Shining a Light on Teen Mental Health

Julie Greicius
Thursday, November 10, 2016
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Elizabeth Kuriakose contributed to this story.

With your support, a brighter future is in sight.

When your child gets a fever, you know exactly what to do—call the pediatrician. When he breaks his arm, the first step is clear—head to the nearest emergency room. But if your child develops incapacitating anxiety, a life-threatening eating disorder, suicidal thoughts, or another mental health challenge, would you know where to turn?

Sadly, it is at this great moment of great need that the mental health care system often fails families.

In April 2016, Gunn High School student Chloe Sorensen lost her friend Sarah to suicide. Sarah’s death was Palo Alto’s 15th suicide since 2009 of a person under the age of 24.
 
“Although I had lost many of my peers, and many of my friends were deeply impacted by the previous deaths, it had never hit so close to home for me before,” wrote Chloe in a recent blog post.
  
So many of us—parents, students, educators, and professionals—have similar stories of loss. We know the wave of grief that ripples from school to home, where we struggle to reconcile not only the loss of a peer, but the realization that a person so young could feel so much pain. At the time of her death, Sarah, who was on leave from college, was in treatment for her depression. Unfortunately, that is not the case for the majority of young people who die by suicide.
 
The problem of adolescent mental illness is not unique to Palo Alto, and it cuts across socioeconomic lines. According to the Centers for Disease Control, suicide is the second-leading cause of death for young people ages 10 to 25 in the United States. An estimated 17.1 million U.S. children and adolescents now have, or have had in the past, a diagnosable psychiatric disorder.

Of those, two-thirds of children with a mental illness do not get treatment. This neglect impacts the community in myriad ways, not the least of which is economic. It is estimated that the cost to society of untreated mental illness in young people is hundreds of billions of dollars a year.

You don’t have to be a medical expert to know that this is unacceptable. Adequate mental health treatment is not a luxury. It is the most important and unmet health care need for adolescents. 

“The primary health issue for young people ages 12 to 25 is mental health,” says Steven Adelsheim, MD, associate chair for community partnerships in the department of psychiatry and behavioral sciences at Stanford. “Kids this age are generally pretty healthy as a group, but the issue that is most common during this period is mental health-related problems.”

The Stigma of Mental Health

Unfortunately, the stigma around mental health often prevents people from talking about the issue or getting help.

Adelsheim adds, “Access for mental health support is not nearly as strong as the access for asthma or diabetes or obesity or other conditions. And we wouldn’t allow it to be this hard to get health care for any other condition. But the stigma issues are so big, and the discomfort talking about it is so big, that mental health care is much harder for people to come by.”
 
“Mental health is often the elephant in the room,” said Christopher Dawes, president and CEO of Lucile Packard Children’s Hospital Stanford, to a packed room of nearly 400 attendees at the Adolescent Mental Wellness Conference, hosted this summer by Packard Children’s, the Stanford Medicine Department of Psychiatry and Behavioral Sciences, and the Department of Pediatrics Division of Adolescent Medicine, in collaboration with other community partners.

“We all need to be part of the solution,” Dawes added. Even Chloe Sorensen, after the loss of another peer when she was just 15, was compelled to take action. She stepped up as a sophomore to lead Gunn High School’s newly formed Student Wellness Committee. Since then, she’s enlisted friends and staff to address the issue, helped implement new wellness programs, and worked to fight the stigma of mental illness.

“Rather than turning our backs or sweeping these issues under the rug and allowing them to become taboo,” says Chloe, “we faced our challenge head-on.”

Facing the challenge head-on is exactly what we at Stanford Medicine and Lucile Packard Children’s Hospital are working to do. We’re committed to helping solve the adolescent mental health care problem in the ways in which we are uniquely positioned, qualified, and obligated to do so.
 
Since 2009, we’ve doubled the volume in our out-patient child psychiatric clinic to 20,000 visits per year. We have also increased our presence and partnerships in school and community settings to help identify children with mental health needs earlier.
 
This effort is just the beginning. Today, we’re focused on a vision for a brighter future for young people. 

“As an academic medical center, we owe it to our patients and our community to make sure that we have services that will optimize the level of care,” says Antonio Hardan, MD, chief of the division of child and adolescent psychiatry at Stanford. “Working together by developing a continuum of care, we can change the landscape of mental health treatment for young people.”

Like Chloe, we’re determined to do everything we can to make a difference. 

“We’re working to solve gaps in care along the whole spectrum of childhood mental illness,” says Laura Roberts, MD, chair of the department of psychiatry and behavioral sciences at Stanford. “By the time someone needs inpatient psychiatric care, things have gone too long. We are learning that young people in distress often will have gone for as long as two years before receiving any sort of care from a mental health professional. We want to support kids early—before they get so sick that they need inpatient care, before they have lost their friendships, before they are doing poorly in school, before they have troubles with their families—before they have suffered so much and feel so alone.”

The only way to solve this problem is by working together.

We stand together with many caring individuals and organizations who are devoting their energy and expertise to this issue. We are developing vibrant partnerships with county- and state-based programs, health care providers, school districts, foundations, community coalitions and agencies, other hospitals, and youth and families to explore integrated, innovative, and preventive approaches. 

“It’s time to expand the community conversation about youth mental health,” says Sherri Sager, chief government and community relations officer at Packard Children’s. “We are bringing together a diverse group of community members and leaders to create greater awareness, understanding, and support for young people and their families.”

Our vision, says Roberts, involves four key strategies: performing forward-thinking research, identifying young people who are at risk or are experiencing early symptoms, providing rapid access to a continuum of care, and widely disseminating knowledge and services.

This vision can only become a reality with your help.

Today, we are working to achieve these important goals:

  • Provide essential services and a continuum of care to treat mild to moderate to severe conditions—offering the appropriate intervention at the right time, and preventing hospitalization whenever possible, while also ensuring Stanford-staffed beds are available when needed.
  • Partner with our community in providing solutions, so that families and youth will know where to turn and services will be available and accessible regardless of a family’s financial means.
  • Lead and participate in a variety of innovative youth-centered approaches to help overcome the stigma of mental illness.
  • Lead research into the root causes of mental health disorders and into innovative ways to address the problem through technology and policy, and disseminate these findings nationwide. 

Over the past year, we have:

  • Launched the Stanford Center for Youth Mental Health and Wellbeing, which includes early mental health support and exceptional clinical care, educational and community partnerships, and a mental health and technology program.
  • Established a Crisis Team in our Stanford Health Care/Lucile Packard Children’s Hospital Emergency Department with dedicated staffing. We can now immediately evaluate, provide psychological education, and triage young people to the appropriate care within 24–48 hours, and refer them to an appropriate outpatient psychiatric team if they do not already have one.
  • Partnered with the Palo Alto Unified School District, Mountain View–Los Altos High School District, AchieveKids School, East Palo Alto Academy, Sacred Heart Schools (Atherton), and St. Ignatius College Preparatory (San Francisco) to provide consultation to school staff and leaders or direct clinical services to students. We have also recently expanded these services to San Mateo Union High School District and the Los Altos School District.
  • Secured initial funding to test the feasibility of an early intervention program based on headspace, a model that has proven effective at nearly 100 sites across Australia. The headspace model provides a safe, welcoming place for young people ages 12 to 25 to walk in for early mental health support. We have also secured a commitment of $600,000 from Santa Clara County to pilot a public program modeled on headspace.
  • Engaged 62 local teens and their families in a study to understand their mental health needs and concerns, which reflected the tremendous need for coordinated, accessible, confidential, reliable, and youth-friendly mental health outreach and services in San Mateo and Santa Clara Counties.
  • Continued to work with our community partners in East Palo Alto to improve access to mental health services and to help children become healthier and more resilient (see From Neuroscience to Yoga).
  • Hosted an Adolescent Mental Wellness Conference attended by nearly 400 people. The goal of the conference was to break down stigma associated with mental health diagnoses, increase communication between stakeholders, and identify best practices that can increase access to care.
  • Helped write and pass AB 2246, the Student Suicide Prevention Bill, requiring all school districts in California to adopt suicide prevention and wellness promotion policies for students in grades 7–12.
  • Conducted research on peer-led suicide prevention programs in the San Francisco Bay Area.
  • Helped Caltrain and the city of Palo Alto initiate new technologies to monitor for suicide-related behaviors at the Palo Alto train crossings.

Within the next 12 months, we will address immediate critical needs.

  • In 2017, we’ll start an eight-bed Stanford-staffed inpatient adolescent psychiatric program within Mills-Peninsula Hospital in Burlingame.
  • We’ll continue to work with other local hospitals to develop better and more accessible inpatient care staffed by Stanford Medicine specialists.
  • We’ll launch an intensive outpatient program for suicidal and para-suicidal patients with mild to moderate needs. This after-school clinic would be available three or four times per week for three hours per day of individual, group, and family therapy.
  • We’ll further expand our Crisis Team to local high schools. “Providing mental health treatment in school is important because mental health is part of overall health,” says Shashank Joshi, MD, director of school mental health services for Stanford’s division of child and adolescent psychiatry. “You need your brain healthy to learn.”
  • We’ll launch a school-based program in Palo Alto Unified School District elementary schools to serve children in grades K–5. In collaboration with school administrators and teachers, we will help evaluate and treat moderate- to high-risk students in need of immediate care, and also work with teachers and families to identify issues that may lead to future challenges. 

This is just the beginning. With your support, we can do much more.

  • We’ll launch two pilot sites modeled on headspace to give children and teens a safe, welcoming place to access care for a variety of mental and physical health concerns.
  • We’ll recruit additional faculty with expertise in addiction, anxiety, autism, eating disorders, substance abuse, attention deficit hyperactivity disorder, and other areas to build out our capacity for clinical care and research.
  • We’ll establish a crisis hotline that any local family or care provider can call for referrals on mental health services and resources, so that Stanford expertise is available with a single phone call.
  • We’ll invest in research to better understand the underlying biology of mental health.
  • We’ll foster innovation and lessen the impact of mental health disorders. This will include two new initiatives—a Public Policy Research Center to study and advocate for the best government and civic solutions to mental health, and a Technology Research Center to explore methods of using child- and teen-friendly technologies such as smartphones and video games to increase access to mental health care.
  • We’ll disseminate findings and solutions to change the tide nationwide.

Our Top Priority

We know that mental health, wellness, and care are a top priority for our community, and we want to ensure that every young person and family has access to the level of mental health care they need. We are poised to make this vision a reality, but we can’t do it without your help.

“We want to do beautiful work in real time to encircle young people and support them with resources that they need,” says Roberts, “to prevent what we can, to identify children early, and to have services that are really attuned to what the child needs.”

Creating the services our children and adolescents need simply cannot be done without community support. If you—like Chloe Sorensen and so many other community members—are as moved as we are by the mental health crisis our teens are facing and you are determined to participate in creating a brighter future, we invite you to join us in building a new model of mental health care.

Together with your support, we can bridge the gaps in the current mental health system and ensure that innovative care grounded in science is just a phone call away for every child in need.

As the saying goes, it takes a village—friends, family, and community, including institutions like Stanford Medicine and Packard Children’s—to provide compassionate and meaningful support and care. With your help, we can remove the barriers to care, including negative attitudes toward mental illness, so that no young person feels reluctant to ask for help. It can make the all-important difference in a young life.

Be Part of the Solution

If you’re concerned about the mental health of our children and teens, you can help.

Give now online at supportLPCH.org/mentalhealth.

To discuss giving opportunities, contact Andrew Cope at (650) 724-5005 or Andrew.Cope@lpfch.org.

This article first appeared in the Fall 2016 issue of Lucile Packard Children's News.

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