State plans major mental health overhaul
Amanda Arellano felt a heavy weight pressing down on her chest. It was May of 2021, and the teenager struggled to breathe.
Maria Arellano rushed her 17-year-old daughter to the pulmonologist. Amanda has cerebral palsy, autism, epilepsy, asthma and a heart murmur. With COVID-19 on the prowl, they couldn't be too careful.
It wasn't an asthma flareup, the doctor told them. It was anxiety.
“It makes you feel very powerless,” Maria said of watching her normally gregarious daughter struggle.
Many California parents know this feeling well. Two years into the pandemic, our children are in pain. Rates of anxiety and depression have shot up so quickly that several national leaders — including the U.S surgeon general — have issued urgent public health advisories. School-based therapists report long waiting lists and an increase in fighting and behavior issues. Emergency room doctors say they are overwhelmed by the number of children coming in after trying to harm themselves.
On top of all this, the state is facing a shortage of mental health providers.
State officials know they have a serious problem and have vowed to address it. Along with county public health departments, school districts and other agencies that serve children, the state is grappling with a complicated challenge: Gov. Gavin Newsom's administration plans to build a brand-new system to solve these problems in the coming years. But pressure is mounting to help children like Amanda — now.
Dr. Mark Ghaly, a pediatrician who serves as the state's secretary of Health and Human Services, told CalMatters he feels “concerned but hopeful” about the state's ability to meet the growing need, though he's also “very aware that even the most short, shortterm interventions are not as immediate as I think we would like.”
Last year, Newsom's administration allocated $4.4 billion in one-time funds to create a statewide Children and Youth Behavioral Health Initiative. The bulk of the money has yet to be distributed, but efforts to develop a vision and work with stakeholders are underway.
A crisis was brewing before the pandemic; COVID-19 set it to a boil. Suicide rates among Black youth doubled from 2014 to 2020, state data shows.
Cases of youth deliberately causing self-harm increased 50% in California from 2009 to 2018, the state auditor reported. Children's hospital officials said that mental health emergency room visits spiked dramatically during the pandemic.
From 2019 to 2020, opioid-related overdoses among 15- to 19-year-olds in the state nearly tripled, according to a CalMatters analysis of state data.
Young people's suffering has been widespread, as revealed in a report on the state of student wellness. Based on surveys of 1,200 California middle and high school students from April 2020 to March 2021, 63% of the students reported having had an emotional meltdown; 43% said they had a panic or anxiety attack; and 19% described suicidal thoughts, according to the report published by American Civil Liberties Union California Action, Cal State Long Beach and the California Association of School Counselors.
“We know from the numbers it's getting worse,” said Amir Whitaker, senior policy counsel for ACLU Southern California, who is the report's lead author.
Whitaker leads the Youth Liberty Squad, a group of high school students around the state who are advocating for better school-based mental health care. Many have experienced their own anxieties these past two years. As life edges closer to normal, they find details of their lives changed in unsettling ways.
The trauma of the pandemic — the grief, fear, loneliness and boredom — has layered upon concerns about food and housing insecurity, gun violence, climate change, political polarization, racism, transphobia, deportation and, now, the war in Ukraine.
One in 330 California children has lost a parent or caregiver to the pandemic, according to a report released in December by COVID Collaborative.
Counselors who work in schools say more students are acting out.
Josh Leonard, executive director of the East Bay Agency for Children, which provides mental health services for children, calls this “a natural predictable response to the stress and anxiety at the moment.”
But big systems are not nimble enough to address the building emergency, he said.
Alyssa Hurtado, a social worker with Leonard's agency who works at a Newark elementary school, did her best to stay connected with families during the school closure. Many of her young clients now struggle with separation anxiety. Others have difficulties with motivation and concentration.
“Kind of like, `What's the point?' ” she said.
Across the agency, Leonard says 10 therapy positions remain unfilled out of a total of 50.
Each of those positions would allow the organization to see 18 to 20 additional children.
“Every applicant has 20 different job opportunities right now,” said Stacey Katz, CEO of WestCoast Children's Clinic in Alameda County, who also is trying to fill 15-20 openings.
Alex Briscoe, head of California Children's Trust, an initiative to reform the state's children's mental health system, calls current state leaders “extraordinary” and their investment `“unprecedented.” What can be done now? Some believe the answer lies, in part, with kids themselves. Students can be trained to act as peer counselors, and to be on alert for signs of suicide, many experts say.
A year and a half later, much has changed in Amanda's life. She is vaccinated. The final months of senior year are upon her: Prom. Senior trip. Graduation.
With the help of her mother and her therapist, she is working to find peace within the new reality.