Before the pandemic, the idea of communicating with a therapist via text seemed unthinkable. Then COVID closures and an unprecedented surge in changed everything.

I know what a difference it makes for teens because I talk to them almost every day.

I am a therapist who works for , New York City’s free mental health service connecting young people with licensed multilingual therapists through the secure (and ) platform Talkspace. This effort is breaking down barriers to mental health care, especially for those who may struggle to find a therapist who meets their needs.

The program, launched a year ago this month by Mayor Eric Adams and the New York City Department of Health and Mental Hygiene, is available to anyone ages 13 to 17 living in New York City, regardless of their school, immigration status, income level, or insurance status. No payment or insurance information is required.

While we ask all teens to share a parent or guardian’s information so that they can provide consent, in special circumstances, permits waiving that requirement, for example when the young person is emancipated, incarcerated, or if notification is deemed detrimental to their well-being. That is something that the licensed therapist assesses.

For many teens, it’s the first time they’ve ever talked with a therapist. And my goal is to create a space where teens feel like they can be themselves. Asking questions, staying curious, and not making assumptions are key to helping young people feel supported.

While many of our interactions are asynchronous and over text, I always encourage a live face-to-face video session or offer to send asynchronous audio or video messages. I want them to know that it’s OK to ask questions that can help them better understand therapy, mental health, themselves, and how to advocate for their needs.

They’re often curious to learn about depression, ADHD, PTSD, and other diagnoses they may have heard about or from their friends. Sometimes, they ask if I’m a real human or if I’m AI. They like hearing that I grew up in New York, in the Bronx and Yonkers, that I have a cat, and the types of music I enjoy.

Teens may be experiencing anxiety or depression, or they may be grieving. But they don’t need to be experiencing symptoms of mental illness or living with loss to participate. They may be navigating a new relationship or breakup, adjusting to changes in their family dynamics, or experiencing uncertainty about what they want to do after high school.

We talk about what’s causing them stress and what will improve their quality of life. It’s rewarding when I hear from a teen client who has tried a technique we’ve practiced, like deep breathing, , , or communication skills, and found that it works. From my experience, teens are more likely than adults to share their progress as it’s happening, rather than to reflect on it several months later.

How effective is NYC Teenspace? More than 16,000 teens have signed up for the service so far. that 65 percent of users reported improvement in their mental health, and that number is growing. Underserved neighborhoods in Brooklyn and the Bronx lead the city in signups, and 60 percent of users identify as Black or Hispanic.

Going forward, I hope to see even more teens using it, especially boys. shows that teenage girls have been more than three times as likely to seek help on the platform. We have work to do to increase reach to teen boys, who may encounter more .

Still, I’m astonished by telehealth’s ability to promote strong connections with users, particularly Gen Z. These digital natives communicate effortlessly through text and other online media. They express themselves in ways an adult patient typically wouldn’t. They share photos of their pets, selfies, memes, audio clips — and, yes, lots of emojis — offering glimpses into their world that enrich the therapeutic process.

NYC Teenspace therapists can communicate in 13 different languages, and the platform uses translation support in 120 languages.

No matter what their language, teens tend to find on-demand messaging a more comfortable, accessible option in which to open up about their challenges in ways they might find difficult IRL. Between school, commuting, extracurriculars, and other responsibilities, some teens have avoided therapy because it has been challenging to get to an in-person appointment. Having a private space can often be a challenge for any New Yorker, and this is no different for teens. More than half of all users prefer exclusively engaging with their therapist via messaging.

The current is 1 for every 272 students, and there are even fewer licensed mental health professionals. Last year, nearly in New York City reported experiencing mild to severe depressive symptoms. They worry about the future or something bad happening to them or to their families, which may be a sign of anxiety.

Skeptics of therapy in a digital space may say that the experience of in-person treatment can’t be replicated. In some instances, this is true. However, therapy that can happen via telehealth can connect with teens in a way that meets their needs. As any teen today can tell you, messaging is how they communicate with their closest friends. Online therapy is also much easier than in-person appointments to scale amid unprecedented teen mental health needs.

As with any treatment, it’s important to know the limitations. NYC Teenspace therapists are responsible for assessing clients for risks, including risks to themselves or others. If a teen presents with significant concerns like self-harm or suicidality, their therapist is expected to share resources, make appropriate referrals, and intervene as needed to ensure safety.

For the majority of teens who are not in crisis, NYC Teenspace offers a vital space where they can explore their emotions, develop coping strategies, and build resilience. These are skills they can bring with them as they grow into adulthood.

This story was originally published by Chalkbeat. Chalkbeat is a nonprofit news site covering educational change in public schools. Sign up for their newsletters at .

A new initiative from the University of Vermont hopes to address the shortage of mental health professionals available to support the state’s youth.

Known as the Catamount Counseling Collaborative for Rural Schools, the program plans to train and place 52 school counselors, social workers and mental health clinicians in rural schools throughout Vermont for the next five years.

 from the U.S. Centers for Disease Control and Prevention have found rising levels of depression and anxiety among Vermont middle and high school students. 

Despite this, Vermont lacks an adequate number of . In 2023, the state’s Workforce Development Board estimated a need for 230 more providers to meet growing demand. 

The new Catamount Counseling Collaborative for Rural Schools aims to address the gap. 

Through the program — funded by a $3.8 million grant from the U.S. Department of Education — University of Vermont graduate students are expected to contribute at least 25,000 clinical hours annually to support rural communities.

“Vermont mental health needs are pervasive and complex and they’re currently underserved and this is a way to reach them,” said Anna Elliott, associate professor of counseling.

Elliott, the principal investigator for the grant, has experience running a similar initiative in Montana, where she spent five years developing a program to support rural communities with mental health professionals. 

A key part of the program, Elliot said, is to encourage graduates to continue working in rural schools or mental health facilities after completing their training. She said she tailored the program to Vermont’s unique needs. This included analyzing various statistics from community needs assessments on issues such as suicide rates, substance use disorder and the stigma associated with seeking mental health services, ensuring the program aligns closely with the landscape of Vermont’s mental health needs.

“One of our primary goals in setting up the training program was attending to students’ reports that they often didn’t feel prepared to go and work in a rural environment,” she said. “Having an intensive and intentional training program that sets them up to really understand what they’re walking into and how to be prepared and how to ask for support incentivized students to stay, so we’re hoping to replicate that here.”

The program offers a stipend to those who remain in their assigned schools for at least one year, helping to ease potential barriers like securing a full-time job or finding affordable housing.

In Montana, Elliott said she noticed some graduate students couldn’t stay in rural schools due to limited funding for permanent positions. Other challenges, including housing and job security, also made it difficult for them to remain in these high-need areas.

“I’m taking the model that I did in Montana and integrating that in with the community schools model to not just say, ‘here’s a couple graduate students that will be here for a year’ but let’s actually take a systemic look at what’s happening in the school — what are the needs, resources, barriers and strength,” Elliott said.

To address these challenges, the program focuses on recruiting graduate students who already come from rural areas. By offering low-residency options, the program allows these students to complete much of their coursework remotely. This means they can stay at home rather than moving to campus, making it easier for them to balance their studies with their existing commitments.

“This grant provides significant opportunity to bring students into the helping professions who might not otherwise have access to this kind of specialized training,” said Danielle Jatlow, a co-principal investigator and social worker who coordinates UVM’s bachelor’s of social work program, in a press release from the university.

UVM faculty, including program co-leaders Robin Hausheer and Lance Smith, both associate professors of counseling, are starting outreach to rural schools. They hope to place graduate students in schools as early as this semester, according to the release.

“There are people and kids that are getting served this year that might not have been otherwise,” Elliott said in the release. “So that feels like everything.” 

This was originally published on .

New York City’s free online therapy platform for teens may violate state and federal laws protecting student data privacy, lawyers from the New York Civil Liberties Union and advocates charged in a letter Tuesday to the city’s Education and Health Departments.

, a $26 million partnership between the city Health Department and teletherapy giant Talkspace launched in late 2023, connects city residents between ages 13 and 17 with free therapists by text, phone, or video chat.

In less than a year, roughly 16,000 students have signed up, Health Department officials said. Sign-ups disproportionately came from youth who identified as Black, Latino, Asian American and female and live in some of the city’s lowest-income neighborhoods, .

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Information shared with a therapist is subject to stringent protections under the federal Health Insurance Portability and Accountability Act, or HIPAA. But before connecting with a therapist through Teenspace, teens go through a registration process that asks for personal information like their name, school, mental health history, and gender identity. Advocates are concerned such information is being improperly collected and could be misused.

For one, teens enter the registration information before securing parental consent – a possible violation of federal student privacy laws, the letter contends.

And families don’t get a chance to review the privacy policy – which discloses that registration information can be used to “tailor advertising” and for marketing purposes – before entering the registration information, advocates allege. There’s an option for teens to request that their data be deleted from the company’s platform, but it’s hard to find, according to advocates.

“It’s all very invasive,” said Shannon Edwards, a parent and founder of AI For Families, an organization that seeks to help families navigate artificial intelligence, who co-authored the letter along with NYCLU and the Parent Coalition for Student Privacy. “It’s also very unclear that parents understand what they’re getting themselves into.”

Advocates also pointed to the risk of a potential data breach – something the city has in recent years.

Advocates say similar about have been circulating for years and questioned whether city officials did sufficient due diligence or built in enough additional privacy safeguards before inking the contract.

“It’s the opacity of the relationship here, and the failure to make manifest what the city is doing to ensure there isn’t this data accumulation and sharing for inappropriate purposes,” said Beth Haroules, a senior attorney at the NYCLU who co-authored the letter.

Health Department spokesperson Rachel Vick said the agency has “taken additional steps to protect the data of Teenspace users and ensure information is not collected for personal gain, including stipulations that require all client data to remain confidential during and after the completion of the city’s contract and barring use of data for any purpose other than providing the services included in the contract.”

Client data is destroyed after 30 days if a teen doesn’t connect with a therapist, officials said.

A spokesperson for Talkspace referred questions to the Health Department.

The extent to which Teenspace is subject to state and federal laws governing student privacy in educational settings is somewhat murky, given that the contract is with the city’s Health Department, not its Education Department.

But NYCLU attorneys contend “the City cannot absolve itself of its responsibility to provide the protections inherent in federal and state laws…simply because the contract sits with DOHMH instead of DOE. The service is promoted on public school websites, and it is DOE’s responsibility to ensure that student data is protected, regardless of which City agency signs the contract.”

Parents may be more inclined to trust the platform because it has a “stamp of approval” from the school system, Edwards added.

A Health Department spokesperson didn’t specify whether the program is subject to education privacy laws, but said it’s “not a school based service.”

Teenspace has been the city’s highest-profile effort to address the ongoing youth mental health crisis.

“We are meeting people where they are with a front door to the mental health system that for too long has been too hard to find,” said Ashwin Vasan, the city’s health commissioner, in May.

Some teens have praised the program, noting it’s a way to bring mental health care to young people who may not otherwise have access.

But some mental health providers have argued it can’t replace the kind of intensive care a clinician provides, especially for kids with severe mental health challenges.

Company officials shared in May that they had helped 36 teens navigate serious incidents including reports of suicide attempts and abuse – cases they referred to child protective services, in-person therapists, or hospitals.

Talkspace CEO Jon Cohen previously told Chalkbeat the company uses an artificial intelligence algorithm to scan transcripts of therapy sessions to help identify teens at risk of suicide.

Even advocates critical of Teenspace’s privacy protections acknowledge the severe shortage of mental health providers and say teletherapy can play a role in filling the gap.

“We know you cannot find providers … there is such a need,” said Haroules. But advocates said the city can do more to ensure its vendors are meeting strict standards for data privacy, especially with such sensitive information.

“Everyone thinks, well, mental health is important for kids, these kids of services are required … when on the other side is: ‘How are they getting to it?’” said Edwards. “It doesn’t matter what the app is, there has to be a standard.”

This was originally published by Chalkbeat. Chalkbeat is a nonprofit news site covering educational change in public schools. Sign up for their newsletters at .

Children and adults who would benefit from various therapies to learn or to regain certain developmental abilities can get that help and more during three consecutive four-day that start July 17 at the University of Texas at El Paso.

For the second year in a row, UTEP’s Speech, Language and Hearing Clinic will conduct its free bilingual sessions from 9 to 11 a.m. in the Campbell Building, 1101 N. Campbell St. Each two-hour lesson will balance work with fun, organizers said.

Twenty-nine of UTEP’s speech-language pathology graduate students, backed by four clinical faculty and a staff member, will assist participants ages 5 to senior adults to work on their voice, fluency, aphasia, social skills, and/or the effects of traumatic brain injury to name a few areas.

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Among the participants who plans to attend all three sessions is Kivana Herrera, a 19-year-old Sunset Heights resident on the global developmental delay spectrum. In other words, it takes her longer to achieve certain developmental milestones. Her focus this summer will be to enhance her speech and social skills.

“She loves it,” said Iris Herrera, Kivana’s mother. “They work on things, but they are made to be fun and exciting, so it doesn’t feel like therapy. We think (the summer sessions) are awesome. We wish there were more.”

Herrera said one of Kivana’s speech therapists recommended in spring 2022 that the family try UTEP’s summer sessions. The mother said those sessions helped Kivana increase the number of words she uses in a sentence.

As a result, the family registered Kivana for the free SLHC, which conducts one-on-one sessions during the academic year. These also are important for UTEP’s speech-language pathology students who learn how to conduct assessments and suggest treatments under the supervision of faculty, who are licensed speech-language pathologists.

Herrera said that Kivana enjoys working with the therapists because most are young, and they can talk about clothes, trips, music and social activities. She added that the UTEP therapists have great personalities, and know how to motivate her daughter to work harder.

Herrera’s praise brought a smile to UTEP’s Deena Peterson, coordinator of the summer sessions and a clinical instructor of speech language and hearing sciences. Those comments echoed the verbal and written feedback Peterson received from families of participants from the previous summer, especially from families of school-age children who do not receive therapy outside the academic year.

Many noted how the sessions made their loved ones more competent and confident in their ability to communicate. They mentioned the enthusiasm of the student therapists and their genuine desire to help. As of mid-June, a good percentage of those registered for the 2023 sessions had participated last summer.

Peterson said that these free activities help El Paso’s underserved community members, who sometimes exhaust their health care benefits. She expects to enroll about 100 people for the summer sessions. The participants, separated by age and therapy needs, will use several of the labs, classrooms and conference rooms on the building’s first and second floors. The participant-student ratio will be less than 2-1.

Susan Magaña and Kristin Apodaca, both second-year speech language pathology graduate students, said they enjoyed the one-on-one sessions as part of the clinic, but looked forward to group therapy to practice behavior management techniques and working with children and adults with different goals. They talked about the upcoming sessions in the main therapy lab, which includes two walls with shelves stacked high with colorful toys, books and games used during the clinics and summer sessions.

“We’ll get to learn a lot at the same time,” said Magaña, a 1987 Austin High School graduate who, with her husband, operated a used car lot and home remodeling business before she decided to return to school after her children reached adulthood.

Her interest in her second career was personal. She raised four children with various disabilities to include hearing loss, dyslexia, high-functioning autism and attention-deficit disorder. In recent years, she witnessed her grandparents deal with their Alzheimer’s disease. In all cases, she saw how effective therapists could be.

Magaña said that the summer sessions were a great way children could bridge the therapy gap between the academic years.

Apodaca, a 2019 graduate of Hanks High School, has been interested in a speech language pathology career since high school when she would attend health fairs with her mother, a speech-language pathologist who was happy to help others improve their quality of life through therapy. One thing she has learned as an SLP student is that therapy is harder than it appears.

“It looks as if we’re playing, but there is a lot of intention behind everything we do because of how the brain and speech work,” Apodaca said. “You have to find the right strategies for the client.”

Apodaca said she looked forward to working with and learning from her clients, as well as the other members of her cohort.

“You know that everyone’s heart is in it,” Apodaca said. “Everyone wants to give back.”

Online registration is the best way to secure a spot, but people who cannot register online may contact the program at 915-747-7250 or speechclinic@utep.edu. Those individuals will need to come early on the first day of the session to fill out the necessary consent agreements.

Peterson said she plans to invite representatives from family resource centers to set up information tables in the first-floor student lounge for parents, guardians and caregivers who must stay during the sessions. After the lessons, the student therapists will debrief the parents/caregivers about the therapy conducted that day and how they can continue the learning process at home.

The work the UTEP students do during the summer sessions will benefit them during the 2023-24 academic year as they will work in school and hospital settings prior to graduation.

The summer sessions will follow a separate activity for children ages 5 to 17 who stutter. will operate from 9 a.m. to 3 p.m. July 10-14 in the Campbell Building. This free, intensive therapy program was organized by the at the University of Texas at Austin.

Peterson, who is familiar with the bilingual camp but not associated with it, said the center involves a lot of resources and a lot of fun to include a live deejay daily. She added that the same 29 graduate students who will be part of her sessions will help at the UT Austin camp.

“It’s awesome,” Peterson said. “It’s going to be fun for the kids. It will be a fun, interactive environment.”

This first appeared on and is republished here under a Creative Commons license.

Vanessa’s first two years of high school passed in a haze.

Some days she attended classes at her high school in East El Paso. Other days she ditched school to smoke or vape cannabis with her friends at a park. Then there were days she would arrive at school, walk straight back home and sleep all day after getting high alone in an empty house.

“There wasn’t a day that went by that I didn’t get high,” Vanessa said. “It made me forget the reason why I was alone. It was just a way to escape from reality, to dissociate.”

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Looking back, Vanessa realizes she was still in mourning from her sexual assault years prior and the rift it caused in her family.

When school counselor Alice Gardea felt concerned about why Vanessa was missing so many classes, she referred her to Project Vida, an El Paso-based nonprofit that offers therapy on campus.

Vanessa, who’s now 17 and heading toward her senior year of high school, described that conversation as the moment that “set everything in place.” Weekly therapy sessions helped her navigate her grief and take back control of her life, she said.

As , organizations in El Paso are partnering with school districts to make mental health care more accessible. Local mental health providers say that cost, scheduling conflicts and lack of reliable transportation are among the barriers that prevent students from accessing therapy, especially if they live in rural areas.

Emergence Health Network, a local agency that provides mental health services, offers on-campus therapy and case management in 10 different schools in El Paso County. This month, the organization added the middle school and high school in Fabens, a community about 30 miles southeast of El Paso along the border.

Project Vida, which introduced its first on-campus therapist in 2017, spans 21 schools across El Paso and Hudspeth counties. In some schools, it’s not uncommon to see students who are raising themselves in non-traditional households, said Pamela Ponce, co-chief of school-based integrated health at Project Vida.

Early intervention can be life changing for not only children and teenagers – but also for the family and community they grow up in, Ponce said.

“Many of these people who are having crises in their adult years, those crises could have been prevented if they started getting services early during school age,” Ponce said. “It gives them the ability to learn coping skills, learn more about themselves, how to care for their mental health, then teach that to their parents and siblings.”

Mental health providers on school campus build trust

Project Vida began seeing the need for mental health services on campus in 2015, while its staff was in schools for the organization’s teenage pregnancy prevention program. Facilitators noticed that students were coming into Project Vida’s school offices to ask about topics besides sexual health, such as how to manage their anxiety, Ponce said.

Since Project Vida team members were visible on campus, showing up to lunch and school events, students began seeing them as trusted adults that they could talk to about any health issue, she said.

In 2017, Project Vida piloted its first on-campus, mental health care team at Eastlake High School, located on the outskirts of El Paso in Socorro Independent School District. The suicides of at least two , linked to possible , stunned the district that year.

Project Vida has since expanded to Clint, Canutillo and Fort Hancock, concentrating in middle and high schools and seeing about 300 students a year. Each mental health team, which typically rotates between two campuses, includes a licensed professional counselor or licensed clinical social worker. Availability tends to fill up within the first three months of the school year, although clinicians can take new students in the middle of the school year if their clients finish their treatment plan early, Ponce said.

Ponce said they see students who are grieving the loss of loved ones, experiencing panic attacks or struggling with depression. Students also showed signs of social anxiety when they returned to the classroom after back-to-back tragedies: The 2019 mass shooting at Walmart, followed by the COVID-19 pandemic that has killed more than 3,600 people in El Paso.

Without on-campus services, students in small and rural communities may have to travel half an hour to an hour into El Paso for mental health care. That means a parent might have to miss work – and lose part of their income – to drive their child to their appointment, while the child may have to miss school.

A means people can face long wait times for appointments in El Paso to open up, or can only get monthly appointments rather than weekly or biweekly, Ponce said. Parents can also find it challenging to find a provider that takes their health insurance.

Project Vida’s program is funded by a combination of federal and state grants, as well reimbursements from Medicaid, CHIP and private insurance. The organization works with uninsured people on a sliding scale and won’t turn away anyone who can’t pay for services, Ponce said.

Vanessa described the day her counselor referred her to therapy as the day that changed her life. She thinks she’s better at not letting the painful events she couldn’t control, control her, she said. She’s begun catching up on her academics, quit her habitual vaping and looks forward to homecoming, prom and graduation next year – activities that used to not excite her.

It feels good to have the motivation to live again, she said.

“I recently wrote a poem for English class about my sexual assault and the emotions I was experiencing,” Vanessa said. “As I was writing and reading other poems about assault, it helped me feel it’s OK to not be OK.”

Small communities overcome mental health care stigma

When 18-year-old Ariana Bañez told her parents last year she wanted to see a professional mental health care provider, they didn’t believe her at first, she said.

Bañez, now a senior at Fabens High School, said she probably seemed like the typical overachiever. She was on the student council and competing to become the class valedictorian. She was involved with the school theater program and played French horn in the school band.

But Bañez said she had a hard time adjusting to her school load after returning to campus during the pandemic, after more than a year of virtual classes and canceled extracurricular activities. Bañez remembered trying to hide how overwhelmed she felt, but the pressure manifested in physical ways. She would get headaches and stomachaches. Sometimes she forgot to eat.

Searching for a therapist only brought more stress. The clinics in El Paso that Bañez called were booked and couldn’t take on new clients.

It also seemed taboo at the time to admit she needed help, Bañez said. Fabens has a population of less than 8,000 people – and gossip spreads fast, she described. Some of her peers feel they can’t speak up about anxiety, depression or family problems because “everyone will say, well, get over it.”

“We’re a really close-knit community,” Bañez said. “But when it’s like that, when family issues come up, it gets harder to deal with. It’s hard to really express that without everyone judging you.”

Natalie Mendez, a qualified mental health professional from Emergence Health Network, said educating parents and destigmatizing mental health are a major part of her job. Mendez supervises the network’s team at Canutillo ISD. About 6,200 people live in Canutillo, a census-designated place on the northwest side of El Paso County.

If a parent is receiving services for a child, they don’t necessarily want the staff at the school to know because staff might know their friend and then word gets around, Mendez explained.

Sometimes parents are initially open to mental health services, but opposed once a provider explains treatment options, Mendez said. Other times parents mistake services as a quick fix that will immediately change their child’s behavior, grades and attendance. Ultimately, students should have a direct say in their mental health care and forcing them to get treatment before they’re ready can re-open trauma, Mendez said.

“When a child is not on board, we don’t recommend services because the child has to be in charge,” Mendez said. “Regardless of their age, they need to be the one to set their own goal. … The child and parent are equal partners. Our job is to bridge that partnership so we are working together for the benefit of the whole family.”

The Texas Health and Human Services Commission funds Emergence Health Network’s operation, which includes three schools in Canutillo ISD and five schools in El Paso ISD. Emergence Health Network has seen about 350 students for on-campus services since 2020.

Along with therapy, the organization provides case management and informal youth mentorship. A therapist can help a student trace why they feel anxious in crowded hallways while a case manager can help a student develop grounding techniques, like counting tiles on a ceiling, when they’re in a situation that triggers their anxiety, Mendez explained.

“They’re both tackling the same problem,” Mendez said. “One is understanding the reason, the other piece is, ‘OK, what are we going to do about it?’”

This first appeared on and is republished here under a Creative Commons license.

For five months during her freshman year, Tuli Hannan called New York City mental health providers in her mother’s insurance network after outreach to her school guidance counselor fell flat. In 2016, most therapists she contacted near her Queens home looked to put her on a six-month or longer wait list.

Hannan, who grappled with the will to live at that time, ultimately found a therapist she felt comfortable with at the end of her sophomore year, more than two years after she identified a need for support. Though her search began long before the traumas associated with COVID-19, large numbers of young New Yorkers are facing the same difficulty in accessing mental health support at a time when demand is intensifying.

“You don’t know where to narrow it down, you feel so lost,” Hannan said. “Being the person that’s struggling, you have to keep a stable mind and the patience to look for these services.”

The process led her to become an advocate for expanded mental health support in NYC, where a plethora of services — from community-based organizations, hotlines, in-school clinics and private professionals — left her spiraling and continues to confound her peers, who will return to classrooms next week.

A February 2021 survey of about 1,300 New York City youth, aged 14-24, found that who sought mental health support received it. Across the city, 35 percent of young people surveyed expressed a want or need for services; in the Bronx, half of youth surveyed wanted access.

“People my age, my friends, they normalize the fact that we won’t get the help that we need,” said Hannan, who worked with the Citizens’ Committee for Children of New York on the “Voicing Our Future” survey while she was a student at Information Technology High School.

New York’s School Response Clinicians, a group of 85 social workers helping students in crisis to lessen 911 and emergency room outreach, , up from 242 students from July through September.

The data from NYC mirror mental health stories across age groups nationally — from elementary schoolers to . That the pandemic is exacerbating a pre-existing youth mental health crisis is by now well documented.

At least 28 states have pledged to bolster social-emotional and mental health support with pandemic relief funding. Oklahoma, for instance, of licensed mental health professionals. And since 2020, seven more states now allow mental health days as from school.

To help support the 26 New York City neighborhoods most deeply affected by the pandemic, the city’s Department of Education partnered with to establish more mental health clinics in schools.

The DOE has hired at least as a part of its $635 million academic recovery plan. In the city’s 2022 budget, . No line items reference youth mental health specifically. This could be a red flag in an already-murky support area — many providers fit under the same umbrella of “mental health services,” though not all provide services to adolescents.

Jennifer March is executive director of Citizens’ Committee for Children of New York, the nonprofit advocacy group which specializes in research and conducted the February youth mental health survey. March has led campaigns to improve young New Yorkers’ well-being and is .

“While the recent New York City FY22 approved budget takes tremendous steps in New York’s recovery, the level of suffering and trauma the city’s children and families have experienced requires further action to address. The lack of specificity on how the city will ensure access to critical behavioral health supports and how public dollars will be spent to address long-standing racial disparities in access to child mental health care is deeply concerning,” March wrote in an email to ����Ӱ��.

Looking for help and finding the internet wormhole

For students and families looking for mental health support, the first question becomes: Where do I start? In the internet age, they’re likely to find four sites in a quick search: the DOE’s , the for accessing supports at home, the Department of Health’s and , the confidential 24/7 text, chat and call hotline.

The sites link to each other frequently — the first section of the DOE’s page, for example, lists how to contact NYC Well for immediate assistance, and the Office of Community Mental Health site refers anyone looking to support a young person to the DOE. Yet the relationship between the agencies, and which mental health professional might exist at yours or your child’s school, are unclear without spending hours of research or calling a school directly.

The stigma and fear associated with reaching out for mental health support may prevent someone from turning to a school administrator. One Brooklyn student shared in the write-in portion of the mental health survey that they believe support outside of school should be made free to increase accessibility.

“I feel like people are afraid to talk to people in school in fear that someone will tell their parents what they say. Even if it’s just giving special access through an app like BetterHelp or offering phone calls for 30 minute sessions with therapists who will just let people vent about problems. I’m not sure who would organize that or even if this is already a thing. If it is, it should be better promoted.”

Through the end of July, individuals seeking help were likely to encounter at least some broken links, such as those on an directing to a tool on how to start a conversation over mental health concerns with their child’s school, or one at the Mayor’s Office for Community Mental Health that offered resources for teens experiencing abuse. Now, both and resources have been fixed.

Given that each school’s need varies, mental health support systems range from community schools, which offer wraparound health services; to clinics, health centers, specialists and prevention/intervention programs.

For a parent urgently looking through the DOE’s site for the best person to call at their child’s school, the differences between these iterations and the listing what program each school has, without contact information, is not exactly user friendly.

The city’s Office of Emergency Management operates an . ����Ӱ�� could not find a comparable online resource for mental health that lists drop-in youth centers, community-based mental health organizations, and/or school-based mental health services. The closest resource city-wide is  a health and social services directory, though it does not include school-based resources.

The Community Mental Health office does provide a map of programs on its , but that platform is primarily meant to track reach and impact of city services. A parent or student seeking support cannot use it to find location sites, contact information or learn more. For some youth-specific services, map markers do not populate.

Some students or families opt for the NYC Well hotline to streamline understanding of their options and connect with care providers. Of the people who called on someone else’s behalf in 2019, called for their child. NYC Well’s average answering speed or wait time was 33 seconds from July 2020 through June 2021, according to the Office of Community Mental Health.

In the , a number of youth acknowledged that accessing support could be easier if the process and resources were made transparent in school, where they spend so much of their day. Specifically, one Queens student recommended having therapists accessible in schools and dedicating days or weeks to mental health awareness and establishing healthy habits.

In-school mental health supports inconsistent

A number of schools adopted new mental health initiatives because of and during the pandemic to meet student needs. Now 19 and recently graduated, Tuli Hannan was able to see her school partner with a community-based organization to provide more mental health services.

Students at Information Technology High School in Queens can now access on-call therapists during the school day and take online courses related to mental health, including mindfulness, reflective writing and meditation. Having access to those resources when she searched in 2016 could have made all the difference, she said.

“Now it’s easier for us to reach out to our guidance counselors because they email us, letting us know that this is what’s out here, this is what’s accessible to you, and don’t be afraid to reach out to us,” Hannan said. “I wish that that was passed on to all public schools because I know it’s different at each school.”

The New York Foundling, a centuries-old institution providing care for families and children, is one of many community organizations operating in-school mental health services. Through satellite clinics and staffing school support teams, they assist a student population of about 4,000 at 11 K-12 schools in the Bronx, Manhattan and Queens.

The Foundling is also contracted to provide clinical support in school response teams, a mix of providers and school staff that address students in crisis — a group not tethered to a specific school location.

With an end-goal to break the stigma around mental health and sustain a young person’s well-being, they involve the whole school. In practice, that means year-round support is available for students, as are workshops, training or professional development with any of the adults a young person encounters: guidance counselors, teachers, school leadership and their own families.

“We don’t only focus on the students. We believe that in order for mental health services to be sustainable and effective in school, we have to address the entire school as our client, as a community that we’re working with,” said Reïna Batrony, vice president of services for community- and school-based programs.

To get the word out about their services and full-time clinical staff, Batrony’s teams show up. At PTA meetings, afterschool events or summer school launches, staff share contact information and talk about their work, with the added bonus of normalizing the topic of mental health with parents. Students can also self-refer to their services, they don’t require a staff person or parent to make the call.

“I think everyone tends to be hesitant about mental health support. [It] varies based on culture, based on the type of trauma they may have experienced,” Batrony said. “[It] may also vary based on prior providers they may have experienced.”

The Foundling doesn’t maintain a waitlist; at the schools they partner with, a full-time clinician responds to each referral and request, connecting students or families with their services or community-based resources. For therapy sessions, they meet with youth in a confidential school space, in their homes or at one of their borough offices.

Their services and approach to involving everyone in a young person’s orbit in their mental health could have been impactful for a student like Tuli Hannan, who struggled to find support outside of school. The Foundling partners with just a sliver of the DOE’s and the decision about which ones get that level of support is made by its Office of School Health after assessing a school’s need for services, according to Batrony.

The result is inconsistent access to professional mental health support for students. For schools without full-time clinical staff or mental health centers, the baseline is a referral system and access to as-needed crisis response teams.

Guidance counselors, teachers and administrators receive on how to refer or respond in a crisis — according to the DOE, over 75,000 school-based staff were trained in Trauma Responsive Educational Practices since last year — but are not qualified to provide counseling, psychotherapy or act as social workers.

Ife Damon has been teaching New Yorkers for seven years, and says she proactively addresses mental health in the classroom to help students handle emotions and become self-aware. Since the pandemic began, she’s witnessed her English students at Curtis High School express “feelings of anxiety, stress, even depression.”

Damon makes it known to her classes that there is an in-house mental health center, and if they’re interested, they can connect with her, a guidance counselor, social worker or with the center directly. Young people, she says, typically talk openly about their mental health only “when teachers provide opportunities for students to do so.”

Located on Staten Island’s north shore, Curtis High serves predominantly Black and Latino students, who make up about 77 percent of the student body, and is . Their school-based health center provides vision, medical, dental and mental health care, coordinated by community-based organizations.

Damon serves on the community school advisory board, which hosts an annual forum open to students, parents and community members to assess community need and potential expansion. The forums also solicit feedback for the model, as Damon explains, “How can we better support you as a parent? How can we collaborate with you as a stakeholder in order to strengthen our school and help to make sure our students are getting what they need?”

The RAND Corporation’s found that the model boosted high school graduation rates, decreased chronic absenteeism and resulted in fewer disciplinary incidents for elementary and middle schoolers.

Community schools make up about 14 percent of NYC public schools. For students in the 267 schools, the model expands access to having many of their basic needs met; though citywide, . The DOE has plans to add 130 more community schools to support pandemic healing.

“We know that students cannot fully engage in learning unless their social-emotional and mental health needs are being met. Our expansion of successful established a common approach to supporting students through teacher training, resources, and direct clinical help,” DOE deputy press secretary Nathaniel Styer told ����Ӱ�� in an email.

The department’s growing investments in clinical partnerships are “to ensure every student has a caring adult to go to when in crisis.”

More money, a new mayor and a critical moment

While the push to expand affordable mental health support to New Yorkers fosters a moment in which the city may turn its focus to youth and families.

Licensed master social worker Melissa Koppenhafer works with unhoused young people accessing mental health, housing and workforce support in CORE’s for 16- to 24-year-olds. She said that expanding school and community-based services is critical for the next mayor, but the cost must be subsidized to prevent further financial strain on young people. As CORE’s senior program director of youth and family services, Koppenhafer works with young people who are mostly covered by Medicaid or are uninsured.

“Programs that are available to them that accept Medicaid and are completely free, without a copay, are really going to be what’s successful,” she said. “Twenty dollars is a lot to them. If they’re working minimum wage, that’s more than their one-hour right there.”

In order to foster sustained mental health care for young people, Koppenhafer is also calling for the city to recruit and retain more mental health practitioners of color.

“As someone in the field, I find that people in general tend to like to have providers that they feel they can connect to via race, culture, history — any one of those things can help them connect to someone,” she said.

Though the DOE has hired for this school year, it’s unclear whether any efforts are being made to recruit social workers to better match a student population that is . Advocates say that while it’s a welcome expansion, meeting the recommended 250:1 ratio for students to social workers would .

Eric Adams, Brooklyn borough president, former city police captain and the Democratic mayoral candidate poised to win November’s general election, has of expanding mental health support for young New Yorkers. On the campaign trail, he argued in schools.

Police interventions for students in emotional distress , according to a recent analysis by Advocates for Children of New York. Looking into 12,000 incidents where children were transported to hospitals for psychological evaluations, data shows that Black students and students with disabilities were disproportionately affected and handcuffed.

An found that NYC students vastly preferred more guidance and mental health support over police, and more than two-thirds of those surveyed agreed police should be removed completely.

Advocates contend that NYC’s particular context — on the eve of a mayoral shift, with families’ demand for accessible care mounting along with an influx of federal pandemic relief funds — positions city leaders to make lasting change for youth facing mental health challenges.

“There is a critical opportunity in the year ahead,” said the Citizens’ Committee’s Jennifer March, “to invest in place-based preventive and clinical interventions in pediatric settings, child care and pre-K, schools and communities as our children and adolescents are in crisis and their behavioral health needs have skyrocketed.”

Lead image: At I.S. 584 in the Bronx, sisters Melody and Delany received in-school mental health care from the New York Foundling. (Ryan Lash / New York Foundling)

Kẽa Shá Moon could hear it in her dad’s voice. Something was wrong.

A middle school student in her hometown of Burley had taken his life. Kẽa didn’t know the boy, or his family. But she knew his pain. It called up memories of her own suicide attempt at age 12, and the years struggling with anxiety and sadness before that. It took her back to the bullying that amplified her mental health struggles, and the terrible cycle of cutting and starving herself to try to feel some control over her emotions.

But Kẽa, now 23, made it out. She hadn’t died when she tried taking her own life, and she didn’t want to. By high school graduation she’d vanquished her darkest days, with the support of her family, the help of a therapist and years of hard work.

“My mental health struggles started at such a young age,” Kẽa said. “I don’t think it’s fair to go through life without help. You need help.”

Kẽa’s experiences motivated her father, Cassia County school board member Darin Moon, to help other families struggling with mental health. In 2018, Moon and district spokeswoman Debbie Critchfield helped launch the Connect program, an initiative to get all Cassia County School District children access to free and immediate therapy.

Before Connect, it could take families weeks to get situated with a therapist. Now, a student just has to call a phone number where they can receive immediate crisis counseling, and set up an appointment with a local mental health professional. The school district pays for a handful of therapy sessions to start, and if a family needs more help, Connect can help them transition to long-term care.

“We have been to the bottom, and we have hugged each other, and gotten help,” Darin Moon said. “We want other people who are struggling with this to know that there are better days ahead. The missing link for you is getting the professional help.”

The Cassia County School District doesn’t directly facilitate the Connect program, and doesn’t know which students have enrolled in therapy. That makes it hard to track the kind of data that would indicate how Connect is impacting students’ academic outcomes. Proponents of the program see its impact in the numbers, and the grateful calls and emails they get from parents. Since its inception at least 538 students in the 5,400-student district have accessed Connect therapists.

“We’ve gotten kids served who might not have ever been served,” said Liza Castaneda, a counselor at Burley Junior High.

District counselors see Connect as a valuable tool to help students get help. But they say the pandemic is delaying students’ access to therapists, and worry about children’s transition to long-term care.

The Cassia County District Is No Stranger to Tragedy

Steve Copmann, a 26-year administrator at Burley Junior High, says he’s watched student mental health needs intensify over the last two decades, exacerbated by social media. Bullying that used to end when a student got home from school is now a 24-7 digital reality. The district has suffered a handful of student suicides in recent years.

“There are family life issues happening with divorce and family members dying and some of that natural stuff that happens. Then you throw in social media on top of that and icing on the cake is this whole COVID deal we have going on, and it’s a tragedy,” Copmann said. “It’s tough.”

In its 2018 pilot year, Connect was funded for use in three schools, by about $30,000 in private donations. In 2019 and 2020 the program expanded districtwide, funded by $200,000 in contributions by local businessman Ryan Phipps.

“There are very proud people in the state of Idaho and it’s hard to sit here and say, ‘Hey, my child has mental health issues.’ It’s hard to bring that into the community — and it shouldn’t be,” Phipps said. “That’s a big part of the reason why I said, let’s talk about this. Let’s do this.”

Cassia County voters agreed to foot the cost of the program in a supplemental levy last year, Critchfield said. The $100,000 annual price tag evens out to about $1.50 per student, per month. The levy passed just before COVID-19 further intensified students’ needs.

The district sent information about Connect to students and parents during school closures, and has given out magnets with the phone number in the hopes it’ll be readily available when kids need it most.

But Connect saw a decline in students calling for help during the pandemic. Only 164 students called into the program in 2020, down from the 259 students who used the services in 2019.

“At a time when we know mental health issues are at the highest they’ve ever been in our country, we’re not accessing this as much as I would like to see,” Moon said. “I wish I had an answer for that…We should be using it more than ever.”

Cassia County School District pays Utah-based mental health company Blomquist Hale to facilitate Connect. Intake specialists answer phone calls at any hour and connect families to local providers in the Burley area. Intake calls and therapy services are available in Spanish as well as English, Blomquist Hale business specialist Gia Bower said.

The program is anonymous, so Cassia administrators don’t know which students use Connect. The program doesn’t track race or ethnicity of callers either, Critchfield said, so the district doesn’t know how evenly students from different demographic groups are using the service. Cassia County is about 34 percent Latino.

Cassia County does know that Connect callers have an average age of 12. Girls call in twice as often as boys. And most of the families calling Connect don’t have insurance.

Castaneda, the Burley Junior High counselor, appreciates that Connect provides a bridge to get families into therapy, but worries about families’ access to long-term care. Students without insurance, even some with Medicaid, could struggle to find a local provider if they need help beyond the districts’ free bank of sessions.

“I just don’t want that continuity of care to break. That’s my concern, because that can be a bad experience with mental health counseling,” Castaneda said.

Aimee Hurst, a counselor at Mountain View Elementary, said her families have generally been able to move seamlessly from Connect to long-term care if they need it. Her concern at the moment is that a flood of mental health needs during COVID-19 has created waitlists for local therapists. Connect students who used to be able to get to in-person care quickly have told her they are facing delays. If families aren’t dealing with crisis situations, she suggests they try Connect’s telehealth services, which sometimes offer quicker access.

Crtichfield said Blomquist Hale is working with local therapists on a solution to the delays. The district is starting to see an uptick in student calls again, after the dip in 2020, and Critchfield doesn’t want students to encounter long wait times for therapy — one of the issues Connect was created to avoid.

Whatever its limitations, district staff say they’ve seen the benefits of the program.

One of the first students to use the program was a sixth-grader at Hurst’s elementary school. He was struggling with suicidal thoughts, she said, and his single mom didn’t have the means to pay for therapy.

“It was a huge blessing to be able to go to that mom and say: ‘Here you go. This is one less thing you have to worry about. Just call the number,’” Hurst said.

This article originally appeared at and is published in partnership with