Theresa Nguyen, LCSW, is chief program officer and vice president of research and innovation at Mental Health America, an organization that seeks to promote mental health and prevent mental illness through advocacy, education, and research. Transforming Care spoke to Nguyen about Mental Health America’s efforts to expand access to early intervention and prevention tools for teens and young people.
Transforming Care: Mental Health America has been advocating for ubiquitous mental health screening since it was founded more than 100 years ago and offers free, anonymous screenings via its website. What have those revealed about the state of mental health among young people today?
Nguyen: We have seen a dramatic increase in people using our screening tools since the start of the pandemic two years ago. We know that more than 60 percent are under the age of 25, and while they are a good snapshot of America in terms of race and ethnicity, they skew female because females tend to be more help-seeking when it comes to mental health care. It's alarming that the number and percentage of people screening at risk for suicide and for conditions such as depression and anxiety remain high two years into the pandemic. Across all ages, rates of suicidal ideation are highest among youth, and the highest increases are among Black youth and adults.
Transforming Care: With the needs so high among young people, why aren’t more of them getting mental health services?
Nguyen: That’s an important question with a nuanced answer. We know that 25 percent of people with a mental health issue will experience their first symptom during puberty, a time when they often have the least ability to make their own health care decisions. There are often financial or logistical barriers, including a critical shortage of providers, and young people may not feel comfortable asking their families to connect them with help. Youth from low-income communities have even fewer choices in accessing mental health care, whether you are talking about white kids in the middle of Idaho, Iowa, or Appalachia or inner-city Black kids in Philadelphia or New York City. We are facing situations where more and more youth are actively reaching out for help where none exists. This is why investing in support for early intervention within digital spaces including self-led learning and telehealth are important.
Transforming Care: Given the access barriers, how are you going about it?
Nguyen: Our online platform provides validated screening tools and a library of educational resources to help people on the assumption they may never reach a therapist’s office.
Psychoeducation is often overlooked in both clinical practices and research because mental health care tends to focus on what the doctor or psychologist can tell you versus giving people tools they need to understand and manage their experiences. We want to build skills and knowledge so that if and when people have the interest, ability, and means to access care, they are able to navigate the system and know what to ask a therapist to make sure it’s a good fit. We also have interactive tools for people who may never be able to afford, for example, a cognitive behavioral therapist but want to learn those skills. Our do-it-yourself tools are designed with feedback from users and tend to focus on micro-interventions so the threshold of investment doesn’t need to be an eight-week course. Someone can practice a skill for five minutes and test it in real life. We think gaining those skills and knowledge empowers youth and sets them off on the right path to manage lifelong mental health challenges.
Transforming Care: In November 2020, you surveyed nearly 2,000 youth to find out what they found most supportive during the pandemic. What did you find?
Nguyen: We found that in addition to having access to mental health professionals and mental health breaks as part of school or work, many said that learning to support their mental health during their day-to-day lives and receiving support from other people would be helpful. We think that making coping skills and communities of peer support readily available is key to promoting young people’s well-being. They should be built around where young people spend their time, for instance by integrating resources into sporting activities or online communities.