Multnomah County Chair Deborah Kafoury is urging leaders across sectors to work together to address Oregon’s child and adolescent mental health crisis.
The Chair shared her growing concerns at the Feb. 8 All Hands Raised Partnership Council meeting amid reports that Oregon has the highest rate of youth with at least one major depressive episode in the past year. The state also has the country’s highest increase of youth experiencing a substance use disorder, according to a 2022 State of Mental Health Report put out by the non-profit Mental Health America.
The COVID-19 pandemic has worsened existing behavioral health challenges for students across the country — especially among children of color, kids from immigrant households, youth with disabilities, LGBTQ+ youth, and low-income or homeless students. In response, Chair Kafoury said, communities must improve access to high-quality, affordable and culturally appropriate behavioral health services.
“So many of our kids find themselves needing to cope with a world filled with instability and anxiety, but without sufficient tools or support to make their way through in healthy and effective ways,” Chair Kafoury said. “As a result, too many of our kids end up experiencing mental health challenges that have been made worse by the isolation, disconnection and disruption of the pandemic.”
As a mother to three children emerging from adolescence, Chair Kafoury said she has seen firsthand the difficulties children have faced during the pandemic. Children are also grappling with other challenges, she said, including climate change, community violence, social media pressures, and magnified inequality.
According to data from the Centers for Disease Control and Prevention, more than one in three high school students said they had experienced persistent feelings of sadness or hopelessness in the past year — a 40% increase since 2009. Between March and October 2020, hospital visits for mental health emergencies among children ages 5 to 11 rose by 25%, and 31% for children ages 12 to 17.
The trends have been so alarming that, in October 2021, the American Academy of Pediatrics, the American Academy of Child and Adolescent Psychiatry, and the Children’s Hospital Association together declared a National State of Emergency in Children’s Mental Health.
Chair Kafoury said the trend is backed up by the County’s own behavioral health providers, who have reported significant increases in behavioral health needs and suicidal ideation among youth.
The County’s Student Health Centers are well positioned to support students’ behavioral health. The nine centers provide health services to all youth ages 5 to 18 for no out-of-pocket cost.
Those providers serve students through the County’s School-Based Mental Health Program, which offers mental health services to children and teens who are on the Oregon Health Plan or are without insurance, in 38 schools throughout Multnomah County. Clinicians of color who offer culturally specific services are stationed at a number of those school sites.
“We’ve found that putting counselors directly in schools is absolutely critical to helping families break through the barriers that make it hard to get help for mental health needs,” Chair Kafoury said.
Looking upstream, the County’s Schools Uniting Neighborhoods (SUN) Service System helps connect school communities to wraparound supports. Throughout the pandemic, SUN providers have helped students and their families with basic needs, social and emotional learning, family empowerment and community building.
In July 2021, the County invested $5.4 million of American Rescue Plan Act funds to expand wraparound services and add SUN School family resource navigators. The navigators help families access rent assistance, healthcare, SNAP benefits and other available resources.
“Our SUN Service providers have a unique, embedded perspective on the effects of the pandemic on youth mental health since they have been on the frontlines from the start, and we’d be wise to listen to and leverage their insights to shape the way we respond to this crisis,” Chair Kafoury said.
A panel of four SUN providers joined Chair Kafoury to speak about social and emotional health trends among students, along with best practices for serving students and lessons that they have learned throughout the pandemic.
George Caceres, a SUN site manager at Scott Elementary, said he has witnessed students navigate grief as COVID-19 has upended their lives.
“At Scott Elementary, we are seeing a high number of students struggling due to the immense insecurities that this pandemic has brought on their lives,” he shared. “We have students that are dealing with grief from the loss of their parents, and in some cases their only parent.”
Jacqueline Johnson, a youth advocate for Latino Network, one of the community-based agencies the County partners with to deliver SUN services. Johnson said she has seen firsthand the effects of COVID-19 on young people’s mental health.
“What I’m seeing is a lot of anxiety, a lot of depression, but also the effects of lockdown still today,” Johnson said. “Many of our kids live in multigenerational homes, so there is a worry about going to school and getting COVID, going back to their house, and giving it to their family members.”
Chair Kafoury said the collective work to address the gaps harming youth and communities of color has kept many families afloat, but too many are falling behind. She called on the education, government, business and community-based sectors to “pull in the same direction” to ensure that every student has access to the behavioral health services they need.
“Children and families will always face challenges, but we can — we have to — find ways to make sure that they don’t face those struggles alone, especially during a pandemic that’s buried them under wave after wave of trauma.”