Colorado organizations serving youth rethink their role in addressing mental health crisis

School was never a place where Zuzu Niyongabile felt like she could talk about her mental health, even as she and her classmates at Noel Community Arts School tried to process losing the end of their senior year to the pandemic, on top of the other struggles in their lives.

“I feel like a lot of people in school walk around silent about what’s going on,” she said.

It was only after Niyongabile, now 20, graduated and was searching for a direction in life that she found a healing community at Project Voices of Youth Creating Equity, a Denver nonprofit.

Project VOYCE wasn’t created to help young people with their mental health — it focuses on training youth of color in activism — but organizers realized there was an unmet need when their participants were burning out from the work and the toll of trauma they were carrying from individual hardships and living with racism, executive director Vanessa Roberts said.

Now, the nonprofit’s leaders encourage boundaries and rest, and start and end each meeting with a ritual so the participants feel that it’s safe to be vulnerable, she said.

Project VOYCE is just one of the organizations serving young people that are having to rethink their roles in the face of a youth mental health crisis in Colorado that predates 2020, but worsened during the pandemic. And in many cases, teens themselves are stepping up, looking for ways to support their peers.

In May 2021, Children’s Hospital Colorado declared a youth mental health emergency because of an increase in kids and teens hospitalized in behavioral health crises, and that year’s Healthy Kids Colorado survey found distress was widespread. About 40% of high school students who took the survey reported they had felt so sad or hopeless that they stopped doing some usual activities for at least two weeks over the previous year, and about 47% disagreed that their stress level was manageable most days.

It’s possible the numbers may improve somewhat when the survey is given again this year, since life has largely returned to normal for many families, but about 35% of students reported persistent sadness was disrupting their lives even before the pandemic. And the flow of children in crisis hasn’t slowed, according to Children’s Hospital.

Niyongabile said many of the young people in Project VOYCE discovered they were coping with the same struggles, including trauma related to racism and violence. Together, they could not only feel safe talking about their feelings, but also help each other to heal by encouraging them to use their strengths. For her, that involved leaning into her interest in music.

“We were attacking different traumas and different mental health problems in a way that’s comfortable,” she said.

While there’s no substitute for professional help for someone dealing with a serious mental illness, support from peers and lay adults is going to be vital in addressing mental health problems, said Dr. Ron-Li Liaw, chief of mental health at Children’s Hospital Colorado. There’s unlikely to ever be enough child psychiatrists and therapists trained on adolescent needs to see everyone who’s struggling, she said.

There have been some efforts to increase the availability of mental health care. HealthOne recently opened an intensive outpatient treatment program for youth in Thornton, and the state launched the I Matter program in 2021 as a temporary measure to offer up to six free therapy sessions to youth under 18. The state budget bill includes $6 million to extend that program for another year, until June 2024.

No one knows exactly why children’s mental health has been worsening over the last decade.

Theories include:

• That social media encourages unrealistic comparisons, while possibly decreasing time for sleep and healthy activities
• That kids are deluged with news about seemingly unsolvable problems, like climate change, killings by police and mass shootings
• That middle- and upper-income kids face more pressure to excel for college admissions
• That teens are picking up on their parents’ depression, anxiety or struggles with substances
• That kids have fewer opportunities to practice handling negative emotions and to develop confidence in their own abilities

Those ideas aren’t mutually exclusive, and each struggling young person may face a different mix.

To really address the mental health crisis, the country needs to increase access to treatment, but also to build up young people’s resiliency through connection to others and education about mental health and emotions, U.S. Surgeon General Vivek Murthy said said during a visit to Colorado last month. Another way to prevent mental health struggles is to try to reduce exposure to severe stressors, like bullying and violence, he said.

“We can’t just wait for people to come to the hospitals,” Murthy said.

Kids need to know how their brains work

Kari Eckert believes any adults who spend significant time with youth have a role to play in preventing the worst outcomes of mental illness.

She and her husband Jason started the nonprofit Robbie’s Hope after their 15-year-old son’s death by suicide in 2018. Robbie seemed happy, well-liked and successful in school and sports, so neither they nor the other adults in his life thought he might be suffering, she said. They worked with teenagers to put together a guidebook for parents and other adults who have significant relationships with young people to start conversations about mental health, even for kids who seem fine.

“I thought I had a pulse on Robbie,” she said at a panel discussion during the surgeon general’s visit. “I think Robbie was living with a mask on prior to the pandemic.”

The teens who helped build the guide said they wanted adults to talk with them about mental health on a regular basis, not just when they expressed negative feelings or when suicide is in the news — though they said it’s also important to talk at those times. They also said they wanted adults to listen, not to tell them how they should feel and not to show judgment or disappointment if they report anxiety, depression or stress.

Marin McKinney, a senior at Lakewood High School who has interned with Robbie’s Hope for two years, said her school has student groups focused on mental health, and teachers and counselors know about resources for teens who are struggling. That’s not necessarily the case everywhere, especially in schools that haven’t recently lost a student, she said. Robbie Eckert attended Lakewood High and was friends with McKinney’s older brothers.

“Once a school has been directly affected by suicide, it changes how the administrators are willing to handle” mental health, she said. “I think a lot of teens don’t realize how many people struggle with mental health and suicide until it’s too late.”

Eckert has pushed for the legislature to mandate lessons about mental health, and while so far there’s no appetite to do that, she said individual schools can help by teaching teens how their brains work. They don’t necessarily need to know all the neurotransmitters that might influence their moods, but they do need to understand that sometimes their brains can lie to them, sending messages that they’re worthless and should give up, she said.

“I suspect that my son was receiving messages he was unworthy,” she said.

Ideally, every school would be teaching about mental health, but funding is a barrier, as is the fact that social and emotional learning has become controversial, Eckhart said. That’s “scary,” because kids need to understand their brains and how to ask for help, she said.

Sarah Younggren, a licensed clinical social worker in Denver who works with schools on social-emotional learning, said that despite its conflation with critical race theory, the concept isn’t new or particularly controversial. If kids learn to recognize what they’re feeling and handle those emotions appropriately, they’re more likely to do well in school and in their future careers, she said. For some schools, that might mean a focus on teaching kids to calm themselves down, while others might be focused on bullying and school climate.

“It’s supporting kids in developing skills they need to be successful,” she said.

Resources aren’t reaching students

It isn’t easy to increase the mental health support available for youth.

Emma Nicotra and Batt Erdenbulgan, both high school juniors and members of Colorado Youth Congress, said they and the other members focusing on the group’s mental health initiative had talked about facilitating support groups for students with anxiety, for example, or LGBTQ students. But given that there were only six of them, it rapidly became clear they didn’t have the capacity to do that, Erdenbulgan said.

They also looked into whether peer support specialists could be a solution. But, in Colorado, you have to be at least 18 to get certified, Nicotra said. Peer support specialists are people who have an addiction or mental health condition and have made it their career to provide non-clinical help to those who aren’t as far along in their recovery.

If there was a bill next year to create a youth version with less stringent requirements, the group could get behind that, but, for now, they’re focusing on building a website to help other young people find mental health resources, she said. They might also host events about mental health in the future.

“It’s important for young people to talk to young people,” she said.

In the future, hopefully school-based peer support programs will be more the norm than the exception, though they don’t replace the need for counselors and for social and emotional learning, Murthy said.

The American Rescue Plan and the Bipartisan Safer Communities Act, which passed after the Uvalde school massacre, both included some funding for districts to make investments in mental health, he said.

There seems to be a disconnect between some of the groups offering resources and young people who could use them, Erdenbulgan said. For example, there’s a support group for Asian high school students in the Denver area, but Erdenbulgan, who is Asian, said she never would have known if a friend hadn’t mentioned it.

“These resources don’t reach the people who need it,” she said.

“It takes a village to heal a child”

Schools are going to be a major part of any effort to improve young people’s mental health, though workplaces and extracurricular groups also could do more to facilitate healing, said Alessandra Chavira, 21, who works at Project VOYCE.

When she attended Dr. Martin Luther King Jr. Early College, students weren’t encouraged to talk about their feelings, even when they were reeling from a shooting in the neighborhood, she said.