Summer camp: sun, swimming, archery. And therapy.
MILFORD, Pa. — Heather Klein was in her cabin at Camp Nah-Jee-Wah, nursing her first iced tea of the morning, when a photograph arrived on her phone and she drew a deep, sudden breath.
Klein, the mental-health coordinator for a network of sleepaway camps, has a morning routine: responding to queries from anxious parents, who have looked at the photographs posted online the night before. Why does my child look sad? they want to know. Where are their friends?
This message was from a counselor — and it was serious. A teenage camper had switched from high-tops to Crocs to go to the beach, which allowed her counselor to see a row of cuts the girl had made with a razor.
Klein pulled up the girl’s medical forms, which noted that she had been in therapy for anxiety and depression but made no mention of self-harm. “OK,” she said. “She’s going to have to go home.”
In her role at NJY Camps, a network of Jewish overnight camps in Pennsylvania, Klein spends her days sorting serious risks, ordinary unhappiness, and squalls of parental anxiety.
All day, as campers move in flocks from the dining hall to swimming, to crafts and archery, to their bunks, Klein zips around camp in a golf cart, outfitted with a fanny pack and a walkie-talkie.
Summer camp has always involved a degree of emotional struggle. Homesickness is overcome; high dives braved; bunkmates won over. When adults in the industry refer to a “successful camper,” they often mean one who sticks it out.
But youth mental illness is an urgent problem in this country, a challenge the surgeon general has described as “the defining public health crisis of our time.” Between 2001 and 2019, the suicide rate for Americans ages 10-19 jumped 40 percent, and emergency room visits for self-harm rose 88 percent.
During the pandemic summers, many camp directors say, campers arrived with mental issues of a severity they had not seen before, exceeding the capacity of counselors in their teens and 20s.
As the pandemic recedes, many camps are adding mental support. Some have care teams that meet regularly to discuss interpersonal dynamics among bunkmates. Many set aside time and space for therapy via video during the day. And many camps have created new staff positions focused full time on mental health.
At the NJY camps, which are affiliated with New Jersey’s Jewish Community Centers, among other partners, that person is Klein, who is 51.
A familiar face at NJY, where she has served in various capacities for 15 years, she now focuses year-round on mental-health issues for the network, a position funded by the Healthcare Foundation of New Jersey. A day spent in her company, from 7 a.m. to midnight, offers a glimpse into an increasingly complex juggling act.
7:23 a.m. ‘Big love’
“Those are fresh wounds,” Klein said, peering at the photograph the counselor had sent her, showing a row of reddish cuts on a bare ankle. She felt for the girl and her family, but the camp had a policy: Campers engaging in active self-harm would be sent home.
Over the phone, she talked the counselor through the next steps, starting with the pickup by a family member. “Let’s make sure she is safe and watched and with a staff person at all times,” Klein said. “I’m sending you big love.”
Just like that, the teenager’s camp summer was over. And Klein was needed in Bunk 50.
8:12 a.m. ‘Breakfast meds’
Much of Klein’s day is spent on standard camp fare: In Bunk 15, a camper flushed his bunkmate’s glasses down the toilet. There were dizzying violations of the “No back/no boobs/no butts/no bellies” rule and skirmishes over Jibbitz, the plastic charms that decorate Crocs.
Of the 2,200 children and teens who attend NJY camps in the summer, about 20 percent take medication for attentiondeficit/hyperactivity disorder and 15 percent for anxiety and depression, according to the medical staff. Twenty-five to 30 meet remotely with therapists during camp sessions.
Outside the dining hall, a nurse called out, “Breakfast meds,” and a line of children formed. This, Klein said, is simply part of the fabric of childhood. Last month, when an 11year-old camper began misbehaving, Klein called a bunk meeting and explained to the other children what had happened: The girl had been on a “medication vacation,” and it wasn’t working out.
“I said, ‘Do you know what ADHD is?’” she said. “They said, ‘Oh, yeah, my mom has that. My therapist told me about that.’ Kids know what is going on.”
4 p.m. Blood oxygen
In the infirmary, a curlyhaired boy had reported nausea, vomiting, and difficulty breathing, and also that when he closed his eyes, he saw the color cyan. He thought it would be a good idea to check his blood oxygen levels.
Klein knew the boy. “Mom says he fabricates,” she said. She checked his temperature and led him back to the golf cart. “I think what you’re feeling is nervousness,” she told him, and then dropped him off at the nature center.
A call came in from Round Lake Camp, which is for children with learning differences, social communication, disorders and ADHD. A camper was curled on a porch, gasping for air and crying out, “I’m vibrating!”
Klein stroked the camper’s leg. “Breathe in like you’re smelling a pizza,” she said. “I want to see your belly moving up and down.”
9 p.m. Emotional support rabbit
At 9 p.m., insects wheeled around in the floodlights above the tennis courts. Senior staff had flopped down on the couch in Klein’s office, discussing a camper who had been sent home for flashing a gang sign. They were all exhausted.
Then word came in that two vapes had been found in a camper’s backpack — one nicotine and another marijuana — a violation of camp rules serious enough to require the attention of the CEO.
“I got to call Michael on this,” Klein said, but it killed her: This teenager had been at camp two years ago when word came in that her mother had died. Klein had helped pack her up to go home then, too.
The camper headed to the infirmary, dangling a stuffed animal. “Emotional support rabbit,” said a label on its chest.
Klein watched her leave and covered her face with her hands. Then she rested her elbows on the top of a bookshelf and wept.