Kayla M. Steinmann

Published November/December 2021

It should be no surprise that youth mental health in America is at an all-time low. During the pandemic, youths faced social isolation and loneliness. They lost parents and loved ones and were exposed to other traumas such as food insecurity and homelessness. Critical developmental needs went unmet as children were isolated from friends and missing out on typical school activities and milestones. Even pre-pandemic, data indicated that our youth were struggling with increased rates of depression, thoughts of suicide, and self-harm.[1]

Screening data indicates that the population most impacted by the COVID-19 crisis was youths aged 11-17 years old.[2] Now, still in the midst of the ongoing global pandemic, a new analysis suggests that depression and anxiety in youth has doubled compared to pre-pandemic levels, likely instigating a global mental health crisis in youths.[3]

It is in response to this crisis that two Idaho nonprofits have come together to develop support for youth mental health. DisAbility Rights Idaho (“DRI”) is Idaho’s designated protection and advocacy system, with federal and state authority to monitor any facility or service provider in the state providing care or treatment to individuals with disabilities, or to investigate incidents of abuse and neglect of individuals with disabilities.[4] The Idaho Federation of Families (the “Federation”) provides direct family support services for parents and caregivers of youth with mental health challenges and serves youth through programs that focus on peer support and advocacy. Together, these organizations have created a Youth Rights Series as an ongoing resource for Idaho’s youth.

Current State of Youth Mental Health in Idaho

The data in Idaho is bleak. In 2020, Mental Health America ranked Idaho 48^th in the nation for youth mental health.[5] The national nonprofit ranked the 50 states and the District of Columbia based on seven measures including youth with at least one major depressive episode (“MDE”) in the past year, youth with an MDE who did not receive mental health services, and students identified with emotional disturbances for an individualized education program.[6]

Idaho ranked 50^th for youth with at least one MDE in the past year with 16.22 percent of Idaho youth experiencing an MDE in 2020.[7] The data shows that Idaho youths have been significantly impacted over the past 24 months and Idahoans must build a better support system that equips youth with tools necessary to develop into thriving young adults.

DRI’s Youth Unit

DRI’s 2020 organizational restructuring now means it has a dedicated youth unit, as well as an adult unit, to address the needs of Idahoans with disabilities. The youth unit focuses on a range of critical issues affecting Idaho’s youth, such as addressing the use of restraint and seclusion in public schools and representing families in Medicaid Early and Periodic Screening, Diagnostic, and Treatment (“EPSDT”) denials. However, most of the youth unit’s work entails protecting the rights of children in residential treatment facilities in Idaho through periodic monitoring and investigations.

Idaho has 25 licensed Children’s Residential Treatment Facilities (“CRTF”).[8] Children in these facilities come from all over the country for a variety of reasons but mainly to receive intensive support for serious emotional and behavioral problems. Deficiencies, abuses, and rights violations are widespread in CRTFs.[9] Some CRTFs are turning million-dollar profits while vulnerable children are physically and sexually abused in their care.[10] As atrocities come to light, states are responding by passing legislation to increase regulation of CRTFs, taking steps to bring kids home from out-of-state placements, and shifting funds to community-based services that better serve youth.[11]

Research and logic both affirm that youth are best served when at home in their communities.[12] DRI believes it is essential to avoid out-of-home placement whenever wrap-around, community-based care could meet the needs of the child and the child’s family. Part of keeping Idaho’s children safe from the abuses of residential treatment means emphasizing preventative care and helping children access mental health treatment in their own communities.

DRI and the Federation seek to Empower Youth to be their own Advocates

The collaboration between DRI and the Federation seeks to address youth access to mental health care from the youth’s perspective. The intention of the Youth Rights Series is to increase youth access to mental health services by educating youth directly on their rights and mitigating some of the hesitations they may have that are fueled by lack of knowledge or misinformation. Studies indicate that the top three most common barriers to youth seeking and accessing professional help for mental health problems are (1) limited mental health knowledge, (2) social stigma and embarrassment, and (3) inability to trust confidentiality in therapeutic relationships.[13]

Teenagers may be unaware of the circumstances under which they can access treatment on their own. They may be unaware of confidentiality standards in sessions and avoid needed therapies because they are afraid of getting in trouble with their parents.[14] Through this series, DRI and the Federation work together to improve young people’s knowledge of mental health problems and available support, including what to expect from professionals and services.

The series features Natalie Perry, the Federation’s youth move coordinator interviewing Kayla Steinmann, DRI’s youth unit attorney and the author of this article, on the legal perspectives that affect Idaho youths’ ability to access mental health services. Together they dissect Idaho and federal laws in a youth-friendly format and encourage youths to access treatment. The project thus far has taken on the subjects of confidentiality in mental health sessions and accessing mental health treatment. Young people can take an active role in seeking help, particularly as they age, and the Youth Rights Series aims to equip them with the knowledge they need to take that control into their own hands.

Idaho needs to mitigate the sustained mental health effects of COVID-19 and prioritize recovery planning now. It is more important than ever to start having conversations about mental health and destigmatizing mental health with youths. If you know youth in your life who would benefit from increased awareness of these issues, invite them to check out the series on either the Federation’s or DRI’s websites or YouTube channels.

Other Idaho organizations concerned with increasing education and awareness of youth mental health issues are the National Alliance on Mental Illness Idaho, Idaho Parent Network for Children’s Mental Health, and Empower Idaho. It is incumbent upon all of us to teach our children that it is okay to ask for help.

Kayla M. Steinmann is an attorney in the youth unit at DisAbility Rights Idaho. She recently graduated from Washington University St. Louis School of Law in 2020. Advocating for the human rights of children is her personal passion and reason for attending law school. She enjoys backpacking, playing the ukulele, and baking pies.

Endnotes

[1] See The State of Mental Health in America 2019, Mental Health Am., 5 (2018) https://mhanational.org/sites/default/files/2019%20MH%20in%20America%20Final_0.pdf; 2020 Mental Health in America – Youth Data, Mental Health Am., https://mhanational.org/issues/2020/mental-health-america-youth-data (last visited Oct. 5, 2021).

[2] 2021 Policy Institute: Addressing Youth Mental Health Needs in Schools, Mental Health Am., https://mhanational.org/2021-policy-institute-addressing-youth-mental-health-needs-schools (last visited Oct. 5, 2021).

[3] Sarah Molano, Youth depression and anxiety doubled during the pandemic, new analysis finds, CNN Health (Aug. 10, 2021), https://www.cnn.com/2021/08/10/health/covid-child-teen-depression-anxiety-wellness/index.html.

[4] See 42 U.S.C. § 10805.

[5] See 2020 Mental Health in America – Youth Data, Mental Health Am., https://mhanational.org/issues/2020/mental-health-america-youth-data (last visited Oct. 5, 2021).

[6] Id. (full data set includes: (1) youth with at least one MDE in the past year, (2) youth with a substance use disorder in the past year, (3) youth with a severe MDE, (4) youth with an MDE who did not receive mental health services, (5) youth with a severe MDE who received some consistent treatment, (6) children with private insurance that did not cover mental or emotional problems, and (7) students identified with emotional disturbances for an individualized education program).

[7] Id.

[8] Children’s Residential Programs Provider List, Idaho Dep’t of Health and Welfare, https://publicdocuments.dhw.idaho.gov/WebLink/DocView.aspx?id=2675&dbid=0&repo=PUBLIC-DOCUMENTS&cr=1 (last visited Oct. 5, 2021).

[9] See Position Statement 44: Residential Treatment for Children and Adolescents with Serious Mental Health and Substance Use Conditions, Mental Health Am., https://www.mhanational.org/issues/position-statement-44-residential-treatment-children-and-adolescents-serious-mental-health (last visited Oct. 5, 2021).

[10] Hannah Rappleye et al.,  A profitable ‘death trap’: Sequel youth facilities raked in millions while accused of abusing children, NBC News (Dec. 16, 2020), https://www.nbcnews.com/news/us-news/profitable-death-trap-sequel-youth-facilities-raked-millions-while-accused-n1251319.

[11] Shut Down Sequel: Progress Report, Nat’l Juv. Just. Network, 4 (2020) http://www.njjn.org/uploads/digital-library/ShutDownSequelProgressReport_April2021.pdf.

[12] Id. at 7.

[13] Amelia Gulliver et al., Perceived barriers and facilitators to mental health help-seeking in young people: a systematic review, BMC Psychiatry (2010) https://doi.org/10.1186/1471-244X-10-113.

[14] Id.

15. Note: DisAbility Rights Idaho (DRI) is the Protection and Advocacy System for the State of Idaho. This article was made possible by funding support from SAMHSA, U.S. Administration for Community Living, Department of Health and Human Services and DOE-Rehabilitation Services Administration. These contents are solely the responsibility of DRI and does not represent the official views of any federal grantor. 100% of this article was paid for with federal funds.