The normal anxiety any of us feel when we consult a physician is often increased when the help is sought for a mental health problem. This can be especially true for a Veteran seeking help for a mental problem or suicidal thoughts. In connection with Suicide Prevention Awareness Week, September 6-9, three mental health providers told us how the NY Harbor Health Care System is working to reduce that anxiety.

Yvette Branson, Ph.D., suicide prevention coordinator, noted the erroneous cultural beliefs that may prevent Veterans from accessing care- that anyone who seeks psychiatric help must be crazy, or weak, or that asking someone about suicidal ideas may cause them. In addition, Veterans may face an internal barrier–the belief that “they have to solve their problems alone.”

To reduce this barrier, Dr. Branson said that in the VA, treatment is seen as a collaboration between Veteran and provider, with the Veteran playing an active role. She noted that the former suicide prevention hotline has been renamed the Veterans Crisis Line, precisely to help Veterans feel comfortable about calling early on in a crisis, whether or not they have suicidal ideas. The Veterans Crisis Line, at 1-800-273-8255 is manned by trained people 24/7, 365 days a year. Most Veterans identify themselves, but they do not have to, nor do they have to be registered in the VA system to use the service.

Joshua Hooberman, Ph.D., also a suicide prevention coordinator, observed that when on active duty, servicemen and servicewomen are trained to attend to the overall military mission, not to personal problems. While admirable and necessary, this attitude may interfere with the Veteran getting needed help upon return to civilian life. However, as Dr. Hooberman put it, “It takes a warrior’s strength to ask for help – don’t go into battle without a buddy.” Like the commander who may need help to accomplish the military mission, Veterans too may sometimes need help to accomplish the vital mission of maintaining their own mental health.

Training of staff also improves access to care. Antonia New, M.D., director of evidence based treatment at the Bronx VAMC, noted that staff are trained about an important change in the VA patient population – younger Veterans. Whatever their psychiatric issues, these Veterans are also grappling with the developmental tasks of young adulthood, such as consolidating their identity, and making work and relationship choices. Dr. New’s observation is a good reminder that no Veteran, of any age, should be defined solely by his or her mental or emotional problems.

On Friday, September 9, from 10:30 AM to Noon, Dr. Bruce Levine, Director of Education for the NY Harbor Health Care System, will present Grand Rounds, “Facing Down Stigma in the Consulting Room: Reality Oriented Treatment.” All staff – and all Veterans – are welcome. Grand Rounds “Facing Down Stigma” presentation by Dr. Bruce Levine can be heard at the following locations: BK 1-222, Manhattan 3076S, St. Albans E-121, Staten Island 388, Chapel St., 16th Street.

September 6-9, tables will be set up in VA lobbies, where Veterans or their friends or family can informally meet staff, and get printed information about mental health. Drop by, and always remember “Don’t go into battle without a buddy.”

SMALL BUSINESS KEY TO SMART CARD TEST IN NEW YORK CITY



The Buffalo News (Buffalo, NY) October 14, 1997 | PATRICIA LAMIELL – Associated Press Dry cleaner Paul Breitstein is a frontline soldier in the banking establishment’s war against cash. Breitstein has enlisted in a six-month trial, beginning last week, to test acceptance of smart card technology. here citibanks ignon Smart cards are embedded with a silicon chip that stores value and keeps track of how much money is deposited or spent. As a participant in a study organized by Visa USA, MasterCard International, Chase Manhattan Corp. and Citibank, Breitstein and more than 600 other merchants in Manhattan’s Upper West Side will receive a free countertop machine that will “read” smart cards. Chase and Citibank customers in the area will receive complimentary cards. The Chase cards will be branded with the Mondex logo, MasterCard’s smart card brand. Citibanks’ cards will carry the VisaCash name. Cardholders will be able to transfer cash from their bank accounts onto their cards at an automated teller machine or kiosk, and then use the cards for payment at neighborhood stores. Just like a credit or debit card purchase, merchants will pass the smart cards through their readers to deduct the amount of the sale. The merchants will get their money at the end of the day, when they take the data from the reader and make an electronic deposit in the store’s bank account. At his Landmark Cleaners, Breitstein said he is happy to give his customers another payment option. “Any way they can pay is fine with me,” he says. He is offering a 10 percent discount to smart card users. Credit card associations and banks are promoting smart cards as a convenient and safe form of payment, and their market studies say that consumers want them. For the sponsors and the makers of smart card technology, the potential profits are enormous. Merchants eventually will have to buy readers costing a few hundred dollars and up. And when the trial ends, issuers will start to receive a percentage of every smart card transaction, just as they do on debit and credit card purchases now. In exchange, merchants are relieved of the risk to their safety of handling cash. Banks are relieved of the risk of granting credit to people who won’t pay. Customers can manage their credit better and don’t have to fumble for change for small purchases that normally wouldn’t be charged. But, if they lose the card, it’s like losing cash. “The cash management advantages for merchants are really great,” says Alice Dayton of the Makovsky & Co. public relations firm. “They don’t have to call for bank approval, they don’t have to ID the customer, they don’t have to deal with cash late at night.” In the New York City project, Chase and Citibank will each give away 25,000 cards in an area of affluent, well-educated consumers. For the pilot project to succeed, sponsors say, consumers must be able to use the cards not only at participating big chains like McDonald’s or The Athlete’s Foot, but at the neighborhood’s many small businesses as well. That’s where merchants like Breitstein come in. Sponsors “have felt from the beginning that the small merchants were very critical” to the project’s success, Ms. Dayton says. While smart cards are popular in parts of Europe and Asia, they are not common in the United States. Visa and MasterCard have been testing the cards at college campuses, an Army base and with employees of a bank and a credit card business. Visa also did a test last year at the Summer Olympics, along with First Union Corp., NationsBank and Wachovia Corp. In all 1.5 million cards were issued for use at 1,500 merchants. Visa and the banks proclaimed the Atlanta test a success. Critics said it was unclear how many cards were used. Olympics visitors complained that the cards weren’t accepted at enough vendors close to the games. Merchants said their staff had trouble using the readers. The associations say they learned a lesson. The New York City trial is much smaller than at Atlanta. And in this test, the same readers can process both Visa and MasterCard smart cards, which the sponsors believe will make them more likely to be used. Still, not all merchants expect glowing results. George Bosler says he thinks customers at his Candlelight Wines have little interest in smart cards, but is participating in the study because there is no cost to his business. Bosler says consumers are better served by debit or credit cards. And because a smart card is not insured or traceable, “If you lose it, it’s gone.” Maury Spector, whose West Side Pharmacy is participating, sees smart cards as a step toward the extinction of cash. Spector reluctantly started accepting credit cards 10 years ago, feeling he needed to remain competitive. Back then, 80 percent of his business was cash, and 20 percent was credit. “Now it’s exactly the opposite,” he says. here citibanks ignon PATRICIA LAMIELL – Associated Press

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