Column – Young people should be more than an afterthought in crisis mental health conversations
Published 7:12 pm Friday, September 2, 2022
By Kristin Lennox and Emily Moore
Historically, Virginia’s response to mental health has been more reactive than preventative.
According to rankings by nonprofit Mental Health America, Virginia is 21st in youth mental health and 37th in access to mental health care. Moreover, young people’s needs and experiences have consistently been considered last in policy changes — and when it comes to mental health specifically, they are often an afterthought.
At Voices for Virginia’s Children, youth advocates tell us how challenging it is to receive care when in distress. When interfacing with local crisis hotlines, many have received no response, been put on hold or even been hung up on after describing their needs.
It’s even more troubling when the person dispatched to help is law enforcement and young people end up being transported to a facility in the back of a police car, sometimes in handcuffs, even though they are vulnerable and experiencing a crisis. One 15-year-old mental health advocate, Saniya, shared with us, “Police interaction is usually the last thing you need, because then it feels like you’re in trouble for being in a crisis.”
Nothing described in this scenario is rooted in a healing or trauma-informed approach. These are ways in which we fail young people.
Saniya has asked us whether there would be so many mental health crises among adults now if people’s mental health needs were met when they were young. “Everybody should be getting the same resources,” she said. “No one’s mental health is more or less important based on where they live or what they need.”
On July 16, 988 was launched nationwide as the new three-digit number for the National Suicide Prevention Hotline. Individuals experiencing a mental health emergency who call 988 will be connected with a trained crisis counselor. In Virginia, the hotline is being linked to the state’s crisis response services, which are currently being designed and implemented by state agencies and stakeholders.
However, the idea that 988 is the “new 911 for mental health” is inaccurate. If a call cannot be de-escalated over the phone and an in-person response is needed, depending on where you live, law enforcement may still be dispatched to a site where someone is having a mental health crisis.
During a crisis, a young person or their caregiver should be able to call the 988 hotline and, if needed, have mobile crisis services dispatched to de-escalate, stabilize the situation and reduce the threat of violence from police intervention. But a new law allows 89 of Virginia’s 133 localities — those with 40,000 or fewer residents — to opt out of two protocols regarding the co-response of law enforcement and crisis response teams under the Marcus Alert System. For those living in one of those 89 localities, an attempt to call 988 during a crisis may still result in law enforcement, with or without crisis intervention training, responding to your call.
Traditionally, mental health crisis services for young people are obtained through a confusing patchwork of access points — such as contacting licensed private providers or community services boards, dialing 911 or driving to the emergency room. But there are many hurdles to accessing help and care. This disjointed system is not working.
A truly comprehensive crisis services continuum is one that puts an emphasis on equity and prevention within a community-based model, providing care when and where young people need support. There must be an explicit focus on safety, particularly for Black, Latinx, Indigenous and LGBTQIA+ youth whose first point of “care” during mental health emergencies is often law enforcement.
Young people have been vocal about how Virginia’s current crisis response falls short, and it is past time for their voices to be heard.
Underinvestment hinders access to behavioral health and crisis services
Currently, less than 10% of Virginia’s behavioral health agency budget goes toward resources dedicated to young people. Sufficient funding for services and a culturally responsive, well-resourced workforce are crucial to addressing the mental health needs of young people.
For lawmakers, the next step toward decriminalizing mental health must be to fully fund trauma-informed mobile crisis services and crisis stabilization units, specifically designed for young people, in all communities across the commonwealth to ensure appropriate and adequate crisis response. This investment must include further developing and supporting a diverse workforce of trained mental health professionals.
We must not limit ourselves to thinking of 988 solely as a crisis line. It’s a significant opportunity to build a stronger behavioral health and crisis services system for young people. Policymakers must commit to designing systems with youth in mind first, rather than figuring out how they will fit into “phase two.”
Kristin Lennox is the advocacy and engagement manager and Emily Moore is the policy analyst at Voices for Virginia’s Children, the commonwealth’s only independent, multi-issue child policy and advocacy organization. Kristin and Emily can be reached at email@example.com and firstname.lastname@example.org.