Citing a Mental Health Crisis Among Young People, California Lawmakers Target Social Media

Citing a mental health crisis among young people, California lawmakers  target social media

Source: Kaiser Health News, by ZInnia Finn

Karla Garcia said her son’s social media addiction started in fourth grade, when he got his own computer for virtual learning and logged on to YouTube. Now, two years later, the video-sharing site has replaced both schoolwork and the activities he used to love — like composing music or serenading his friends on the piano, she said.

“He just has to have his YouTube,” said Garcia, 56, of West Los Angeles.

Alessandro Greco, now 11 and a soon-to-be sixth grader, watches videos even when he tells his mom that he is starting homework, making his bed, or practicing his instrument. When she confronts him, she said, he gets frustrated and says he hates himself because he feels like watching YouTube isn’t a choice.

Alessandro tells her he just can’t pull himself away, that he is addicted.

“It’s vicious — they’ve taken away my parenting ability,” Garcia said. “I can’t beat this.”

Some California lawmakers want to help Garcia and other parents protect their children’s mental health by targeting website elements they say were designed to hook kids — such as personalized posts that grab and hold viewers on a specific page, frequent push notifications that pull users back to their devices, and autoplay functions that provide a continuous stream of video content.

Two complementary bills in the state legislature would require websites, social media platforms, or online products that children use — or could use — to eliminate features that can addict them, harvest their personal information, and promote harmful content. Those that don’t comply could face lawsuits and hefty fines. One of the measures would impose penalties of up to $7,500 per affected child in California — which could amount to millions of dollars.

Federal lawmakers are making a similar push with bills that would tighten children’s privacy protections and target features that foster addiction. One would require online platforms to provide tools to help parents track and control their children’s internet use. The measures were approved by a U.S. Senate committee July 27.

“We have to protect kids and their developing brains,” said California Assembly member Jordan Cunningham (R-San Luis Obispo), a lead author of both bills and a father of four children, at a committee hearing in June. “We need to end Big Tech’s era of unfettered social experimentation on children.”

But Big Tech remains a formidable foe, and privacy advocates say they are concerned one of the California measures could increase data intrusions for everyone. Both bills have cleared the state Assembly, but whether they will survive the state Senate is unclear.

Tech companies, which wield immense power in Sacramento, say they already prioritize users’ mental health and are making efforts to strengthen age verification mechanisms. They are also rolling out parental controls and prohibiting messaging between minors and adults they don’t know.

But these bills could violate companies’ free speech rights and require changes to websites that can’t realistically be engineered, said Dylan Hoffman, executive director of TechNet for California and the Southwest. TechNet — a trade association for tech companies, including Meta (the parent company of Facebook and Instagram) and Snap Inc. (which owns Snapchat) — opposes the measures.

“It’s an oversimplified solution to a complex problem, and there isn’t anything we can propose that will alleviate our concerns,” Hoffman said about one of the bills that specifically targets social media.

Last year, the U.S. surgeon general, Dr. Vivek Murthy, highlighted the nation’s youth mental health crisis and pointed to social media use as a potential contributor. Murthy said social media use in teenagers had been linked to anxiety and depression — even before the stress of covid-19. Then during the pandemic, he said, the average amount of teenagers’ non-academic screen time leaped from almost four hours a day to nearly eight.

“What we’re trying to do, really, is just keep our kids safe,” Assembly member Buffy Wicks (D-Oakland), another lead author of the California bills and a mother of two children, said at the June committee hearing.

One of Cunningham and Wicks’ bills, AB 2273, would require all online services “likely to be accessed by a child” — which could include most websites — to minimize the collection and use of personal data for users younger than 18. This includes setting default privacy settings to the maximum level unless users prove they are 18 or older, and providing terms and service agreements in language a child can understand.

Modeled after a law passed in the United Kingdom, the measure also says companies should “consider the best interests of children when designing, developing, and providing that service, product, or feature.” That broad phrasing could allow prosecutors to target companies for features that are detrimental to children. This could include incessant notifications that demand children’s attention or suggestion pages based on a child’s activity history that could lead to harmful content. If the state attorney general determines a company has violated the law, it could face a fine of up to $7,500 per affected child in California.

The other California bill, AB 2408, would allow prosecutors to sue social media companies that knowingly addict minors, which could result in fines of up to $250,000 per violation. The original version would also have allowed parents to sue social media companies, but lawmakers removed that provision in June in the face of opposition from Big Tech.

Together, the two California proposals attempt to impose some order on the largely unregulated landscape of the internet. If successful, they could improve kids’ health and safety, said Dr. Jenny Radesky, an assistant professor of pediatrics at the University of Michigan Medical School and a member of the American Academy of Pediatrics, a group that supports the data protection bill.

“If we were going to a playground, you’d want a place that had been designed to let a child explore safely,” Radesky said. “Yet in the digital playground, there’s a lot less attention to how a child might play there.”

Radesky said she has witnessed the effects of these addictive elements firsthand. One night, as her then-11-year-old son was getting ready for bed, he asked her what a serial killer was, she said. He told her he had learned the term online when videos about unsolved murder mysteries were automatically recommended to him after he watched Pokémon videos on YouTube.

Adam Leventhal, director of the University of Southern California Institute for Addiction Science, said YouTube recommendations, and other tools that mine users’ online history to personalize their experiences, contribute to social media addiction by trying to keep people online as long as possible. Because developing brains favor exploration and pleasurable experiences over impulse control, kids are especially susceptible to many of social media’s tricks, he said.

“What social media offers is a highly stimulating, very fast feedback,” Leventhal said. “Any time that there is an activity where you can get a pleasurable effect and get it fast and get it when you want it, that increases the likelihood that an activity could be addictive.”

Rachel Holland, a spokesperson for Meta, explained in a statement that the company has worked alongside parents and teens to prioritize kids’ well-being and mitigate the potential negative effects of its platforms. She pointed to a variety of company initiatives: In December 2021, for example, it added supervision tools on Instagram that allow parents to view and limit kids’ screen time. And in June, it started testing new age verification tactics on Instagram, including asking some users to upload a video selfie.

Snap spokesperson Pete Boogaard said in a statement that the company is protecting teens through steps that include banning public accounts for minors and turning location-sharing off by default.

Meta and Snap declined to say whether they support or oppose the California bills. YouTube and TikTok did not respond to multiple requests for comment.

Privacy groups are raising red flags about the measures.

Eric Null, director of the privacy and data project at the Center for Democracy and Technology, said the provision in the data protection bill that requires privacy agreements to be written in age-appropriate language would be nearly impossible to implement. “How do you write a privacy policy for a 7-year-old? It seems like a particularly difficult thing to do when the child can barely read,” Null said.

And because the bill would limit the collection of children’s personal information — but still require platforms that children may access to gather enough details to verify a user’s age — it could increase data intrusions for all users, he said. “This is going to further incentivize all online companies to verify the age of all of their users, which is somewhat counterintuitive,” Null said. “You’re trying to protect privacy, but actually you’re now requiring a lot more data collection about every user you have.”

But Karla Garcia is desperate for action.

Thankfully, she said, her son doesn’t watch violent videos. Alessandro prefers clips from “America’s Got Talent” and “Britain’s Got Talent” and videos of one-hit wonders. But the addiction is real, she said.

Garcia hopes legislators will curtail the tech companies’ ability to continually send her son content he can’t turn away from.

“If they can help, then help,” Garcia said. “Put some sort of regulations on and stop the algorithm, stop hunting my child.”

Employee Productivity Is Up, But So Is Burnout

Employee productivity, stress, burnout are all up among remote workers |  BenefitsPRO

Source: BenefitsPRO, by Jessica Mach

Remote work has resulted in a boost in productivity, according to a new report, but worker burnout has also skyrocketed.

That’s according to a survey of 175 HR executives in the U.S. recently released by The Conference Board.

Sixty-two percent of organizations with primarily remote workforces said they’ve seen productivity grow since the start of the pandemic, the report said. While organizations that have on-site work policies also have reported productivity increases, this was the case for only 47% of respondents.

At the same time, 77% of respondents say they’ve seen an increase in employees who identify as burned out—up from 42% in September 2020.

Employees are also using fewer vacation days, feeling less engaged, and have lower morale. More are seeking support for their mental health as they work a greater number of hours.

“Since the outbreak of the pandemic, employee well-being has declined and burnout is on the rise,” said Rebecca Ray, executive vice president of human capital at The Conference Board.

“To retain workers, HR leaders will need a strong focus on improving the employee experience. That includes both allowing and encouraging employees to integrate their work and personal lives in a way that works best for them.”

Respondents did note some areas of improvement in organizational culture, however.

More than 70% of respondents said that since the start of the pandemic, commitment to corporate social responsibility, genuine caring by managers, transparent communication by leaders, and collaborative technology have changed for the better.

Meanwhile, more than 60% of respondents said they’ve seen improvements in the quality of leadership at their organizations, as well as inclusivity, commitment to innovation, and articulation of mission and purpose.

However, 25% of respondents said the level of trust between organization leaders and employees has declined since the start of pandemic.

Obamacare Significantly Reduces Cost of Mental Health Care for Young Adults

The Affordable Care Act (ACA) has significantly reduced out-of-pocket behavioral health care costs for adults 19 to 25, according to a study published in the Psychiatric Services Journal. Young Latinos, African Americans, and other racial and ethnic minorities saw the greatest reduction in out-of-pocket behavioral health expenses. This demographic often has higher unemployment and lower salaries, so they are less likely to seek behavioral health services. The ACA’s dependent coverage provision has reduced the number of uninsured young adults by at least three million. The ACA allows young adults to remain on their family’s health plans until they turn 26. Because of this, the expansion of health care access is also expected to increase the number of users of mental health and substance abuse treatment services. Behavioral health conditions often emerge during the 19 to 25 year age range. Also, this age group has a higher rate of serious mental illness than other adults.

State Finalizes Medical Provider Network Rules

The California Dept. of  Insurance has issued final regulations that include requirements for health insurers to create and maintain adequate medical provider networks. “These regulations go into effect immediately because they address a number of critical problems consumers have faced with insurers when seeking timely access to care,” says Insurance Commissioner Dave Jones. He had issued temporary emergency regulations, which have been in effect since late January 2015. The regulations require health insurers to do the following:

  • Include enough numbers and types of providers in the network to deliver covered services.
  • Adequately provide for the treatment of mental health and substance use disorders.
  • Include an adequate number of primary care providers and specialists with admitting and practice privileges at network hospitals.
  • Monitor and adhere to new appointment wait time standards.
  • Regularly report information about the networks and changes to the networks to the Dept. of Insurance for review.
  • Maintain accurate provider network directories available to the public and update them weekly.
  • Arrange out-of-network care at in-network prices when there are insufficient in-network care providers.

Study Looks At the Effectiveness of Health Policies


The Health Care Cost Institute (HCCI) released six policy briefs that look at how national and state policies affect health care costs and utilization. Researchers looked at commercial claims data for more than 50 million insured Americans. The following are Key findings:

  1. Provider consolidation drives up spending on cancer treatment: The consolidation of outpatient practices drove significant increases in cancer treatment spending. Hospital outpatient departments and their affiliated clinics were able to charge insurers additional facility fees. Consolidation also increased the use of more expensive medicines and other outpatient care components.
  2. Unrestricted access to physical therapy reduces opioid use and lowers costs: Seeing a physical therapist as the first point-of-care for lower back pain reduces potentially costly services later on, including emergency department visits and use of prescription opioids. Patients who sought physical therapy first for lower back pain had significantly lower costs, including out-of-pocket costs, for physician, outpatient, hospital, and pharmacy care compared to patients who saw another type of provider.
  1. Nurse practitioners push down the price of primary care: Prices for primary care services fell 1% to 4% in states that allowed nurse practitioners to treat patients without a supervising physician. However, spending on health care increased. Higher total health care costs may be a result of increased volume in services, which may stem from increased access to care.
  2. Designing insurance benefits to incentivize patients to choose low-priced providers for colonoscopies can lead to savings of 8.5% per procedure: Medical spending would decrease by approximately $95 million per year if just three health insurers-Aetna, Humana, and UnitedHealthcare, adopted a reference-based payment program for colonoscopies. These estimates were modeled on the health care savings of the California Public Employees’ Retirement System (CalPERS).
  3. Reimbursement for telehealth services is nearly 40% lower than non-telehealth care: Telehealth claims submitted by primary-care providers have increased from 1,246 claims in 2009 to 2,558 in 2013. But they continued to be reimbursed at lower rates. While many states permit reimbursements for telehealth services, only seven states have passed laws that mandate reimbursement parity between telehealth and non-telehealth care.
  4. Mental Health Parity law has a limited effect on access to mental health services: The Mental Health Parity and Addiction Equity Act (MHPAEA) has had little to no effect on access and use of mental health services for patients with depression, bipolar, or schizophrenia.

Californians Are Encouraged To Explore Mental Health Coverage

The California Assn. of Marriage and Family Therapists (CAMFT) urges Californians to investigate mental health coverage during open enrollment. Under California law, psychotherapy may be much more affordable than most people assume. The Affordable Care Act and the Mental Health Parity and Addiction Equity Act require insurers to provide behavioral health coverage to treat mental health disorders or substance abuse  that is comparable to coverage for treatment of physical health with no annual limits. Despite robust access to affordable mental health care, many policyholders are not utilizing it to their full benefit. Often, the obstacle is a lack of information about the available options. The website,, allows consumers to search for local therapists who accept clients with managed care plans.

Exchange Plans Block Access Mental Health Drugs

Exchange Plans Block Access Mental Health Drugs
Health exchanges have made it hard for patients to get medications for mental health, according to a recent fact sheet from Pharmaceutical Research and Manufacturers of America (PhRMA). The following are excerpts from a fact sheet from the organization:

We have seen a number of states where there are barriers to getting meaningful coverage for the medicines that physicians prescribe. We’ve seen a significant amount of aggressive utilization management, particularly for classes like anti-psychotics. We see placement of medicines on the highest (4th and 5th) tier where medicines face not a copay, but coinsurance. High cost sharing can often be a significant barrier; and we’re very concerned with that. We’ve also seen aggressive use of step therapy and “fail first,” in which an individual patient has to fail first on a particular compound before getting access to the one their doctor prescribed. That’s concerning because treatment failure can be very complicated for someone living with mental health disorders. Even when a patient rebounds, they may never get back to where they were. We have real concerns about high use of step therapy and prior authorization in these exchange plans. We’re hearing the most complaints about the use of step therapy and prior authorization.

Mental Health Bill Reintroduced

Chairman Tim Murphy (R-PA) and Rep. Eddie Bernice Johnson (D-TX) reintroduced the Helping Families in Mental Health Crisis Act, H.R. 2646. The revamped bill builds upon the previous bipartisan version. H.R. 2646. It breaks down federal barriers to care, clarifies privacy standards, expands parity accountability, invests in services for the most difficult to treat cases, and drives evidence-based care. Rep. Murphy said, “We are moving mental health care from crisis response to recovery, and from tragedy to triumph.”

The Helping Families in Mental Health Crisis Act was first introduced in December 2013, following a yearlong investigation led by Oversight Chairman Murphy into the nation’s broken mental health system. The investigation revealed that the federal government’s approach to mental health is a chaotic patchwork of antiquated programs and ineffective policies across numerous agencies.

As documented in a recent Government Accountability Office (GAO) report, 112 federal programs intended to address mental illness aren’t connecting for effective service delivery. Also, there is a lack of inter-agency coordination for programs supporting people with serious mental illness.

While the federal government dedicates $130 billion towards mental health each year, the mental health system is best described by its deficits. To name just a few:

  • There is a nationwide shortage of nearly 100,000 needed psychiatric beds.
  • Three of the largest mental health hospitals are criminal incarceration facilities.
  • Privacy rules frustrate physicians and family members and generate nearly 8,000 official complaints a year.
  • Only one child psychiatrist is available for every 2,000 children with a mental health disorder.
  • The leading federal mental health agency does not employ any psychiatrists.

The Helping Families in Mental Health Crisis Act of 2015, H.R. 2646 would do the following:

  • Create an Assistant Secretary for Mental Health and Substance Use Disorders with mental health credentials within HHS. The assistant secretary would elevate the importance of mental health in the nation’s leading health agency, coordinate programs across different agencies, and promote effective evidence-based programs.
  • Require the Assistant Secretary for Mental Health and Substance Use Disorders to make public all federal investigations into compliance with the parity law so that families and consumers know what treatment they have rights to access.
  • Establish a National Mental Health Policy Laboratory to drive innovative models of care and develop evidence-based and peer-review standards for grant programs.
  • Dedicate funding for the Brain Research Through Advancing Innovative Neurotechnologies Initiative.
  • Require psychiatric hospitals to establish clear and effective discharge planning to ensure a timely and smooth transition from the hospital to appropriate post-hospital care and services.
  • Provides additional psychiatric hospital beds for those with an acute mental health crisis who need short term (less than 30 days) immediate inpatient care.
  • Support advances in tele-psychiatry to link pediatricians and primary care doctors with psychiatrists and psychologists in areas where patients don’t have access to care.
  • Require the Assistant Secretary for Mental Health and Substance Use Disorders to study and recommend a national strategy to increase the number of psychiatrists, child and adolescent psychiatrists, psychologists, psychiatric nurse practitioners, clinical social workers, and mental health peer-support specialists.
  • Include child and adolescent psychiatrists in the National Health Service Corps.
  • Authorize the Minority Fellowship Program.
  • Authorize, for the first time in federal law, the Recovery After Initial Schizophrenia Episode (RAISE), an evidence-based early intervention program.
  • Reauthorize the National Child Traumatic Stress Network.
  • Launch an early childhood grant program to provide intensive services for children with serious emotional disturbances in an educational setting.
  • Provide incentives to states to offer community-based alternatives to institutionalization.
  • Reauthorizes the Garrett Lee Smith Suicide Prevention Program, invest in research on self-directed violence, and authorize, for the first time in the statute, the Suicide Prevention Hotline.
  • Extend health information technology for mental health providers to coordinate care with primary care doctors using electronic medical records.
  • Establishe an inter-agency Serious Mental Illness Coordinating Committee to organize, integrate, and coordinate the research, treatment, housing and services for people with substance use disorders and mental illness.
  • Ends the decades-old prohibition on physicians volunteering at community mental health clinics and federally qualified health centers.

Congressman Murphy, a psychologist with nearly three decades experience, has been a champion for reforming the broken mental health system. He yearly introduces the bipartisan congressional resolution declaring May as Mental Health Month, to end the stigma associated with mental illness and promote public awareness of mental health. He will soon advance a similar resolution recognizing the month of June as PTSD Awareness Month. A provision in the previous version of his Helping Families in Mental Health Crisis Act was recently adopted on the House floor. Murphy offered a bipartisan amendment with Rep. Michelle Lujan Grisham (D-NM) and Rep. Earl Blumenauer (D-Ore.) to the Commerce, Justice, Science and Related Agencies Appropriations Act of 2016, to advance and expand Mental Health Courts, a successful model of collaboration between criminal justice and mental health systems for those with serious mental illness.

Californians With Mental Health Issues Face Discrimination

Californians With Mental Health Issues Face Discrimination
Many California residents with mental health issues report discrimination in personal relationships and in the workplace, according to a RAND Corp. study. Just 41% of those surveyed say that people are caring and sympathetic to those with mental illnesses while 81% say that people with mental illness face prejudice and discrimination. More than two-thirds of said they definitely or probably would hide a mental health problem from co-workers or classmates, and more than one-third said they would hide their condition from family or friends.

Nearly 90% who had a mental health problem faced discrimination. Most often, they faced discrimination in intimate personal relationships, but they also reported high levels of discrimination at school, in the workplace, and from health care providers and law enforcement officials. However, Californians who are facing psychological distress are showing signs of resiliency. More than 80% of those surveyed have a plan for staying or becoming well and say they can meet their personal goals. In addition, about 70% of those surveyed said that they are satisfied with life. The large majority of respondents say that recovery from mental illness is possible and say they would seek treatment for a mental health problem if needed.

Proposition 63, which imposed a special state tax on people with incomes over $1 million, funds the California Mental Health Services Authority (CalMHSA). Wayne Clark, executive director of CalMHSA said, “This new report…highlights the need to confront stigma, and the opportunity to promote mental health in our state with the statewide stigma reduction efforts offered by CalMHSA.” The survey found that the mental health education campaign mounted by CalMHSA is reaching people facing psychological distress. About one-third of the people surveyed had been reached during the previous 12 months by the early intervention efforts, such as viewing the campaign’s documentary on ending stigma about mental illness. In addition, other activities that could be related to the CalMHSA efforts reached nearly 90% of the group during the previous 12 months.

Insurers Fall Short in Mental Health Coverage

Insurers Fall Short in Mental Health Coverage
Health insurance plans are falling short in coverage of mental health and substance abuse conditions according to a report by the National Alliance on Mental Illness (NAMI). The organization surveyed 2,720 consumers and analyzed 84 insurance plans in 15 states.

A federal parity law, enacted in 2008, requires mental health benefits in some employer-sponsored plans to be provided on the same terms as other medical care. Coverage was expanded under the Affordable Care Act (ACA) in 2010. However, the report finds the following problems with mental-health coverage:

  • A Lack of mental health providers is a serious problem in health insurance networks.
  • Nearly a third of survey respondents reported insurance company denials of authorization for mental health and substance abuse care. For ACA plans, denials were nearly twice the rate for other medical care.
  • More than half of health plans analyzed for the report covered less than 50% of anti-psychotic medications.
  • High out-of-pocket costs for prescription drugs discourage people from participating in mental health and other medical treatment.
  • High co-pays, deductibles, and co-insurance rates create treatment barriers.
  • There is a serious lack of information about mental health coverage that would enable consumers to make informed decisions in choosing health plans.

The report makes these recommendations:

  1. Strong enforcement of the 2008 parity law is needed at the federal and state levels, including establishing easily accessible procedures for filing complaints.
  2. Insurance companies should be required to publish the clinical criteria that’s used to approve or deny mental health and medical-surgical care.
  3. Health plans should be required to publish accurate providers lists in their networks and to update them regularly.
  4. The Dept. of Health & Human Services should require all health plans to provide clear, understandable, and detailed information about benefits and make this information easily accessible. HHS should develop tools to help consumers compare plans before enrollment.
  5. Congress and the Executive Branch must work together to decrease out-of-pocket costs under the ACA for low-income consumers.

Last Updated 08/10/2022

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