How Can We Improve Mental Health Care for Children and Families?
Combating stigma and fostering promotion and treatment for mental wellness
With young students returning to in-person education after a long layoff, it is time to focus on what we can do to bolster mental-health support systems.
I take seriously my distinct roles of counselor, educator, school consultant and higher education administrator, but my role as the mother of three teenagers, whose lives have been upended by this pandemic, currently causes me to lose sleep.
I often learn of a different family in my personal circle facing an unanticipated crisis with their teens who, like my children, have been deprived of critical experiences and milestones, who take classes in their pajamas from their darkened bedrooms, and whose social lives are sparse and insufficient.
Prior to COVID-19, nearly eight million U.S. youths had at least one treatable mental health disorder. Even then, when access to care was less impeded, nearly half went untreated. As the pandemic abruptly limited the socialization of our youth, it has decreased access to critical resources when youth vulnerability is at an all-time high.
Virtual schooling and widespread cancellations of extra-curricular opportunities have resulted in increases in anxiety, depression, substance use and suicidality among youth, while also increasing the likelihood of their witnessing or experiencing domestic violence and maltreatment as the wide-reaching impact of the pandemic takes its toll on adult mental health.
As Philadelphia’s schools re-opened recently for many young students, even those not facing mental health challenges may experience difficulty readjusting.
Our own systems at Jefferson are experiencing an up-tick in behavioral health emergencies. In fact, our Counseling and Behavioral Health Department (CBH)—which houses two clinical masters programs, Community and Trauma Counseling (CTC) and Couple and Family Therapy (CFT)—is now working closely with the trauma center at Abington – Jefferson Health to grow their capacity to support the ever-increasing number of pediatric patients seen in the emergency department with behavioral health needs.
In the coming weeks, CBH students will begin interning at Abington to support the growing pediatric behavioral health crisis.
While we are taking steps to bolster our own systems, we must also look to support other critical systems that serve our region’s youth.
Historically, schools have served as critical venues for mental health services.
Disproportionately, children growing up in poor, under-resourced communities—like many across the School District of Philadelphia catchment area—are more likely to receive mental health support solely within school settings. Schools also identify emergent family needs and can serve as entry points for health care and other critical services.
Nearly 40 Counseling and Behavioral Health Department graduate students work within K-12 schools throughout the region to support the mental health needs of students.
As Philadelphia’s schools re-opened recently for many young students, even those not facing mental health challenges may experience difficulty readjusting.
Mandated adherence to expectations around distancing and masking that are unnatural to children craving reconnection, earlier wake times to account for school commutes, academic and social regression as a result of disengagement and isolation, stressed and even fearful teachers—all pose unique adjustment challenges for students and staff. An increase in behavioral health referrals, and a rise in discipline referrals that often mask behavioral health needs, are more than likely.
Our public-school systems have long been challenged by students’ behavioral health needs, and it is these same systems that employ only a small number of behavioral health providers, like school counselors, psychologists and social workers.
We can no longer ignore mental health. Significant investments must be made to support the well-being of our children.
Our department has long been a partner to the School District of Philadelphia, the Mastery Charter School system and a number of other schools and districts locally.
Each of us across Jefferson must do more collectively and individually before the crisis becomes insurmountable.
Nearly 40 CBH graduate students work within K-12 schools throughout the region to support the mental health needs of students. Though this number has decreased slightly since school buildings have closed, most of these students continue to work with students and families virtually.
The department has also engaged in innovative projects to support student well-being. One such example is a program where Dr. Angelle Richardson, assistant professor, served as a trauma and grief counselor within Furness High School two days per week, while also supervising CTC students on site to better address student needs.
Unfortunately, this program was put on hold when schools closed their doors last March, though plans are in the works to resume this partnership when buildings reopen. Students from the CFT program, who historically partner with several district schools through their Community Partnership Initiative (CPI), including Southwark Elementary in South Philadelphia, have also had limited opportunities to directly support students this year, but closed buildings did not stop their efforts.
This year, our CFT students engaged in meetings with counselors and teachers at Southwark, participated in some online classes with students via Zoom and developed ideas for addressing absenteeism and non-participation amongst kindergarten and first-grade students.
Finally, department faculty members have extended their expertise to various schools throughout the region, with the aim of growing community wellness strategies. Just last week, I facilitated a panel, which included Drs. Nicole Johnson and Angelle Richardson for the parent community of West Oak Lane Charter School, during which we focused on parent wellness and stress.
Each of us across Jefferson must do more collectively and individually before the crisis becomes insurmountable.
Far from advocating that all of us assume a therapist role, I call upon each of us to grow our capacity to identify concerns and offer support.
We must also press our elected officials to fund programs focused on prevention, early intervention and access to high quality care.
Now is the time for schools and systems to research and replicate novel intervention approaches that yield positive outcomes. These include partnerships with community organizations that increase a school’s capacity to address needs, or school-based integrated care clinics that address the whole child, providing health and mental health care in a collaborative, coordinated approach within the child’s natural environment. These programs reduce barriers to care for deserving children and families.
We will not have enough trained mental health providers in the years to come to serve the growing needs of our children. Healing happens in the context of safe, supportive relationships. Most children, if reared and educated within protective, nurturing spaces, will rebound from challenges quite well.
Committing to being a safe and consistent adult for the children in your lives is the bare minimum. Every adult should consider doing more.
Health and human service providers, faith leaders, community members, coaches, parents and grandparents should be equipped with an expanded skillset related to mental health. How can that happen?
Dive in and commit to increasing your awareness of and sensitivity to the impact of adversity on child development.
Far from advocating that all of us assume a therapist role, I call upon each of us to grow our capacity to identify concerns and offer support.
Pursuing training in Youth Mental Health First Aid or other (often free) programs can grow your skills and knowledge.
Resources abound related to trauma-informed approaches in schools, health care and communities. Dive in and commit to increasing your awareness of, and sensitivity to, the impact of adversity on child development.
As Frederick Douglass wisely asserted, “It is easier to build strong children than to repair broken men.” Today’s children are tomorrow’s leaders. We must all commit to doing our part to build strong children and mitigate this crisis.
Jeanne Felter, PhD is an associate professor and Chair of the Counseling and Behavioral Health Department at Thomas Jefferson University.
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