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The state of youth mental health on California’s Central, South Coasts and why things are so bad

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One in three high school students across the U.S. have reported persistent feelings of sadness or hopelessness. In the decade leading up to 2019 suicide rates went up 57% among teens and young adults.

The story comes from KCLU’s podcast The One Oh One. You can listen to the full episode here.

Editor’s note: The following story deals with suicide. If you have suicidal thoughts, the National Suicide Prevention Lifeline is 1-800-273-8255 (En Español: 1-888-628-9454; Deaf and Hard of Hearing: 1-800-799-4889).

17-year-old Marcie Walton attends Thousand Oaks High School. For this piece I asked her to journal about her mental health. This is an extract.

“Usually when I'm having a bad mental health day, it looks like me over analyzing everything, being super stressed out and just overall, not really getting things done, just being more anxious or sad than usual. And I'm currently being treated for OCD in therapy right now, so. It's just everything is like a trigger for me on the bad days. I try and calm myself down by taking deep breaths and counting to 10. Realizing all of the surroundings around me, just tuning in, back into the present moment if I'm getting in my head or anything like that.”

Walton has good and bad days. She has coping strategies like cuddling a dog, or settling down with some hot chocolate or watching a favorite TV show… things that make her feel better.

Walton is not alone in how she feels.

Heather Chamberlin Scholle is the mental health services coordinator for the Conejo Unified School District.

“So we are at Conejo Valley High School, and I want to take you into one of our wellness rooms so you can have an idea of some of the things that we've been doing this school year. Come on in,” said Chamberlin Scholle as she took me inside one of their wellness rooms.

“And in this room, we have tried to make it a very welcoming, safe space for students,” Chamberlin Scholle continued.

Wellness rooms like this one are in schools all over the district. The room has comfy chairs and messages like “you matter” on the walls. Students can pop in to take a moment for themselves or meet with a counselor.

Chamberlin Scholle oversees the mental health clinicians and therapists that care for the 17,000 students throughout the district – which includes the cities of Westlake Village, Thousand Oaks and Newbury Park.

She defines her work as “removing barriers for kids to get their emotional needs met”. And she really wants to normalize that kids are struggling right now.

“You just have to look at the data. Kids are struggling with their mental health. If we can catch it early, then we have a much better chance of this student not having to get to a point where they're suffering to get the help that they need,” said Chamberlin Scholle.

The district recently did a mental health survey with middle and high schoolers and found anxiety is a top concern and that there tends to be a lot of stigma attached to being depressed. They also found kids really want to learn how to be resilient and self manage how they feel.

To keep more of an eye on the students who are really struggling they started something called red flag data.

“So every student had access to a CVUSD issued Chromebook. If they do a search on that Chromebook about being depressed, being suicidal, being anxious, self-harming. I get those flags and then we follow up,” said Chamberlin Scholle

In the last school year they followed up on 600 students typing in those kinds of searches.

“But it was the acuity of what was coming across my screen that was concerning to me. ‘I want to die. How do I end my life? What's a painless way to commit suicide?’ These were like the high level students that we were really, really concerned about,” said Chamberlin Scholle.

When there is a concern like this, a risk assessment is done to determine if the student is safe or not, and then they take the action needed to help that student. Chamberlin Scholle says what was most concerning to her were the number of psychiatric hospitalizations.

“In normal years. My colleague and I, we would be able to kind of have the kids on our radar just in our heads. And last year there were so many that we… we had to create a spreadsheet,” Chamberlin Scholle said.

In the last school year there were 82 psychiatrist hospitalizations that the district is aware of and some of those hospitalizations were students cycling through multiple hospital stays.

Bethany Stern works throughout the Conejo Unified School District. We meet up at Newbury Park High School.

“I've been a school psychologist for between internship and field work. This is my thirteenth year and I definitely see a level of like loss of hope that I didn't really feel previously,” said Stern.

We sit at one of those outdoor metal lunch tables. It’s just before the end of the school day so a few students are milling around and we can hear Frozen being sung from what must be a theater or music class nearby.

Stern primarily works with students who need residential placements and have significant mental health needs.

“A lot of our students who have to go to treatment for that, for severe depression, to the point that they want to end their life, has been very eye opening and very concerning for me and for my colleagues on our mental health team, for sure,” said Stern.

Just like Heather Chamberlin Scholle, Stern is also concerned about the increase in self-harm.

“So I will say when I started here I did not have the number of kids being hospitalized for having hurt themselves. I didn't have the number of kids cutting themselves and engaging in that non suicidal self-injurious behavior that we, you know, we see quite regularly now,” said Stern.

Inside a youth crisis call center

Further north in Santa Barbara County is the SAFTY mobile crisis team. SAFTY is an acronym for Safe Alternatives for Treating Youth.

They work with 20-years-olds and younger. When there’s a crisis, schools, parents and youth call them for free on their 800 number.

“What a crisis looks like is when a youth is having thoughts of suicide, self-harm, thoughts of aggression towards others or even homicidal ideation. Severe mental health symptoms. So it could be anything from psychosis symptoms to having a panic attack,” said Meghann Torres, program manager for SAFTY, which is part of the non-profit Casa Pacifica.

Torres has held all the positions at SAFTY from manning the crisis hotline to today – managing the crisis team.

She says their main goal is to help stabilize youth in their home. They also try not to write psychiatric holds unless it is absolutely necessary.

“We have the opportunity to come in, provide them the space to really explore ‘What are those thoughts of suicide that you're having? How often is that happening? When did it start?’ We also use very direct language. We use the term suicide. The reason for that is we signal to them, I'm comfortable having this conversation with you,” said Torres. “Then we help them navigate through the fears that are coming up around their parents knowing or what is it going to look like for the day? So one of the questions we ask is, you know, ‘What's your goal for today?’ Oftentimes youth say, ‘I want to go home’.”

A few rooms down from Torres’ office is where the crisis hotline is stationed.

“So I have the line this morning, which means I'm answering the crisis hotline,” said Jessica Holt. “And it's been quite busy this morning but we turn the line on at eight and this morning, as soon as I turned the line on, the phone was ringing.”

Holt is a crisis care specialist at SAFTY.

“Some of them being follow ups with parents, some of them being the need to help seek psychiatric placement for some of the youth who are currently in emergency rooms in our county,” continued Holt.

Holt shows me something she finds really helpful when she’s doing this kind of work. There’s a group text with their entire team where they are constantly communicating and supporting each other. There were a lot of hearts in the thread of messages.

As we’re talking the phone rings.

Holt is quick to answer.

“SAFTY mobile crisis, this is Jessica.”

Holt starts to take down the details of the caller.

“You said your daughter, right? OK. She's 13. Is she safe right now?”

Finding out that the 13-year-old is safe, Holt then shares what SAFTY can do for this concerned parent and for their daughter.

Not long after that call. Another comes in. It’s from a school concerned about one of their students. After an initial conversation with the school, Holt speaks with the student.

Here is an extract from that conversation.

“Hi, this is Jessica, from SAFTY. How are you? OK, you've talked to us at SAFTY before, right? Yes. OK, so you know about who we are and what we do. Can you tell me just a little bit about what's going on with you today and what brought you to your counselor's office? To do what? Hurt yourself how? To cut yourself?”

Holt continues to work with this student asking specific questions about their state of mind.

“How long have you been having those thoughts? For two days? Did something happen two days ago that made thoughts start?”

The crisis center gets about 2,000 calls a year - a number that has remained stable since 2016.

They looked through their data for me, and in September last year, as an example, they received 64 calls from schools – that’s about 15 a week. From all over the county.

The calls are also majority female – 67 percent.

The number of calls hasn’t changed on their end, but the types of calls have. They’ve seen an increase in calls about suicide attempts.

Why is this happening?

So the big question I know you’ll be asking is why is this happening to young people? Why have things got so bad?

I put this to the mental health experts I met and they describe the situation as the perfect storm – there’s the 24 hour news cycle, climate change, gun violence in schools, stressed out parents, access to substances, the pandemic, the pandemic, the pandemic!

And then there’s the thing you know I’m going to say – social media – which these experts say is eroding self-esteem, taking bullying to the next level and is a constant reminder to kids of how they’re not being included in that party or that friend group. School can be a really tough place to be for kids and it’s no wonder there’s also been an increase in school avoidance.

What do the youth say?

So that’s what the experts say, but what about the young people themselves…

For the rest of the episode you’re going to hear from four young people Kathryn, Evie, Elise and Lily who live in Ventura and Santa Barbara counties.

First you’ll hear from Kathryn who is a senior in high school. You’ll also meet Evie – Evie is in tenth grade and uses they/them pronouns.

Both requested I only use their first names to protect their privacy.

We connected over Zoom. I started off by asking them to describe how kids their age were feeling these days.

Kathryn [K]:There are definitely some people who are doing just fine. But I think that from what I'm seeing, just overall anxiety is kind of at an all time high because there's so much we don't know on a day to day basis.

Evie [E]: I do not think that the state of mental health of the people around me is good right now because I mean, we have all the struggles of being a teen like figure out what we're going to do with our lives, figuring out who we are, like sexual awakenings, gender awakenings, all that fun stuff. And then on top of that, we put the pandemic and the isolation and terrifying new situations that just builds and builds on anxiety that was kind of already there, just from existing.

Michelle Loxton [ML]: So you might have already touched on this already, but how would you describe your… your own mental health?

[E]: I've had to work very hard on my mental health since I was a kid and counseling has really helped me personally. But there's been a lot of ups and downs… in this past year has been particularly scary.

[K]: And I have… kind of a similar experience. I started to develop OCD back in like second grade and I was diagnosed with, you know, a few different things in junior high. And I worked really hard and I would say that right now I'm in a pretty good place. But of course, just like the anxiety already of going off to college and taking, you know, so many AP classes at a time along with balancing extracurriculars and friends and family and physical health can be overwhelming.

I connected in-person, at their school, with Elise Jones, who’s a senior, and eleventh grader Lily Oliver.

They told me what worries them the most about youth mental health.

Lily Oliver [LO]: I think the number one thing would just be like negative thoughts or just the negative energy that's within all of our lives, like with school, especially. I think that just because we're in the middle of the year right now, that's like the number one thing that we're all worrying about is the future.

Elise Jones [EJ]: I think what worries me personally is people are bottling up their emotion, and I'm like myself, I'm I am really afraid to share my feelings and become vulnerable with people, and I think that's that's a really, um, people, a lot of people experience that they're afraid of rejection and just afraid of reaching out. I'm terrified of my friends’ mental health getting so bad that it's too late and I can't help them anymore, and that's what really scares me. It's… I just want people to reach out and have a place to do so where they feel comfortable.

When they feel they’re struggling with their mental health, Lily and Elise have things that help them. You’ll hear from Lily first.

[LO]: So personally, I love to journal. I have a therapist, too, so I talked to her about my journaling, and she always advocates for me to journal every single day. Another thing I do is listen to podcasts. I love podcasts. I think they're so therapeutic and calming. Doing more personal check-ins with yourself daily. Whether it's like affirmations or just checking in with yourself, saying if you're OK or the Wellness Center, I think that's also a very valuable resource at our high school.

[EJ]: Yeah, I love the journal as well. I find it very hard to talk to people, and a lot of my problems are… are minor things that happen throughout my day and I just. But they really weigh on my mind. And so I love journaling at night. And by the time you know, I get it all on paper, I'm calmed down and you know, I can understand the situation a little bit better and it just helps so much. I love to exercise. You just start small, you know, start going on small walks and just getting out the door is that first step. It's all you need to do. And once you're out there, you know it all feels better.

Back now to Evie and Kathryn – they told me what helps them the most when they’re struggling. Kathryn first.

[K]: I think that individual teachers who really understand and are educated on mental health are the most helpful. From personal experience and experiences with my friends, like most of the teachers I've had, if I go up and or a friend goes up and we explain a problem, they're very willing to help.

[E]: I totally agree. I was in high levels of mental health care in my freshman year of high school, and if I wasn't able to negotiate with my teachers and come up with different plans, and if they weren't understanding, I would have had to like dropout of school, it would not have worked.

I ended my conversation with Evie and Kathryn by asking them to share a story that would help paint a picture of the situation. Kathryn went first.

[K]: So I had a classmate and I'm going to be purposely vague. I had a classmate. We were taking a physics quiz and they were having a panic attack and they took themselves to the back of the classroom and started to stab themselves with a pen. And I noticed and I happen to be really close to this person. So I went back there and I kind of wrestled the pen from them and I held them down and I was trying to cover their arm because it's bleeding. And our physics teacher came over and he did not know what to do. You know, he was. He felt awful and shocked, but he couldn't really do anything. So I kind of took charge of the situation… you know. And I was like, Try not to cry. And I was kind of, like, shaking. But I knew, like, OK, he doesn't know what to do. I need to know what to do.

One of Kathryn’s classmates, who was in the physics class that day, confirmed this incident to me.

Kathryn went on to describe how she took her classmate, who was in crisis, to the school nurse who said the classmate could sit down for 20 minutes and then return to class.

[K]: And meanwhile, I was like looking at this person and seeing, like, you know, the blood on their arms and like, I know this person well, I know what they're going to do next. And I'm like, You don't understand, like they are going to escalate in hurting themselves until an ambulance has to come, as many have come onto campus since the school year has started.

Eventually Kathryn said the classmate’s parent was called in, the classmate went home.

Despite the trauma of what had just occurred Kathryn was sent back to class.

[K]: And luckily, I had a really good friend in that class to kind of just held my hand and let me cry.

Kathryn reported the incident to her school district. They have confirmed this to me. Kathryn is working with her district to improve mental health services in her school.

Evie also shared a story with me.

[E]: Winter of 2019 I moved here to Santa Barbara. I had maybe a month or two before everything shut down due to the pandemic, and I was not able to make the connections that I needed to make, and the isolation affected me a lot. My anxiety got worse and worse. It got to the point where activities that I wanted to do I couldn't even enjoy because I was just too anxious to enjoy them. And that led to a pretty deep depression. And in the fall of 2020, things got really, really scary, and I ended up in high levels of mental health care. I was in partial hospitalization for two months and intensive outpatient care for three. But I think. That just the situation of the last couple of years has made it so that people who were previously able to manage their anxiety and stress were just not able to do so anymore, and just so many people were in crisis.

Thank-you to Evie, Kathryn, Elise, Lily and Marcie for sharing so much with me.

If you or a young person in your life is experiencing a mental health crisis, in Ventura County you can call 1-866-998-2243. And in Santa Barbara County the SAFTY crisis crisis hotline is 1-888-334-2777. 

The mental health counselors I spoke to for this piece also encouraged parents or guardians to reach out to their child’s school if they’re concerned.

Heather Chamberlin Scholle again.

“My message to parents is if you're concerned. Don't wait. Reach out. Don't worry about what other people are going to think. Don't worry about, Oh my gosh, is the school going to think I'm this terrible person? No, I mean, this is we see this every single day, multiple times a day. You are not alone in this. You really aren't,” said Chamberlin Scholle.

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