In Silicon Valley, getting to the bottom of gaps in mental health care for teens

Teen mental health care turned into a top concern among school officials, parents and health care experts in northern Santa Clara County following a tragic series of well-publicized suicides among current and recently graduated high school students.

The second “suicide cluster” in less than a decade, it was hardly seen as an anomaly, prompting federal health officials to step in and conduct a short-term epidemiological study to figure out what’s going on. Dozens of seminars, “listening sessions” and mental health symposiums later, the region doesn't seem much closer to a real solution.

On an anecdotal level, local mental health counselors say the problem is manifold: academic pressure and anxiety is through the roof, substance abuse is a growing concern and emotional support from parents is often stretched thin by the high cost of living and workaholic nature of Silicon Valley. Many parents relocated here for work, and admit they have no idea what it's like to grow up in the Bay Area.

Despite widespread acknowledgment of the problem, youth mental health care services are sparse in the region, often starting and ending with designated counselors on campus. These therapists work on behalf of nonprofits, which provide heavily subsidized services through piecemeal contracts with school districts that could vanish at a moment’s notice.

In an area flush with cash, why is Santa Clara County struggling to do right for its troubled teens, and provide the counseling and psychiatric services needed to prevent youth depression and suicide? In recent years, county supervisors have acknowledged that one of the gaping holes in mental health care — zero inpatient psychiatric beds for adolescents — is unacceptable in a county with more than 1.8 million residents. It’s likely that the service gaps don’t end there.

Through the 2018 California Fellowship program, I'm planning to take a deep dive into the myriad of federal, state and county funds that pour into county coffers designated for mental health, in an effort to get a solid handle on how well the money is being spent and how many teens and young adults are supported by already existing mental health initiatives. Health care funding frequently has a byzantine structure, making it difficult to assess just how much money flows into mental health services.

The hope is that, along the way, health care officials can give me a better idea of whether the funds actually meet the needs of teens struggling with depression and anxiety, or whether it's woefully inadequate and part of the problem.

I also intend to size up how mental health care access varies between major private insurers in the area, as well as Medi-Cal and the Valley Health Plan run directly by Santa Clara County. Therapists have told me that in the constant battle to cut health care costs, many families are getting short-changed on mental health services that could really turn the corner on teen depression.

Starting last year, school districts are required under AB 2246 to adopt suicide prevention policies for kids in middle and high schools that “specifically addresses the needs of high-risk groups.” It sounds promising, but what do these plans actually look like? How much money is financing suicide prevention? And who holds school districts accountable?

The limited surveys and data our paper, Mountain View Voice, have gathered over the years show that between 14 and 17 percent of local high school teens reported that they “seriously considered” attempting suicide in the last year. Other alarming figures: 11 percent of high school juniors reported binge-drinking in the last 30 days, and a growing number are illicitly using prescription medication.

The trouble is that the data is outdated and only getting older by the day. More and more school districts in the state are choosing not to participate in the California Healthy Kids Survey because it’s no longer tied to Title IV federal funding, making it difficult to assess teen mental health problems in the first place. Health experts conducting so-called “needs assessments” for the region have cited data as old as 2007.

[Photo by Studio Roosegaarde via Flickr.]