As young people struggle with mental health issues, schools often provide the best avenue for getting them help. However, Washington state has fallen behind in providing services to students.
Eric Bruns, professor of psychiatry at the University of Washington School of Medicine, said school is the most common venue for young people to receive mental health supports and so, from a public health standpoint, there is no better place to invest in resources.
"That's because kids spend the majority of their non-sleeping hours that aren't at home in schools, and we have professionals there," Bruns explained. "We have adults who care about young people who can, systemically or just informally, observe when kids are struggling."
One concern is mental health professionals are not spread evenly across Washington schools. A 2022 report from the mental health advocacy group Inseparable found the ratio of students to mental health professionals is high. For instance, in some schools, there is only one psychologist for more than 1,400 students.
Youth mental health experts said state lawmakers can help in this session by providing more resources.
Anna Nepomuceno, director of public policy for the National Alliance on Mental Illness-Washington, said legislators could also ensure Medicaid coverage of services in schools. She noted students tell her mental health support at schools is a top priority.
"There's a lot of students whose health insurance might not cover adequate mental health care, so they don't have access to it. Or they're unable to find therapists, especially if you're on Medicaid," Nepomuceno observed. "Sometimes the waitlist to see a therapist is really long, especially when you're talking about youth mental health."
The Superintendent of Public Instruction has proposed almost $6 million for grants to support school districts with the least access to behavioral health services.
Nepomuceno added school mental health resources were important in her life.
"I went to a high school that was a bit more affluent. We had a school psychologist, we had a therapist, and I actually saw both of them," Nepomuceno recounted. "I personally don't know if I'd be alive if I didn't have access to those services when I was young."
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As winter drags on with a recent rare burst of snow across North Florida, many Floridians struggle with seasonal affective disorder.
It is a form of depression triggered by shorter days and less sunlight. Mental health professionals across the state are offering practical strategies to help people cope, emphasizing the importance of light exposure, social engagement and seeking professional support.
Judy Charuhas, clinical director of outpatient services for Impower, a Florida-based telehealth provider, said simple acts of kindness can boost a person's mood and emotional well-being.
"Melatonin helps us feel better. Serotonin, endorphins -- when your endorphins get going -- you feel better," Charuhas outlined. "One thing people can do with depression that helps more than anything else is do something for someone else."
A recent study showed 40% of Americans say their mood drops in the winter, 41% are sleeping more, 28% feel fatigued and 27% report experiencing depression.
Lourdes Araujo, president of the Florida Counseling Association, recommended a light therapy box, which mimics sunlight exposure, for those experiencing symptoms.
"If the sunlight goes away, you can extend that time by using this sunlight exposure approach," Araujo explained. "It's really proven to be helpful with depressive symptoms."
She also encouraged cognitive behavioral therapy techniques to challenge negative thoughts and set realistic goals.
Dr. Rhonda Randall, chief medical officer and executive vice president of UnitedHealthcare Employer and Individual, stressed the importance of maintaining social connections and leveraging available mental health resources.
"People who have strong social connections actually live longer," Randall pointed out. "When we think about longevity and quality of life, those strong ties to friends and family are very good to our health."
Randall added many insurance plans offer mental health benefits such as virtual therapy, coaching and digital self-help tools, which can be convenient options for those who struggle during the winter months.
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Some 125,000 children in Michigan struggle with major depression, which can hinder learning, behavior and relationships, according to a recent survey. Research shows the benefits of school-based services to connect them with the care they need.
Together with parents, school mental health resources can help keep kids safe.
Scott Hutchins, who manages the behavioral health unit for the Michigan Department of Education, stresses the importance of these services, especially in light of the pandemic and school shootings.
"Those needs have only been exacerbated since COVID and those other violent tragedies," he said. "So, what mental-health services do is, they allow us to break down the barriers that students need to get the care that they need."
However, the state needs more of these professionals. Michigan has one school psychologist per almost 2,200 students. The recommended ratio is one for every 500 students. The state also requires school districts to include suicide-prevention hotline contact information on IDs for students in grades 7 through 12.
Statistics show youths receiving school-based mental-health services are six times more likely to complete treatment than those receiving community-based services.
Angela Kimball, chief advocacy officer for the nonprofit mental health advocacy group Inseparable, noted that funding is one key challenge in expanding the school mental-health workforce.
"In order to become a licensed professional," she said, "you not only have to pay for schooling, but there's also periods of supervision - where people are essentially working for free and having to pay for supervision as they work towards their credentials."
Kimball said groups like hers are pushing for policies to improve staff ratios and encourage people to consider mental-health careers. In the meantime, if you or someone you know is in crisis, call 988 to be connected with a trained counselor, available 24/7.
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About half of youths experiencing depression in Illinois are not receiving treatment. While the state ranks fairly well nationwide when it comes to youth mental health, officials say there is room for improvement.
Andrea Durbin, CEO, Illinois Collaboration on Youth, said anxiety and depression are at an all-time high, especially with LGBTQ youths and those in immigrant families.
"This is a time for us to be compassionate and empathetic and to embrace folks who are feeling this way and to be supportive, and understand where this is coming from and what our responsibility as adults is to protect them," she said.
The state's Children's Behavioral Healthcare Transformation Initiative passed in 2022. It emphasizes the importance of proactive mental-health screening in schools, similar to vision and hearing tests. Now, a new state law requires yearly mental-health screenings for seventh through 12th grade students.
Despite this progress, barriers to community-based mental-health services for youths still exist and include cost, transportation, insurance issues and stigma.
Angela Kimball, chief advocacy officer with Inseparable, said school-based services that provide different levels of support are one of the most effective tools for supporting student mental health and improving access to care.
"We are starting to see some improvements in student mental health, and that's very encouraging, but the need is still very, very high," she explained. "So we can't let our foot off the pedal now. We really need to do everything we can to build the workforce and to make sure students are supported."
She said youth who get school-based services are six times more likely to complete treatment and have improved long-term education and work outcomes. Yet currently, most state schools don't have the recommended ratio of mental-health staff to students. State-funded programs such as the Behavioral Health Workforce Center are working to address the provider shortage. Kimball added that state policies and initiatives that continue to provide solutions to any roadblocks to mental-health services are crucial to providing youths the care they need.
Disclosure: Inseparable contributes to our fund for reporting on Criminal Justice, Health Issues, Mental Health, Social Justice. If you would like to help support news in the public interest,
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