Supporting youth mental health: Opportunities and obstacles
This story is part of the Mental Wellness Project, a solutions-oriented journalism initiative covering mental health issues in southwest Michigan, created by the Southwest Michigan Journalism Collaborative. SWMJC is a group of 12 regional organizations dedicated to strengthening local journalism. For more info visit swmichjournalism.com.
Local leaders who work with young people say a generational mental health crisis is looming but not inevitable. To avoid a crisis requires more adequate funding for services – not a new need by any means. The leaders also expressed a need less well-known outside of social service circles: Youth know what they need, and they know what works for them, so providers need to listen more and direct less.
Data released earlier this year from the U.S. Centers for Disease Control and Prevention show the factors that contribute to a worsening mental health for the country’s youth were starting to add up even before the pandemic. And the rates of psychological distress among already marginalized youth have only increased since COVID-19 arrived.
The need to protect youth mental health is not only a local concern. Last week in Los Angeles, U.S. Surgeon General Dr. Vivek Murthy hosted a summit on the topic. Murthy’s office has flagged the rising number of mental health disorders in youth as “the leading cause of disability and poor life outcomes.”
In order to better understand the local impact, the support systems that are available, and the gaps in the system in the greater Kalamazoo community, the Southwest Michigan Journalism Collaborative’s Mental Wellness Project held a forum with experts in the field.
Hosted by WMUK’s Gordon Evans, the forum included:
- Alexis Caples, assistant youth development coach at the Kalamazoo Youth Development (KYD) Network, and an advisor to the Kalamazoo County Youth Cabinet, which is composed of youth, ages 14 to 20, who identify important local issues and seek solutions to them;
- Lissette Mira-Amaya, a mental health therapist with three decades of experience who now works with the Van Buren Intermediate School District;
- Christina Smith, the youth involvement coordinator at ASK Family Services in Kalamazoo who works with high school students experiencing mental health and emotional challenges;
- Sean Washington, executive director of the Mylestone Project in Battle Creek, who has years of experience in youth development.
What follows are the key takeaways from the 75-minute recorded discussion meant to further educate the journalism collaborative’s coverage.
Insurance and stigma are barriers for young people accessing mental health and substance abuse support
The lack of insurance is an ongoing problem, especially for residents without the documentation required by U.S. authorities. “There’s a lot of children and families who are not eligible to have Medicaid,” says Amaya. “And so, if they do not have insurance or coverage of any kind, then their ability to access mental health services is quite limited. And the same thing for substance use disorders.”
Amaya says families who immigrated to the U.S. are “very scared” about applying for Medicaid or other coverage, “because they’re afraid that when they do apply for legalization in the U.S., that is going to be a negative in their background to apply for government services.” She added that aside from that, people in general “just don’t want to apply because they just don’t want to be a part of the system because they don’t trust it. Not just Latinos but others too.”
Accessing care can also be an issue for families with insurance, says Smith. Her agency, ASK, only accepts clients with government-sponsored benefits. “If they have private insurance, we do not accept them. And even for folks on private insurance or have insurance through their job, getting therapy, getting involved in support groups, can be extremely, extremely expensive. The co-pays for seeing a therapist are sometimes too much for families to really take on that expense.”
The stigma attached to mental health issues is another obstacle to care. Smith says the fear of societal disapproval is a problem for people of all ages but especially for younger people. “The stigma against seeking help for mental health challenges is something that the high school-aged youth that I work with really face a lot of – being afraid to disclose that they have a mental health challenge, being afraid to talk about their mental health challenge with their parents or supportive adults in their lives.”
Clinicians and providers need to listen to youth
Another potential barrier to care is adult caregivers who dismiss young people and attempt to implement treatment or solutions without youth input. Caples says this unilateral approach is most often seen when adults adopt the standpoint that, “’I’m in charge because I am adult. I know what’s best. You can come to me, but I still know what you need. Although you’re the one living your own lived experiences, because I’m the adult, I can tell you that I hear you, but you should do this.’”
More clinicians are needed overall, and more who are bi-cultural, bilingual.
A challenge to successfully addressing youth mental health concerns is a severe shortage of trained staff, including bi-cultural and bilingual therapists, and an overall lack of diversity among area clinicians.
Amaya says cultural and language diversity are critical to success, “because sometimes we express ourselves better in one language and in the in another language. And if you can’t get that then it’s really hard to trust the clinician who is seeing you.”
Agencies need funding to provide needed resources
At the Mylestone Project, Washington says pinched resources at many agencies leads to less-than-ideal experiences for the young people they are trying to help. “I’ve dealt with one youth that was dealing with marijuana addiction. And the answer he was given was, ‘We will pay for a taxi to take you to a neighboring county where they might have a program for you.’ That’s just a non-answer for a kid that reaches out and says, ‘I’m having this issue.'”
Not having enough money and staff also creates serious problems for those providing services. “Burnout has been increased tenfold throughout the past two years, and specifically the mental health and education fields,” Smith says. “On top of that, I think that while there aren’t enough clinicians in general, there is also not enough representation amongst the clinicians. There aren’t enough clinicians or social workers or counselors that can identify with the youth that they’re serving, and that the youth can identify with, as well.”
So, what are the solutions?
Empower youth. One solution is creating safe spaces for young people to talk about their lives with counselors and with their peers one-on-one, providing an opportunity to both put their guard down and to create impactful connections with others in the same situation and with trained professionals who can help. Providing more support to teachers and other staff at schools, who are also struggling with burn-out, anxiety, and depression in the wake of COVID, is also crucial.
Use the arts. Another potential solution is to engage arts and cultural groups to lend a hand. Smith says she’s found that the arts are an excellent way to get young people to talk about their lives and the challenges they face. “They love slam poetry and getting your voice out that way,” Smith says. “They love acting, making up plays, to highlight their experience as young people navigating this really strange world we’re in. They really enjoy doing collaborative art projects…Every youth that I’ve worked with has really, really responded well to just that creative freedom. Not being afraid to just put it out there, whether that’s on paper, into a crowd of folks listening to their poetry, that is something that’s very powerful for them.”
Don’t wait until a crisis. Smith says her agency, ASK Family Services, has also launched a “warm-line” to let people talk about the challenges they face. “It’s not a hotline. Anyone can call it to talk about pretty much like anything that they have questions about. The warmline will act as a landing pad for people who have questions about services or available resources in the community that they might be able to link up with.”
Get therapists in schools. Amaya says another thing that needs to be done is getting more mental health workers in area schools. “Where I work in the Van Buren Intermediate School District, we started a program three years ago with three therapists, and it has grown to 18 therapists within the last three years. Because the schools are realizing the importance of having that support for children. If kids are depressed or anxious or having a really hard time at home, and they can’t process the stuff, they don’t pay attention, they can’t concentrate, they have lots of problems with school.”
But Amaya says adding more mental health experts in school is only the first step. “We have to recognize that if we listen to children or our youth, they already have many solutions. And that supporting them on those things that they have identified usually works really, really well.”
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