Kailin Hsu, MD, Director of Product Solutions and Clinical Programs
Pediatric leaders are currently facing a unique set of challenges, including the youth mental health crisis, “tripledemic”, and workforce burnout to name a few. In an effort to facilitate best practice sharing, my colleague, Katherine Virkstis, ND, VP, Clinical Advisory Services, and I have launched a new cohort that brings together pediatric leaders across the country in roundtable-style sessions. Our Pediatric Leadership Cohort meets quarterly and recently held its first session on youth mental health. During this session, participants from various healthcare organizations shared a multitude of ideas with one another to address this alarming trend.
Why is youth mental health an issue?
The United States is witnessing an unprecedented level of need and urgency in youth mental health, which has been further exacerbated by the COVID-19 pandemic, racial injustice, and gun violence. 42% of high school students report persistent feelings of sadness or hopelessness, and the percentage of youth who have had a major depressive episode has climbed since 2019. Further compounding this plight are the glaring disparities that have caused children and adolescents of color to suffer disproportionately more. Suicide is the second leading cause of death for 10-18 year olds, with the highest increase in the rate of suicide amongst non-Hispanic Black youth ages 10-24 from 2018-2021.1
As voiced by our cohort participants, our healthcare systems are facing the strain of downstream consequences. There are increasing rates of health-related emergency department visits among adolescents, long referral times to mental health providers, bottlenecks in long-term mental health facility placement, and an uptick in workplace violence.2
Though the effects of poor mental well-being among children and adolescents are obvious, our nation’s youth and healthcare systems continue to struggle in the face of a worsening situation.
What are the challenges in tackling the youth mental health crisis?
Our Pediatric Leadership Cohort identified the following barriers to improving youth mental health:
- The mental healthcare ecosystem is poorly coordinated, difficult to access, confusing to navigate, and lacking in workforce and sufficient services.
- Both primary care providers and school staff are not well-equipped to identify early warning signs and intervene appropriately.
- There is a stigma associated with mental health that makes it difficult to recognize and accept help, as well as hindering large-scale change in certain communities.
- There are regulations on services that can be provided and the establishment of a sustainable reimbursement model presents additional challenges.
Interestingly, the rising cost of care, which is often a significant barrier in healthcare, was not cited as an obstacle in this case.
What can be done to improve youth mental health?
Our cohort participants shared remarkable strategies and tactics to better the emotional well-being of children and adolescents. Here are some of my top 4 insights from the session:
- Invest in upstream measures by improving education and training on behavioral health issues for primary care providers and school staff. These individuals will often be the ones well-positioned to recognize youth who are struggling and navigate them towards appropriate mental health support.
- Cultivate a hospital environment that is more sensitive to the needs of those with behavioral health issues. Create dedicated areas that are designed to provide structure and remove excessive stimuli, train staff on trauma-informed care and safe handling, and adopt a continuity of care team model to optimize the care and experience for patients, families, and care teams.
- Support staff on the frontline, enabling them to stay on the frontline. Establish an internal code for escalation of patients with behavioral health issues and create response teams for behavioral de-escalation. Hire leadership that is focused on the mental health and well-being of both patients and staff.
- Promote further research and innovation in youth mental health. Advocate for health policy and funding proposals related to mental health, lead research projects, and collaborate with philanthropists and entrepreneurs to encourage innovative solutions.
Exploring the role of digital technology in youth mental health
Moving the needle on youth mental health will require an inventive combination of technology, layered with human connection, to extend our reach, intervene more upstream, and scale our efforts. Get Well has collaborated with Canopy Children’s Solutions and Learn to Live to develop Canopy Anywhere – a comprehensive solution that provides mental health and social determinants of health (SDOH) services to youth and their caregivers.
Through Get Well’s tech-enabled outreach, screening, triage, and resource navigation, Canopy Anywhere offers a range of resources, including a digital wellness program, virtual cognitive behavioral therapy powered by Learn to Live, in-person mental health support, and community-based organizations. Canopy Anywhere also delivers hope content, empowering youth and caregivers to take actionable steps towards improving their well-being.
We are currently piloting a version of this program in two public schools in Mississippi. By engaging students and caregivers through a web-based program, we are identifying those at risk for mental health and SDOH issues, respectively, and navigating them to appropriate services. Through this pilot, we are also providing education on mental health issues and strategies for improving and maintaining high levels of hope. Early feedback from the pilot is promising: 81% of youth we reached out to activated their account, 20% of youth who completed the Hope Scale were identified as needing additional mental health support due to low hope scores and navigated appropriately, 56% of youth identified were previously unidentified on the school’s universal screener, and 46% of caregivers who completed the SDOH screener were identified as requiring SDOH resources and successfully navigated to them. These compelling results highlight the prevalence of mental health and SDOH needs in the community, and the power of technology to identify and address those needs.
If you are interested in learning more about Get Well’s efforts to improve youth mental health, please reach out for more information.
Special thanks to leaders from the following healthcare organizations who contributed to our engaging inaugural session: BayCare, Children’s Hospital at Montefiore, Children’s Hospital Colorado, Children’s National Hospital, Connecticut Children’s Medical Center, Seattle Children’s Hospital, Stanford Medicine Children’s Health. If you are a pediatric care leader and would like to join our Pediatric Leadership Cohort, register here.
1Child and Adolescent Mental and Behavioral Health Principles. Child and Adolescent Mental Health; April 14, 2023. Accessed January 26, 2024. https://downloads.aap.org/DOFA/2023%20CAMH%20Principles.pdf
2Yard E, Radhakrishnan L, Ballesteros MF, et al. Emergency Department Visits for Suspected Suicide Attempts Among Persons Aged 12–25 Years Before and During the COVID-19 Pandemic — United States, January 2019–May 2021. MMWR Morb Mortal Wkly Rep 2021;70:888–894. DOI: http://dx.doi.org/10.15585/mmwr.mm7024e
