Cloutier: The Bay Area should be leading change for the youth mental health crisis
Santa Teresa High School social worker Alonso Avalos is one of the school's two full-time counselors. Photo by Lorraine Gabbert.

    Our society is experiencing an epidemic wave of behavioral health disorders that’s impacting our most vulnerable populations.

    The pandemic exacerbated a pre-existing emotional environment for young people that led to increased suicide rates, severe depressive episodes and likely early drug addiction among our youth. Too many of those young people are being left out of care, get too little care or have complex issues that our current system cannot address.

    Our “system of care” is broken. As our U.S. Surgeon General described back in December, we have a dangerous confluence of a dramatic increase in mental illness among adolescents that is not fully understood, a shortage of credentialed therapists, inadequate insurance coverage and a system that is a patchwork of starts and stops for parents trying to get their kids into consistent and effective treatment.

    The State of Mental Health in America reported that more than 2.5 million youth in the U.S. have severe depression yet 60% of them have not received mental health treatment. In addition to causing unnecessary suffering among our children, these untreated mental health disorders in youth will go on to become serious mental illnesses in adulthood. It will also lead to hundreds of millions of dollars in lost earnings, under and unemployment, costs of jails and prisons and waves of homelessness.

    We simply don’t have enough clinical capacity to address this tidal wave. We are going to have to focus on broad, preventive strategies to stem this wave of suffering among our young people. Prevention needs to start at home and in school – and preferably before the beginning of the teenage years.

    At home, one of the greatest protective factors a child has is a sympathetic caregiver who can help the child understand their own feelings and buffer that child’s exposure to adverse experiences that cause emotional distress. Listen to your children’s concerns and challenges with empathy to foster a sense that you are an emotional ally who is a reliable source of comfort and emotional stability for them. It is also okay to give your kids direction and set limits; so called authoritative parenting, that is neither authoritarian or so unstructured that it creates further anxiety in children.

    But it’s not always that simple; many parents and caregivers have a hard time finding resources or even knowing where to start. And there are also often cultural and attitudinal barriers that prevent children from being able to find the right words and concepts to communicate their feelings and worries to caregivers.

    Because so much of a child’s time is spent in school, teachers, counselors and administrators also play a critically important role in early prevention and treatment. Schools are lacking necessary mental health resources, and with teachers already overworked and burnt out, it can’t just fall on them. Efforts to build in social emotional learning, though under attack in many places, is an important building block to normalize talking about feelings in school-aged children and fostering health development.

    In looking beyond the confinements of school and home, there’s another major challenge: our community is in desperate need of additional behavioral health workers, especially bilingual professionals. The good news is that many evidenced-based interventions exist to address this epidemic. We do, however, need more public and private funds and broader insurance coverage to scale a sufficient treatment response to counteract the epidemic display of symptoms.

    This adolescent behavioral health epidemic is too large to fall on just one group of stakeholders. If we are to prevent it from continuing to cause increased harm, it requires a new response that will call on all of us – parents, neighbors, schools, faith-based organizations, youth organizations, social media platforms and elected officials.

    So what can you do to help create homes, workplaces, schools and communities where mental wellness is valued, discussed and embodied?

    • Normalize talking about difficult emotions and feelings, such as stress, grief, or loss with children and also with other adults. Model talking about feelings that are difficult and normalize that it is healthy to share them with others who adolescents can trust.
    • Consider reducing or eliminating screen time at night to improve quality and length of sleep. There is increasing evidence suggesting that an overall reduction in sleep time among adolescents due to screen time is short circuiting what the brain needs to do during sleep to regulate mood.
    • Dedicate a meal weekly where everyone is encouraged to share something about their day where the sharing of emotional experiences is learned and valued. Create a sense of belonging and purpose that gets ritualized with your family as they face life together.
    • Talk about mental health and how it affects your family with community leaders and elected officials. Be courageous on behalf of our adolescents and remind leaders of their obligations to foster healthy communities. End the stigma by being forthcoming about your own struggles and success with your own mental health as an example of resilience for your children and peers.
    • Reach out for help early – consult your pediatrician, school nurse, or call us to get help.

    If we can’t create change in the Bay Area, where we have a deep commitment to philanthropy, world class research institutions, a drive for innovation, renowned experts and a commitment to social justice — who else can do this?

    Our children, our families, and our communities deserve no less.

    Mark Cloutier, MPP, MPH, is the chief executive officer of Caminar, a Bay Area-based behavioral health care agency.

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