Individuals with Depression Not Seeking Help from Mental Health Professionals, Study Finds

As the public conversation about mental health continues, new federal data released by the Centers for Disease Control and Prevention suggest that nearly two-thirds of individuals who have severe depression do not seek the assistance of mental health professionals. The report, by the National Center for Health Statistics within CDC, also found that people with mild depressive symptoms, as well as those with moderate or severe depressive symptoms, reported difficulties with work, home, and social activities related to their symptoms. For those with severe depression, nearly 90 percent reported such difficulties.  Nearly 3 in 4 with moderate depression also reported having difficulty in those everyday situations.

Studies have shown that the most effective treatment for depression, especially for severe depression, is a combination of medication and therapy. Although medication can be prescribed by a primary care physician, therapy is generally provided by a mental health professional.

The study, which covered 2009-2012, found:

• 7.6% of Americans (aged 12 and over) had depression (defined as moderate or severe depressive symptoms in the past 2 weeks). Depression was more prevalent among females and individuals age 40–59.
• About 3% of Americans (aged 12 and over) had severe depressive symptoms, while almost 78% had no symptoms.
• People living below the poverty level were nearly 2½ times more likely to have depression than those at or above the poverty level.
• Almost 43% of persons with severe depressive symptoms reported serious difficulties in work, home, and social activities. Of those with severe symptoms, 35% reported having contact with a mental health professional in the past year.

According to the National Institutes of Health, more than 20 million people in the United States have depression. Its symptoms go beyond feeling sad for a few days, and interfere with people's daily lives, causing energy loss, feelings of worthlessness, problems with sleeping, or thoughts of death or suicide.

A report by the Connecticut Department of Public Health (DPH) issued earlier this year found that 1 in 6 Connecticut adults (16.7 percent) reported having been told they had a depressive disorder. Women were significantly more likely to have been told they had a depressive disorder (19.0 percent) compared to men (14.2 percent).The likelihood of having been diagnosed with a depressive disorder decreased significantly for each increase in income range, the study found.  The DPH data is from 2012.

According to the CDC, depression is a serious medical illness with mood, cognitive, and physical symptoms. Depression is associated with higher rates of chronic disease, increased use of health care facilities, and impaired functioning.  Its causes may be genetic, environmental, psychological or biochemical.  Numerous studies have also shown that individuals with depression have more functional limitations than those without depression. The DPH study points out that “Depressive disorders may interfere with a person’s work and daily activities and prevent them from functioning normally. Some forms of depression develop under unique circumstances; others occur in episodes or may be longer-term.”

Concussion Education Plan Due to School Districts on January 1; Advisory Panel Meets Today

Three weeks from now, Connecticut should have in place a state concussion education plan to be used by local and regional boards of education.  That’s according to a law passed by state legislators earlier this year in response to growing concerns about the potential lifelong effects of concussions on students injured in school sports. Local school boards will be responsible for implementing the plan using written materials, online training or videos, or in-person training.

The Connecticut Youth Concussion Advisory Group, coordinating the state’s effort, has met four times this fall.  Minutes of the most recent meeting, on November 6, were posted to the group’s website more than a month later, just days ahead of the meeting scheduled for Thursday, December 11.  That meeting is to include an update on the Concussion Education Plan, according to the meeting agenda.

Although the law was approved in May, it was highlighted in public ceremonies in September in Westport, the hometown of three mothers who were instrumental in advocating for passage of the law. Each of their sons’ lives were changed by concussions. Ann Sherwood, Pippa Bell Ader and Diana Coyne came together to form the Parents Concussion Coalition, FOX Connecticut reported.

Public Act 14-66 requires the state Department of Education to consult with the state Department of Public Health, the governing authority for intramural and interscholastic athletics, an appropriate organization representing licensed athletic trainers, and an organization representing county medical associations to do the following:

• By January 1, 2015, develop a concussion education plan to be used by local and regional boards of education. Boards of education will be responsible for implementing such plan using written materials, online training or videos, or in person training.
• Develop a signed informed consent, which must include a summary of the concussion education plan, and a summary of the local board’s policies regarding concussions. For the school year beginning July 1, 2105, local boards of education must prohibit a student athlete from participating in intramural or interscholastic athletic activities unless the student athlete and a parent or guardian returns such form.
• Collect and report to DPH all occurrences of concussions, including the nature and extent of the concussion and the circumstances in which the student sustained the concussion.

The law also requires that a training course regarding concussions be developed or approved, and that “a refresher course regarding concussions, including current best practices, and, for football coaches, current best practices around the frequency of games and full contact practices and scrimmages.”  That provision was effective on October 1. 

At the November meeting of the Advisory Group, “there was discussion regarding the pros and cons of mandating a specific time frame between stages of recovery from a concussion versus considering each case individually and relying on the student’s physician,” the meeting minutes reported.  Among materials reviewed were a Concussion Web page, Concussion Education Initiative Course feedback, and an annual review and refresher course.

Regarding data collection, the Advisory Group “discussed what will work best for schools; what is an ideal versus realistic approach.”

The Connecticut Interscholastic Athletic Conference (CIAC) Board of Control is requiring all CIAC member schools (including private and parochial schools not covered by the law) to develop a plan and begin implementation in the 2014-15 school year.

Westport’s Staples High School is among the Connecticut school that now provide concussion protocols on their websites, so that students, parents, coaches and the community are aware of expected practices.  According to the Staples site, “links include concussion education, the concussion care plan that is to be filled out by your physician when a concussion occurs, our procedures for concussion management, and our Return to Play protocol that will be followed by all athletes before returning to competition after sustaining a concussion.”

Connecticut was one of the first states in the nation to adopt a concussion law, in 2010, following Oregon and Washington, which implemented similar statutes in 2009.  The law dealt primarily with training requirements for coaches.

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Two CT Metro Regions Among Nation's Best for Young Workers

Two of Connecticut’s metropolitan regions have among the highest median earnings for full-time workers age 18 to 34, according to U.S. Census Bureau data.  The Bridgeport-Stamford-Norwalk area ranked #5, with Hartford-West Hartford-East Hartford ranked #6, just ahead of New York-Newark-Jersey City.  Connecticut and California were the only states to have two regions among the top ten. The media income in the Bridgeport-Stamford-Norwalk metropolitan area was $42,757, and the Hartford-West Hartford-East Hartford region was $42,322 for 18-34 year olds working full-time, according to the data, highlighted in an article posted to The Atlantic’s CityLab website.

Those median salaries in Connecticut compare to a media of $33,883 for the same age category nationwide.    The data indicates that 21.9 percent of the region’s population is age 18-34 in the Hartford metro area; 19.9 percent in the Stamford centered region.

Nationwide, the website points out “since the start of the Great Recession in 2007, the median wage for people between the ages of 25 and 34, adjusted for inflation, has fallen in every major industry except for health care.”  The Atlantic reported earlier this month that “overall U.S. wages are barely growing, and wages for young people are growing 60 percent more slowly than overall U.S. wages.”

“When you dig into the numbers,” the website continues, “the Hartford, Connecticut, metro area emerges, beaconlike, in the darkness: It has become one of the most lucrative job markets for young Americans.”

The report notes “a higher median income for young workers than in New York, Seattle, or Chicago. Millennial wages in many smaller metropolitan areas, including Austin, Minneapolis, and Denver, also lag behind Hartford's.”  The Hartford-West Hartford-East Hartford region offers the combination of strong median income and a cost of living that isn’t rising at the rate of other metropolitan areas, which makes the region “looking remarkably attractive.”

Also this month, the real estate website Zillow predicts “a big year for home buyers in 2015, with more millennials entering the market amid rising rents.”   Zillow’s annual housing predictions identified the five best housing markets for first-time homebuyers in the year ahead, and ranked Hartford at #2, just behind Pittsburgh and ahead of Chicago, Las Vegas and Atlanta.

Looking ahead to 2015, Hartford was among the “markets most favorable to first-time buyers … with strong income growth among 23-34 year olds, significant growth in the number of entry-level homes on the market and home prices that won’t take a big chunk out of buyers’ paychecks.”

CT’s First Sensory-Friendly Performance Ready at Hartford Stage

Hartford Stage will host a first-ever sensory-friendly performance of its annual holiday classic, A Christmas Carol - A Ghost Story of Christmas on Tuesday, December 9.  This will be the first time that Hartford Stage has offered this type of performance for the community – and apparently the first such effort in Connecticut. A “sensory-friendly” performance is a theatre production that is modified to accommodate individuals with sensory-input disorders, such as people on the autism spectrum, those with anxiety, and people with a range of cognitive abilities.

At the Tuesday night performance, “house rules” will be relaxed – people may need to get up, move around, and leave the theatre in the midst of the performance. There is no expectation that the audience will be completely quiet during the performance.  In addition, a Quiet Room will be available with sensory-friendly toys for anyone who needs a break from the performance.

"Sensory-friendly performances are designed to create a performing arts experience that is welcoming to all families of children with autism or other disabilities which create sensory sensitivities," says Jennifer Roberts, director of education for the theater.  The Hartford Stage website adds, “Our goal is to create an environment where people with autism or sensory needs, along with their families, can enjoy coming to the theatre together and will feel comfortable, supported and free to be themselves.”

Officials point out that while the script of A Christmas Carol will not change, some of the technical elements will be softened to accommodate sensitive ears and eyes. For example, haze will be reduced and strobe lights will be removed from the production. Lights in the audience will be remain lit at a dim level during the entire show to allow safe movement in and out of the theatre.

Abrupt and loud sound effects will be lowered, and there will be a signal to the audience to warn them that a potentially jarring moment is about to happen, so that caregivers can be ready to help those with sensory sensitivities.

The hope is to achieve “a judgment-free, fun experience for the entire family.”  About 150 people, students and their families, are expected to attend the performance.

Hartford Stage has prepared a plot synopsis and social story to help prepare audience members for the experience. They have encouraged families and caretakers to read the synopsis of A Christmas Carol and use the social story to prepare for the whole theatrical experience, from beginning to end.

The production, designed for age 9 and up, is about two hours long with a 15-minute intermission.   Theatre Development Fund’s Autism Theatre Initiative served as an advisor for the performance.

[view NBC Connecticut news story on the sensory-friendly performance]

Connecticut Ranks #12 in Child Homelessness Risk and Response, National Numbers at All-Time High

A new report finds 2.5 million children experienced homelessness in the United States in 2013, representing one in every 30 children in the country - an historic high in the number of homeless children. The report by Homeless Children America at the American Institutes for Research, called America’s Youngest Outcasts, documents the number of homeless children nationally and in every state, their well-being, their risk for child homelessness, and state level planning and policy efforts. It used the most recent U.S. Department of Education count of homeless children in U.S. public schools, which was released in September, and on 2013 U.S. Census data.

From 2012 to 2013, the number of children experiencing homelessness annually in the U.S. increased by 8 percent nationally. The number of homeless children also increased in 31 states and the District of Columbia and in 13 of those states, it increased by 10 percent or more.

Connecticut’s child homeless number was virtually unchanged.  The report examined childhood homelessness on a state-by-state level, ranking the states from 1 (best) to 50 (worst). Connecticut’s overall ranking was #12.

The top 11 states were Minnesota, Nebraska, Massachusetts, Iowa, New Jersey, Vermont, New Hampshire, Pennsylvania, Hawaii, Maine and Maryland.

For Connecticut, the report shows there were 5,508 homeless children during the 2012-2013 school year. That is virtually identical - down  by four children - from the 2011-2012 data, and nearly 200 less children than in 2010-11. Connecticut, based on those numbers, ranked #1 in the nation 2012-2013 in the “extent of child homelessness” category.

The state ranked #17 in policy and planning, based on factors including the number of emergency and transitional housing units for homeless families, and state planning efforts.

The 130-page report, which will be presented to Congress, at a briefing scheduled for February 10, listed six causes of child homelessness nationwide:

• the nation’s high poverty rate
• lack of affordable housing across the nation
• continuing impacts of the Great Recession
• racial disparities
• challenges of single parenting
• the ways traumatic experiences, especially domestic violence, pave the way toward and prolong homelessness

“Without decisive action now, the federal goal of ending child homelessness by 2020 will soon be out of reach,” said Dr. Carmel DeCandia, Director of the Boston-based National Center on Family Homelessness at American Institutes for Research. “Living in shelters, neighbors’ basements, cars, campgrounds, and worse—homeless children are the most invisible and neglected individuals in our society.”

According to the report, research shows that homeless children are hungry and sick more often. They wonder if they will have a roof over their heads at night and what will happen to their families. Many homeless children struggle in school, missing days, repeating grades, and drop out entirely.

Up to 25% of homeless pre-school children have mental health problems requiring clinical evaluation; this increases to 40% among homeless school-age children. Homelessness, especially in young children, may also lead to changes in the brain, which can interfere with learning, emotional self-regulation, cognitive skills and social relationships.

The report also recommends a series of “effective responses” to child homelessness:

• Safe, affordable housing.
• Comprehensive needs assessments of all family members.
• Family-oriented services that incorporate trauma-informed care.
• Identification, prevention, and treatment of major depression in mothers.
• Parenting supports for mothers.
• Education and employment opportunities for parents.
• Further research to identify evidence-based programs and services for children and families.

The National Center on Family Homelessness, founded in 1988, is described as the nation’s foremost authority on child and family homelessness, using research and evidence-based approaches to prevent and end family homelessness.

CT Ranks #4 in High-Speed Internet Use; #14 in Computer Ownership, Census Data Shows

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Connecticut ranks #14 in the nation in computer ownership, and #4 in high-speed internet use, according to national data compiled by the U.S. Census. Overall, 83.8 percent of U.S. households reported computer ownership, with 78.5 percent of all households having a desktop or laptop computer, and 63.6 percent having a handheld computer, according to the recently released data.

The top ten in computer ownership were Utah, New Hampshire, Alaska, Wyoming, Colorado, Washington, Oregon, Minnesota, Maryland and New Jersey.  Also just ahead of Connecticut were Hawaii, Massachusetts and Idaho.

Nationwide, 88.4 percent of the population lives in a household with a computer.  In Connecticut, it is 90.8 percent.  Utah leads the way at 94.9 percent.  At the bottom of the list are West Virginia, Alabama, New Mexico and Mississippi, all at just under 83 percent.

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The Census Bureau data also indicated that, on average, 78.1 percent of Americans live in a household with high-speed Internet use.  The top ranked states were New Hampshire (85.7%), Massachusetts (85.3%), New Jersey (84.5%), and Connecticut (83.9%).  Rounding out the top ten are Utah, Maryland, Hawaii, Washington, Colorado and Rhode Island.  The lowest percentages were in New Mexico, Arkansas and Mississippi.

In analyzing the data from metropolitan areas, the U.S. Census Bureau indicates that none of Connecticut’s metro regions made the nation’s top 30 in computer ownership, but the Bridgeport-Stamford- Norwalk metropolitan region was ranked #7 in the nation in high-speed internet use.

The data used in the report, released in November 2014 for calendar year 2013, comes from the American Community Survey, a large and continu­ous national level data collection effort performed by the Census Bureau. Computer and Internet data from the ACS are based on a sample of approximately 3.5 million addresses.

Nationwide, 74.4 percent of all households reported Internet use, with 73.4 percent reporting a high-speed connection.

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Of the 25 states with rates of computer ownership above the national average, 17 were located in either the West or Northeast. Of the 26 states with rates of high-speed Internet subscriptions above the national average, 18 were located in either the West or Northeast.

The Census Bureau also reported that although household computer ownership was consistently higher than household Internet use, both followed similar patterns across demographic groups. For example, computer ownership and Internet use were most common in homes with relatively young household­ers, and both indicators dropped off steeply as a householder’s age increased.

The most common household connection type was via a cable modem (42.8 percent), followed by mobile broadband (33.1 per­cent), and DSL connections (21.2 percent).

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Census Bureau Uses Bracketology to Test Population Knowledge

Three of Connecticut’s largest cities are in the game, but they may not last long.  The U.S. Census Bureau, in an effort to boost public knowledge of the relative populations of cities across the country, has launched “Population Bracketology.”  The interactive data game includes the 64 most populous metropolitan areas in the in the 50 states and District of Columbia.  The single-elimination bracket system will be familiar to any fan of March Madness. Making the grade are Bridgeport, Hartford, and New Haven.  Their respective round one opponents make the Connecticut cities strong underdogs in need of a sizable population surge.  Bridgeport goes up against San Francisco, Hartford faces Baltimore, and New Haven is up against Portland. (No, not Portland, Connecticut.)

Players start by choosing one of two versions of the game, geographic level: metro areas or states. Then they click on the name of the city in each match-up that you think has the larger population. Green shows a correct answer, red indicates an incorrect answer. Players are urged to “see how close you can come to a perfect score of 63” and then asked to “mouse-over results to view the most current population estimates for each pair.”

Data for the 50 states, D.C., and Puerto Rico are based on July 1, 2013 population estimates. Among the other New England states in play are Boston, Worcester and Providence.

Connecticut College Earns Place on LGBT-Friendly List

Connecticut College in New London is included in the Campus Pride list of the top 50 LGBT-friendly colleges and universities for 2014, the only higher education institution in Connecticut to make the list. Campus Pride, founded in 2001, is a national nonprofit network of student leaders and campus groups devoted to improving college life for lesbian, gay, bisexual and transgender students across the United States.

This is the first time Campus Pride has expanded its "Best of the Best" list to 50 colleges. In previous years, the top 25 institutions were honored. Campus Pride executive director Shane Windmeyer said the larger number of honorees reflects the progress colleges and universities have made in improving safety and academic life for LGBT students.

The LGBTQ Resource Center on the Connecticut College campus “aims to serve the unique needs of Lesbian, gay, bisexual, transgender, queer and questioning students by providing a supportive space, resource library, social events and educational programming,” according to the school’s website.

“We are committed to understanding how homophobia and heterosexism interlink with sexism, racism, and classism to perpetuate oppression,” the Center website points out. The Center also serves as a resource for the entire College community to learn about issues related to sexuality and gender identity.

The Campus Pride top 50 list is based on data from the Campus Pride Index, which includes detailed reports on the policies, programs and practices toward LGBT students, faculty and staff at more than 425 college campuses.

Connecticut College received a top rating of five stars from Campus Pride, highlighting efforts to provide a safe and supportive academic life for LGBTQ students. Colleges are ranked on a scale of one to five stars by LGBT experts in higher education. The College first appeared on the list in 2013.

"I am delighted that Connecticut College has once again earned national recognition for one of our most deeply held values: our commitment to an inclusive campus community,” said Connecticut College President Katherine Bergeron. “Our learning environment is enhanced immeasurably through the diverse perspectives and experiences of each member of this campus."

"More than ever, colleges today want to be viewed as LGBT-friendly and a welcoming place for all students." Windmeyer said. "Upper-level administrators are now understanding how LGBT-friendliness is key to future institutional success."  Officials said the Campus Pride ranking has become a critical factor for LGBT students and their families when choosing a university.

Since the Resource Center opened on the Connecticut College campus in 2007, policies have improved every year, along with the number of services offered to the transgender community. Now transgender students are offered housing consistent with the personal identities and gender-neutral restrooms in campus residences and academic buildings. Training on transgender issues is readily available to students, faculty and staff.

Millennials Consider Company's Causes When Accepting A Job

Millennial employees – those born in the past 20 years - prefer joining a company-wide or team-specific volunteer project rather than merely donating to a fundraising campaign.  In addition, their decision to accept a job is influenced by the company’s connections to the community, and whether they are seen as making a difference in the world. Those are among the findings in the 2014 Millennial Impact Report, issued by Indianapolis-based Achieve.  

The annual survey found that companies need to build relationships with millennial employees to spark their passions and create opportunities to engage both their professional and personal interests.  The findings indicated that employers should develop what was described as a triple platform of involvement – company-wide, department-based and interest-driven.

While only 39 percent of Millennials researched their company’s “cause work” prior to their interview, 55 percent said they were influenced to take their job after discussing cause work in their interview. Notably, 92 percent of the Millennials surveyed felt they were working for a company that was making a positive impact on the world.

In the Greater Hartford area, the survey findings would be no surprise to the leadership of HYPE (Hartford Young Professionals and Entrepreneurs).  Their mission, “to help young professionals become better engaged in community life,” responds to their generation’s strong desire to have a meaningful community connection, at work and in life.  HYPE, which is administered by the MetroHartford Alliance, has 4,000 members, and climbing.

Their efforts have been integral to Hartford’s efforts to promote a more vibrant downtown, and to boost involvement with a range of organizations and agencies that strengthen the fabric of the city.  The organization’s website offers nearly two dozen volunteer activities in the community for members, but makes clear that’s only the tip of the iceberg.  Greater New Haven has a similar organization, PULSE, a program of the Greater New Haven Chamber of Commerce and the Quinnipiac Chamber of Commerce.

Throughout the first four years of the Millennial Impact Project, the following trends emerged and evolved:

• Millennials engage with causes to help other people, not institutions.
• Millennials support issues rather than organizations.
• Millennials prefer to perform smaller actions before fully committing to a cause.
• Millennials are influenced by the decisions and behaviors of their peers.
• Millennials treat all their assets (time, money, network, etc.) as having equal value.
• Millennials need to experience an organization’s work without having to be on site.

The report indicates that "this is a generation that has grown up with a new way of learning. Asking questions in a non-linear fashion and then finding the answers -- all while connecting with their peers, friends and colleagues to make change happen. Today's Millennials are transforming communities, relieving suffering and pursuing social change in a way that may run counter to the traditional ways of organizing, but it's because they are wired to work differently -- collaboratively, transparently, interactively, and entrepreneurially -- to affect positive change in their local communities and around the world."

Achieve, in partnership with the Case Foundation, leads the national research team of The Millennial Impact Project, which they describe as the most comprehensive and trusted study on Millennial  (age 20-30) involvement with causes.

Connecticut Ranks #2 in Access to Justice, Report Concludes

The nonprofit National Center for Access to Justice has produced rankings on how well state court systems serve poor and disabled residents and other members of the public – and Connecticut is among the nation’s leaders. Connecticut ranks #2 overall in a composite index compiled by the organization, called the “Justice Index,” which includes a range of access factors.  The state ranks in the top 10 in each individual category, including access to attorneys, language assistance, disability assistance, and ease of self-representation.

The top 10 in the overall rankings (100 being highest), are:

1. Washington, D.C. 80.9
2. Connecticut 73.4
3. Hawaii 69.9
4. Minnesota 69.4
5. New York 67.4
6. Delaware 66.7
7. Washington 65.6
8. Colorado 65.6
9. Wisconsin 65.2
10. Tennessee 64.0

At the bottom of the list were Illinois (34.5), Kentucky (33.4) and Oklahoma (23.7).

The Justice Index is a snapshot of the degree to which certain selected best practices for ensuring access to the civil and criminal justice systems have been adopted across the country. The aggregate map shows summary views of the national and state-by-state commitment to providing access to the civil and criminal courts for some of the nation’s most vulnerable populations.  The report website includes maps illustrating state rankings in each of the categories.

Connecticut ranked #8 in the nation in the number of civil legal aid attorneys per 10,000 people in poverty.  The states ahead of Connecticut in the rankings were D.C., New York, Maryland, Hawaii, Arkansas, Massachusetts, and Oregon.  The data indicated that Connecticut also ranked in the top 10 (at #4, behind D.C., New York and Massachusetts) in the number of attorneys per 10,000 people, at 60.

The report also indicated that more than 80% of litigants appear without lawyers in matters as important as evictions, mortgage foreclosures, child custody and child support proceedings, and debt collection cases. “Making courts user-friendly for these self-represented litigants is imperative if we are to keep the promise of equal justice for all,” the report indicated.  In comparing the 50 states’ systems for self-represented litigants, Connecticut ranked #9.  The top states were Hawaii, California, Delaware, Arizona, Iowa, Indiana, Washington, Massachusetts and Connecticut.

More than 25 million people in the United States have limited proficiency in the English language, according to the report.“ While many of these people use English at work and in their daily lives, understanding what happens in a courtroom can be more difficult. Many others have less facility with English and are lost in telling their story – whether inside the courtroom or speaking with court clerks – without the support of a trained and qualified interpreter and without translation of official court documents.” Here again, Connecticut’s justice system was among the best, ranking #3, behind only Delaware and Minnesota.

In ranking the states for their support of people with disabilities, Connecticut joined five other states tied with a #1 ranking.  The other top-rated states were Colorado, Hawaii, Maine, Minnesota and Tennessee.  The report noted that ‘for those who cannot see, hear, speak or otherwise navigate a courthouse, or for those with emotional and cognitive challenges that make it difficult for them to participate in their own cases, access to justice depends on support from the justice system.”

The Justice Index was created by NCAJ with the pro bono help of Pfizer, Skadden Arps, other law firms in the Pfizer Legal Alliance, UBS, students at Cardozo School of Law and University of Pennsylvania Law School, Deloitte, and MSDS. The Justice Index measures selected elements of state justice systems and highlights statewide laws, rules, and policies.