“So much has changed in the difference between these years that the generations are separated by,” said Millie McGlone, a high school student from Fort Thomas. “So much has changed. There’s social media now, so that affects a lot of people’s mental health; whether they would like to admit it or not, it does. Everything that’s going on is so different.”
McGlone is a fellow with an organization called Hopeful Empowered Youth, or HEY!, a multiorganizational agency that aims to create systemic changes to the infrastructure around youth mental health. Her comments came in response to a question about what adults struggled to understand about youth mental health.
Mental health diagnoses among American youth, especially depression and anxiety, have been on the increase since at least 2016, according to the National Survey of Children’s Health, a program administered through the U.S. Census Bureau and Department of Health and Human Services.
Communities across the region and the country are considering how to respond.
“What we’ve seen is the severity of the cases has gotten more intense over the years,” said Jennifer Ossege, clinical psychologist and co-owner of Viewpoint Psychological Services, which has offices in Fort Thomas, Florence and Crestview Hills.
In 2023, about 20% (or about 5.3 million) of children aged 12 to 17 received a diagnosis of some kind of mental health or behavioral problem.
Between 2016 and 2023, there was a 35% increase in diagnosed mental health or behavioral conditions. The prevalence of diagnosed anxiety increased 61% during the same period, while depression increased 45%.
Finally, in 2022 and 2023, the percentage of kids ages 3 to 17 who admitted to having one or more mental, emotional, developmental or behavioral conditions in Kentucky came in higher than the national average at about 30%, according to the Child and Adolescent Health Measurement Initiative, which partnered with the U.S. Department of Health and Human Services to furnish the National Survey of Children’s Health.
“We’re seeing the trend with adults, as well,” Ossege said. “Anxiety and depression rates have gone up significantly. Particularly since COVID – we were on the edge of a mental health crisis, or some would say we were in a mental health crisis before COVID happened – but since 2019, I think, the depression and anxiety rates for adults have gone up, and all of that trickles down, right? So when adults are struggling with their own mental health, their own depression and anxiety, that gets reflected in their kids and just in the world around us.”
Multiple factors, such as the localized family dynamics that Ossege points to, contribute to a given mental health landscape. Additionally,these factors range from individual characteristics, such as one’s genetics and coping skills, all the way up to broad social factors like government policy.
Lockdowns during the pandemic increased physical and social isolation among many people, arguably amplifying any conditions already apparent before COVID. Couple this with academic, social and family pressures to succeed and fit in, plus the anxiety-inducing mechanics of social media and the internet, and you have a cocktail for increased rates of certain conditions among kids and teens.
“There are many benefits to social media, but there’s also things with social media that can cause – can trigger anxiety, worry, depression, feeling left out,” said Melissa Haag-Costin, a licensed counselor and counselor supervisor of Pediatric Associates, which also has offices across the region. “With teenagers they’re in that developmental stage where they are trying to figure out who they are, where they belong, who are their core group of people, what are their values?
“They have a mind of their own now, and so they also are having this conflict: ‘This is how I was raised. This is what I’m taught, but this is my opinion and what I think,’ and how to navigate through those challenges.”
Cost barriers persist
It’s true that some options for treatment and prevention have increased. There are now more options for telehealth, and many school districts have brought in expert consultants to bolster their mental health resources. Still, there are difficulties that teens and their families can encounter when trying to get services. One barrier, depending on a family’s financial and demographic situation, is paying for treatment.
“There still is a huge barrier for a lot of families [as it relates to] insurance,” said Nicole Pfirman, senior vice president with MindPeace. MindPeace provides in-school providers and treatment at no cost to schools in an effort to lift barriers for students and families. They serve 250 schools in Southwest Ohio, Pfirman said, and are looking to expand into Northern Kentucky.
“There is a lack of care because families either can’t afford the co-pays or the insurance providers,” Pfirman said. “For example, we have a lot of families who are immigrant families that have no access to insurance, which means they hardly have any access to mental health care.”
MindPeace is one of HEY!’s partners, and Pfirman sits on the organization’s steering committee.
To make matters worse, helping professions generally often don’t pay as well as other health care professions. Northern Kentucky also has a shortage of youth psychiatric providers, according to the American Academy of Child and Adolescent Psychiatry. On top of all that, burnout among helping professionals is high, both Ossege and Haag-Costin said.
Young people themselves point out that the region has options for people going through extreme mental crises but fewer options for dealing with more workaday stresses.
“There needs to be some kind of service or some kind of place for people to go when they feel like they’re not OK and they need some help with something, but they’re not in a crisis situation,” McClone said. “There’s not a place in the world for people who are in between.”
HEY! and its partner organizations and funders draw their vision from a community-wide needs assessment published early in 2024. The assessment found that, “while the region is a national leader in youth behavioral health care, siloed funding, lack of insurance reimbursement, decreased social connections and a shortage of access to clinical care continue to serve as barriers to youth and their families,” according to a HEY! news release.
Focus on prevention
The organization then used the insights from the needs assessment to furnish a 10-year strategy for building out resources in Greater Cincinnati. They’re in the process of identifying 10 schools in the region to run pilot programs next year for what they describe as a “school of wellness” model, which aims to offer a broader continuum of mental health services than what’s currently available.
“We had young people at the table [during] that needs assessment, mostly teenagers, young adults, who continually asked us, ‘If you’re going to do anything with this needs assessment, please focus on the prevention side,’” said HEY! Executive Director Clare Blankemeyer.
Blankemeyer emphasized that any changes around youth mental health needed to have the input of, well, youths. A key part of HEY!’s work is its youth fellows, age 14 to 24. McGlone was part of the inaugural cohort. The fellows draw from their own experience, including their experience with mental health and mental health systems, to offer suggestions on the sorts of changes needed. They sit on working groups aimed at addressing specific aspects of the organization’s work.
One of the key gaps, McGlone and Blankemeyer said, is the lack of so-called third spaces for youths, which refer to social environments outside of work and school where young people can safely congregate and socialize. There just aren’t many places for kids to hang out, McGlone said, and she thought that a lot of mental health problems could be identified before they became crises if more such spaces were available.
This attitude was reflected in the comments of the other youth fellows LINK nky spoke with. They also spoke to the need for greater cultural competency and understanding among adult providers, especially as it related to youth in the LGBTQ community and youth with a history in the foster care system.
“I would like to see more third spaces,” McGlone said. “Like, more developed places that teens can go and meet other people and socialize and make new friends and just be – safely – because where I live, at least, there’s not a lot of places.”
“I think the biggest thing is sometimes parents come in – or people in general come in – and really expect change to happen like magic,” Ossege said. “And, you know, we don’t have a magic wand. We’re helping change learning and systems. That takes time.”
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