In a Boston V.A. hospital, six social workers are conducting phone and telehealth visits with veterans from a single, crowded room, clinicians say. In Kansas City, providers are planning patient care while facing each other across narrow, cafeteria-style tables in a large, open space, according to staff members.And in South Florida, psychiatric nurses have been treating veterans with mental health conditions in a hallway near a bathroom, sitting down with them in a makeshift medical bay jury-rigged out of filing cabinets and a translucent screen.“People walking by can hear everything that’s going on,” said Bill Frogameni, an acute care psychiatric nurse at the Miami V.A. hospital and director of the local chapter of the National Nurses United union, referring to the patient intake setup in a V.A. facility in Homestead, Fla., outside Miami.“The nurses are triaging these patients asking standard questions: ‘Do you feel like harming yourself or others? How long have you been feeling suicidal? Do you have a plan to harm yourself?’” Mr. Frogameni said. “It’s very personal stuff.”“People walking by can hear everything that’s going on,” said Bill Frogameni, an acute care psychiatric nurse and director of the local chapter of the National Nurses United union in Miami.Scott McIntyre for The New York TimesThe cramped conditions are the result of President Trump’s decision to rescind remote work arrangements for federal employees, reversing a policy that at the V.A. long predated the pandemic. Since Mr. Trump’s order, the Department of Veterans Affairs has been scrambling to find adequate office space for tens of thousands of health care employees, even those who see most or all of their patients virtually, while maintaining the legal requirement of confidentiality.Are you a federal worker? We want to hear from you.The Times would like to hear about your experience as a federal worker under the second Trump administration. We may reach out about your submission, but we will not publish any part of your response without contacting you first.

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More than $800 million in N.I.H. grants canceled as of early May — nearly half of those terminated to date — covered the health of sexual and gender minority groups, The Times found.The Trump administration has scrapped more than $800 million worth of research into the health of L.G.B.T.Q. people, abandoning studies of cancers and viruses that tend to affect members of sexual minority groups and setting back efforts to defeat a resurgence of sexually transmitted infections, according to an analysis of federal data by The New York Times.In keeping with its deep opposition to both diversity programs and gender-affirming care for adolescents, the administration has worked aggressively to root out research touching on equity measures and transgender health.But its crackdown has reverberated far beyond those issues, eliminating swaths of medical research on diseases that disproportionately afflict L.G.B.T.Q. people, a group that comprises nearly 10 percent of American adults.Of the 669 grants that the National Institutes of Health had canceled in whole or in part as of early May, at least 323 — nearly half of them — related to L.G.B.T.Q. health, according to a review by The Times of every terminated grant. Federal officials had earmarked $806 million for the canceled projects, many of which had been expected to draw more funding in the years to come. Scores of research institutions lost funding, a list that includes not only White House targets like Johns Hopkins and Columbia, but also public universities in the South and the Midwest, like Ohio State University and the University of Alabama at Birmingham.We are having trouble retrieving the article content.Please enable JavaScript in your browser settings.Thank you for your patience while we verify access. If you are in Reader mode please exit and log into your Times account, or subscribe for all of The Times.Thank you for your patience while we verify access.Already a subscriber? Log in.Want all of The Times? Subscribe.

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Just nowShareSaveNick TriggleShareSaveGetty ImagesLucy says she’s always been a bit of worrier, but two years ago she began to get anxious and started having panic attacks.”I didn’t know what was happening and my parents didn’t either,” says the 15-year-old. “It was scary. The attacks would occur without warning. It got worse and I began to have them in public.” Lucy started missing a lot of school and stopped socialising. She says it was hard for her parents to see her struggling. “We didn’t know what to do or where to go.”For six months, she tried to manage her anxiety herself, but eventually the family decided to pay for a talking therapy called cognitive behavioural therapy.Lucy says it has made a huge difference. While she still has panic attacks, they are much less frequent and she is back attending school and doing the things she enjoys.Lucy’s story is far from unique. NHS figures suggest one in five children and young people aged eight to 25 has a probable mental health disorder.Why problems are so commonThe teenage years are when problems become increasingly common as young people grapple with the challenges of growing up, exam stresses, and friendships and relationships.There are biological reasons too that make emotional health problems more likely, says Prof Andrea Danese, an expert in child and adolescent psychiatry at King’s College London.”Teenagers’ brains don’t develop all at once. The part that processes emotions matures earlier than the part responsible for self-control and good judgement. This means young people can feel things very intensely before they’ve fully developed the ability to manage those feelings, which helps explain some of the emotional ups and downs parents often see.”The zenith, he says, is adolescence, when emotional reactions are further heightened by hormones and changes to the internal body clock which impact sleeping patterns.When and how to helpSo, what constitutes normal emotional challenges – and when should teens and their parents be worried and consider seeking professional help?Prof Danese says he understands why many find this difficult to judge. He considers the following as normal teenage emotional traits:Periodic irritability and moodinessOccasional social withdrawal or desire for privacyAnxiety about social acceptance or academic performanceExperimenting with identity and independenceEmotional reactions that seem disproportionateProviding these are not interfering too much with daily activities, parents should feel able to support their children, he believes.The most common problems teenagers experience are low mood and anxiety. For low mood, Prof Danese says, maintaining healthy routines around eating, sleeping, being active and keeping in touch with friends and family is important as is planning activities that your child enjoys, such as trips out or playing a sport.”And help them identify, break down and try out solutions for problems that may have arisen,” he adds.For anxiety, calming techniques are helpful, he says. These can include breathing exercises, grounding, whereby you concentrate on the environment around you and what you can see, touch and smell, and mindfulness activities.”It’s important to avoid the trap of providing unnecessary reassurance,” Prof Danese says. Instead, alongside teaching calming techniques, parents should discuss and test out feared situations. “To reduce worries, it can help to write them down or talk about them at a special ‘worry time’ once a day.”Building resilienceStevie Goulding, who runs the parent helpline for Young Minds, says anxiety is the issue they get the most calls about. “Many children will have bouts of anxiety and even panic attacks. It’s difficult for parents. They can easily find themselves lacking in confidence and judgement about what to do. We get lots of calls from parents in that position. When they see their child struggling it can make them question themselves and they just don’t know where to turn.”The main advice we give parents is to communicate with their children. Give them permission to talk about what is bothering them – and if they don’t want to talk to them, ask if there is someone else they would prefer to talk to.”Ms Goulding also recommends talking to your child’s school as they may have noticed things too.But she adds: “Children need to be given space – avoid the temptation to rush in and try to fix things. Just reflect what they are saying and listen.”Getty ImagesChild psychologist Dr Sandi Mann agrees, saying parents have an understandable temptation to want to resolve whatever issue their child is facing when that is not necessarily the best solution.She says instead parents should help teach and build resilience in their children – and has written about this for the BBC.She recommends parents:Explain setbacks happen to everybody, giving examples of things that have gone wrong in your own lifeEmbrace mistakesEmpower them to make their own decisions, stressing they are largely responsible for their own happinessChallenge their beliefs, particularly black-and-white thinking and catastrophising”I think we sometimes can create the impression that children and young people are not able to solve their own problems when we are rushing them to get help or turning to medication.”Signs professional help is neededBut Dr Mann and Prof Danese both stress parents should not shy away from asking for professional support when needed. “There’s nothing to be ashamed of,” says Dr Mann. “We just need to know when to try to solve problems and when to get help.”They both highlight similar behaviours that should act as a trigger for parents to get help. These include:Self-harm and suicidal thoughtsExtreme changes in eating or sleepingDramatic personality changes and expressions of hopelessnessSignificant interference with daily functioning, such as going to school or socialisingProlonged withdrawal from activities that were once enjoyedDr Elaine Lockhart, chair of the Royal College of Psychiatrists’ child and adolescent faculty, says parents should feel comfortable about broaching mental health with their children and asking for help.”We know lots of children struggle. The idea that the school years are the best years of your life is a fallacy.”But with long waiting times for NHS child mental health services, knowing where to go for help is not straightforward, particularly if you cannot afford private therapy.The first point of call is normally your GP or mental health support teams that are linked to schools in some areas. As well as referrals to NHS mental health services, they can put you in touch with local organisations and charities that can provide support. “Schools themselves can also help – some have counselling and support services,” says Dr Lockhart. “But I think parents can underestimate the role they can play even if their child is waiting for support or actually getting therapy or treatment. The home is where they will spend most of their time – so parents are a big part of the solution.”If you need mental health support the following links provide information about how to get help:

A new training program teaches aides to stop baby talk and address older people as adults.A prime example of elderspeak: Cindy Smith was visiting with her father in his assisted living apartment in Roseville, Calif. An aide who was trying to induce him to do something — Ms. Smith no longer remembers exactly what — said, “Let me help you, sweetheart.”“He just gave her The Look — under his bushy eyebrows — and said, ‘What, are we getting married?’” recalled Ms. Smith, who had a good laugh, she said. Her father was then 92, a retired county planner and a World War II veteran; macular degeneration had reduced the quality of his vision and he used a walker to get around, but he remained cognitively sharp.“He wouldn’t normally get too frosty with people,” Ms. Smith said. “But he did have the sense that he was a grown up, and he wasn’t always treated like one.”People understand almost intuitively what “elderspeak” means. “It’s communication to older adults that sounds like baby talk,” said Clarissa Shaw, a dementia care researcher at the University of Iowa College of Nursing and a coauthor of a recent article that helps researchers document its use.“It arises from an ageist assumption of frailty, incompetence and dependence.”Its elements include inappropriate endearments. “Elderspeak can be controlling, kind of bossy, so to soften that message there’s ‘honey,’ ‘dearie,’ ‘sweetie,’” said Kristine Williams, a nurse gerontologist at the University of Kansas School of Nursing and another coauthor.We are having trouble retrieving the article content.Please enable JavaScript in your browser settings.Thank you for your patience while we verify access. If you are in Reader mode please exit and log into your Times account, or subscribe for all of The Times.Thank you for your patience while we verify access.Already a subscriber? Log in.Want all of The Times? Subscribe.

3 hours agoShareSaveSimon Maybin & Michael BlastlandThe Autism Curve, Radio 4ShareSaveVenessa Swaby/Luke Nugent (Luke Nugent Studios)

Kennedy has warned of an epidemic of chronic disease, but the budget blueprint would close the C.D.C. center focused on prevention.Robert F. Kennedy Jr., the nation’s health secretary, has said that tackling a chronic disease “epidemic” would be a cornerstone of his Make America Healthy Again agenda, often invoking alarming statistics as an urgent reason for reforming public health in this country.On Friday, President Trump released a proposed budget that called for cutting the funding of the Centers for Disease Control and Prevention by almost half. Its chronic disease center was slated for elimination entirely, a proposal that came as a shock to many state and city health officials.“Most Americans have some sort of ailment that could be considered chronic,” said Dr. Matifadza Hlatshwayo Davis, health director for the city of St. Louis.Of the proposed cuts, she said, “How do you reconcile that with trying to make America healthy again?”The federal health department last month cut 2,400 jobs from the Centers for Disease Control and Prevention, whose National Center for Chronic Disease Prevention and Health Promotion runs on the largest budget within the agency.Programs on lead poisoning, smoking cessation and reproductive health were jettisoned in a reorganization last month.We are having trouble retrieving the article content.Please enable JavaScript in your browser settings.Thank you for your patience while we verify access. If you are in Reader mode please exit and log into your Times account, or subscribe for all of The Times.Thank you for your patience while we verify access.Already a subscriber? Log in.Want all of The Times? Subscribe.

President Trump on Friday proposed slashing $163 billion in federal spending next fiscal year, a drastic retrenchment in the role and reach of government that, if enacted, would eliminate a vast set of climate, education, health and housing programs, including some that benefit the poor.Issuing his first budget proposal since returning to office, Mr. Trump sketched out a dim view of Washington. His blueprint depicted many core government functions as woke, weaponized, wasteful or radical, as the president looked to justify his request that Congress chop domestic spending to its lowest level in the modern era.Mr. Trump proposed cutting funding for some federal law enforcement, including the F.B.I. He called on lawmakers to slash money meant to police tax evasion at the Internal Revenue Service. He recommended striking billions in funds that help finance clean water projects. And the president reserved some of his deepest cuts for education, health and science, including the National Institutes of Health and the Centers for Disease Control and Prevention, which would see their budgets cut by around half.Democrats immediately rebuked Mr. Trump for his proposal. Senator Chuck Schumer of New York, the Senate minority leader, called it “heartless” and an “all-out assault on hardworking Americans.” Even some Republicans took issue with Mr. Trump’s budget, although others, like Speaker Mike Johnson, endorsed the blueprint.Mr. Trump also asked Congress to reduce, if not eliminate, billions of dollars in federal aid to help the poorest Americans. For one, the White House called for reconfiguring federal programs that provide rental assistance to low-income families, cutting aid by more than $26 billion next fiscal year. And the administration proposed the termination of a federal initiative, backed by some Republicans, that aids needy families in paying their monthly heating bills.In one of the few spending increases included in the budget, Mr. Trump asked lawmakers to bolster spending at the Department of Homeland Security by more than $43 billion, furthering his work to crack down on immigration, conduct deportations and build a wall along the U.S.-Mexican border. The president also requested more than $1 trillion for the military next fiscal year.But he asked lawmakers to approve that increase essentially on a one-time basis, as part of a broader legislative package — due later this year — meant to advance the president’s tax agenda. The approach angered some Republicans, who signaled they would pursue a larger increase to military spending as part of the yearly process to fund government agencies and programs.“It is peculiar how much time the president’s advisers spend talking about restoring peace through strength, given how apparently unwilling they’ve been to invest accordingly in the national defense or in other critical instruments of national power,” said Senator Mitch McConnell of Kentucky, the Republicans’ former Senate leader, in a statement that denounced the administration’s “accounting gimmicks.”For Mr. Trump, the budget served to formalize his conservative vision and his disruptive reorganization of the government, a campaign that has already shuttered entire agencies and dismissed thousands of federal workers without the explicit approval of Congress.Some of Mr. Trump’s proposed military increases could benefit Elon Musk, the tech billionaire who has advised Mr. Trump on cost-cutting as part of the Department of Government EfficiencyMr. Trump’s budget supported the creation of a new missile defense shield and a renewed campaign for “U.S. space dominance.” Both are areas in which Mr. Musk and his rocket company, SpaceX, could stand to win major contracts funded by any increase in spending.In a letter Friday accompanying the spending blueprint, Russell T. Vought, the leader of the White House budget office, said the administration had produced its submission after a “rigorous, line-by-line review of spending.”Mr. Vought added that the president sought to root out money “contrary to the needs of ordinary working Americans and tilted toward funding niche, nongovernmental organizations and institutions of higher education committed to radical gender and climate ideologies antithetical to the American way of life.”Sharon Parrott, the president of the left-leaning Center on Budget and Policy Priorities, said many of the budget changes contemplated by Mr. Trump still seemed most likely to fall hardest on low-income Americans, particularly those who rely on government services.“This is the latest repudiation of some of what he promised on the campaign trail, in terms of being a president who was going to seek to serve people struggling at the margins of the economy,” she said.Mr. Trump’s proposal is not law. Totaling about $1.7 trillion, after accounting for the full set of spending changes the president seeks, the budget serves only as a formal guide to Congress, where it immediately generated opposition.“President Trump has made his priorities clear as day: He wants to outright defund programs that help working Americans while he shovels massive tax breaks at billionaires like himself and raises taxes on middle-class Americans with his reckless tariffs,” Senator Patty Murray of Washington, the leading Democrat on the Appropriations Committee, said in a statement.The criticism was not limited to Democrats, as Republicans also raised alarm about cuts to some programs that serve the neediest Americans. Outlining her “serious objections,” Senator Susan Collins, a Maine Republican who leads the Appropriations Committee, added in a statement: “Ultimately, it is Congress that holds the power of the purse.”By releasing the budget, Mr. Trump set the stage for what is bound to be a complicated, monthslong process to fund the government and avert a shutdown before an existing spending deal expires on Sept. 30. Entering that fight, many Republicans have echoed Mr. Trump’s desire to slash federal spending, though warring G.O.P. factions have disagreed at times over the exact scope.Party lawmakers have also raced to identify potentially trillions of dollars in cuts that they can include to finance a related package that would expand a set of expiring tax cuts for families and businesses, one of the president’s signature — and costliest — economic policy priorities.But Mr. Trump’s proposal carries additional significance. He and his top budget adviser, Mr. Vought, subscribe to the idea that the commander in chief wields expansive authority to halt or cancel spending, even if Congress instructs otherwise. Their view has paved the way for the administration to slow, freeze or cancel billions of dollars in funds, sparking a vast array of lawsuits and prompting more than three dozen ongoing federal investigations into their activities.On Friday, Mr. Trump’s proposal left unanswered some of the most important questions facing Washington and its finances. It was silent on the nation’s fiscal trajectory, even as the president seeks to cut taxes in a sprawling and costly legislative package that carries substantial implications for the nation’s $36 trillion debt.“It remains to be seen what the rest of the president’s proposals will hold, and there is still the multitrillion-dollar question of whether the reconciliation bill will blow up the debt,” said Maya MacGuineas, the president of the Committee for a Responsible Federal Budget, a group that advocates deficit reduction.Nor did the president’s new budget address the future of the federal benefit programs, including Social Security, Medicare and Medicaid, that comprise the largest share of federal spending annually. Some Republicans are particularly interested in rethinking Medicaid, which provides health insurance to poor families, as a source of savings to pay for their tax cuts.The administration is expected to send those details in a fuller budget to Congress as soon as this month.Reporting was contributed by

Decades of research have turned up no miracle treatment for measles, but studies show the M.M.R. shot is 97 percent effective in preventing the disease.With the United States facing its largest single measles outbreak in 25 years, Health and Human Services Secretary Robert F. Kennedy Jr. will direct federal health agencies to explore potential new treatments for the disease, including vitamins, according to an H.H.S. spokesman. The decision is the latest in a series of actions by the nation’s top health official that experts fear will undermine public confidence in vaccines as an essential public health tool.The announcement comes as Mr. Kennedy faces intense backlash for his handling of the outbreak. It has swept through large areas of the Southwest where vaccination rates are low, infecting hundreds and killing two young girls. On Friday, the Centers for Disease Control and Prevention reported more than 930 cases nationwide, most of which are associated with the Southwest outbreak.Critics have said Mr. Kennedy has focused too much on untested treatments — such as cod liver oil supplements — and offered only muted support for the measles vaccine, which studies show is 97 percent effective in preventing infection.The decision to put more resources into potential treatments, rather than urging vaccination, could have grave consequences at the center of the outbreak.“We don’t want to send the signal that you don’t have to get vaccinated because there’s just a way to get rid of it,” said Jennifer Nuzzo, an epidemiologist at the Brown University School of Public Health.Scientists have already thoroughly studied various vitamins and medications as potential treatments for measles, said Michael Osterholm an epidemiologist at the University of Minnesota.We are having trouble retrieving the article content.Please enable JavaScript in your browser settings.Thank you for your patience while we verify access. If you are in Reader mode please exit and log into your Times account, or subscribe for all of The Times.Thank you for your patience while we verify access.Already a subscriber? Log in.Want all of The Times? Subscribe.

The number of people choosing an assisted death could top 4,000 a year within a decade of the law coming into force if MPs vote for it, a review of the policy says.The estimate forms part of the official impact assessment, which has been carried out by civil servants to inform MPs as they debate whether to allow assisted dying in England and Wales.It said initially the numbers coming forward would be low, but are expected to grow over time.But even within 10 years of the assumed October 2029 start date, the upper estimate of just over 4,500 assisted deaths a year would represent less than 1% of all deaths, the document said. The lower estimate was just over 1,000 deaths.The impact assessment also provides a financial analysis of the costs and savings involved – it is not a document that gets into the ethical or philosophical arguments for and against the policy.It comes as the bill returns to the House of Commons later this month, with a crucial vote that will determine whether the bill becomes law expected to happen in mid June.In the first six months, savings for the NHS could range from around £919,00 to £10.3m.This figure includes hospital care, primary and community care, hospice, medicines and other care costs that someone choosing an assisted death would not need.By the time the system has been running for ten years, savings could range from £5.84m to £59.6m.But there will be costs too. Staffing an assisted dying service could cost in excess of £10m a year within a decade. And training costs in the first six months alone could be over £11m.One assisted death would likely involve six health and care professionals working 32 hours.It said this could take staff away from existing services, but the overall impact of this was uncertain.And each panel that would review cases, comprising of a lawyer, psychiatrist and social worker, could cost £2,000 a day.Overall, it said it was not possible to calculate whether the costs outweighed the savings or vice versa as there were too many uncertainties.The Department of Health and Social Care said the government was neutral on the issue. It said the document had been produce to help ensure any legislation that passes through parliament is “workable, effective and enforceable”.Kim Leadbeater, the Labour MP behind the bill, said she was grateful for the work that had been done on the impact assessment.She said she was still “firmly of the view that the overall impact of this long overdue reform will be to make end of life care in England and Wales more compassionate and significantly safer”.But Baroness Tammi Grey-Thomson, a former Paralympian and member of the House of Lords, who opposes assisted dying, said: “This assessment highlights how assisted dying would put disabled and other vulnerable people at grave risk by providing financial incentives to an already overburdened and under-resourced NHS to offer assisted dying as a ‘treatment option’.”