The Brief

After M graduated from high school in California, she got a job at a fast food restaurant making burgers. Her coworkers were chatting over the fryer one day when M got a weird feeling, like somehow they knew what she was thinking. It was like her coworkers could read her mind and were discussing her thoughts with each other.

"I was like, are they talking about burgers or are they talking about me?" says M, now 21. NPR has agreed to identify M by her middle initial because she fears the stigma around her mental illness could disrupt her career path.

There was one coworker in particular, a guy she had a crush on, and she was pretty sure he was watching her. She suspected he hacked into her phone so he could listen to her conversations, find out where she was and follow her around. If she was walking down the street, or hanging out in the park, she saw him. Her mom remembers M wanted to sleep with the lights on, repeatedly asking her through the night, "Mom, is someone here?"

A crisis, a hospital stay, a rare referral

One day, her mom said M got so paranoid, so scared, she locked herself in the bathroom and just screamed and screamed and screamed.

Her mom wanted to call for help. But she didn't have a job at the time. This was about a year into the pandemic, and the hotel where M's mom worked had been closed since the first lockdown. When she lost her job, she lost her family's health benefits, too. "My husband was like, 'What is that going to cost?'" her mom remembers.

M's mom called 911 anyway. In the hospital, M was diagnosed with schizophrenia and within a few weeks she was enrolled into a specialized two-year outpatient treatment program at the Felton Institute near San Francisco. Her relatively quick path into effective treatment is highly unusual for patients like her.

M is one of 100,000 young adults or adolescents who have a psychotic episode every year in the US. A psychotic episode is characterized by hallucinations, like hearing or seeing things that are not there; delusional beliefs; and paranoia.

On average, it takes people a year and a half to get into meaningful treatment, if they ever do at all. About 80 to 90% of affected young people inch through the country's fragmented mental health care system, many struggling to find a clinician with adequate training in psychosis.

Only 10 to 20%, including M, find space in one of the holistic treatment programs recommended by the National Institute of Mental Health as the gold standard of care for early psychosis. That's because these programs rarely have enough slots available for the people who need there, and because health insurance companies typically refuse to cover the full cost of these programs, even when they are available.

But M is considered one of the lucky ones. Through her state-based public insurance, she never paid a dime for any of the care she received at the Felton Institute's early psychosis program.

A suite of wrap-around services

For two years, M was surrounded by a team of providers looking out for every aspect of her well-being, including a physician, who prescribed antipsychotic medications and a psychotherapist, who did weekly therapy with M to work through her paranoia and delusions.

But the program also provided an occupational therapist, who would go with M to the gym, or coach her through conflicts she had with her friends; a peer specialist who had also been through psychosis and could relate on a personal level; a family support specialist who worked with M's mom; and an education and employment specialist, who helped M look for a job.

Treatment that leads to independence and a career

At first, M wasn't interested in work. Her new medications made her really tired. Fatigue is a common side effect of antipsychotics, and that was layered on top of her already low motivation, which is a common symptom of schizophrenia.

"Since I didn't really have anything to do, I would just take super long naps during the day," M recalls.

But then she met Monet Burpee, Felton's job coach. On a typical workday, Burpee will drive her clients to the local mall or downtown shopping district, charting their path according to the "Help Wanted" signs. Together, they'll chat with store managers about open positions, then sit down and fill out the applications together.

Burpee says helping her clients who have psychosis find work is about more than landing a paying job; it's also about helping them see themselves differently — as independent, career-oriented people, rather than permanent patients dependent on government support programs such as Supplemental Security Income (SSI).

"If you work, you're going to notice a huge improvement in your self-esteem," she tells them. "It has better long term, positive results versus you just sitting around on SSI."

Monet Burpee (right) talks to the manager of a restaurant in Redwood City, CA on one of the job-scouting expeditions she undertakes on behalf of patients receiving a suite of interventions and services for psychosis.

(

April Dembosky/KQED

)

This is what she told M, and when she was ready, the two of them went to the mall on a job scouting expedition. They filled out the applications together. "Next thing I know, I was being interviewed and I got hired," M says.

She started out as a cashier at a new fast food restaurant and within three months she got promoted to a manager role. Now Burpee is coaching her on how to ask for a raise. "She has a brand new car," Burpee says, beaming with pride. "She's meeting new friends." For M, it was just one step in her long-term recovery plan.

"I want to focus on getting a degree, to get a better career," she says.

A revolutionary idea for treating schizophrenia

The Felton Institute's early psychosis program is one of about 50 in California and 350 in the country. They were started about fifteen years ago with what was then a revolutionary idea.

Back in the 1980 and 90s, doctors didn't really know what to do with schizophrenia, and they didn't have many options. They prescribed doses of antipsychotic medications that were so high, they turned people into zombies. They advised patients to give up on any career ambitions and sign up for disability payments instead. Even today, some doctors still see schizophrenia as a lost cause. "There's a real failure to appreciate how much potential there is to manage the illness and symptoms," says Dr. Daniel Mathalon, a psychiatrist with UCSF's early psychosis program.

Around the turn of the century, a new generation of doctors started thinking: What if we ask patients what they want and actually work with them toward full recovery?

"It's not just about stabilizing you clinically. It's about making sure we don't lose track of your future," says Tara Niendam, a child psychologist who runs the early psychosis clinic at UC Davis. "You should be in college. You should be living on your own."

With other conditions like diabetes or cancer, the sooner people get into care, the better they do. The same is true of psychotic illness. Upwards of 80 studies from early psychosis clinics show that patients see a greater reduction of symptoms, like voices or delusions, and a greater improvement in functioning at school, at work and in their social lives, compared to people who get treatment as usual.

Dr. Tara Neindam at the UC Davis Behavioral Health Center in Sacramento on Feb. 7, 2023. Dr. Niendam is a licensed clinical psychologist with training in assessment and treatment of youth at risk for, or in the early stages of, psychosis.

(

Beth LaBerge/KQED

)

There are a few reasons why earlier treatment is more effective, Niendam explains. People respond more quickly to medication given earlier and at a lower dose, so they have fewer side effects that make them want to stop taking them.

In addition, when symptoms are new, patients are more curious about their psychotic experiences, and more willing to question their delusional beliefs. And their families are also more curious, and more willing to stay involved in treatment, she says.

Building circles of ongoing support

This is one reason the early psychosis programs put a lot of emphasis on supporting the families who are supporting the patients.

M's mom found she needed almost as much help as her daughter did after the diagnosis. She blamed herself. She started meeting once a week with Mike Krechevsky, Felton's family specialist. He walked her through what schizophrenia was and wasn't, explained that it was no one's fault, and helped her manage her own feelings about it so that she didn't pass them on to M.

"When you express anxiety to your child, they don't feel as though they have any capability of going out in the world, stumbling, falling, picking themselves up, learning from their mistakes, and moving forward," Krechevsky says. "If you continue to do that, they're never going to recover."

A reverse disparity with insurance coverage

Normally, the separate and unequal health systems in the U.S. favor the wealthy. But in an unusual twist, M and her family were able to get access to such comprehensive, holistic care after her psychotic episode primarily because her mom had lost her job and her commercial insurance plan.

That's because states and the federal government, through block grants and public coverage such as Medicaid, provide most of the funding for early psychosis clinics, an investment that amounts to tens of millions of dollars every year.

Government officials believe that expenditure will save money in the long run, because without sufficient treatment, people with schizophrenia tend to deteriorate to the point that they end up on disability benefits, in a group home, on the street or in jail – all things the government pays for.

But commercial insurance companies, like Anthem or Blue Shield, don't face those risks. They don't have the incentive to cover full-scope psychosis treatment, and most of them don't.

This means low-income families with public insurance like Medicaid, which in California is called Medi-Cal, have more access to this gold standard of care, while working and middle class families covered by private insurance plans usually cannot.

"It is a reverse disparity," said UC Davis' Niendam during testimony before a state senate committee, about the impact of this disparity at the early psychosis clinic she runs in Sacramento.

"I can give the Rolls Royce of care if you walk in and you have Medi-Cal," she said. But "60% of Californians have commercial insurance. That's 60% of kids who can't get care; 60% of kids whose parents call me crying when I tell them they can't access my clinic."

Turning away patients with the wrong coverage

It's the same at the Felton Institute in the Bay Area, according to early psychosis director Adriana Furuzawa. For every one person who has Medi-Cal and is eligible for care at her clinic in Alameda, she says , there are another two with commercial insurance who are turned away. In 2022, they turned about 100 people away.

"It was very difficult to think that behind each number, there is a young person, there is a family, that we're saying no to, when we have the resources right here," Furuzawa says.

So what happens to these kids? Generally, they're on their own to find a psychiatrist and therapist who accepts their insurance. Health plans will pay for these medical services. But they won't cover the other crucial components to the care: the job and education support, the peer specialist, the family coach.

This amounts to discrimination, health advocates argue. If someone has cancer, insurers would never just pay for surgery and radiation, but not chemotherapy.

"It's a package of services," says David Lloyd, former chief of policy at the Kennedy Forum. "So the idea that you can split apart the package of services and only reimburse for little components of it, really destroys the whole evidence base of what the service is."

This almost happened to M. A few months into her treatment, her mom got her job back at the hotel, and the family was again covered by her commercial insurance plan. In most counties in California, this would have meant M got kicked out of the program. Her mom said there would have been no way she could afford to pay for a job coach, a family coach, and a peer specialist on her own.

"I couldn't do it. I would definitely stop all the help," she says, even though that help was critical to keeping M healthy. Maybe she would have turned to Craigslist to find other parents to talk to, she said, or looked up mental health advice on YouTube to pass on to M. "I just hope and pray for the best."

States seek solutions to coverage gaps

In 2022, state lawmakers in California wanted to help families like M's, by forcing insurance companies to cover the full spectrum of early psychosis treatment. Lawmakers in one state, Illinois, enacted a law like this already, while those in Massachusetts and Virginia are working on a similar effort. But the proposal in California, Senate Bill 1337, died under pressure from the insurance lobby.

Historically, insurers have not covered the costs of non-medical services provided by non-licensed staff, like job or family coaches. More importantly, they do not like being cornered into covering specific treatments, said Nick Louizos, a lobbyist with the California Association of Health Plans, a trade group that represents companies like Anthem, Blue Shield and Kaiser.

"Science evolves. Research evolves. There could be evidence-based techniques that are better in the future," Louizos said during testimony at a state senate health committee hearing.

While there are scores of studies that show the treatment works in the short-term — people are more likely to stay in school, in jobs, in treatment, and out of the hospital — the treatment hasn't been around long enough to know how long the positive effects last.

"There is a lack of evidence of this model's long-term effectiveness," Louizos said.

Perverse incentives to drop private coverage

The private insurance restrictions create a perverse incentive for middle-income families who need help now. Some parents are so desperate to give their kids the best care, they actually drop them from their health plan and enroll them in Medi-Cal so they can access county-funded clinics like Felton.

Some counties, including Sacramento and San Mateo, have taken an even bolder step. Health officials there determined that denying young people the full suite of care is unethical, so they decided to use county taxpayer dollars to pay for any services that private insurers refuse to cover.

In the end, this extra support at the county level is what allowed M to stay in the Felton program.

But all of these workarounds are problematic, according to Lloyd. For-profit insurance companies are essentially making more profits by allowing the public to pay their bills.

"That's not an appropriate role for taxpayers to be picking up that burden," he says. In addition, the lack of funding from private insurance reimbursement is stifling the growth that's needed in these programs to hire more employees and provide care for all the young patients who need it.

In California, an alternate pathway to full coverage?

In California, expanded coverage and access could be arriving soon, via a different legal mechanism.

A novel 2021 California law was designed to expand the kinds of mental health care insurers are required to cover. Under this law, SB 855, health plans must make mental health coverage decisions based on expert-recognized guidelines for treatment, rather than their own internal, often arbitrary or cost-driven, criteria.

Multiple agencies, including the National Institute of Mental Health, the Centers for Medicare and Medicaid Services and the American Psychiatric Association, all recommend full-scope early psychosis care for treatment of a first psychotic episode.

Since this story was first published last spring on KQED.org, California's largest state health regulator, the Department of Managed Health Care, finalized guidance that explicitly requires insurers to cover full-scope early psychosis care, and is incorporating that guidance into the official rules that will be used to enforce SB 855. The final version of the regulations is expected to take effect in spring of 2024.

M and her family haven't had time to follow all these legislative battles and policy changes. All they know is that the full-scope early psychosis care has been life changing.

M has struggled recently with some of symptoms at her new fast food job. The difference is that now she knows what's happening. She has new skills to help quiet the voices. She knows her mom will understand and support her. And she knows there are half a dozen providers at Felton who will pick up if she calls for help.

When her mom thinks about the generosity of those providers, or the luck of landing in a county that stepped up and paid for all of M's care, she thinks about her own father. He was a doctor in the Philippines, and none of his patients had insurance. If they didn't have money, he treated them anyway. "I remember people paying him with chicken and rice," she says.

She thinks, maybe all the help M got was because of him. Maybe it was her dad's karma paying off.

This story comes from NPR's health reporting partnership with KQED and KFF Health News.

This story was originally published by CalMatters. Sign up for their newsletters.

Immigration enforcement agents are inciting panic at California’s community colleges.

Santa Monica College said that one of its students was arrested and deported last May. Then in December, Santa Barbara City College said that federal immigration officers used their campus parking lot as a staging ground, prompting an uproar from community activists. 

Last month, the San Diego Community College District said ICE agents arrested a student on a public street that cuts through the urban campus and proceeded to chase another student up the steps of the school’s Arts and Humanities building.

Last Monday, federal agents arrested the father of a student in a campus parking lot at Allan Hancock College in Santa Maria, south of San Luis Obispo.

College presidents say they’re doing everything in their power to keep students safe and prevent federal immigration enforcement officers from coming on campus. But they admit that they have limited power in these situations.

“If ICE agents want to come and walk in the middle of campus, they can do that,” said Kevin Walthers, the president of Allan Hancock College.

State laws require colleges to notify students if immigration enforcement agents are on campus and agents must present a warrant before entering a "nonpublic” area in a school, such as a classroom or office building. But parking lots, quads and many other outdoor spaces are considered public.

By the time Walthers learned ICE agents had arrived at the campus parking lot, they were gone — the arrest happened in a matter of minutes. He said he never received a warrant and was only able to issue a notification to students and faculty after the arrest. The same was true in San Diego, said district Chancellor Gregory Smith.

President Donald Trump rescinded a longstanding policy that prevented immigration enforcement in “sensitive” locations, such as schools. The California Community Colleges Chancellor’s Office, which oversees the state’s 116 colleges, has been outspoken about protecting students without legal status and offered guidance to schools on dealing with immigration agents. Attorney General Rob Bonta released his own, more detailed guide last month.

Chandler Rebel, a spokesperson for the Department of Homeland Security, which oversees immigration enforcement, said “ICE does not target schools” and denied arresting anyone on the Allan Hancock campus, despite witness testimony and photographs. Rebel did not respond to questions about the officer who chased a San Diego City College student on campus.

After their interactions with immigration agents, Santa Barbara and San Diego city colleges put up or are in the process of installing signs in parking lots, sidewalks or at the entrances to classrooms and buildings, telling agents they need approval to enter.

In practice, these messages may not prevent immigration agents from coming onto their campuses, college presidents say. “It's kind of our district putting every effort that we can think of, and hopefully it is a deterrent,” Smith said.

A regular Monday 

Last Monday morning, Mayrin, 18, said she was sitting in the passenger seat while her father drove her to Allan Hancock College, where she had statistics class that day. As they drove by the Olive Garden just outside of campus, she said she saw a large black car follow them down the road.

Mayrin and her father parked in the campus lot, she said, where a masked man approached the window and asked for their identification. CalMatters agreed to withhold her full name because she fears drawing attention to her family’s legal status.

“I was calling people. I was crying. It was a mix of emotions, mostly just worried about my dad,” she said. Maryrin gave the officer her state ID and told him that she’s a U.S. citizen. Her father, who immigrated from Mexico and has lived in the U.S. for about two decades, did not have identification on him and the officer pulled him into his car, she said.

Mayrin spent the next 20 minutes alone in her father’s car, crying and calling family, before college staff, including campus police officers and the dean of counseling, brought her into a conference room to ask what happened and provide support.

Mayrin’s father was one of at least 17 people who were arrested last Monday by immigration enforcement agents in the Santa Maria area, said Assemblymember Gregg Hart, a Santa Barbara Democrat, in an emailed statement. “Mass enforcement sweeps like this are designed to send a message of fear and intimidation – one straight from President Trump.”

A student walks through San Diego City College in downtown San Diego on Oct. 9, 2026.

(

Adriana Heldiz

/

CalMatters

)

The largely Latino towns in California's Central Coast region, which include Santa Maria, have experienced waves of immigration enforcement since Trump took office.

In April, Walthers said the college’s police chief had a meeting with other local police chiefs, the FBI and ICE officers who oversee the Central Coast. The college’s police chief asked immigration officials to provide advance notice before coming on campus. “The response was that ICE would not be coming to campus,” Walthers said. In retrospect, he said he wished the agreement was more formal.

After the arrest last week, Walthers said he got in touch with a federal immigration officer in Los Angeles and said he felt “optimistic” after the conversation that it wouldn’t happen again.

‘Without us knowing or without any previous approval’

In December, a local organization that advocates for immigrants, 805 UndocuFund, alerted Santa Barbara City College officials that ICE agents were at a campus parking lot and appeared to be using it as a staging area, according to Jordan Killebrew, the executive director of public affairs for the college.

Killebrew said agents were “occupying our parking lots without us knowing or without any previous approval.”

The college has since signed an agreement with 805 UndocuFund to help alert the college of the presence of federal law enforcement agents. The group will also provide college students and staff with resources and referrals including legal, financial, mental health and emergency support services for immigration-related matters.

Killebrew said the college spent about $1,200 on 12 signs, which say its campuses “may not be used for civil immigration enforcement staging areas, processing locations, or operations bases.”

The San Diego college district was already in the process of putting up similar signs when ICE appeared on campus last month. District spokesperson Jack Beresford said the four-college district spent $71,000 on 68 signs, including the cost of the labor to install them. The district also created a new policy requiring any entity, including law enforcement, to get prior approval before conducting “official business” on campus.

“We don't let a bank just come and set up a booth,” said Smith, the chancellor of the San Diego district. He said immigration enforcement agents would need approval before conducting their business, including arrests.

Whether the policy will actually work is less clear. “By the time I know that they're here and get down there to tell them they're not allowed to be here, they're going to be gone,” Smith said. “What I'm hoping that we have set up with this is a legal argument that it's an illegal seizure, the same as if they just broke into somebody's home.”

The policy has never been tested in court. He said he hopes it never gets there.

This article was originally published on CalMatters and was republished under the Creative Commons Attribution-NonCommercial-NoDerivatives license.

Tropical Storm Rachel brought dangerous surf to Long Beach’s oceanfront but little of the rain forecasters had warned about, as conditions are expected to gradually improve through Tuesday. While relieved, city officials reiterate that the Peninsula is far from in the clear, with major cleanup and emergency repairs underway as several seaside homes are still too dangerous to reenter.

The Peninsula was inundated with mud, sand and plenty of cameras, as onlookers and national news outlets clustered in tight side streets to get a good angle at the wave-damaged homes, as well as the splintered timber bulkhead and boardwalk. With waves and tides high but not quite at levels seen Saturday, crews pumped out excess water in the streets and shoveled sand and debris out of the storm drains.

Kristan Lund, a National Weather Service meteorologist, said Rachel moved through Southern California faster than anticipated, limiting the amount of time Long Beach and nearby cities were exposed to its rainfall.

The center of the storm moved onshore in northern Baja California on Saturday night, according to the National Hurricane Center. Forecast tracks shifted south in recent days, but the storm then veered north-northeast toward Las Vegas, widening the gap between Long Beach and its reach.

Expected to get up to half an inch of rain starting as early as Saturday, Lund said the city shouldn’t expect more than a tenth of an inch through Monday, though a weather pattern Sunday evening may bring drizzles through the night.

The worst-case scenario also failed to materialize. Lund said peak swell, high tide and wind direction never lined up. “The high surf, you know, we were expecting it to come up on the backside of the high tides,” she said. “And thankfully, it ended up being a little too late.”

Several homes were red-tagged as waves continue to slam the bulkhead along the Peninsula in Long Beach, Sunday, Oct. 11, 2026.

(

Thomas R. Cordova

/

Long Beach Post

)

Monday morning tides are expected near 7 to 7.5 feet, with surf of 4 to 6 feet. Water levels were still 1 to 1.8 feet above predicted tides, driven by El Niño-related thermal expansion, a Kelvin wave and elevated astronomical tides. Lund said a lingering southerly swell may shift westerly, putting west-facing beaches at some risk of coastal flooding.

The NWS said a coastal flood warning for Los Angeles and Catalina Island areas — which include Long Beach — was scheduled to drop to an advisory at 3 p.m. Sunday. Minor to moderate flooding is still possible through Tuesday afternoon, though it’s expected to be less severe than on Friday and Saturday.

Even so, the damage along the Peninsula’s Seaside Walk is extensive. Waves topped the boardwalk’s protective bulkhead and sent water into homes and streets. Inspectors have red-tagged nine buildings across 13 addresses, a designation meaning they are unsafe to enter. One building has a yellow tag, which restricts use.

A kayaker watches waves hit a walkway in front of homes in Long Beach, Calif., Saturday, Oct. 10, 2026, as Tropical Storm Rachel approaches.

(

William Liang

/

AP Photo

)

A mandatory evacuation order covering homes between 64th and 66th places runs through noon Tuesday, and 39 more residences are under an evacuation warning.

Residents are not being allowed back inside. Assistant Fire Chief Jake Heflin said many have asked to retrieve belongings. “That’s the emotional side of it,” he said, but firefighters cannot send anyone into a building that could be on the verge of collapse.

At a control post they set up in the Claremont parking lot, firefighters gathered in front of a screen reviewing drone footage from the day that looked at the cracking and shifting homes.

A Long Beach search and rescue team fills sandbags at the Claremont lot for Long Beach residents on Sunday, Oct. 11, 2026.

(

Thomas R. Cordova

/

Long Beach Post

)

Several of them pointed while others took note, looking for signs to suggest which building is closest to collapse and comparing their worsening conditions over the past couple of days.

If one falls, Heflin said, responders have bullhorns to sound off, then seal the area and conduct searches.

Crews are reinforcing the bulkhead and boardwalk with lumber beams and plan to place about 30 heavy-duty sandbags, each about 3,000 pounds, with a crane on 65th Place. City Spokesman Laath Martin said life safety remains the city’s top priority.

In response to the storm, the city has spent more than $1 million on one-time costs from its Tidelands emergency reserves, which are set aside for only coastal uses. Long Beach has also fast-tracked a multimillion-dollar plan to rebuild the Peninsula’s beach.

Large sandbags are placed at the base of the seawall to absorb some of the force of the waves as ocean water slams into the wooden bulkhead along the Peninsula’s boardwalk in Long Beach, Monday, Sept. 28, 2026.

(

Thomas R. Cordova

/

Long Beach Post

)

Over this week and the next, city officials say, they hope to start trucking in 50,000 to 100,000 cubic yards of sand, followed by a $11.4 million dredging project that could add another 415,000 cubic yards of sand — the most moved in decades.

Officials are pursuing outside funding aggressively and are in talks with the governor’s Office of Emergency Services for reimbursement to public projects, sand restoration, coastal work and emergency bulkhead repairs.

“We will be working with the state closely to identify any kind of reimbursement,” Martin said.

For private homes, the city is urging owners to contact their insurers right away. Long-term demolition and cleanup are the property owners’ responsibility, they say.

Native Americans celebrate their centuries-long history of resilience with ceremonies, dances and speeches.

Former President Joe Biden officially commemorated Indigenous Peoples Day in 2021. An increasing number of states and cities have also recognized it — pivoting from a day long rooted in the celebration of explorer Christopher Columbus to one focused on the people whose lives and culture were forever changed by colonialism.

Here is a look at why it’s called Indigenous Peoples Day and how people celebrate.

Why is it called Indigenous Peoples Day?

Indigenous Peoples Day has been recognized for decades in different forms and under a variety of names to celebrate Native Americans’ history and culture and to recognize the challenges they continue to face.

Biden had said in a statement that the day is meant to “honor America’s first inhabitants and the Tribal Nations that continue to thrive today.”

It is typically observed on the second Monday in October, the same day as Columbus Day, a federal holiday established decades ago to recognize Columbus’ sighting in 1492 of what came to be known as the Americas.

The day is often marked by protests against memorials to Christopher Columbus, for environmental justice, for the return of Indigenous lands and in honor of missing and murdered Indigenous women.

President Donald Trump has said he will not follow his predecessor’s practice of recognizing Indigenous Peoples Day alongside Columbus Day in October.

Is Indigenous Peoples Day a federal holiday?

Although it is not a federal holiday, some states, as well as Washington, D.C., have holidays honoring Native Americans, some of which are on the second Monday in October. Indigenous Peoples Day is typically paired with Columbus Day or replaces the federal holiday altogether. A number of cities and school systems observe Indigenous Peoples Day as well.

Native Americans have campaigned for years for recognition

“For generations, federal policies systematically sought to assimilate and displace Native people and eradicate Native cultures,” Biden wrote in the Indigenous Peoples’ Day proclamation.

“Today, we recognize Indigenous peoples’ resilience and strength as well as the immeasurable positive impact that they have made on every aspect of American society.”

In a separate proclamation on Columbus Day, Biden praised the role of Italian Americans in U.S. society, but also referenced the violence and harm Columbus and other explorers of the age brought about on the Americas.

Landing in what is now the Bahamas on Oct. 12, 1492, Columbus, an Italian, was the first of a wave of European explorers in the Americas pursuing quests for gold and other wealth, including people to enslave. In the course of that quest, Native populations were decimated.

“Today, we also acknowledge the painful history of wrongs and atrocities that many European explorers inflicted on Tribal Nations and Indigenous communities,” Biden wrote. “It is a measure of our greatness as a Nation that we do not seek to bury these shameful episodes of our past — that we face them honestly, we bring them to the light, and we do all we can to address them.”