When a teen tried repeatedly to kill herself, her mother discovered why America’s mental health crisis keeps getting worse

My 13-year-old daughter was bound and determined to find a way to end her life. One morning last December, I picked her up from school after she was suspended for having alcohol in her water bottle. When we got home, she jumped out of the car and ran towards the highway by our house. I chased her, screaming to anyone who would listen: “CALL THE POLICE! CALL 911!” 

I felt urine run down my legs as she walked into the middle of the road and stood on the double-yellow line. A semi-truck approached. I ran to grab her and pull her back. She did not jump in front of the truck, but the fear that ran through my body forced me to have her involuntarily committed and transferred by law enforcement to a state mental health facility about four hours from our home.

Like any concerned parent, I sought out every resource possible to get her the help she needed. She needed individual and group therapy and a psychiatrist to evaluate her, prescribe appropriate medications, and monitor her progress.

The federal government has been warning for years of a shortage of mental health service providers. In a 2016 report published by the U.S. Department of Health and Human Services, researchers estimated dramatic shortages of psychiatrists, therapists, counselors and other behavioral health specialists by 2025. COVID-19 escalated the need as more people, teens included, struggle with depression and anxiety. 

I did not realize how bad the problem was until I tried to get my daughter care that could save her life.

My daughter made the first of about eight attempts on her life a few days before Christmas of 2020. She took a massive amount of ibuprofen. She informed me on Christmas Day, after she started experiencing anal bleeding. 

I locked away essential prescriptions and threw away unneeded over-the-counter medications, but a few months later, she found blood pressure medication that came through the mail and took enough to warrant another trip to the ER. When she couldn’t find pills, she went after knives and began cutting. One night, I went to check on her in the bathroom and found her in the tub starting to slit her wrists. 

We live in rural Wisconsin, about an hour from Minneapolis/St. Paul. After her first suicide attempt, I could not get my daughter in with a therapist in our area for about four months. I put her on a waiting list to see a psychiatrist, and she did not have her first appointment for almost nine months. She had two stays at short-term mental health facilities because of the lack of high-quality outpatient programs near our home. 

Mental health services are not cheap. Good insurance coverage is crucial for all but the richest families. We are fortunate: my daughter’s father retired from the Navy after 20 years of service, so she is covered under TriCare, the insurance program for active and retired military members and their dependents.

But if good coverage makes mental health services possible, insurance bureaucracy can push care maddeningly out of reach. TriCare divides the country into two broad coverage areas, with TriCare East administered by Humana Military, and TriCare West administered by Health Net Federal Services. The line between east and west runs along the St. Croix River, the natural boundary between northwestern Wisconsin and Minnesota. We live two miles from the border, but I cannot get my daughter mental health services in the Minneapolis/St. Paul area without a fight. And even then, I don’t always win. 

I found one residential 90-day program five states and 1,200 miles away that was covered by TriCare, but I wasn’t ready to send my daughter that far away. Many families with a child at risk of suicide want to try an outpatient program before a residential one, but the nearest outpatient program covered by insurance is at least three hours away, and has a less-than-stellar reputation. I have had to cobble together a therapist, a psychiatrist, and a weekly dialectical behavioral therapy (DBT) group, which focuses on coping skills, to give my daughter something resembling the support that a comprehensive inpatient or outpatient program would offer. I drive her 40 minutes each way to the only DBT weekly group covered by insurance within a 100-mile radius.

I’m fortunate to have the flexibility and the skills to make this work. Many parents cannot take off work to drive their child long distances for mental health services. Many immigrant parents don’t have the language skills to navigate a broken, frustrating, and complex system. And of course, many families — those of color disproportionately, do not have good insurance or any at all. 

My daughter is making great strides. But I wonder if the last 18 months would have gone better if she hadn’t had to wait for the care she needed and we hadn’t had to fight to find services covered by insurance.  

The COVID-19 pandemic has helped catapult mental illness, especially in teens, to the forefront of media coverage. Ken Burns has a new documentary about youth mental illness. In April, the U.S. Preventive Services Task Force released draft  recommendations to screen all children and adolescents ages 8 to 18 for anxiety. The task force already recommends screening 12- to 18-year-olds for major depressive disorder.

If mental health is such a serious issue for teens, why is it so hard to get them the help they need?

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