Challenge the status quo on student mental health
A one-size-fits-all approach is not going to get it done
WE ARE FACING a seismic shift in the mental health of an entire generation. Children today are grappling with profound emotional and mental distress:
According to the CDC, one in three high school students experienced such persistent feelings of sadness or hopelessness in the past year that they couldn’t participate in their regular activities. And approximatldely one in six reported making a suicide plan.
In a recent report from the Pew Research Center, more than 40 percent of parents in the US say they are extremely or very worried their child might suffer from anxiety or depression; mental health was the number one concern among parents surveyed.
The way we approach mental health is fundamentally flawed. Historic disparities and inequities documented in our health care system are multiplied in mental health care. We routinely underestimate need, provide a limited toolbox to address symptoms, and fail to account for the economic truth that merely growing our current approach is unaffordable, ineffective, and unsustainable. Only a fundamental change to our systems of care can turn the tide on children’s mental health.
Schools have become, by default, the place where children’s mental health problems are first recognized and supported. While in recent years much work has been done to address problems with access to care, too often parents and caregivers receive referrals to resources or names of providers that do not have openings. As the problem with access grows worse, we are missing an incredible opportunity for timely intervention. Schools should become the primary access point for care, not by default, but by design.
The fact is, there will never be enough clinicians to provide one-on-one care for all the children who need it. We can’t hire our way out of this workforce shortage. Instead, we must partner our way out of it while simultaneously broadening the scope of care beyond individual therapy. We need to find new ways to apply a community-based approach to child mental health. Instead of a one-size-fits-all approach, we must adopt a holistic approach to care that emphasizes accessibility and collaboration, leveraging personal relationships to facilitate treatment.
Across the Commonwealth and the country there are initiatives, programs, and even app developers trying to do just that. The school-based bryt program, developed by the Brookline Center for Community Mental Health, is available to students at 250 schools across eight states. Bryt programs have successfully helped tens of thousands of students transition back to full participation following a mental health disruption.
In schools, 10 percent of students with the most significant challenges take up 90 percent of school counseling time. By focusing on students with the most serious problems, bryt shifts that paradigm, enabling schools to support the mental health needs of the other 90% percent.
Researchers at Clark University have developed the “Mi Peace” app, which provides guidance and self-help for common mental health concerns. It gives students more control over their own treatment and has the potential to reduce the need for one-on-one therapy. The app is offered to schools and community groups to support the needs of the young people they serve.
School officials in the Cherry Creek district of Colorado recognized that more than half of the programs to which they had traditionally directed students experiencing serious mental health challenges had closed down in recent years. To meet the need, Cherry Creek passed a bond allowing the district to build an in-district facility that will offer three levels of care – intensive outpatient, step down, and transition – to support its students. This brings incredible value by eliminating barriers that often prevent children from accessing treatment.
What unites these approaches is a willingness to challenge the status quo and think differently about how, where, and by whom care is delivered. We must utilize all tools, all technologies, and all innovations. Only then will we have a mental health system that adequately, equitably, and effectively meets the needs of children today.
To transform, we must acknowledge that today’s mental health care system is part of the problem, not the solution. It is a problem Massachusetts Gov. Maura Healey seems poised to prioritize with her appointment of Kate Walsh as secretary of Health and Human Services.
Walsh has a track record of innovating in healthcare, and the governor has stated her commitment to addressing affordability and promoting health equity while maintaining the highest quality of care. Together, they can create an environment that not only encourages innovation and change but catalyzes and incentivizes it. Acknowledging the system’s shortcomings will take bold action, the kind Healey talked about on the campaign trail and is now equipped to accomplish.
Ian Lang is the chief executive officer of The Brookline Center for Community Mental Health. The Brookline Center transforms the mental health system through the development and delivery of innovative programs and services.