What I learned while reporting about youth in psychiatric crisis

When I first met Jack Hays in May 2022, he’d been confined to a small hospital room for more than five months. 

Jack, 17 at the time, was stuck in the hospital because there was no place for him to go. His mother, Greta, had begged state agencies for years to get Jack the care he needs. But his home state of Washington lacks outpatient mental health care to keep him stable and living at home. There are few residential settings that accept youth like Jack, who doesn’t speak verbally, has a history of aggressive behavior, and autism. And Washington officials have largely abdicated responsibility for helping families navigate this broken mental health system.

The result, I found through an extensive data analysis, is that hundreds of children and teens are warehoused for weeks or months inside Washington hospitals every year. A couple of months ago, I published stories exposing the extreme physical, emotional and financial toll of this youth psychiatric boarding crisis. 

I’ve spent my career writing about youth. But Jack and his family graciously let me into their lives in a way that few have before. In his hospital room last May, Greta rubbed Jack’s feet and let him stroke her hair. She welcomed me into her family’s home and told me stories about Jack as toddler. She cried when she told me about Jack’s love of car rides, that feeling of freedom the whole family felt when they took a drive just for the fun of it. And as I got to know Jack and Greta better, it became easy to understand their anger. Greta was eager for her family’s story to get out there; maybe Jack and others like him, she told me, would finally get the care they deserved. 

But I had to think carefully about how to write their story. Because Jack can’t speak, how could I ensure that I had informed consent to write about him? How could I balance my instincts to be protective, even paternalistic toward Jack, with the wishes of his mother and legal guardian Greta, who desperately wanted their story told? 

Navigating these questions helped me craft my own set of ethical reporting guidelines. I also came away from this experience with a stronger commitment to writing ethically about people who are usually left out of news coverage, including those with mental illness. Here are some of the lessons I’d share with other reporters tackling similar projects:

When writing about vulnerable people, talk early and often with your editors. Research best practices, and carefully develop your own if you struggle to find guidelines that fit your reporting experiences.

I’m fortunate to be a member of a team of compassionate, mission-driven mental health journalists at The Seattle Times. But my editor Diana and I faced a special challenge as we tackled stories on youth boarding. Several of the families I interviewed had children with intellectual disabilities. Many were unable to give informed consent. 

Unfortunately, reporting guidelines on the topic of youth with mental health conditions are lacking. Over the course of a year, we ended up creating our own.

For each story, we wrote down a long list of considerations. How could our coverage affect the child’s future ability to attend higher education, or land a job? How would this child react to our story once they read it? If they are unable to read, how would they feel when their parents showed them their photographs in the newspaper? How do we avoid perpetuating stigma or other negative consequences for our sources? What underlies parents’ motivations to open up to journalists? Is it ethical to rely on consent from a youth’s legal guardian? How could news coverage spark positive change? 

The list went on and on. My editor and I discussed the details at length with higher management. We had long conversations about why we were telling a particular family’s story. Before we published, we took great care to ensure our stories reflected the totality of the child we were writing about — not just their experience with mental illness. 

Our reporting team has also benefited from several brown bag talks with suicide and trauma experts. We talk often about how to approach ethically complex reporting situations. Having these conversations on a regular basis has also helped us refine the ways we interview and write about vulnerable sources.

Why are you linking a source’s personal story to data? Ask yourself the hard questions about your motivations for telling an individual’s story. 

I was at a conference recently where journalists discussed the power of narrative storytelling, and the particular strength of pairing data with narrative. I agree that humanizing our storytelling is important: bringing readers into the lives of those in their community keeps them engaged and can compel real change. But we can’t forget the impact of our stories the people who agree to participate in them. 

This thinking informed both my reporting and writing process.

Weeks of my project were spent hunched over my computer, toiling in enormous Excel files that I’d only just learned to navigate. I was thrilled once I’d finally cleaned the data, analyzed it, and come away with a set of findings. 

But I also spent months reporting with Jack and Greta.

Reporting with vulnerable sources can feel extractive, and I took several steps to ensure Greta and her family understood the potential consequences of being in the news. During a particularly tough in-person interview with Greta, she had an ally — her mother — in the room to support her. When she got emotional, I gave her lots of space to take a break and clear her head. She knew she always had the power to end an interview or skip questions I asked.

When it was time to write, and to weave Jack’s story with these data-driven takeaways, I made a list of all the ways Jack’s experiences reflected the data (there were many), and the ways it didn’t. While Jack’s story only told part of the overall story, so too did the data. It was important for me to highlight how the two fit together, but also the ways in which Jack’s experiences were unique. 

As I wrote the story about Jack, I pulled details and scenes from my notebook that helped people understand what he was like before he was hospitalized — what he cared about, and why his family cares so deeply for him. 

Those details didn’t always fit neatly with a data point I’d gleaned from my analysis. But they were important to illustrate the whole picture of Jack as a teenage boy like many others, and of a system that was built to fail youth like him.