Why Those Most Impacted by the Youth Mental Health Crisis Might Be the Answer to Solving ItHealth
The need for solutions to address the adolescent mental health crisis has never been so dire. But some of the needed solutions — like addressing the lack of mental health providers through educational incentives or securing funding for states and territories to expand school mental health services — will take time to implement. Fortunately, there are several unique opportunities to expand on the work we’re already doing to make a big impact. In fact, what helped me save my life wasn’t a new program or initiative. It was other teens.
From middle to early high school, I struggled with suicide, depression, disordered eating, and other mental health challenges. I felt especially isolated in my rural community, where access to care was limited and where conversations about mental health were nonexistent. At the same time, I dealt with the stigma associated with men’s mental health, which was further complicated by my sexual orientation and queerness. I remember feeling like there was no one in the world who could understand the challenges I faced — and I almost took my life because of it.
What I needed then was to know that I wasn’t alone; that there were people in the world just like me, who understood the context in which I lived and the identities that I held, and who could show me that it was possible to overcome the issues I faced. This is the foundation behind peer support: the belief that people with lived experience in mental, behavioral, or substance use conditions can support, inspire, and empower those with similar issues. It’s about leveraging a sense of relatability and understanding that can be hard to achieve in professional settings, especially for those who might feel unable to connect with a mental health provider due to stigma, differences in life experiences, or accessibility.
Though peer support services have existed across the nation in some form for decades and have been proven to be effective and beneficial, the infrastructure for these services has been built for and centered on the adult population. Even so, we know that children and adolescents benefit from this sort of care. For one, research shows that teens feel comfortable talking about their mental health with the individuals close to them, which often includes friends. In addition, the connection young people have to their peers is a known protective factor for numerous mental, behavioral, and substance use conditions. And given that almost 60 percent of youth with major depression do not receive any mental health treatment, the need for innovative approaches to address this shortage in care has never been so important.
It makes sense then to invest in opportunities that make youth peer support widely available and accessible. One of the earliest pioneers in this work are youth-led crisis intervention programs, which have serviced the needs of young people in some parts of the country for almost four decades. And it’s the exact sort of program that helped me save my own life.
During my freshman year of high school, I was able to volunteer with YouthLine, a free, confidential, teen-to-teen crisis help support hotline based in Oregon. As a volunteer, I received 63 hours of training in crisis intervention and response, where I learned skills like active listening, direct communication, and de-escalation. I also received national certifications and curricula like SafeTALK Suicide Alertness and Youth Mental Health First Aid (YMHFA). I underwent countless practice scenarios and learned how to use real-world resources to connect people to help and care in their own communities.
For the next four years, I spent three-and-a-half hours each week in the YouthLine office under the supervision of a masters-level clinician responding to texts, chats, calls, and emails from teens across the world about a range of topics, including but not limited to suicide, depression, self-injury, stress, abuse, substance use, and hopelessness. Through YouthLine, I realized that others dealt with the same issues I did, which later empowered me to seek professional treatment and pursue a career in mental health.
Twenty-year-old Adia Fadaei has a similar story. She started to volunteer with the California-based Teen Line when she was just 14. Though she didn’t have lived experience with a mental, behavioral, or substance use condition leading into it, the knowledge and skills she learned through the over 65 hours of intensive training on psychoeducation and mental well-being helped her navigate the mental health challenges that arose later in her adolescence.
Once on the lines, Fadaei’s shift consisted of not only supporting others but also supporting herself. An hour of each shift was dedicated to activities that focused on bettering her own mental health and well-being, like self-care and personal development. After she aged out of Teen Line, Fadaei became a crisis counselor with the 988 Suicide and Crisis Lifeline and hopes to pursue a career in clinical psychology after graduating from college. Since teen crisis counselors receive early exposure to mental health professions that are typically not found until higher education, these programs serve as important pipelines for the mental health workforce, which is much needed given the current shortages of school counselors, psychologists, social workers, and psychiatrists across the country.
In addition to the personal impact these programs have had on both Adia’s and my mental health and futures, our work has, without a doubt, profoundly touched or saved the lives of countless teens. In 2019, Teen Line served over 21,000 teens, and in 2021, YouthLine reached almost 25,000 children and adolescents from across the world. And the numbers just keep growing. Since its inception, YouthLine has experienced annual increases in call volume of about 15 percent, with additional increases because of the COVID-19 pandemic. Even so, the program has been able to meet the demand by de-escalating over 97 percent of high-acuity contacts on the phone, referring thousands of teens to resources in their community, and helping all contacts develop a safety plan or set of next steps.
With the recent one-year anniversary of the 988 Suicide and Crisis Lifeline and the continued discussion of how to tailor its services to children and adolescents, we have the perfect opportunity to integrate existing youth-led crisis intervention programs into the 988 framework through a national sub-line staffed by teens, for teens. Right now, when someone reaches out to 988, they can press “1” to be connected to the Veterans Crisis Line; “2” to be connected to the Spanish sub-network; and “3” to be connected to an LGBTQIA+-focused service. What teens need is to have the option to press “4” to be connected to another trained teen. A system like this would not only help reduce response times, supplement the existing workforce of crisis workers, and centralize existing services, but also offer teens a chance to be connected to peers who understand the issues they face.
Because sometimes all a young person needs to better their mental health—and to later make an impact—is to know they’re not alone.