By Cheryl Platzman Weinstock, KFF Health News

If you or someone you know may be experiencing a mental health crisis, contact the 988 Suicide & Crisis Lifeline by dialing or texting “988.”

Elliott Hinkle experienced depression and suicidal thoughts even before entering the foster care system in Casper, Wyoming, at age 15.

At the time, Hinkle, who is transgender, struggled with their sexual identity and gender issues, and their difficulties continued in foster care. They felt like they had no one to confide in — not their foster parents, not church leaders, not their caseworker.

“To my knowledge, I don’t remember ever taking a suicide screening,” Hinkle said. “No one ever said: ‘Are you having thoughts of taking your life? Do you feel hopeless?’”

With their psychological and behavioral health needs left unaddressed, Hinkle’s depression and suicidal thoughts worsened.

“Do I stay in the closet and feel terrible and want to end my life?” Hinkle said. “Or do I come out and lose all my supports, which also feels dangerous?”

Children in foster care are significantly more likely to have mental health issues, researchers say. They attempt or complete suicide at rates three to four times that of youths in the general population, according to several studies.

LGBTQ+ people in foster care, like Hinkle, are at an even higher risk of having suicidal thoughts.

Yet despite the concentration of young people at risk of serious mental illness and suicide, proactive efforts to screen foster children and get them the treatment they need have been widely absent from the system. And now, efforts underway to provide widespread screening, diagnosis, and treatment are threatened by sweeping funding cuts the Trump administration is using to reshape health care programs nationwide.

In June, federal officials announced they would shut down a suicide hotline serving LGBTQ+ youths as part of those cuts.

Children in foster care use a disproportionate amount of Medicaid-funded mental health services. Meanwhile, President Donald Trump’s massive budget package, passed this month by Congress, contains substantial shifts in Medicaid funding and policies that are projected to drastically reduce services in many states.

“I think anybody who cares about kids’ well-being and mental health is concerned about the possibility of reduced Medicaid funding,” said Cynthia Ewell Foster, a child psychologist and clinical associate professor in the University of Michigan psychiatry department. “The most vulnerable children, including those in foster care, are already having trouble getting the services they need.”

A lack of federal standards and other system-level issues create barriers to psychological and behavioral care in the child welfare system, said Colleen Katz, a professor at Hunter College’s Silberman School of Social Work in New York.

“When you’re talking about anyone getting screened for suicide ideation upon entrance into the system, it’s inconsistent at best,” she said.

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Katz said all children entering foster care should have a brief, standardized suicide screening embedded into their initial medical assessment. And more screenings need to be conducted throughout a foster care stay, she said, because youths getting ready to transition out of the system are also vulnerable.

Hinkle, now 31, said the summer before they aged out of the system was “one of the darkest periods, because I was coming to terms with the church not wanting me to be gay and I was about to lose stable housing and whatever foster care support there was.”

Katz studied transition-age youths in foster care in California, which has the highest numbers of placements in foster care nationwide. According to her analysis, 42% of study participants had thoughts of taking their life and 24% had attempted suicide, and she expects findings would be similar in other states.

Katz also examined suicide screening tools and found many that already exist could work and be easily administered by trained child welfare workers or alternative frontline service providers, or embedded in existing mental health services.

Still, the quality of services varies by state and locality and can hinder attempts to curb suicides.

Julie Collins, vice president of practice excellence at the Child Welfare League of America, which advocates for improvements to the child welfare system, said the gap in suicide prevention in foster care mirrors the overall nationwide void of behavioral health services for children and adolescents. “The preparation of people coming into the field isn’t what it needs to be,” Collins said of the lack of training for caseworkers.

Ewell Foster is trying to change that.

She worked with the state of Michigan to redefine and update the competencies required to earn an undergraduate certificate in child welfare in the state. Eighteen colleges and universities that offer certificate programs in child welfare in Michigan now teach about suicide prevention.

“It’s something the workforce has asked for,” Ewell Foster said. “They need real clear guidance on what to do when they are worried about someone.”

So far, Ewell Foster’s effort to change the wider system has not run into any roadblocks. Her work with Michigan’s child welfare agency is still being funded under a grant administered by the Substance Abuse and Mental Health Services Administration.

Agency spokesperson Danielle Bennett said such grants will continue for up to three years.

However, the future of the federal agency has been in question for months. The Trump administration has laid off hundreds of its employees and has proposed folding its functions into another agency.

Some states have made changes to address the foster care gaps on their own, but often it has taken legal action to spark changes in suicide prevention efforts.

In Kansas, officials made several changes after the state settled the McIntyre v. Howard class action lawsuit in 2021 on behalf of foster children who the suit alleged were subjected to inadequate access to mental health resources and moved from home to home frequently.

The state increased salaries for social workers in the child welfare system and reduced their caseloads, among other things.

Other states, including Texas, have implemented similar changes after facing lawsuits.

Still, experts caution that the changes taking place in foster care systems are not enough to steer outcomes.

Lily Brown, an assistant professor of psychology and director of the Center for the Treatment and Study of Anxiety at the University of Pennsylvania Perelman School of Medicine, said moving the needle in suicide prevention will require implementing a universal risk assessment for children in state care.

Brown recently sought a grant to fund and implement free, universal suicide risk screening in foster care throughout Pennsylvania. She had several counties agree to the project, but not enough to support her application — the study wouldn’t have had enough participants to work statistically, she said.

Without such studies, foster care systems nationwide can’t meet the needs of children, she said.

April Miller, 27, entered the system in Minnesota at age 3. As a Native American, she is part of a group that is overrepresented in foster care.

“The child welfare system as a whole neglected me,” said Miller, who said she endured several traumatic events in her early life, including witnessing a murder.

“I did a lot of self-harm and had thoughts of suicide but didn’t have access to means, which is why I am still alive,” she said.

Today, Miller is a social worker and suicide prevention coordinator in Bemidji, Minnesota.

Similarly, Hinkle’s experience in the system made them driven to change the trajectory of other young people.

Hinkle provides training, consultation, and policy development services at Unicorn Solutions in Oregon in support of youths and young adults affected by systems such as child welfare, with a particular focus on the LGBTQ+ community.

They said they are committed to making sure that sexual identity and gender topics are not avoided in the system.

“I think every young person should feel loved and cared for,” Hinkle said.

©2025 KFF Health News. Distributed by Tribune Content Agency, LLC.

By Linda Bell, Bankrate.com

When my husband and I refinanced our mortgage in 2009, we felt confident we were making the right move. Since both of us had exceptional credit, we knew we could reduce our mortgage rate by one percentage point or more, as is considered de rigueur when refinancing. A no-brainer, right?

In retrospect, I wonder. We should have considered other factors beyond the rate, ranging from the overall cost of refinancing to its impact on our home equity stake. And we should’ve made some comparisons among lenders, instead of rushing off to our current bank.

Here are seven missteps I made when refinancing my mortgage in 2009 — and what I would do differently today.

1. Focusing only on the interest rate

I have to admit: I was laser-focused on the fact that we could lower our mortgage rate by 1.25% and shave almost $300 off our monthly mortgage payment. That felt like a huge win, and in some ways, it was.

What I didn’t consider was the real cost of refinancing. I didn’t fully grasp the importance of the APR (annual percentage rate). The APR reflects the total cost of the loan: not just the interest rate, but lender fees, points and other closing costs. Your APR can be as much as a full point higher than the quoted interest rate.

Lesson learned: The APR is inevitably higher than the interest rate and is the real number you should compare when evaluating offers. If I could do it over, I would run the numbers through a mortgage refinance calculator to understand the total cost of the refinance, including how much interest we would pay over time and closing costs, not just the monthly savings.

2. Not paying closing costs upfront

Refinancing isn’t free: Like a primary mortgage, it comes with closing costs — various fees associated with applying for, administrating and underwriting the loan that you pay upfront — unless you roll them into the mortgage instead. A no-closing-cost refinance, which lets you do that, sounded great at the time. Between the appraisal, title insurance, lender fees, and everything else, these costs added up, and I didn’t want to pay a big sum out-of-pocket. Plus, adding these expenses into the loan just felt easier.

What I failed to grasp: When you roll over closing costs, the lender adds them to the principal of the new mortgage — and the amount interest is charged on. That results in a larger loan balance, higher monthly payments and more interest paid overall over the life of the loan.

Lesson learned: It’s been more than 15 years since we refinanced. I know by now we’ve recouped the cost of the loan. But at the time, we didn’t crunch the numbers in a mortgage refinance break-even calculator to weigh our options. If I were refinancing now, I would be more interested in paying off the mortgage sooner rather than realizing the immediate savings.

3. Not negotiating fees

While some are non-negotiable, many refinancing fees aren’t set in stone — they’re at the lender’s discretion. That means the lender can lower or even waive these charges, including big ones like the origination fee. Lenders may also offer discounts for automatic payments or paperless statements, to stay competitive and win your business.

In our case, we simply accepted the terms the lender offered as-is, without asking any questions. We don’t know for sure if they would’ve changed anything, but — if you don’t ask, you don’t get.

Lesson learned: Negotiation might not wipe away every fee, but even trimming a few hundred dollars can make a difference. Comparing refinance offers from various lenders puts you in a much better position to get the best deal.

Which brings me to my next mistake…

4. Not shopping around

Refinancing is like buying anything else: You better shop around, as the song says. We made the mistake of refinancing with our mortgage lender without even considering any other institution, mainly because it was easier. I didn’t compare rates, fees, customer reviews or loan terms across companies. I was just happy we were approved and ready to move forward.

Refinance rates and terms vary from banks, credit unions and online lenders. Even if you’ve been a loyal customer, your current lender might not have the best deal.

Lesson learned: Get quotes from at least three to five mortgage refinance lenders and compare their overall costs. Even a small difference in the rate, like 0.25%, can lead to significant savings over time.

5. Ignoring the impact on home equity

The most important consideration in refinancing is how much home equity you have. It can eat into your homeownership stake, especially if you borrow against portion of your home’s value with a cash-out refinance.

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If you recall, 2009 was a precarious time for the U.S. economy, near the official tail end of the Great Recession. To say home values were dropping would be an understatement. Between December 2006 and December 2009, home prices fell 20% on average, according to the Federal Reserve Bank of Philadelphia.

At one point, like millions of homeowners, we were actually underwater on our mortgage, meaning we owed more than the home was worth. And rolling in closing costs didn’t help the situation either. By increasing our overall mortgage balance, we chipped away at the homeownership stake we had built (your home equity equals your home’s value minus the mortgage — the amount of the home you own outright).

Lesson learned: Since then, we have recouped the equity we lost and more. But some homeowners aren’t so lucky. ATTOM Data Solutions reports that more than 5 million properties were still “seriously underwater” in 2019, a full decade after the housing crisis ended. (“Seriously underwater” mortgages are classified as those at least 25% higher than the homes’ estimated market value.) Always consider how much a refinance will impact your equity. If home values fall, or you plan to sell before prices recover, refinancing can do more harm than good.

6. Not buying points

Knowing that we didn’t plan to move, we probably should have taken a longer-term view when we refinanced. At the time, we chose not to buy points to lower our interest rate, as we didn’t want to spend extra upfront.

Points will typically cost you 1% of the loan amount, which in turn lowers your interest rate by about 0.25 percentage points. While that may not sound like a big difference, over the life of a loan, it can really add up. Let’s say you are refinancing your $300,000 mortgage to a 30-year fixed loan at 7% interest. Here’s how the savings might break down:

Without buying points, a mortgage with a 7% interest rate will cost you $418,527 over the life of the loan.

Buying one point for $3,000 lowers the interest rate to 6.75%, and you will pay $400,486 over the life of the loan.

Buying two points for $6,000 lowers the interest rate to 6.5%, and you will pay $382,634 over the life of the loan.

In other words, paying $6,000 now can save you $35,893 in interest costs.

Lesson learned: Buying points doesn’t make sense for everyone, as it will extend your break-even point on the refi. But if you’re planning to stay put for the long haul, it’s worth doing the math. Fifteen years after the refinance, it’s clear we’ve paid far more in interest than we would have if we’d made that investment. What felt like saving money ended up being a costly mistake.

7. Overlooking term options

When we refinanced, we went from a 30-year loan, which we’d already been paying for five years, into a brand-new 30-year mortgage. In hindsight, we missed a big opportunity.

By refinancing into another 30-year mortgage, we basically reset the clock, effectively extending our mortgage and stretching our debt to 35 years. That means we’ll end up paying more in interest over the long run, even with the lower rate. What I didn’t realize was that refinancing into a 15- or 20-year loan could have dramatically reduced what we paid over time, even if the monthly payment was a bit higher.

Lesson learned: Refinancing doesn’t just have to be about lowering your monthly payments. It’s also a chance to shorten your loan term and potentially save a lot in interest.

The moral to my mortgage mistakes story

Do I regret refinancing our mortgage? No, but if I could rewind the clock, I would approach the process more cautiously. I would’ve run the numbers more carefully, thought harder about the long-term trade-offs and asked more questions upfront about APR and how our home equity might be affected. I would’ve taken a closer look at the costs we rolled into the loan, tried to negotiate fees, and considered whether buying points really made sense for us.

I also didn’t explore whether other refi options, like a shorter-term loan might have been a better fit or realize how important it is to shop around for the best lender.

Lesson learned: The refinancing process isn’t just about snagging a lower rate. Sometimes it pays to think long-term, even when the short-term savings are tempting.

©2025 Bankrate.com. Distributed by Tribune Content Agency, LLC.

VIENNA (AP) — An Austrian court on Friday convicted an acquaintance of the main suspect in last year’s foiled plan to attack Taylor Swift concerts in Vienna on terrorism charges unrelated to the plot and sentenced him to two years in prison.

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The state court in Wiener Neustadt convicted the 18-year-old defendant, whose name was given only as Luca K. in line with local privacy rules, of involvement with a terrorist organization and criminal organization, the Austria Press Agency reported. He largely admitted to the accusations, which included sharing propaganda of the Islamic State group and glorifying an IS sympathizer who killed four people in Vienna in 2020.

The suspect, who converted to Islam in 2022, was arrested shortly before the planned Swift concerts in August last year but was not charged with involvement in the plot. Defense lawyer Michael Dorn said he wasn’t the closest friend of Beran A., the 20-year-old main suspect, who remains under investigation.

The defendant said he now sees his actions as a mistake and is glad he was arrested, APA reported. “I have had a daughter, now I see life more seriously,” he added.

The time he has spent in custody will be deducted from the sentence. The verdict can be appealed.

By ANDREW WILKS and STEPHANIE LIECHTENSTEIN, Associated Press

ISTANBUL (AP) — Iranian and European diplomats met Friday in Istanbul in the latest drive to unpick the deadlock over Tehran’s nuclear program.

Representatives from Britain, France and Germany, known as the E3 nations, gathered at the Iranian consulate building for the first talks since Iran’s 12-day war with Israel in June, which involved U.S. bombers striking nuclear-related facilities.

The talks, which ended after four hours, centered on the possibility of reimposing sanctions on Iran that were lifted in 2015 in exchange for Iran accepting restrictions and monitoring of its nuclear program.

Journalists wait outside of the Iranian consulate, in Istanbul, Turkey, Friday, July 25, 2025, ahead of a meeting between European and Iranian diplomats for talks over Tehran’s nuclear program. (AP Photo/Francisco Seco)

The return of sanctions, known as a “snapback” mechanism, “remains on the table,” according to a European diplomat speaking on condition of anonymity due to the sensitivity of the talks.

“A possible delay in triggering snapback has been floated to the Iranians on the condition that there is credible diplomatic engagement by Iran, that they resume full cooperation with the IAEA (International Atomic Energy Agency), and that they address concerns about their highly-enriched uranium stockpile,” the diplomat said.

European leaders have said sanctions will resume by the end of August if there is no progress on containing Iran’s nuclear program.

Tehran, meanwhile, has said the U.S., which withdrew from the 2015 deal during President Donald Trump ’s first term, needs to rebuild faith in its role in negotiations.

Deputy Foreign Minister Kazem Gharibabadi said Iran’s engagement was dependent on “several key principles” that included “rebuilding Iran’s trust – as Iran has absolutely no trust in the United States.”

In a social media post Thursday, he also said the talks shouldn’t be used “as a platform for hidden agendas such as military action.” Gharibabadi insisted that Iran’s right to enrich uranium “in line with its legitimate needs” be respected and sanctions removed.

Iran has repeatedly threatened to leave the Nuclear Nonproliferation Treaty, which commits it to refrain from developing nuclear weapons, if sanctions return.

Gharibabadi described Friday’s talks as “serious, frank and detailed.” Posting on X, he said the two sides discussed lifting sanctions and the snapback mechanism while agreeing to further talks.

“Both sides came to the meeting with specific ideas,” he said. “It was agreed that consultations on this matter will continue.”

Friday’s talks were held at the deputy ministerial level, with Iran sending Gharibabadi and a fellow deputy foreign minister, Majid Takht-e Ravanchi. A similar meeting was held in Istanbul in May. The identity of the E3 representatives were not immediately clear but the European Union’s deputy foreign policy commissioner was thought to be attending.

The U.K., France and Germany were signatories to the 2015 deal, alongside the U.S., Russia and China. When the U.S. withdrew in 2018, Trump insisted the agreement wasn’t tough enough. Under the original deal, neither Russia nor China can veto reimposed sanctions.

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Since the Israeli and U.S. strikes on Iran, which saw American B-52 bombers hit three nuclear sites, Iran’s Foreign Minister Abbas Araghchi has accused the E3 of hypocrisy, saying they failed to uphold their obligations while supporting Israel’s attacks.

Against the backdrop of the conflict, which saw Iran respond with missile attacks on Israel and a strike on a U.S. base in Qatar, the road ahead remains uncertain.

While European officials have said they want to avoid further conflict and are open to a negotiated solution, they have warned that time is running out.

Tehran maintains it is open to diplomacy, though it recently suspended cooperation with the IAEA.

A central concern for Western powers was highlighted when the IAEA reported in May that Iran’s stockpile of uranium enriched to 60% – just below weapons-grade level – had grown to over 882 pounds.

In an interview with Al Jazeera that aired Wednesday, Iranian President Masoud Pezeshkian said Iran is prepared for another war and reiterated that its nuclear program will continue within the framework of international law while adding the country had no intention of pursuing nuclear weapons.

A spokesman for Iran’s Atomic Energy Organization said Thursday the country’s nuclear industry would “grow back and thrive again” after the recent attacks by Israel and the U.S.

Liechtenstein reported from Vienna. Associated Press writers Nasser Karimi and Amir Vahdat in Tehran, Iran, contributed to this report.

The Associated Press receives support for nuclear security coverage from the Carnegie Corporation of New York and Outrider Foundation. The AP is solely responsible for all content.