Congress enacted
16:34
Speaker 1: the Elementary and Secondary Education Act the EESA. This act
16:39
Speaker 1: helped provide resources to school districts to help ensure that
16:43
Speaker 1: students with disabilities had access to quality education.
16:47
Speaker 2: The Education of the Handicapped Act replated that replaced the
16:51
Speaker 2: EESA in nineteen seventy. It established a new grant program
16:55
Speaker 2: that further provided educational resources and programs for students with disability.
16:59
Speaker 2: The IEP or the individualized Education plan as we know it,
17:03
Speaker 2: was first introduced to school systems when the right of
17:06
Speaker 2: students with disabilities to attend public schools were legally recognized
17:10
Speaker 2: under the Education for All Handicapped Children the EHA in
17:14
Speaker 2: nineteen seventy five, So really kind of like the ADA,
17:18
Speaker 2: the IEPs are a relatively new thing. The law contained
17:22
Speaker 2: the first requirements for the development of an IP for
17:24
Speaker 2: students with disabilities requiring special education services, and then an
17:29
Speaker 2: amendment was added in nineteen ninety seven, again really not
17:31
Speaker 2: that long ago, that required individualized transition planning for students
17:35
Speaker 2: with an IEP, and then another amendment in two thousand
17:38
Speaker 2: and four that required early intervention for students, greater accountability
17:42
Speaker 2: and improve educational outcomes, and raise the standards for instructors
17:46
Speaker 2: who teach special education classes. So some relatively new things
17:51
Speaker 2: in the world of education in terms of helping students
17:54
Speaker 2: with disabilities have the rights that they deserve.
17:57
Speaker 1: And I know that it seems like niche note, but actually,
18:01
Speaker 1: when I was studying for my boards, one of these
18:03
Speaker 1: questions popped up and said, what replaced the EESA in
18:07
Speaker 1: nineteen seventy I know, yeah, when I was reading these
18:10
Speaker 1: show notes, I was like, I kind of remembered that
18:13
Speaker 1: I didn't remember the exactly answer. I was like, ah,
18:16
Speaker 1: like I had to kind of study this and learn this.
18:19
Speaker 1: I know in this show, we like to tell you
18:21
Speaker 1: about how this relates to our jobs, and i EPs
18:25
Speaker 1: are a huge part of my job. We ask every
18:28
Speaker 1: single patient that comes through our office do you have
18:30
Speaker 1: an IEP? Do you have a five le four? And
18:33
Speaker 1: if we are diagnosing someone with a mental health diagnosis,
18:37
Speaker 1: that will qualify for an IP. Particularly ADHD is probably
18:41
Speaker 1: the one that we have the most, but you can
18:44
Speaker 1: also get an IP for depression. You can also get
18:46
Speaker 1: an IEP for anxiety. I write a ton of letters
18:50
Speaker 1: telling the schools in the school district, like, please evaluate
18:53
Speaker 1: the student for an IP. I think it would be
18:55
Speaker 1: a great So it's helpful sometimes to have a letter
18:59
Speaker 1: from a doctor, especially if it's a doctor that's diagnosed
19:01
Speaker 1: you with those things. If anyone's in a position where
19:04
Speaker 1: they feel like their child needs an IEP, doctors can
19:08
Speaker 1: help write that letter to get that process going in
19:10
Speaker 1: case anyone's curious.
19:12
Speaker 2: The thing for me that was eye opening when I
19:14
Speaker 2: first started working in a school, and maybe it's just
19:17
Speaker 2: our school but with just how many people were on
19:19
Speaker 2: a five h four are an iap it's a lot
19:21
Speaker 2: more common than I think I assumed. I think back
19:25
Speaker 2: to my time in high school. I don't know if
19:27
Speaker 2: I knew anybody that was on a five h four
19:28
Speaker 2: plan and then IPS, and I'm sure it did, but
19:31
Speaker 2: maybe I just didn't notice. So it's a lot more
19:33
Speaker 2: common than people think like it is. It's a thing
19:36
Speaker 2: that's out there. Even think of this. It's it's so
19:39
Speaker 2: that's for like primary secondary education, right elementary through high school. Well,
19:44
Speaker 2: there's people who go to college and need student services.
19:47
Speaker 2: That's basically the upper education higher education equivalent of five
19:53
Speaker 2: oh four's and IEPs, At least from my understanding, I
19:55
Speaker 2: know people have those. So it's a lot more common
19:59
Speaker 2: than I think we we assume it is so.
20:01
Speaker 1: And then on the flip side of that, where we'll
20:04
Speaker 1: talk a little bit about five oh four plans, which
20:07
Speaker 1: are similar also get kids extra resources in school, but
20:11
Speaker 1: five oh fours tend to focus more on accommodations for
20:15
Speaker 1: students with disabilities to ensure access and equality in the
20:19
Speaker 1: general education environment, while IEPs provide specialized instruction and services
20:23
Speaker 1: for students with specific disabilities. The key difference is that
20:28
Speaker 1: the IEP falls under the Individuals with Disabilities Education Act
20:32
Speaker 1: the idea, while the five oh four are part of
20:37
Speaker 1: the Rehabilitation Act of nineteen seventy three. There are also
20:40
Speaker 1: several states who want to remove this section five oh four.
20:44
Speaker 2: I remember I.
20:44
Speaker 1: Had an attending explain it to me in very general terms,
20:48
Speaker 1: as five oh four can be so much more general.
20:52
Speaker 1: So IEPs tend to be for specific disabilities. There's like
20:56
Speaker 1: thirteen specific things it can before, but if five O
20:59
Speaker 1: four can be much more general, so like if someone
21:01
Speaker 1: has a seizure disorder and needs extra accommodations in school
21:05
Speaker 1: to help them get through and manage their seizure disorder,
21:08
Speaker 1: that would probably be more along the lines of a
21:10
Speaker 1: five oh four, Whereas if someone had ADHD, that would
21:13
Speaker 1: fall more under an IEP as a general example.
21:16
Speaker 2: And you can still even have ADHD and have a
21:18
Speaker 2: five oh four plan. It all really kind of depends
21:21
Speaker 2: on the accommodations. And yeah, I think I think you're
21:23
Speaker 2: really right on the five o fours and being more
21:26
Speaker 2: generalizable in terms of like the accommodations. It's basically I
21:30
Speaker 2: try to think of it as like you mentioned it
21:33
Speaker 2: in the notes. But just like iaps specialized instruction with
21:37
Speaker 2: specialized time with specialized instructors along with general education, but
21:42
Speaker 2: there also might be things where they have to modify
21:45
Speaker 2: things for certain classes and things that they can do.
21:47
Speaker 2: Whereas like a five to oh four is here are
21:49
Speaker 2: the accommodations that help you access a general education without
21:53
Speaker 2: things needed to be modified, without things needed to be changed,
21:56
Speaker 2: things like can take a break as needed, things like
22:00
Speaker 2: is able to have extended time on tests or example,
22:04
Speaker 2: you know, things like that. So yeah, I think you're
22:06
Speaker 2: right on there, But really you might be wondering why
22:09
Speaker 2: we're kind of talking about all This's why it's so important.
22:12
Speaker 2: A lot of reasons why, especially if you're a provider,
22:14
Speaker 2: it's good to know about these things, especially if you
22:15
Speaker 2: work with kids and teens. But really, one thing that's
22:18
Speaker 2: been coming that's been becoming more and more apparent in
22:21
Speaker 2: my class that I've been teaching, is that things are
22:23
Speaker 2: changing very quickly, or at least they look like they're
22:26
Speaker 2: changing very quickly. With this new presidential administration, things are
22:30
Speaker 2: just flying in and out right. How many executive orders
22:32
Speaker 2: have been signed since January twentieth or January twenty first, right,
22:36
Speaker 2: things have changed very quickly. You know, actually this week
22:40
Speaker 2: that the week that we had the class on disabilities
22:43
Speaker 2: developmental unacquired, my Monday section had their current events and
22:47
Speaker 2: talked about how federal funding was beginning to freeze, right
22:51
Speaker 2: because for certain things. The next day my Tuesday section
22:55
Speaker 2: said how it was no longer frozen, right, So shit
22:57
Speaker 2: was changing within twenty four hours. I think even in
23:00
Speaker 2: my Monday section had stopped being classed and said something
23:03
Speaker 2: changed already. So things are flying left and right, and
23:06
Speaker 2: it's really important to just know what has been in
23:10
Speaker 2: place and what may be challenged. Right, there's also concerns.
23:15
Speaker 2: Concerns basically can continue with the potential dissolving of the
23:18
Speaker 2: Education Department, who provide the fundings for things IPS and
23:22
Speaker 2: five bell fours. And then also as mental health professionals,
23:25
Speaker 2: it's really important that we know how to support our
23:27
Speaker 2: clients and patients and getting the services and supports they need.
23:30
Speaker 2: Just like Justin talked about, a letter from Justin is gold, right,
23:34
Speaker 2: a letter from a doctor is gold in terms of
23:37
Speaker 2: being able to get those things in place. You know,
23:39
Speaker 2: I work our school counselors, they're the case manager for
23:42
Speaker 2: our five O four plans, and they need a medical
23:44
Speaker 2: statement to get the process started. If you're going to
23:47
Speaker 2: move to an IP, there's testing from like the school
23:49
Speaker 2: psychologists and other things on the educational side, but there's
23:53
Speaker 2: also a diagnosis. So a letter from a mental health
23:56
Speaker 2: professional can really go a long way in helping advocate
24:00
Speaker 2: for our clients to get the things that they need.
24:02
Speaker 1: And I've seen it so many times in my patients.
24:04
Speaker 1: Kids are struggling, We get them on the right treatment,
24:07
Speaker 1: but they also get a five or four or an
24:09
Speaker 1: i EP in place, and school turns around. They finally
24:12
Speaker 1: get the support the things that they need to succeed
24:15
Speaker 1: in school. So being able to succeed in school helps
24:19
Speaker 1: you so much in life. If you can graduate from
24:21
Speaker 1: high school, if you would have struggled and dropped out,
24:24
Speaker 1: if you're able to graduate, that increases your quality of life,
24:27
Speaker 1: It increases the amount of money you can make. It
24:29
Speaker 1: can change your entire life getting that help early in school.
24:33
Speaker 1: So we are big believers in these programs, which is
24:37
Speaker 1: why it's so scary that Trump has said multiple times
24:40
Speaker 1: that he wants to get rid of the Department of Education,
24:42
Speaker 1: because if that funding drives up, then that program essentially
24:46
Speaker 1: stops from our perspective, horrifying. That's really, it's really scary.
24:53
Speaker 2: One thing I do want to say, and not really
24:56
Speaker 2: that makes me hopeful, But and no, not that it
25:01
Speaker 2: makes me hope. I don't know. I guess I'm just
25:02
Speaker 2: thinking of organ specifically. Right, Like, I saw a chart
25:06
Speaker 2: in a map that basically said, like how much federal
25:09
Speaker 2: funding do certain states take in? And I just say
25:12
Speaker 2: hopeful for me? And I'm being selfish because I live
25:14
Speaker 2: in Oregon. Oregon isn't getting a huge chunk of federal funding.
25:19
Speaker 2: Like it's not like fifty percent. It was maybe in
25:21
Speaker 2: like the ten or fifteen percent range, which is still
25:24
Speaker 2: a sizable chunk that needs to be made up. But
25:26
Speaker 2: it's something that we can probably work through. If you know,
25:29
Speaker 2: catastrophe strikes and there's no longer any funding that way.
25:33
Speaker 2: What's really fucked up and really sucks is it looks
25:37
Speaker 2: like a lot of the states that may have potentially
25:39
Speaker 2: voted for Donald Trump are the ones that are really
25:41
Speaker 2: going to get be impacted. Right. A lot of the
25:43
Speaker 2: states in the Midwest, a lot of these states that
25:46
Speaker 2: use and need a lot of these services and resources
25:49
Speaker 2: and maybe aren't realizing that they've used these resources and
25:53
Speaker 2: services and basically voted against their own well being. I
25:57
Speaker 2: went on a long talk with my students a few
25:59
Speaker 2: weeks ago, basically, like, our job as clinicians is not
26:03
Speaker 2: to change someone's mind, is not to change their values
26:06
Speaker 2: and things that they believe in. Our job is to
26:09
Speaker 2: listen and to be there to support them and to
26:11
Speaker 2: try to understand where they're coming from. And I tell
26:13
Speaker 2: you know, I can understand. I'll be fine going on
26:16
Speaker 2: the record saying that, like I can try to understand
26:18
Speaker 2: where someone comes from if they're voting for someone like
26:21
Speaker 2: Donald Trump of like feeling like their needs are going
26:23
Speaker 2: to be met. I can try to understand that. I
26:25
Speaker 2: don't agree with it, but I can try to understand that.
26:27
Speaker 2: So that's why it really sucks when you see things
26:29
Speaker 2: like this and seeing where what states are going to
26:32
Speaker 2: be impacted, and a lot of them. The Venn diagram
26:35
Speaker 2: of states that voted for Donald Trump and states that
26:38
Speaker 2: are going to be largely impacted by cuts like this,
26:41
Speaker 2: it's almost a perfect circle. And that's not great.
26:44
Speaker 1: Saw. It was like Kentucky, Texas, a lot of Southern
26:48
Speaker 1: states and Midwest states, the ones that tend to lean
26:52
Speaker 1: red are the ones that use and receive them most
26:55
Speaker 1: funding from the Department of Education, so they're going to
26:58
Speaker 1: be impacted the mouse.
26:59
Speaker 2: So yeah, even just a part of education, right, we're
27:01
Speaker 2: thinking about Medicare, Medicaid foods down CBT, yes hard.
27:07
Speaker 1: Most recent proposed budget in the House had like an
27:11
Speaker 1: eight hundred billion cuts to Medicaid. It's like, oh, my good,
27:15
Speaker 1: people are going to really suffer. So Eddie and I
27:17
Speaker 1: are scared the star just because we care about people
27:26
Speaker 1: and these policies impact people. And I know that I
27:30
Speaker 1: have some friends who work at the VA and Elon
27:34
Speaker 1: Musk even posted that meme about federal workers like crying
27:39
Speaker 1: about the Doge Department, and it's like, no, they're crying
27:42
Speaker 1: because you're ruining their lives, man, Like, these people are
27:45
Speaker 1: hard working, these people are sacrificing their time to help veterans,
27:52
Speaker 1: and you're treating them like second class citizens and their
27:56
Speaker 1: jobs need to be cut. And so yeah, I don't know,
27:59
Speaker 1: we're starting to get off the rails here and get
28:00
Speaker 1: too political. But it's just like, boy, I wish we
28:03
Speaker 1: could just treat people like human beings, like their people.
28:10
Speaker 1: So when we talk about accommodation, what do we actually mean,
28:16
Speaker 1: like the type of accommodations that kids can get in school.
28:20
Speaker 1: These are things like providing a private space in case
28:24
Speaker 1: they need to calm down, in case they need to
28:26
Speaker 1: have their own space to get their school work.
28:28
Speaker 2: Done, things like reducing distractions. And actually, I want to
28:31
Speaker 2: go a step further. This is not just for kids
28:34
Speaker 2: and teens, but even workplace accommodations. Right under the ADA,
28:38
Speaker 2: you're entitled to reasonable accommodations. So I think that's the
28:41
Speaker 2: best part of what I was putting. This is a
28:43
Speaker 2: lot of these can be flexed. This could be for
28:46
Speaker 2: kids and teens, or this could be for adults working.
28:48
Speaker 2: So a lot of things that are.
28:50
Speaker 1: Possible flexibility with work schedule. And boy, that's a really
28:53
Speaker 1: helpful one with kids with ADHD because they tend to
28:55
Speaker 1: have a hard time remembering to turn stuff in, So
28:58
Speaker 1: if you give them a more flexible deadline, then they're
29:02
Speaker 1: more likely to just get stuff turned in when it
29:05
Speaker 1: works for them.
29:06
Speaker 2: Providing additional technology, so that can be things like recording devices,
29:10
Speaker 2: speak to text programs on work computers. I actually had
29:13
Speaker 2: a coworker whose hands were impacted by something. They had
29:18
Speaker 2: some type of disability where they're find motor functioning had
29:22
Speaker 2: been impacted for a while, and they had a text
29:25
Speaker 2: they had to speak to text program for writing their
29:28
Speaker 2: progress notes and all of their notes for work, So
29:31
Speaker 2: that helped them a lot to not be behind on
29:33
Speaker 2: anything and not feeling like they need to type everything out.
29:35
Speaker 2: They had the program on their computer up thanks.
29:38
Speaker 1: We have identifying and reducing triggers.
29:40
Speaker 2: Pretty straightforward one that I think, yeah, work or at school.
29:44
Speaker 2: And then the last one which will take us to
29:46
Speaker 2: our last topic for today, is a support animal. So
29:50
Speaker 2: if you're in the mental health field or you're just
29:52
Speaker 2: a consumer or a person outside of it that has
29:56
Speaker 2: been living in this world, you've probably noticed that there's
29:59
Speaker 2: people with animal with them that do some type of
30:02
Speaker 2: or have some type of role, and those the two
30:04
Speaker 2: types of animals are a service animal or an emotional
30:08
Speaker 2: support animal or an ESA. We figured it would be
30:11
Speaker 2: good to close with this to just kind of give
30:12
Speaker 2: you some examples of what they do and what they're
30:15
Speaker 2: there for, and just to to know like what kind
30:18
Speaker 2: of protections you have. So a service animal, they're typically dogs,
30:23
Speaker 2: are starting to perform a specific task to help somebody
30:26
Speaker 2: with a disability. Do you know what the other animal
30:29
Speaker 2: is that's allowed to be a service animal?
30:31
Speaker 1: I'm blank? And what is it?
30:33
Speaker 2: A miniature horse?
30:36
Speaker 1: I have heard about the I didn't. I wasn't sure
30:39
Speaker 1: though if it was the emotional support animal or if
30:41
Speaker 1: it's an actual service animal.
30:44
Speaker 2: Yeah. I had to look it up a couple of times.
30:46
Speaker 2: That's what the notes told me. If someone wants to
30:49
Speaker 2: fact check me, leave us a comment.
30:50
Speaker 1: But that's what Yeah, I'd love to you know, if
30:53
Speaker 1: I were blind, I would want a seeing Shetland pony.
30:56
Speaker 1: I think that would be really.
30:59
Speaker 2: In terms of an emotional support animal, it's an animal
31:02
Speaker 2: that provides therapeutic benefit to an individual with a mental
31:04
Speaker 2: health disorder. This is a lot broader, and you can
31:09
Speaker 2: see different things like cat's dogs, a fish, even for
31:13
Speaker 2: someone like in college, just different things. What's really important
31:18
Speaker 2: to know and what we want providers to remember, is
31:20
Speaker 2: that service animals are included under the ADA, but unfortunately
31:24
Speaker 2: emotional support animals are not, so that really can lead
31:27
Speaker 2: to some issues if people don't understand their rights. It's
31:30
Speaker 2: important to know the difference. It's important, especially if you're
31:33
Speaker 2: a treatment provider or clinician, to know that you know
31:36
Speaker 2: if you're going to write a letter for someone for
31:38
Speaker 2: an emotional support animal and support of them, just knowing
31:41
Speaker 2: that there may be some liability. And I don't say
31:43
Speaker 2: that to scare anybody. I say that more to say
31:46
Speaker 2: that emotional support animals are very it's an unregulated entity,
31:51
Speaker 2: whereas service animals are very regulated. So just knowing that
31:55
Speaker 2: going into it, just knowing that there's a lot of
31:56
Speaker 2: people with bogus websites out there that just write letters
31:59
Speaker 2: willing know and get them out to people, and people
32:02
Speaker 2: spend their hard earned money trying to get an emotional
32:04
Speaker 2: support animal letter and get up end up being scammed.
32:07
Speaker 2: And there's just a lot. So it's really just important
32:09
Speaker 2: to know the differences and what you can do as
32:11
Speaker 2: a provider, what you can do to support people who
32:14
Speaker 2: may need one of each of them.
32:15
Speaker 1: I do work with a lot of people with emotional
32:17
Speaker 1: support animals, and I would say probably about like a
32:19
Speaker 1: quarter of them say that their emotional support animals end
32:22
Speaker 1: up being more anxious then the people who need them.
32:27
Speaker 1: And like the emotional support animals need their own emotional
32:30
Speaker 1: support animals. They're like old pippins are really anxious puppy.
32:33
Speaker 1: You need to be some puppy Brozaic.
32:36
Speaker 2: It could be hard to take them out there, you know,
32:38
Speaker 2: into the world every single day. You know, a lot
32:40
Speaker 2: of dogs and animals I think enjoy there alone time.
32:43
Speaker 2: So yeah, I've heard of that too. I'll wrap up
32:47
Speaker 2: with the take home message and playing us out if
32:49
Speaker 2: you want to also give a takehold message justin Really,
32:53
Speaker 2: it's just important that we're aware of what's going on.
32:55
Speaker 2: We need to know how to best support our clients
32:57
Speaker 2: and patients especially and unfortunately if resources and supports may
33:02
Speaker 2: be taken away. So it's just the more you know,
33:04
Speaker 2: the better.
33:05
Speaker 1: My take home point would be that everyone should be
33:08
Speaker 1: treated like a human. A lot of these laws, a
33:11
Speaker 1: lot of these things that we've talked about today are
33:14
Speaker 1: just an attempt to try and get people an equal
33:18
Speaker 1: and level playing field, get them the access to the
33:21
Speaker 1: things that everyone else already has. So it can change
33:25
Speaker 1: people's lives in such a profound and dramatic way, and
33:29
Speaker 1: I think everyone should get behind I EPs five oh
33:32
Speaker 1: four's the ADA. There's a lot of really cool things
33:36
Speaker 1: that we've been able to do, and hopefully we don't
33:39
Speaker 1: move backwards.
33:40
Speaker 2: Yes, with that, thank you all for listening on Apple Podcasts, Spotify,
33:45
Speaker 2: Wherever you get your podcasts you can find us. Feel
33:48
Speaker 2: free to leave us a five star review, leave us
33:50
Speaker 2: a comment, we'd love to see it. You can find
33:52
Speaker 2: us on social media at Millennium mayc and at our
33:55
Speaker 2: website millennialimac dot com. Shout out Australia and remember take
34:00
Speaker 2: care of all mentals.
34:02
Speaker 1: Ozzi, yozzi, yozzi, oh yoi oi