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“Waking Up” After 20 Years of Depression
The Feeling of Losing Hope For two decades, daily life made me feel like I was moving through deep sand. Getting out of bed felt impossible, and even walking to the kitchen to do simple tasks like refilling my water bottle felt like a marathon. I dreaded waking up each morning, knowing I would...
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Beyond the Offence: Trauma, Borderline Personality Traits, and Female Offending
Women involved in the criminal justice system often present with complex and overlapping psychological, social, and developmental needs. Histories of childhood adversity and victimization are common in justice-involved populations, and research has linked cumulative adverse childhood experiences...
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When Decline Looks Like Competence: Recognizing Distress in High-Functioning Clients
The clients our field is least equipped to detect are not the ones whose lives are visibly coming apart. They are the ones whose lives are not. A director who has never missed a deadline, a physician whose charts are immaculate, an attorney whose win rate has not moved in a decade. By the time any...
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How Behavioral Health Practices Can Finance Growth and Expand Access to Care
Behavioral health providers face a difficult balancing act: demand for services continues to grow, while practices must manage workforce shortages, reimbursement pressures, administrative costs, technology needs, and the expense of expanding care capacity. For many organizations, the challenge is...
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If You’re Hearing “I’m Fine,” It May Be Time for a Deeper Conversation
As a psychiatrist, I hear "I'm fine" a lot. At the start of each session, I ask some version of, "How are you?" or "How have you been feeling since our last visit?" Inevitably, many people reply, "I'm fine." I hear it from patients, friends, and colleagues. I've even caught myself saying it when...
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When Tomorrow Cannot Compete: Why Immediate Relief Can Eclipse a Future That Still Matters
Someone can understand the consequences of substance use, love the people their substance use is hurting, and still reach for immediate relief. From the outside, the choice can look like proof that the person does not care enough. From inside the moment, what matters in that later life may no...
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Cannabis Legalization and Adolescent Behavioral Health: Are Current Policies Sufficiently Protecting Adolescents?
The rapid expansion of cannabis legalization across the U.S. has raised growing concerns about its impact on adolescents. Cannabis remains the most commonly used recreational drug among U.S. youth (Young-Wolff et al., 2026), and while cannabis use is not legal at the federal level, medical use has...
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Mind the Gap: Inside New York City’s Mental Health Crisis
Nearly a million New Yorkers cannot access the mental health care they need. A broken workforce, a fraying safety net, and deep inequities are forcing the nation's largest city to reimagine how — and for whom — mental health care is delivered. The Emergency Room at Midnight The...
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The Treatment Handoff Is Part of Care
A person can complete withdrawal management successfully and still lose the next step of care. A residential client can make meaningful progress and then leave without a confirmed outpatient appointment. A receiving program may know that a referral is coming but lack the medication list, risk...
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Beyond Translation: Why Behavioral Health Systems Need Bicultural Leadership and a Culturally Humble Workforce
Hispanic Heritage Month allows us to honor and celebrate Latino and Hispanic histories and cultures. But it should also challenge behavioral health organizations to ask a harder question: Have we evolved beyond merely translating words to truly understanding people? Language access is vital....
