Youth, advocates discuss mental health access

By Jim Sabataso
RUTLAND HERALD
Youth advocates and professionals joined Lt. Gov. Molly Gray on Monday for a discussion about the state of mental health care access in Vermont.

The hour-long conversation was part of Gray’s tri-weekly “Seat at the Table” series of virtual meetings featuring community, nonprofit and business leaders from across the state.

More than 70 people joined Gray for Monday’s panel discussion, which highlighted the need for greater access to and support of mental health care services for young Vermonters.

“I felt that the most important way to give those who are most impacted — our young people — a voice in the conversation is to put them at the center of the conversation,” Gray said in her introduction of the four-person panel that includes two Vermont high school students.

Fatima Khan, a senior at Essex High School and member of the Vermont Youth Lobby, said demand for mental health services for youth was increasing even before the pandemic and has only grown more since.

“The COVID-19 pandemic exacerbated this need for resources because it’s subjected youth to social isolation, loss of routine and traumatic experiences,” she said.

Khan cited government data that pointed to a rise in behavioral health needs among school-aged youth, including significant increases in moderate-to-severe anxiety and depression.

In 2020, she said, there was a 24% increase in emergency room visits for mental health reasons for children ages 5-11 and a more than 30% increase in visits for 12- to 17-year-olds.

She added suicide remains the second leading cause of death among young people between the ages of 10 and 24.

“Throughout the pandemic, many of my peers, including myself, found themselves living with a perpetual sense of uncertainty and hopelessness. And in response to these problems, there was nowhere to turn to. We need more mental health resources for youth in Vermont and to expand existing ones (by) putting more funding into these important causes,” she said.

Khan called on the state to be more proactive in addressing mental health care needs by increasing the pipeline of mental health providers and expanding telehealth infrastructure.

She also called for providing more mental health resources in schools, including expanding the curriculum in health classes and hiring more school counselors for students to talk to.

Additionally, Khan noted a lack of access to affordable health care coverage and significant disparities in access to services among BIPOC and LGBTQ+ youth.

“We have to improve our mental health systems and provide more funding because if we want to save lives and save futures, we have to take concrete steps to improve access, to help youth find the care that they need and that they deserve,” she said.

Lexi Lacoste, a senior at Burr and Burton Academy in Manchester, underscored the need to erase the stigma of mental health issues and suicide by focusing on increasing education and access to resources.

Lacoste, who attempted suicide while in eighth grade, said she regularly shares her story with other youth in an effort to raise awareness.

She characterized her experience learning about mental health and suicide in middle school as lacking and acknowledged people’s unwillingness to talk about it at school and at home. She said even her own family discouraged her from talking about what happened to her.

“We have words, like suicide and self-harm and eating disorders and mental health. We consider those taboo topics and taboo words, and we steer around it. And I’ve always asked the question of why,” she said.

Lacoste said she finally got the help she needed after starting high school when teachers began to advocate for her.

Since then, she has used her experience to help others.

“I told myself that even though I was still struggling, I wasn’t allowed to commit suicide until I saved one other person’s life,” she said.

She said she has since helped save the lives of five people.

“I believe that the easiest way to help Vermont youth is if we start having these conversations,” she said.

Dr. Christian Pulcini, a pediatrician at UVM Medical Center, described the challenges young people face in getting adequate, timely care for mental health needs.

“There’s extreme challenges in infrastructure, resources and, certainly, personnel to meaningfully address the current mental health crisis in the state,” he said.

Pulcini recently conducted a review of “boarding” times — that is, any patient being kept in the emergency department despite a more appropriate setting for them being identified — at 11 hospitals across the state. He reported that of nearly 300 children, the mean boarding time was four days waiting in an ED for mental health treatment.

On a single day last month, he stated, there were 18 young people boarding for mental health issues in EDs across 12 hospitals — eight of them had been waiting for more than a week, another eight had been waiting between one and six days.

Moreover, Pulcini reported that 80% of those children had previously been diagnosed for mental health conditions, two-thirds of them were previously engaged in mental health treatment before they arrived at the ED, and 75% had presented with suicidal thoughts or a suicide attempt.

“Children should be in school learning. Children should be at home developing. And when needed, children should be receiving appropriate mental health services in the right setting at the right time to get back to the aforementioned activities.”

Danielle Lindley, director of children, youth and family services at Northwestern Counseling Supports & Services, echoed Pulcini’s concerns about a lack of resources and personnel.

“As the pandemic continues, mental health continues to be impacted and, as a system of care, we are overwhelmed, under-resource and not adequately meeting the needs of our youth,” she said.

Lindley noted that approximately 340 children are currently on a waitlist to access services statewide.

In her program, which provides home- and community-based support to children who have been been diagnosed with autism spectrum disorder, the waitlist currently exceeds 40 — an all-time high.

She said Department for Children and Families offices around the state, which are seeing an increase in reports of child abuse and neglect, are operating at 51% staffing capacity.

“Across the state we have high numbers of students in need who are not receiving adequate social-emotional behavioral supports,” said Lindley. “Schools are seeing increased incidence of violent outbursts, vandalism, sexualized behaviors, defiance, eloping, running away and increased threats of harm to self and others. The complexity of these behaviors is putting tremendous pressure on the capacity of our public school system.”

She attributed the issues to a lack of staff members because of the pandemic, citing low wages and burnout as factors driving people from the field.

Lindley called on the state to create incentives to retain and recruit staff, and to invest in programs that support mental health urgent-care initiatives.

“Essentially, in a time when we need services to be creative, innovative and flexible and for capacity to increase, we are left providing less-than-adequate care and not able to come close to providing the highest quality of care for many youth,” she said.

If you or someone you know are struggling with suicidal thoughts, please reach out to the National Suicide Prevention Lifeline at 1-800-273-TALK (8255), or contact the Crisis Text Line by texting TALK to 741741.

jim.sabataso @rutlandherald.com