For Elias Avalos, the pressure became especially heavy during his junior year of high school. Now 17 and a senior, he remembers feeling exhausted and stuck while trying to manage four Advanced Placement classes and the expectations he felt as the son of Salvadoran immigrants.

“I’ve been dealing with feelings of burnout and unbelonging for a while,” Avalos said. When those feelings build, he turns to skateboarding. The hobby, he said, helps him separate from schoolwork and clear his mind.

His experience reflects a broader concern across California. In the 2026 Children Now report card, 94% of Californians ages 14 to 25 reported having mental health concerns in an average month. Stress and anxiety were the most common issues cited.

California Health and Human Services lists crisis hotlines, wellness tools and youth mental health resources on its website. But families and advocates say help remains difficult to obtain. They point to insurance denials, the complexity of navigating mental health systems and the cost of care as barriers that too often keep young people from treatment.

Avalos interns at the RYSE Youth Center in Richmond, where he is part of a youth research team studying what affects teen mental health. He said young people in his community are dealing with neglect, limited coping tools and too few places designed with youth in mind.

“What I learned is that here in Richmond, we don’t have access to a lot of support systems, which leads youth to go down different paths,” he said. Avalos said he knows people who have experienced homelessness, sold drugs to help their families or lost their lives. “It’s a harsh reality that youth in Richmond really do face.”

Kelly Hardy, one of the lead authors of the Children Now report, said the findings show that young people’s mental health needs urgent attention. Services, she said, must be available in places where youth already spend time, including schools and community spaces.

Children Now, an Oakland-based nonprofit, supported a law that took effect in 2024 allowing minors 12 and older to consent to their own mental health treatment or counseling. This year, the organization is backing Senate Bill 363, which would require health insurers to report how often they deny or modify treatment requests. Supporters say the measure is intended to make therapy, counseling and other behavioral health services easier for young people to access.

Hardy said untreated mental health struggles can affect physical health and increase the risk that youth turn to substance use to manage symptoms. The response, she said, should be care and treatment rather than punishment.

Avalos said he never learned how to talk through difficult emotions at home. In some spaces, he did not feel safe opening up, so he learned to keep problems to himself. That is one reason, he said, he has never gone to therapy. Like many Latino youth, he worried that what he told a therapist might be shared with his parents.

“I didn’t want to be a burden to my family and friends with my problems because I didn’t want to add something extra,” he said. “Everyone is going through something. It’s just something I got to get out of myself.”

When relatives ask about his internship, Avalos said he keeps his answers general, focusing on the values he has gained rather than the painful realities he is researching. He said he was raised to observe more than to speak.

Dr. David C. Turner III, an assistant professor of Black life and racial justice at UCLA’s Luskin School of Public Affairs and a senior adviser at the Alliance for Boys and Men of Color, said the mental health struggles of Black and Latino boys cannot be separated from larger systems. He cited structural racism, the overcriminalization of Black children and long-standing problems in education as factors that contribute to poor outcomes.

Turner said harsh discipline and criminalization in schools can push young people away from education and leave them feeling devalued.

“It demonstrates to these young men that they don’t matter, their opinions don’t matter, how they learn doesn’t matter,” he said, adding that school can become a place where young people feel their spirit has been broken.

Turner said children of color are often expected to carry heavy burdens with few support systems. His work includes advocating for legislation that would expand mental health services in schools and efforts to dismantle the school-to-prison pipeline, which disproportionately affects Black and Latino students.

In Los Angeles, 16-year-old Bryce Collins is trying to change conditions for students in the Los Angeles Unified School District. Collins, a high school junior, has worked since October with Students Deserve, an organization focused on ending the school-to-prison pipeline. He is also calling for more school-based spaces that support students’ mental health.

Collins said too many Black youth are dealing with racism, stress and anxiety on their own.

“Being a young Black male lets me know how I have to approach some of these areas,” he said. “I can’t do what everybody else do. I don’t got the privilege. I have to hold myself to a higher standard because that’s not how society views us typically.”

The youngest of seven siblings, Collins said his older brothers helped prepare him for the possibility of racial profiling. Around age 12, he began noticing people who were not Black watching him closely when he entered certain spaces. He believed it was because of his race.

More recently, Collins said, the pressures of being a young Black man, thinking about college and dealing with family responsibilities have added to his stress. Sometimes, he said, the weight of it causes him to shut down.

“My goal is to find better ways to manage my mental health besides going unresponsive to people,” Collins said. “I feel like I should come up with better ways instead of not talking or not letting people know what’s going on in my life.”

Original source: CalMatters

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Jordan Janz knew his gamble on an experimental gene therapy for his rare disease might be paying off when he returned to work and a friend sniffed him.

“He said, ‘you have a normal smell, you smell good,’” Janz recalled. “And I’m like, ‘that’s probably the nicest thing you’ve ever said.’”

The 22-year-old Canadian man’s previous treatment required 40 to 60 pills a day and left him smelling like rotten eggs or stinky cheese. He was born with a flawed gene that left him unable to make a protein needed by virtually every organ in the body. Kids with this disease can throw up a dozen times a day, need eye drops every hour to prevent blindness and often kidney transplants before they’re adults.

Now, Janz and a growing number of others with rare diseases have hope of not just better treatments, but perhaps a cure. Gene therapy increasingly is being used to attack the root cause of their problems by supplying the DNA they lack.

Janz was the first person in one such study at the University of California, San Diego. He and two other participants no longer need the eye drops and pills that only delayed progression of their disease and left them smelling bad. The company that developed their therapy is testing it for several other diseases by simply adjusting what gene is supplied.

Other companies are doing the same, and U.S. health officials are working on guidance to encourage the trend.

“I am very excited for the field because I feel like we’re beginning to get to a critical mass,” where a single method or product can be deemed safe and then adapted for many uses, said Dr. Peter Marks, head of the U.S. Food and Drug Administration center that oversees gene therapies. “You’re essentially using the same rocket ship to put stuff into space dozens of times.”

NOT SO RARE DISEASES

In the United States, a disease is considered rare if it affects fewer than 200,000 people, said Ron Bartek, a board member of the National Organization for Rare Disorders and whose son, Keith, died of one — Friedreich ataxia, a progressive neurological condition.

There are more than 7,000 rare diseases and collectively, they’re not so rare — about 30 million Americans have one.

Seven gene therapies are approved in the United States and a few more are sold in Europe or elsewhere. In 2017, when the first ones were OK’d in the U.S., 854 companies were developing them. That grew to 1,085 by the end of last year, according to the Alliance for Regenerative Medicine, an advocacy group for the field. More than 400 gene therapy trials are underway now.

“It’s really been an exciting couple of years,” Bartek said. “We’re finally looking at the possibility of profoundly beneficial therapies” for many diseases.

There’s interest from not only small biotech firms but also universities and big companies such as Pfizer and Novartis, he said.

DOCTORING DNA

Gene therapies often aim to supply a gene people lack. The trick is getting the new one where it needs to be without triggering other problems.

Some therapies, such as ones for inherited forms of blindness, inject the treatment into the eye. A common method for others is to remove some of a patient’s blood cells, alter them in the lab to carry the desired gene, and return them through an IV.

What has scientists excited is better vectors — disabled viruses that ferry the gene into cells — that seem safer and more effective.

One, surprisingly, may be HIV, the virus that causes AIDS. Doctors recently reported that a gene therapy using modified HIV from London-based Orchard Therapeutics gave a working immune system to 48 babies and toddlers who were born without one. Avrobio, a Massachusetts company, also is using HIV in gene therapies it is testing for cystinosis, Janz’s disease, and several others.

BioMarin Pharmaceutical Inc. in California is taking a similar approach with a different virus called AAV for hemophilia, a blood clotting disorder, and several other diseases.

“The only thing that’s changing is the payload, the gene,” said Avrobio’s chief scientific officer, Dr. Chris Mason.

THE SNIFF TEST

Janz lives in Consort, a Canadian village of 700 in Alberta. His mother called the first day of enrollment for Avrobio’s study under Stephanie Cherqui, a pediatrics expert at UCSD.

People with cystinosis are unable to clear cystine, a chemical that builds up in their cells and forms crystals that damage kidneys, eyes and other organs, and leads to muscle weakness, trouble swallowing and even breathing. The vomiting is so bad that many kids need a feeding tube placed in their stomach, and wind up being home-schooled because they’re teased by classmates and their medical needs are so complex, Cherqui said.

“When you meet these families, these children are suffering every day from the disease,,” she said. “I can’t even imagine. It’s terrible.”

Gene therapy offers hope of a one-time fix. The therapy doesn’t have to get into all cells to work, just enough of them to make sufficient amounts of the protein that removes cystine so it doesn’t build up.

Janz was treated in 2019 and said he feels “essentially cured,” though it will take longer to know if he really is, and he may need a kidney transplant someday because of damage done by his disease. Tests show that crystals in his eyes, skin and muscle have greatly decreased. Instead of 54 pills a day, he just takes vitamins and specific nutrients his body needs.

“I have more of a life now,” Janz said. “I’m going to school. I’m hoping to open up my own business one day” — a deli featuring charcuterie, prepared meats such as hams and sausages. It’s an interest he developed during years of frequent trips to Chicago as a young boy to try other treatments. He stayed so often at the Omni Hotel that the chef let him cook in the hotel’s fancy restaurant when he was 13. The staff even bought Janz a knife kit and his own chef’s hat, apron and shoes.

CHALLENGES REMAIN

Gene therapy doesn’t work for everyone, it’s unknown how long any benefits will last, and safety remains a concern. In the past, a couple gene therapies that used different vectors triggered cancer in a few patients who received them.

“Every time we think we have overcome the safety issues, we continue to butt up against them,” the FDA’s Marks said. “I have confidence that we will work through them … but we can’t get too sure of ourselves.”

Marks and many other scientists think gene editing eventually may offer a long-lasting way to do gene therapy. Instead of just supplying a missing gene to cells, editing permanently alters a patient’s native DNA to insert a gene or knock out one that’s causing trouble.

Brian Madeux, a Phoenix-area man who is now 48, became the first person in the world to have gene editing tried inside his body in 2017 for a metabolic disorder called Hunter syndrome. Through an IV, he received billions of copies of a corrective gene and a genetic tool to put it in a precise spot.

But the therapy wasn’t potent enough to allow him or eight other patients to stop weekly IV treatments to supply the enzyme their bodies are unable to make.

Even though it didn’t give the hoped-for result, “I think the doctors have learned a lot from me,” Madeux said recently. “I felt that I could help other people” by furthering science.

“I took a shot, a chance that something could cure my disease,” he said. “I’m very happy that I did it.”

___

The Associated Press Health and Science Department receives support from the Howard Hughes Medical Institute’s Department of Science Education. The AP is solely responsible for all content.

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Researchers at Columbia University Mailman School of Public Health led the research, as part of Women’s Interagency HIV Study (WIHS), the largest national prospective cohort study of women living with HIV and at risk for HIV infection in the U.S. Their analysis of in-depth interviews with 30 HIV-negative women, nearly all who are women of color, appears in the journal AIDS and Behavior.

Despite PrEP’s increasing availability and inclusion in many state Medicaid formularies, just over half of the women interviewed had heard of PrEP. These women, whose median age was 51, shared a near uniform view that LAI PrEP was a useful option for others, but that it was not relevant for their lives. This was due to low levels of perceived HIV risk, primarily due to being in monogamous partnerships. However, previous research suggests a potential disconnect between perceived HIV risk and actual HIV risk; the only group of women for whom HIV incidence is not decreasing is 55 and over. An earlier study of HIV-negative women in WIHS found that 7 percent had a partner living with HIV, 38 percent had a new partner in the past six months, 19 percent reported consistent condom use, and 18 percent reported using cocaine or heroin—all risk factors for HIV.

Women pointed a number of barriers to using LAI PrEP, including their fear of new—and perceived untested—injectable products, injection location (buttocks) and related side effects (soreness); the need for more frequent doctors’ visits (LAI PrEP injections require clinic visits every two months vs. every three to six months for pills); and medical mistrust. The researchers note that medical mistrust might also be particularly salient for women of color given the U.S.’ history of forced sterilization campaigns that often used injections.

Reported benefits of LAI PrEP included beliefs that shots were more effective than pills, and convenience and confidentiality related to injections. The researchers speculate that LAI PrEP may provide a safeguard for women whose partners refuse condoms or for those who believe their partners may be unfaithful, while providing confidentiality in ways that minimize the fear of retaliation—providing women with more autonomy over their bodies and control of their health.

Women living with HIV comprise nearly one-quarter of all persons living with HIV in the U.S. Although HIV incidence has declined among women overall since 2010, HIV incidence has not decreased among women 55 and older. In addition, racial and ethnic disparities remain stark: in 2017, Black women constituted 59 percent of new HIV diagnoses among women despite being just 13 percent of the female population. Other research has shown that older adult women do not see themselves at risk for HIV, and often lack knowledge about HIV risk. However, HIV prevention programs rarely target women over 50 and healthcare providers rarely communicate with this demographic about sexual risk.

“Women of color in the U.S. are at disproportionate risk of HIV acquisition, and we must explore how prevention measures can be scaled up and deployed in ways that can be easily incorporated in their daily lives,” said first author Morgan M. Philbin, PhD, assistant professor of sociomedical sciences at Columbia Mailman School. “Continued efforts must be made to provide information about PrEP in an appropriate and non-stigmatizing way to all women, and also to address all types of barriers that challenge women’s ability to access and to use PrEP.”  

Co-authors include Carrigan Parish, Elizabeth N. Kinnard, Sarah E. Reed, and Lisa R. Metsch at Columbia Mailman; Deanna Kerrigan, American University, Washington, D.C.; Maria Alcaide and Margaret Fischl,  Miami Miller School of Medicine;  Mardge H. Cohen, John H. Stroger Jr., Hospital of Cook County, Chicago; Oluwakemi Sosanya, Montefiore Medical Center, New York City;  Anandi N. Sheth, Emory University School of Medicine, Atlanta; Adaora A. Adimora, University of North Carolina at Chapel Hill; Jennifer Cocohoba, University of California, San Francisco; Lakshmi Goparaju, Georgetown University Medical Center; and Elizabeth T. Golub, Johns Hopkins Bloomberg School of Public Health.

The study was conducted with core funding from the Women’s Interagency HIV/AIDS Study.  Philbin’s work was supported by a grant from the National Institute on Drug Abuse (DA039804A).

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“The first time I tried to end my life, I was driving on the freeway. I jumped lanes into on-coming traffic. A huge semi was coming right at me.  At the last second, I swerved and ended up in a ditch.”

Lopez grew up in an explosively abusive household with a brother who used him as a punching bag and father who had been irreparably scarred by war. “I had to learn to fight to be able to beat up my brother…and learn to survive. I met my wife Cheryl at age 16. I’ll be 63 this year, and through all but the last 17 years, I was constantly abusing drugs, alcohol…and my family.”

Knowing that he had loved pottery as a child, Lopez’s wife bought him a Potter’s wheel for a birthday.  For a time, it just set there.

Lopez tried everything to stay clean and tried everything he could think of to hold onto his job as a coffee salesman, but nothing worked. Feeling that he and his family had had enough, Lopez decided to end his life a second time.

“I tell people, that second time I tried to commit suicide… That wasn’t an attempt: I died that day.”

Lopez was losing the only job at which he’d ever succeeded due to the business being sold. “I was never taught how to cope with setbacks or anything negative, so one day. while no one was in the house, I drank two bottles…two full fifths of alcohol and I downed a bottle of pills. The last thing I said was, “Let’s do this.”

Enter an angel.

“Suddenly, I wasn’t upstairs sprawled out on my bed anymore. An Angel had taken me downstairs to show me what was going to happen. He said, “You’re going to be a well-known artist.” I said I’m a coffee salesman, not an artist. He quieted me and brought me downstairs and showed me the wheel that my wife had bought sometime before. He reminded me that I loved to work with pottery as a child.”

Ever the salesman, Lopez made a deal with his angel. “He showed me the wheel, he showed me the sequence of events and how it would play out, and even AMOCO, where I would have my own show, but I didn’t believe it.  I said, “If all of this is real, and I wake up…prove it to me. Let me wake up without a hangover.”  

Lopez soon awoke needing none of the alcohol, drugs, or the medications for PTSD-related stress, depression, and diabetes that he had needed to help keep his then-400 pound frame going.

“I woke up, and I felt fine.  I was amazed.”

Lopez’s wife was not so amazed.

“As soon as my wife came home that day I said honey I’m done: I’ll never touch another drug or drink. “My wife and kids had heard that so many times, she laughed in my face.

The drugs and alcohol stopped immediately. The need for psychotropic drugs ended two years ago. The worst-case that many people, including many of his doctors, had ever seen is now alcohol, drug…and medication free. He’s also down more than 200 pounds.

“It started…my comeback, the minute I sat down at the wheel.  To me, the wheel is life itself, playing out in front of me.”

That night Lopez sat at the wheel hour after hour “throwing” a total of 200 pounds of clay.  When he was finished, at nearly four in the morning, he had made figurines, bowls, pots and dishes.  I looked at my wife and said, “Honey, you bought me a wheel… Now you have to buy me a kiln.”

Lopez had somehow managed to learn his craft through every gin and drug-soaked meeting with many ceramic masters. “Somehow, I retained it all, and never forgot a thing.  Within months, I was selling my art at the “Village Fest” in Palm Springs. Still, Lopez’s wife and children were skeptical. The weight of years of broken promises, broken pottery, shattered hopes and dreams littered the floor of Lopez’s life like bits of clay thrown from his potter’s wheel.

“I learned that life is like the clay: it’s in my hands…but I can’t force it, or I’ll destroy it. I had to learn to work slowly and use my very life as the persuasive proof that I had changed. I tell people that I don’t mold the clay into shape…I persuade it.”

Lopez had gotten financial support from his rightly-skeptical wife…but little else. “I began to feel as if I was going to crumble, feeling like I would never be the artist I wanted to be…feeling that I had failed.  I began to cry, right there at a show, at my booth, surrounded by all the other vendors. I just started to cry, and I felt disgusted.”

“I don’t know why I said it, but I looked up, and I said, “God, if you told me the truth, I want to make $376 today. I still have no idea why I picked that number…it was crazy: the most I’d ever made at a show was 75 bucks. But I just sat there angry, disgusted…and crying.”

Enter angels numbers 2 and 3. 

In Rich Lopez’s world, angels look just like ordinary folks… and two of them approached his booth that day.

“They were an ordinary-looking couple, and she said to me “why are you crying? “I looked up, aggravated and said, “Don’t worry about it.” She said, “I’d like to buy that piece-it’s beautiful. And I’d like that piece.” They were 40 or 50-dollar pieces!!!”.”..and I’d like that piece as well.”

When the woman was finished, the husband spoke up.  I was in shock. The husband said, “Honey if you’re done, I’d like to get one or two pieces.” I couldn’t speak. As I was totaling everything up, she said, “Will you take a check?” “I just looked up, tears in my eyes and said, “Are you angels? “They both smiled. I said, “You’re angels! “She said no, we’re not…but you’ll be fine.” When I totaled it up, it came to $375. When she handed me the check I was shaking and crying, and I just said, “Thank you, thank you, over and over again. They waved goodbye, and as my wife came back to my booth, she said, “Who are they? “They were angels,” I said.  My wife looked at me as if I was back on the stuff, then she looked at the check and said, “They spent $376? “What? What?,” I said. I looked at the check: the woman had made a mistake and had written out the check for $376.

When I told my wife what it happened, we were both in shock.  Every time we looked at the check, we just shook our heads. Neither of us wanted even to cash the check. We finally cashed it after almost a year. My wife began to believe in me then.” Lopez says with a broad smile.

As if all this wasn’t enough to convince Lopez’s wife and even the most hardened skeptic…there’s the dream. “I was feeling frustrated because my artistry seemed to be stalled, after such a rocket of a beginning…and NAME NAME NAME OF NAME NAME NAME said, “This is California.  There are a thousand guys doing pretty bowls. Claremont is filled with people who have style. You have to find your own niche.” That’s when I had the dream. I saw myself hovering over baskets, with a unique tool. It was a tool that’s not made for the trade. I immediately woke up, took a steak knife, ran to my grinding wheel…and fashioned the tool that I use to make the striations in the clay that mimic a woven basket.  It came to me in a dream.” 

After that, things moved quickly for Lopez, a one-time student at Mount San Jacinto and Chaffee Colleges.  Lopez had his work featured at many exciting venues including the Western Science Center in Hemet and many homes and galleries around the country.  His artwork now fetches as much as $2000 for one of his signature ceramic basket that looks remarkably like a woven basket. “I am half Indian, and I spent over a year on the reservation learning the art of basket weaving. It’s those ceramic “woven” baskets that were featured in my first major show at AMOCA.”

AMOCA-The American Museum Of Ceramic Arts in Pomona is the premier ceramics gallery west of the Mississippi and home to some of the country’s most exceptional ceramics exhibits.

Lopez may have been one of the first ceramicists to have a show of his own, but it was the second time he had visited AMOCA. “When I walked in, I began to cry. Everything looked exactly as I remembered it in my visit with the angel. I knew the walls…the floors, the steps, the furniture. I had been there before.”

Looking at the peaceful, vibrant, contemplative, honest artwork rich Lopez has created in the 17 years since his epiphany, one would never realize the hurt, the pain and the tragedy and triumph behind each piece.  And for Lopez, that’s just as well.

“I sit at the wheel for hours on end, and I tell the clay my story. It answers back…and I give thanks. When people see my work, they see a bit of me in every piece.  I want them to see a part of themselves too: the best part. My world is now filled with art and with peace.”

And when you’re near Rich Lopez, in his studio, with his art, it is his world, all you can do is sit back and stare…and wonder at its beauty.

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