Main Street
Dr. Aaron Kennedy, UND Fulbright Grant Recipient; APA Dr. Petros Levounis
Support for Prairie Public is provided by Trollwood Performing Arts School, presenting the Adams family, a musical comedy full of laughs, fun for the whole family, and all the antics the famous family is known for. Tickets available at trollwood.org or by calling 218-4776502. Performance is run July 16th through the 20th and July 23rd through the 27th at Bluestem Center for the Arts in Morehead. Welcome to Main Street. I'm Prairie Public. I'm Craig Wuhman-Shine. On today's show, we delve into a deeply troubling issue. More than 50,000 Americans died by suicide in 2023, the highest number on record. In fact, data from 2021 revealed that over 12 million American adults contemplated suicide with 1.7 million attempting it. Joining host Mark Maselli and Margaret Flintner to discuss the crisis is Dr. Petros Lavonas, President of the American Psychiatric Association in a Conversation on Healthcare. But first, we speak with Dr. Aaron Kennedy. He's an Associate Professor and Graduate Program Director for the School of Atmospheric Sciences at the University of North Dakota. Dr. Kennedy, an expert in weather, has been awarded a Fulbright grant to continue his research in Iceland. I began our interview by asking Dr. Kennedy how he learned about his selection as a Fulbright Scholar. It was an email basically and it's a multi-stage process and so you actually go through two round reviews. You're first reviewed by scientists in the United States and then if you make it past that point, your application goes to the State Department and so the State Department looks into you, I guess, make sure whether you're a decent character or not. And then more importantly it goes to the host country, in this case Iceland, and then they look at the applications and decide whether this is a project that they want to invest in and bring you there. And once they make that decision, you get the notification. It's not uniform across all the countries because each country has their own Fulbright commission as they call it. And so I was fortunate that I found out pretty early. It was like early February. It's a really prestigious international education exchange program that's sponsored by the U.S. government. My research says it was established in 1946 under legislation introduced by Senator J. William Fulbright and the program aims to increase mutual understanding between peoples of the United States and other countries through the exchange of persons knowledge and skills and in your case a lot of science, Dr. Kennedy. Is that kind of the summary of the Fulbright program? Yeah, that sounds good to me. I think something they stress to us is that it's just as important that the countries support the Fulbright program. And when we're supposed to discuss it, they talk about how it's a joint collaboration between the commission in the United States, which is what you just talked about, and also the commissions in these other countries that support these activities. Because they also send people to the United States, so it's a two-way exchange. Let's talk about your academic background briefly before we go forward into what you plan to do with the Fulbright grant. You told me earlier that you were really into studying like supercells, which reminds me of tornadoes and that kind of stuff. And now you're in a place where, boy, we get a lot of snow. Tell me how you migrated, I guess, to North Dakota. Yeah, so I guess as a scientist, I'm just curious about a lot of things. And when I worked on serostorms, I was mainly using radars. So you look on TV and you see the map over the precipitation. That's typically coming from a radar. And I was using that to look for whether certain storms would be used for nadoes or not. And then the opportunity arose to work on climate research at North Dakota, and in that case, I was using a different type of radar to look at where clouds are occurring. And then we're comparing what reality was to when a climate model was making clouds. And the idea is if the climate model doesn't produce clouds at the right times or the right properties, then the climate simulations and projections aren't going to be good. And so we're trying to improve the climate models. And so there's this common thread of using radars. And then it also expanded using something called lidars, which is basically radar, but with light. Imagine a laser beam pointing up in the air, that light scatters off things like clouds and smoke and turns out blowing snow, which is what I research. And so I worked on that climate research for my Ph.D. And then I still do a little of the serostorm stuff here and there. But once I became a professor, you know, now you can explore your own areas you're interested in. And I lived in North Dakota long enough that I felt, you know, I think we could do a better job forecasting blizzards and understanding blowing snow, which, of course, impacts us during the winter. And I think all of these tools and things I've learned about over my educational career has prepared me to study that topic. And so I started writing proposals in that area and building up my research. And the other thing that happened was I was always into doing field work. So going out in the field and I feel like, you know, our eyes are the first instrument we have to understand what's happening. And so I started working more with instrumentation and building instruments. And so I love tinkering with computers and electronics. And so I started getting more into building instruments. And that's actually part of what I'll be doing. And Iceland is bringing some of these instruments I've built there to see how well they work in a very different climate. So when we have a blizzard here in North Dakota, I run inside, it sounds like you run outside. Am I right about that? Yeah. And so the joke in our department is I don't want to call it hazing. But if you're a research member in my group, the first thing you're going to do is you're going to launch a weather balloon in a blizzard. And we do that routinely to understand what the atmosphere looks like. And you know, that's the most challenging of conditions to launch a weather balloon in. And once you've done that, then you're basically part of the group. You're received. So tell me about some of these specialized instruments that you've designed. What did they tell us that we didn't know before? Yeah. If you've ever been in North Dakota blizzard, the question is, is that snow falling from the sky? Is it just coming up off a surface and blowing ground? Is it bull? And when we look at these events with the radars and lidars I talked about earlier, we see certain signals that seem to indicate whether the snow is falling or it's blowing. And that can help us separate the processes that are happening, but we need the ground truth. And so how do you get ground truth? Well, it turns out we tried using other weather instruments. There's this thing called visibility sensors that basically look at how much particulates in the air and tell you how much less you can see. That doesn't really separate the blowing snow and falling snow, so that doesn't help us. There's these other instruments, like, you know, for example, precipitation gauges of those have problems and blowing snow. And it turned out that a lot of instruments that we were using just didn't work very well. And so the only way to get ground truth really is to actually physically image, basically, photograph what's happening. And so there are some instruments out there that take pictures of the snowflakes as they fly by, and then you can tell whether they're broken apart in a blizzard event or they're like pristine snow that's falling out of the sky. The problem is those are really expensive, like we're talking instrument costs that are close to, you know, six figures. And that makes it very hard to do the science because there's limited amount of money for science. So technology has come a long way since those instruments are developed, and I felt that I had enough photography background and computer background that I could basically build my own snowflake imager at a much cheaper price. And that's what I did. I built. It's called Oscar, open snowflake camera for research and education. And this is basically a camera that it's an industrial camera. It shoots something like 30 to 60 photos a second. And to actually image the snowflakes, it's paired to a high speed LED strobe light. So imagine you go to like a party and there's a strobe light flashing. It's that, but much, much faster. And that basically, it's just no different than flash photography, it basically freezes that snowflake as it's going by, and we could get an image of what the snowflake actually looks like. And the nice thing is I used off the shelf components. I've used a lot of 3D printing, which has been a huge development in our field. And I print all the parts to connect everything together, which ends up being a big cost of the fabrication. And now I have an instrument that's on the order of about $5,000. And so I've just reduced the price of the instrument by order for two orders of magnitude. That means we can have network of these instruments. It means that I can put these in different environments. If you break one, it's not the end of the world because they aren't as much money as it would normally be. And so you can really push them to their limits to see what they can tell us about what's happening. This is a layman's question, and I'm almost not wanting to ask you, but does it snow differently in Iceland than it does here? In other words, do storms develop in a different way? Are they similar? Is it similar anywhere there's snow? It's definitely different. In fact, there's some papers that are coming out talking about how snowfall varies across the northern hemisphere. And the snow we get here is very different. We know that no matter what, you have to have moisture in the air to get the snow, right? Guess what? If you're in North Dakota in the middle of a continent during the winter, that moisture has to come from really far distances. Now Iceland is right on the North Atlantic, and that water can basically come from next door. And the other thing that's a huge difference between the two areas is North Dakota is super flat. So we don't get much impact from the terrain for determining where we get a lot of snow or not. Now in the mountains, you do, and Icelandic is very mountainous. And so what happens in Iceland is the air from the ocean basically rises up over the mountains and they just get dumped on with lots of snow. And that snow will have different characteristics than the snow we have here that's developed by what we call our mid-latitude storm systems. And joining our conversation with Dr. Aaron Kennedy, he's an associate professor and graduate program director for the School of Atmospheric Sciences at the University of North Dakota. And he's been selected to receive a Fulbright U.S. Scholar Fellowship grant to engage in overseas research. For him it will be in Iceland during the 2024-25 grant cycle. Why Iceland? That's a great question. It actually goes back to COVID. So one of the good things, maybe the only good thing to come out of COVID was I had some flight credits left over from flights that got canceled because of stuff going on. And it was right after Iceland was opening up again and I decided that, you know, I want to see a volcano. There was volcanoes erupting there. I had a friend from undergraduate school at Oklahoma who was from Iceland and she went back and she's essentially the lead meteorologist for the Hazards Division for the Icelandic Meteorological Office. And she was posting pictures of them like basically having a picnic lunch in front of a volcano. And I said, you know, I'm a earth scientist. That sounds like an amazing way to use up my flight credits. And so, went over there, saw the volcano, met up with her and then we started talking shop, right? And so, learned about what they were doing at her meteorological office. She learned about my research and she's like, hey, you know what? This blowing snowy researching, that's actually really important in parts of Iceland where we have avalanches. I said, huh, that's interesting. And so then a year goes by, I had the opportunity to go to a conference to present in Iceland. And I gave a talk at the Icelandic Meteorological Office and said, hey, here's all the research I'm doing. You think there's a project here we could collaborate on and say, yeah, you know, your instrument will probably help us with avalanche forecasting and parts of Iceland. And then it just came down the brainstorming, okay, how do we make this like international project happen? And that's where the Fulbright came in. And so, there was a lot of legwork up front to come up with this project. I think it was pretty unique in that I already had really strong connections with Iceland because I had literally given a talk to their forecasters and explained what I was doing. And from there, it was, you know, putting an application together to the Fulbright program to try and get this approved for the full shindig. As you're doing your research in Iceland, then is it solo or are you collaborating with other scientists from maybe international destinations? So I'll be collaborating with Iceland Meteorological Office. And just for perspective, their meteorological office is probably about the size of one of our national water service offices in our country where we have lots and lots of national water service offices. Iceland is roughly like half the size of North Dakota about half the population. So that makes sense. And so they have different divisions and one of their divisions works on avalanche forecasting. And so I will be collaborating with them. We've already had Zoom calls this summer to talk about, you know, what type of experiments are we going to run? I'm going to bring my snowflake images as sort of a test to see how they work in the Icelandic marine Arctic climate. But then I have these other sensors that basically tell you how much blowing snow is occurring just like the total amount. And we're going to be putting those on top of a mountain that overlooks a town where they get avalanches. And we're going to see if these snow fences are putting in, just like we have snow fences along our road, whether that helps reduce the chance for avalanches that impact their towns. How long would it take one to understand that? Probably not just one snow cycle or one winter. Well, that's a great question. That's something we talked about in the last Zoom call. We're going to get this, you know, winter observations and see where that gets us. They're also supposed to be installing a new weather radar, which is where my snowflake cameras could really be useful. That actually got delayed into the following year. And so we're already brainstorming ways that we could continue the collaboration past the life of the Fulbright, which is actually, you know, that's part of the purpose of these projects is to build collaborations that go well beyond the life of the grant. Sustained then. And so I ended up, once I realized that this is something that could be multi-years, a multi-year project, a couple of the instruments, I actually, we have what we call indirect funds at our institution, I hoard those for special things. This is a special thing. And so I bought the instruments with that so I can use them in Iceland for multiple years. And then eventually they'll come back to you indeed and I'll deploy them in the countryside. But for at least this upcoming winter and probably the winter or two beyond that, they'll be deployed so we get ample data that we can understand what's going on. How does this type of research, this work that you do, tie back into then the classroom? For a student, you might be teaching at the University of North Dakota. Oh, so I can't wait to actually include the data we collect into the classroom. That's something that I like to do in the classroom is show real world data. And so I teach a remote sensing class where we learn to interpret radar and satellite data. And in the past, we've always just used United States data and it would be nice to show the students the type of data that's being collected in other countries. And so one of the byproducts of this will be incorporating the data collected from this project into the classroom. The other thing is I have graduate students that work on my projects and we're working, I told them to have their passports ready because I'd like them to come out and be able to tour the meteorological office in Iceland, help with at least the take down of instruments in Iceland or help maintain them. So getting them some international experience too and then that will filter back to the experiences they had when maybe eventually they teach and they can disseminate that to students down the line and just continue the continuing education process. Just watching this morning, this idea that there are so many models that try to forecast and of course this is the time of year where we're worried about hurricanes developing in the Atlantic and where their course might go. And some of them seem to be relatively close, others are just like all over the map. Why is that even still today that we have all of these different models with international input at times, not uniform I guess in what they're projecting? Yeah so you know the math, the math of how the air moves is basically the same. Those parts of the models are pretty similar but there's something called the physics which is how the precipitation forms, is there blowing snow there? How does energy transfer through the atmosphere? And what's happened is there's been different groups in the world that have developed different parameterizations as we call them to model these very complex processes. If you think of a normal weather model, the scale that is on the order of like miles. And you know that if you're out say in a farm field, if you're behind a shelter belt or out in the open, the distance you can see the visibility because the blowing snow is going to be very different. So it is impossible for us to represent the process at the scale they're actually happening. So we have to make assumptions, approximations and those assumptions, approximations we make are different in these different models and when you couple everything together you can get very different model results. And then the other thing that happens is you know we only have a finite amount of data that goes into these weather models and there's a lot of statistical math that goes into taking that data and coming up with something we think is the basically the initial conditions of the model. Like what's happening in the atmosphere right now when we run it and the math behind that also varies between these different models and that can lead to different solutions. And so the end result is if you look out an hour or two in the model, they're all going to be pretty similar. But as you start integrating a time, all those little changes start adding up and you can get very different solutions. As curious as the U.S. lead in climate forecasting and climate understanding or are there other countries, specifically European countries, maybe that are right there with us or maybe even ahead of us? Well, that's actually a pretty contentious topic. My personal opinion is the Europeans are doing a great job with many aspects of their models. The data simulation where you actually take all the data and put it into the model to give you those starting conditions for the model, Europeans have really emphasized the math going into that and what's happened. And it makes sense because you think of Europe, what's downstream from Europe, it's the Atlantic Ocean. There's not many observations out there. Here in North Dakota, we have all the observations from the U.S. states, we have a lot of population on the eastern coast, we have all the observations of the United States, we kind of do stuff brute force. So I think for some of the stuff, the Americans, we're playing catch up. On the other hand, we have a lot of great research labs that I think are really pushing the boundaries of these parameterizations that I mentioned. And so I don't really see it as us or stem. At the end of the day, both ourselves and the Europeans and the other countries need to learn from each other. And at the end of the day, we're all trying the same thing. We're trying to provide good forecasts for weather and climate that will help society. Tell me about the role of the University of North Dakota's Atmospheric Sciences program in providing our future meteorologists, et cetera, and especially understanding weather here in the country. Yeah, so we're actually a pretty diverse program. We just hired multiple new faculty members. We're sort of going through transition. We had a bunch of our senior members retired. Historically, we've always had a strong component in aviation meteorology. And so when I mentioned those parameterizations, things we built for models, there has to be observations that guide that math. And so we have a strong history in putting instruments on airplanes and flying those airplanes through storms and different environments to understand what's happening. And that will continue. We also have faculty that work on that data simulation. I mentioned how we interpret the observations, how we go in the model. And then we have faculty that focus more on the extreme events, what we call mesoscale meteorology, which is like small-scale phenomena impact us. In my cases, of course, it's blizzards and winter storms, but we have faculty that focus on the severe storms and tornadoes and tornadoes and tornigensis. And then we have new faculty coming in that focus on lightning meteorology and then also flash drought and drought and climate impacts to that. And even tropical meteorology, we have some coming in that is more of expert in the tropics. Do you have deliverables that you will be responsible for to produce after your experience with the Fulbright work that you'll be doing? Yeah. So the Fulbright, I think the deliverable is you provide a presentation about what you did and you also write a report about what you did. That's what checks the box. To me, the real deliverable is what is the data collect? What do we learn? And then publishing papers and explaining what we learned from this project. But then the other deliverable is actually it's less tangible in that it's about building bridges between the two countries. And so maybe one of the deliverables is trying to get someone from Iceland to come to University of North Dakota and do a Fulbright here or perhaps working with North Dakota as a very large Icelandic population. Perhaps it's speaking with them about my experience and really just building connections. And I don't know how you can quantify that. I suppose you could do it by people that are impacted or whatever. You're becoming a scientific ambassador in my mind. Yeah. And that's exactly what the Fulbright is. You're an ambassador, what I would like to see is the ability to send students to Iceland to learn about stuff that they can't hear. For example, learning about mountain meteorology and arctic and stuff like that. That's something that's more difficult to do here. You can learn about it. But in my mind, the best way to learn about something is to see it in action. And on the flip side, we can send perhaps Icelandic meteorologists here to learn more about instrumentation, be able to bring that information back to Iceland that will help them in the long term. When will you be in Iceland? So I leave the end of August. So I get there around the, I think it's like the 27th and then I don't have a date I'm coming back yet. It'll be sometime probably early May. It depends some on other projects going on. Like I might be actually helping out with some serious storm research next summer. So it depends on how active my research in North Dakota is while I'm there. For the full bright. The point of the full bright is to go to this other country and do your work there. You are allowed outside of the country for, I think it's a maximum like two weeks. And so the hope is that we have an active blizzard period and like blizzard research north but don't stop, doesn't stop. My students will be continuing that. But if I see an active period, I might come back here for a week or two to help out with that research and immediately go back to Iceland. And so the exact timeline in the spring semester is still a little cloudy. But I'll basically be there from the end of August to basically May. Dr. Aaron Kennedy, first, congratulations. This is a wonderful, wonderful thing for you. He's an associate professor and graduate program director for the School of Atmospheric Sciences at the University of North Dakota. And he's been selected to receive a full bright US Scholars Fellowship grant to engage in overseas research for the 2024-25 grant cycle. And as he just told us, he's heading to Iceland. Best wishes, Dr. Kennedy. Thank you so much. Coming after the break, a discussion with American Psychiatric Association president, Dr. Petros Lavonas, that's after this. Support for Prairie Public is provided by Stage West, presenting Andrew Lloyd Webber's musical cats for 12 performances June 30 through July 18 at 7.30 p.m. at Ascension Health Plaza at the Lights, West Fargo, Jellicle Cats, Come One, Come All, Tickets and Information at WestFargoEvents.com. Welcome back to Main Street on Prairie Public. I'm Craig Blumenshine. More than 50,000 Americans died by suicide in 2023, the highest number on record. Joining host Marc Micelli and Margaret Flintner to discuss the crisis is Dr. Petros Lavonas, president of the American Psychiatric Association in a Conversation on Healthcare. Dr. Lavonas, who's finishing his term, is at the center of efforts to prevent suicides. His focus continues to be on substance use addictions. He and APA members have launched a campaign called Confronting Addiction from Prevention to Recovery. And a reminder, if you are anyone you know is contemplating suicide, immediate help is available. Please call the suicide and crisis lifeline right now at 988. Some really disturbing news came from the CDC and some provisional data reporting that more people died from suicide in the United States last year than any other year on record. And now you've spoken out in the past that when people are feeling suicidal, they're doubly adverse to seeking mental health support. I wonder if you could tell us about the APA Foundation's Mental Health Works Campaign and what it intends to do. Our campaign has one major goal, open up the conversation. Way in the past, we thought that when you talk about suicide, you may be making things worse. You know that it's not true, the more we talk about this matters, the better off we are. Well Dr. LaVunas' anxiety of course is a big contributor to distress that may get people to that state. And the U.S. Preventive Services Task Force has now recommended for the first time, I believe, that physicians screen all adult patients under age 65 for symptoms of anxiety. Are you and your members seeing or are you hearing reports of an uptick in referrals coming from primary care and other physician and other health care provider practices? Do you think this is going to be helpful? It is going to be helpful to raise awareness about the anxiety disorders. But we have not really seen the effect that you mentioned yet. Maybe too early, this is just happened this summer. So we haven't seen the uptick that maybe we will experience in the future. But more than this specific referrals, it's once again in the spirit of opening up the conversation and making this diagnosis much less fearsome than they used to be. I know you're very proud about being elected as president of the APA, what an honor. And you've chosen as the theme of your presidential year, confronting addiction from prevention to recovery. You say you don't want to just move the needle on addiction. You want the needle to keep moving. I'm wondering if you could share with our listeners, what do you mean by that and how are you making it happen? I don't remember ever having a presidential team focusing on addiction. So I thought it was time to do so. I'm an addiction psychiatrist. Myself, it's a major issue for our patients, for the general public. I thought it was time to choose addiction, prevention, addiction, recovery, addiction treatment as the theme of my presidential year. But this is 12 months. So there is only that much that one can accomplish in 12 months. We're four campaigns that we are unleashing during this 12 months and we're very proud of them, vaping, opioids, alcohol and the technological addictions. But it is something that needs to get going beyond these 12 months. And we already convened a group of like-minded organizations and the spirit of this meeting is what can we do to sustain these campaigns, to sustain these efforts beyond these 12 months. And I was so pleasantly surprised by how well-aligned we are, all these organizations from OB-GYN, obstetics, gynecology to internal medicine, to the American side of addiction medicine. And we were really, really very similar goals, very similar tasks. And I do have great hopes that the addiction, recovery and the prevention will continue beyond my 12 months of residency. Well, what you're saying, Dr. Lavoon, certainly resonates with those of us who are in the primary care space, certainly in the nation's community health centers, which is where Mark and I are primarily focused because smoking, vaping, alcohol and opioids are really what is shortening the lives of our patients and causing tremendous distress. So we are very appreciative you're taking that focus. But I want to talk specifically about the vaping for a moment. A study in the journal Drug and Alcohol Dependents noted that people with mental illness are more likely to use e-cigarettes and to use them more frequently than people without mental illness. That's exactly what I always said about smoking before there was such a thing is vaping. That was certainly well known. But many people see vaping as less harmful than cigarette smoking. How are you and APA getting the word out about this as a real concern? Yeah. It is a real concern, exactly like you said. Is that a myth out there that smoking cigarettes or vaping should be the least of someone's problems if they have mental illness? And that couldn't be a part of this from the truth. As you very well know, the majority of people who live with mental illness will not die of bipolar disorder or schizophrenia or depression or ADHD. They will die from tobacco and from vaping and from alcohol and one of those disorders. So we want to dispel that myth that, hey, if you're already mentally ill, there's have a little fun, have your vaping, have your cigarette. This is an absolutely terrible message that people have been penetrating. I'm wondering if we can switch to alcohol use disorder. I'm wondering what you can share with us about some of the innovations. We see a lot of benefits. And I think Margaret, we saw this from maybe the Veterans Affairs working on psychedelic drugs for treating alcohol addiction when combined with psychotherapy. What other interventions are you think are promising in this area? Yeah. The study on Selocybin by my friends, the growth is quite a revolution in our field because here you have a substance that has been viewed for decades if not more as a major villain and part of one of the worst addictions you can think of and now it is being studied and shown in a preliminary fashion to be helpful in the treatment of alcohol use disorder. So it is switching positions. We're not there yet, we haven't crossed all our T's and all our I's in terms of drug interactions, in terms of long-term effects, in terms of pregnancy and so on and so forth. But the preliminary results are quite encouraging in terms of Selocybin for the treatment of alcohol use disorder. The other thing about alcohol that we're doing to mention is a shift in the appreciation of outcome studies for alcohol use disorder. It used to be that only complete abstinence was something that we would appreciate as a worthwhile outcome of any treatment study for alcohol. And in 2023 we very much appreciate and respect decrease in heavy drinking as being another very desirable outcome of alcohol studies. So we have shifted our research focus on alcohol as well. One of the groups that we're very concerned about are women and young women, females and their teens and early 20s, they're reporting drinking more, actually getting intoxicated at higher rates than their male peers, something that we maybe had not seen previously. And I'm wondering as you try and craft messages and policy, is there a targeted public policy approach needed that's specifically designed to reach young women in the way that we've tried to reach other particular populations of focus? Yeah. Yes, we do. And the point there, which is very well-established, is the concept of telescoping among women. And that has to do that although it may not be that there are as many women who start drinking heavily as men. Once women start drinking heavily, then from the early points of the illness to the most severe form of the illness, the process is abrupt. And that is of huge concern, of course, to us. And also greatly underappreciated because people just read the studies of the major epidemiological studies and say, hey, this is primarily a men's problem, not a women's problem. And yet, this idea of telescoping is particularly catastrophic for women. Adding to that, the other well-known fact that women tend to drink in private situations more alone. So the opportunities for red flags to go up are less than men tend to drink more in public. And so hopefully there is a friend or somebody with a catastrophe coming down and to say, well, when I'm in it here, maybe there's something that we can do about it. Well, women tend to drink more at home. And when nobody else is around, again, I'm talking about it in general here. There's a lot of men and a lot of women here, in the other side as well. But that is of great concern to us. Very fascinated by the work you're doing as editor of the book, Technological Addiction. And you say the book is really a wake-up call learning the medical community and society at large to the addictive potential of technology. And you've talked about gaming being addiction as well as cyber sex, social media, texting, email, and online auctions. When do these activities reach the level of addiction and what does treatment look like? So the vast majority of people are not going to have a problem with technology. However, there's a small group of people, maybe 3%, 4%, 5% who will cross the line and be on the other side. And what we see with these patients is something very similar to what we see with the people who live with substance use disorders. We see tolerance. We see people needing higher, higher amounts of the same activity in order to sustain the same level of excitement. We see withdrawal. We see people abruptly stopping using an internet game and becoming irritable and depressed and anxious and suffering from insomnia, classic symptoms of withdrawal. We see people trying to cut down and not being able to do so despite the fact that they recognized that it's not good for them. The classic major blocks of the assessment and diagnosis of addiction, consequences, relationships going south, hobbies being ignored, professional responsibilities being put aside, medical consequences. So these are the things that we look for when we do give the diagnosis of technological addiction. So internet gaming is being appreciated. There is a formal medical diagnosis by the International Classification of Diseases. And then there is the general public. There is the rest of us who engage in social media. And to me, that's a social experiment. We're not sure how it's going to end up. I see my 12-year-old niece engaging with social media and having an entire world that is virtual, which I couldn't even have them having at her age. Will these friendships be at par better, worse than the friendships that I had when I was 12 years old? I'm not quite sure. I think that this has to play out and find what we're going to see some years down the line. And you know, is that there are some significant effects of engagement with technology. For example, older adults are particularly vulnerable to scams. People who may not have their best interest in mind. So my 12-year-old niece will have much better antibodies against those scammers than perhaps quite their older adults. And particularly, I'd say about children younger than 12 who are on social media, who are being exposed to things which are seem intentionally designed to keep them engaged and for periods of time that may call out other activities more helpful, perhaps, for that age group. Maybe we can come back to that if we have a few minutes. But I did want to make sure to give you an opportunity to talk about another of your key areas that you're focused on and that is opioid addiction. I think you had a poll that showed that Americans strongly favor improving access to treatment over imposing stricter punishments, legal punishments. Can you share a little bit with us and our listeners about what insights you'll be bringing to this issue during your term? Yeah. We do know that medications for opioid use disorder are safe, are effective, turn people's lives around, and yet they have not been adopted as much by long, long shot by either primary care physicians and by the general public. Still a lot of myths are out there that don't want to substitute one addiction for another. I don't want more medication. I just want to be clean. I want to detoxify all these things that we have tried and we know that they are not effective, that they are more trouble than good, and we do have the answer. I mean, we do have, to me, it's an addiction psychiatrist, there are so many substances for which we do not have any medications. For example, I'm thinking about the stimulants, cocaine, crystal methaphyrone, who have wonderful psychosocial interventions who have wonderful psychotherapies that can address these conditions, but we do not have a medication. And then we do have medications for a backup use disorder, we'll have medications for opioid use disorder that work extremely well, and we do not use them. It's such a shame. You know, I want to pull the thread a little on that concept. We've been engaged in providing school-based health services for about 30 years. And mental health, we've always been saying what we want to have happen is to normalize the use of mental health clinicians, right? But today, we have more and more schools calling us up and saying, you've got to come in now, which, you know, we used to start with dental and men go to medical and behavioral health was sort of the last rail, but now it is really, I think, really to your point, is resonating across the country. People are demanding. That's exactly what we're going to experience, because you couldn't have put it better. We use the screen from the rooftops about wake up, you know, mental illness has an important issue. You know, people were like, we would land on deaf ears. And all of a sudden, the table has completely changed. And people are screaming, you know, we need more help, we need support, we need services, we need this disorder. We haven't been prepared to respond to this kind of demand. So this is where our work got out for us to figure out how we can respond to this demand that we see everywhere around us. Let me just get to one last area. You have a webinar about how generative AI and related technologies may affect mental health and the practice of psychiatry and how to recognize the strengths and risk of AI driven technology. I'm wondering what your feelings are about AI and any advice that you might want to share. Yeah, I'm quite positively predisposed to AI. And I think that there's a lot of promise there. I do a lot of CBT going to behavioral therapy with my patients. And what I do is I give them homework, and I give them tables to fill, and I give them Excel sheets so that they can record their feelings and put grades and rate their ratings and all that stuff that are incredibly amenable to AI, to apps, to things where people can record the activities and their thoughts and their feelings. What is missing is the intersection with the clinician. There are some apps that advertise, you don't need that clinician at all, you can do it all by yourself, and we do not think that this is effective. We do think that you need a human being to be involved in some capacity. And these electronic devices can be wonderful adjuncts, but it cannot replace the human being. On the other end of the spectrum, there are some apps that require the clinician to be available 24/7 to the patient, and that is unwearable as well. So somewhere in between from not including the clinician at all, to having clinician 24/7 is the sweet spot where we're striving to find out exactly how we will combine the personal touch of a trained therapist with an app. Dr. Lavoonas, thank you for your leadership, for all that you're doing, and we look forward to speaking with you again in the future. Thank you so much. That was the American Psychiatric Association President, Dr. Petros Lavoonas, with host Mark Micelli and Margaret Flitner in Conversations on Healthcare. And remember, if you are anyone you know as contemplating suicide, help is available now. Call the suicide and crisis lifeline at 988. The FM Kicks band brings jazz to area parks this summer with concerts at First Leather and Church in Fargo, 6 p.m. July 17th, and Gooseberry Park in Morehead, 7 p.m. July 18th, volunteers recommended details at FMKicksband.com. The Kicks band receives funding from the arts partnership with support from the cities of Fargo, Morehead and West Fargo. North Dakota Native American Essential Understanding number 7 is about native identity. In the United States, individual and communal identity is defined and supported by shared native languages, kinship systems, tiojpa, clan structures, traditional teachings, values, sacred laws, and ceremonies. A continuum of tribal identity, unique to each individual, ranges from assimilated to traditional lifestyle. There is no generic American Indian. In this episode of Dakota Datebook, we'll listen to Dusty Olson, enrolled member of the Mandan Hidatsa Aricara Nation, talk about essential understandings in our schools. Right now we have 80 percent of Native Americans in the school system. And with that and putting the sense of learnings in the curriculum, I've been vying for it for a while since I've seen it down in South Dakota, of how they're all on it. And I want to be a part of it, but it seems like there's no cliche. Some things never change. And partials like that, they just still want to keep it through how it is. And I think change is good over there because it sets a whole new culture of how we perceive the school. And we're getting a new school now, so it would be, I think it'd be time now that they changed their curriculum up and use a little bit of the culture and implement it into our high school and into curriculum, into the new school. So I've always been trying to, been trying to battle, I guess, trying to get this into the school and also kind of jealous that the detail has an alternative learning school. And right now I'm on, I'm on the head teeter tottering right now, trying to get an alternative school and partial and it's, it's always the money factor in a place right now because we go out into school and we get new, everything but it's just that we don't have that. I'm Scott Simpson. If you'd like to learn more about the North Dakota Native American essential understandings and to listen to more indigenous elder interviews, visit www.teachingsofourelders.org. The Dakota Day book is produced in cooperation with the State Historical Society of North Dakota. Funding for this series is from Humanities N.D. and the North Dakota Department of Public Instruction. Art's programming on Prairie Public is supported in part by the North Dakota Council on the Arts, a state agency developing, promoting and supporting the arts in North Dakota. Former President Trump survived an assassination attempt then a federal judge threw out one of the indictments against him. Now the Republican National Convention is underway confirming his third straight nomination for president. What happens next? We'll catch you up on the first night's action on the next morning edition from NPR News. There's five hours of morning edition every weekday here on Prairie Public. And that's a wrap for today's mainstream. From all of us here at Prairie Public, thank you for joining us. Tomorrow on the show, Sarah Adi Coleman, director of the North Dakota Department of Commerce Tourism Division, talks about how North Dakota tourism is soaring to new heights with a record breaking 25.6 million visitors last year and 3.3 billion in spending. We hope you can join us again tomorrow right here on Main Street Journal. [Music]