“How do you eat an elephant? One bite at a time.” That piece of advice has been showing up in many different parts of my life lately, including at a recent youth mental health forum in Oakland, hosted by Lincoln Child Center on January 6th. The event featured a wide range of presenters, including child advocates, legislative staff, young people with lived experiences, clinicians, policy experts, and educators. Panelists discussed common barriers to quality mental health care for kids and young people and proposed solutions that we all can pursue in 2017 to ensure that every child is valued and receives appropriate mental health services when needed.
Several themes emerged from the discussions among the panelists and audience members. To begin with, most participants seemed to agree about the common barriers to mental health care that children and youth face. For example, as panelist Dr. Lynn Thull, a licensed and practicing child psychologist, discussed, the state is “fragmented” when it comes to providing mental health services to children and youth. There are numerous state and county agencies that address children’s issues—including, for example, child welfare, mental/behavioral health, probation, and education—but none of them talk to each other, and, in some cases, discord exists within a single agency. This results in confusion for youth and their families, repeated denials of service, a lack of accountability, and young people having nowhere to go for help.
In a heartbreaking example of what can happen when a young person’s mental health needs go unaddressed, panelist L. Karen Monroe, Alameda County’s Superintendent of Schools and a former school principal in Oakland, relayed an incident that occurred some time ago in which a student attempted suicide on the school playground. Fortunately, the young person survived that incident, but school-based mental health services were non-existent at the time, which continues to be a pressing issue for youth in many educational settings. Thankfully, Superintendent Monroe and other allies have been putting their heads together to create innovative programs that address the lack of mental health programming for youth at schools.
Another presenter, Leslie Preston, Director of Behavioral Health at La Clinica, discussed how vulnerable children and youth often receive the short end of the stick when it comes to mental health care because of the bureaucratic hurdles and unending paperwork involved in the client and provider experiences. She discussed how clinicians must spend a significant portion of their time completing paperwork, remarking that they “spend as much time treating a chart as they do treating families.”
Despite such challenges, forum participants were hopeful and recommended a number of encouraging solutions—or “bites”—that stakeholders can pursue going forward. A significant topic of conversation revolved around youth’s need for peer counselors and how the field could benefit from incorporating nontraditional methods of treatment into its daily practices. Jeremiah McWright, a youth panelist and a leading voice in California’s foster youth community, stated: “We need someone we can relate to.” His sentiments were echoed by other participants and audience members. For example, during the question and answer session, Patrick Gardner, YMA’s President, mentioned how California used to have a peer counseling program as a part of its Children’s System of Care, but that no longer exists. He recommended that policy-makers and others in positions of power bring back the peer counseling program as it “improved accountability” and “is an essential part of delivering services.” In fact, when it comes to improving mental health for young people, peer counseling is evidence-based and has been proven to “[r]educe symptoms and hospitalizations” and “[e]ncourage more thorough and longer-lasting recoveries,” among many benefits.
Some other proposals included initiatives to achieve full access to mental health care for young people and demanding that the state do a better job of collecting data and assessing the quality of mental health services being provided. In one example of what we can do to achieve full access, Mr. Gardner pointed to the expansion of Katie A. services. Previously limited to foster youth and youth at risk of out-of-home placement, these therapeutic services are now available to all Medicaid eligible youth who need them, including those in the juvenile justice system. However, implementation has been slow. Building out these services, for all youth who are now eligible, would enable thousands of additional young people to receive individualized, strengths-based services in their home communities, rather than being shipped to faraway congregate juvenile institutions and group homes.
Our local communities hold the key to achieving lasting change when it comes to the mental health of our young people. As Toby Ewing, Executive Director of the Mental Health Services Oversight and Accountability Commission, stated, “money isn’t the issue.” He recommended three steps youth, families, and advocates can take to secure better results:
- “Set clear goals for children in your community”;
- “Make clear whose job it is to achieve those goals”; and
- Figure out discreet ways in which the community can measure progress and hold the identified decision-maker/s accountable.
While the above tasks and goals might seem daunting at first, it’s helpful to remember that if we take it one “bite” at a time and band together at the community level, we’ll get there slowly but surely.