NICD Issue Dialogues

Civil Discussions About

Our Nation’s Most Pressing Challenges

Creating Community Solutions on Mental Health

National Youth Convening

July 19-21, 2016

Washington, DC

“The trip to Washington DC was the greatest opportunity I have ever been offered. It was a life changing experience for me that opened up so many new doors in my life. I realized when I got chosen for this journey that there are others like me who struggle with mental health issues, and that boosted my confidence in myself instantly. I had to give up many things that I have been involved in to join this group, due to those who did not support me in the school system. This experience was greater than anything the school system could have given me. I made many new friends and I learned how as youth we can change the world of mental health, all thanks to those we learned from in Washington.”

-- Maegan Elliott, Birmingham

About the Event

Since 2013, NICD – and a team of national partners – has been working with communities across the country to help organize dialogues that lead to action on mental health. More than 81,500 people in hundreds of communities, and in every state, have participated in frank and sometimes difficult conversations about the prevalence, the costs, the negative attitudes, and the barriers to treatment.

The work of Creating Community Solutions on Mental Health (CCS-MH) focused, in particular, on engaging young people, since half of adult mental health problems begin before age 14, and three-quarters begin before age 24. One of the most successful aspects of CCS-MH was the development of Text, Talk, Act [WJ1] – a face-to-face, text message enabled conversation about mental health that to date has been used by 70,000 people, the great majority of whom are 24 and younger. Visit the CCS websitehere; and read the full story here. [WJ2]

To continue amplifying and supporting young people’s voices on mental health, NICD held the 2016 National Youth Convening: a safe space where young people from around the country could come together on the issue.

The 2 1/2 day conference brought together 37 youth leaders [WJ3] and activists from six cities: Albuquerque, New Mexico; Birmingham, Alabama; Columbus, Ohio; Kansas City, Missouri/Kansas City, Kansas; Sacramento, California; and Washington, DC. The participating young people all had “lived experience,” meaning either they, or a very close relative, have experienced a mental health challenge. Also participating were representatives from the Text,Talk, Act “brain trust,” the group of mental health experts, young people, social media experts, and deliberative democracy experts that helped shape that initiative.

A steering committee composed primarily of young people designed the Dialogue to:

· Share their success stories in reducing stigma in communities.

· Brainstorm solutions to the challenges they face.

· Build their leadership skills.

· Plan for action steps that will sustain the momentum of the work.

· Get certified inMental Health First Aid (MHFA).

Understanding the Issue

The young people who have been part of CCS-MH – and who participated in the July, 2016 Convening – are well-versed in the facts about mental health in our country and in their communities. And, they know, from direct experience being active on this issue, how important it is that the facts are broadly understood: it helps reduce stigma and also motivates change.

10 Key Facts about Mental Health in America:

1. About one in five adults − approximately 43.6 million Americans − experiences mental illness in a given year. [Source]

2. Only 44% of adults with diagnosable mental health problems and less than 20% of children and adolescents receive needed treatment. [Source]

3. Half of adult mental health problems begin before age 14, and three-quarters begin before age 24. But fewer than one in five teens gets treatment.[Source]

4. African American and Hispanic Americans use mental health services at about one-half the rate of whites, and Asian Americans at about one-third the rate.[Source]

5. About 50% of students (age 14 and older) with a mental illness, who are served by special education, drop out of high school -- the highest dropout rate of any disability group. [Source]

6. 31% of college students have found it difficult to function due to depression in the past year; more than 50% have felt overwhelming anxiety. [Source]

7. Suicide is the tenth leading cause of death in the U.S.[Source] -- more common than homicide[Source] -- and the third leading cause of death for people ages 10 to 24[Source]. More than 90% of those who die by suicide had one or more mental health conditions.[Source]

8. People with mental illnesses are much more likely to be victims of crime than perpetrators. Just 3-5% of violent crimes are committed by individuals who suffer from a serious mental illness.[Source]

9. People with mental health and substance abuse problems, and youth transitioning to adulthood, very often lack insurance. Not being able to afford care is among the top reasons adults say they don’t seek treatment. [Source]

10. While Americans have learned a great deal about mental illness over the last several decades, negative beliefs about people with mental illnesses persist.

During the Dialogue

“We did a lot of talking with the other cites who were participating. When they described the challenges in their communities it was interesting to see how things are different in different parts of the country. But, everybody said stigma was the main challenge.”

-- Legend Walker, Kansas City

Over 2 1/2 days, participants in the National Youth Convening worked in small and large groups to articulate the challenges they face, identify best practices and lessons learned from their local work, and brainstorm strategies for moving forward. The participating young people also articulated a series of challenges that slow progress on this issue. These include:

In considering such challenges, participants identified a number of priority action steps for the six cities they represented. One area of particular focus was taking action within school systems, which have significant access to children, starting at an early age. Top recommendations in this area included:

• Teacher training.

• Educational assemblies for middle and elementary school students.

• Support and tutoring with a focus on mental health.

• Awareness campaigns.

• Peer mediation.

Another focus area for participants stemmed from their knowledge that the current economic realities and power structures in many communities actually lead to mental health problems. Participants urged:

• Outreach programs geared toward inclusion and community empowerment.

• Greater access and awareness on minority mental health.

• Monitoring of the police.

• More work and job opportunities for undocumented people.

• Cross-community conversations to promote understanding.

“I found it to be very useful -- connecting with other youth and learning about what’s going on in other communities. We brought back a heightened awareness about the importance of 1-on-1 community building and in-school advocacy. While we were there, we worked hard to make sure the link between mental health and the systems of oppression that greatly affect people in marginalized communities stayed front and center in the conversation.”

-- Independence Vespa, Sacramento

There was also much discussion about concrete operational strategies such as:

• Community fundraisers to support mental health work.

• Engaging celebrities to increase awareness.

• Seeking a greater voice from national political leaders.

“The saddest thing about convening around mental health topics is going away and not knowing if you’ll ever see your companions again…Altogether, the week was a continuously eye-opening expression of righteousness and prosperity. The conference has taught me the real solution to breaking the stigma: inclusion. If only this opportunity were given tri-annually or bi-annually, and that all youth could participate.”

-- Michael Branche, Jr., Columbus

Meetings with Policymakers

Youth convening participants went to Capitol Hill to meet with their state representatives or staff members to raise concerns about mental health issues. The Albuquerque team, for example, talked about the recent shuttering of mental health centers and the negative impact this has had on their community. They also raised concerns about how the state’s Medicaid reimbursement policies have reduced access to case management supports.

Youth convening participants also met with representatives from the Substance Abuse and Mental Health Services Administration to learn more about the federal funding landscape and possible grant opportunities.

These meetings with policymakers – a first for most of the youth – inspired new levels of confidence and educated youth about the importance of preparation in these contexts. Upon their return from DC, many found that meetings with local officials were far less intimidating. Others were inspired to continue researching policy questions and opportunities.

“We went to the Capitol and talked with the staff people in Senator Blunt and Senator Yoder’s offices. It felt like we really got them to hear us, and we were hoping for that. Everybody on our team was so passionate. It was great to see them participating and giving their opinions.”

-- Olivia Freeman, Kansas City

MHFA Training

On the last day of the convening, youth convening participants went through the official, eight-hour Mental Health First Aid certification process. The course teaches participants how to help someone who is developing a mental health problem or experiencing a mental health crisis. They learn to identify, understand, and respond to signs of addictions and mental illnesses.

Moving Forward: Follow-up Action and Impact

Through meeting people from across the country who are focused on the same concerns, the participating youth found validation of their own work as well as some concrete ways to adapt and expand on it. The convening also exposed many of them to new and challenging ideas. For the youth from Birmingham, for example, it was the complexities of creating safe spaces in a community, a school, or in interpersonal interactions. Jan Bell, the lead coordinator for Birmingham’s Mental Health Youth Council said: “Creating safe spaces as a response to mental health issues was not something I had heard the youth talk about before they went to DC, but when they came back they were energized to take action on it.”

Following the convening, the teams returned home from DC and went back to work, bringing with them newfound energy, information and skills.

In Albuquerque…

Returning Albuquerque participants introduced to their Mayor’s Youth Advisory Council (MYAC) peers the Breaking the Silence program: a stigma-busting curriculum on mental illness and suicide that they learned about during the convening. Since then, the city has funded the training and facilitation support needed to implement this peer-led collaboration in public, charter and private schools. Nearly all of the MYAC’s 18 members have been trained to be facilitators in their schools, and Breaking the Silence school presentations and other awareness activities are slated to begin in January 2017.

Two participants also presented to 100 attendees of the New Mexico YES! (Youth Employment Summer Institute) convening, speaking about New Mexico's behavioral health crisis and their CCS Youth Conference experience.

Finally, Albuquerque convening participants are also researching how to initiate a localYouth M.O.V.E. chapter, or similar peer-led mental health advocacy effort.

“My experience at the conference was one of a kind and unforgettable. I look forward to learning more about what we're doing in our community regarding resources available for youth, and to helping my peers be more aware of their own mental health.”

-- Maika Padilla, Albuquerque

In Birmingham…

Birmingham participants -- who are part of the local Mental Health Youth Council (MYHC) -- continue to meet monthly as a team. Among the activities they’ve undertaken since their return from DC, they have been:

· Operating an MHYC booth at the “Out of Darkness Walk” and distributing wallet cards, brochures, and Text Talk Act cards.

· Recruiting high school counselors to complete Mental Health First Aid training.

· Meeting with the Mayor to discuss implementation of Birmingham’s annual Mental Health Summit.

· Providing input to the city’s Mental Health Priority Group and being invited to be part of the policy development and implementation team on school-based mental health initiatives.

In addition to this work, over the next six months the MHYC members have also committed to a “Creating Safety” campaign focused on targeted bullying and harassment of vulnerable groups, such as youth who are LGBTQ, Muslim, immigrant, or of color.

In Columbus:

Upon returning from DC, the Columbus youth — who are part of theFranklin County Youth Council (FCYC) and the South Side Community Collaborative’s Teen Institute leadership Academy — were interviewed by a local TV station about their experiences. Watch the news cliphere.

In the fall, the youth had several opportunities to continue their advocacy efforts. They participated in a panel with the Chief of Police and other law enforcement officials about building trusting relationships with youth. They met with Columbus Mayor Andrew Ginther to discuss his vision for services and supports for youth. And, they met with members of the City Council where they raised concerns about the increasingly punitive role of School Resource Officers. Several follow-up meetings have been planned to continue these conversations.

The youth have also been working to train peers in Mental Health First Aid, targeting two local high schools. A commitment by Nationwide Children Hospital’s Behavioral Health Department has also been secured to conduct a series of trainings for youth and youth workers on trauma, social emotional learning and group dynamics.

In Kansans City…

While in DC, the Kansas City youth strengthened their commitment to education-related action steps, such as teaching mental health curricula in schools, training teachers and staff in Mental Health First Aid (MHFA), increasing the use of Text, Talk, Act (TTA) and transforming school climates by encouraging youth leadership and reducing bullying and stigma.

Since the conference, the full KC team has put into action a strategy to use ribbons, buttons and window clings to make trained “First Aiders” visible in schools and the community. The national council responsible for MHFA created the logos.

In addition, the head of a local community mental health center’s behavioral health program volunteered to include funds in his budget for annual refresher trainings for new MHFAiders. The center will also be partnering with the University of Missouri-Kansas City School of Education to train students in its teaching and counseling degree programs starting in June. Finally, the Associate Dean for Continuing Education at UMKC hopes to train staff members so they can offer MHFA on an ongoing basis to students, faculty and staff at the nine charter schools they sponsor.

The Kansas City team is also getting traction on TTA, increasing its use in local high schools. And, the director of the Missouri Association of Student Councils has agreed to encourage schools statewide to use TTA.

In Sacramento…

Upon their return from DC, the Sacramento team of 10 has continued to meet twice per month and is focusing on how to establish 1:1 support networks, connections, resources and services for their community, especially for queer, trans and of-color youth who are homeless and/or living in marginalized communities. They have been doing advocacy in local high schools for young people who are not getting adequate care and respect with regard to their gender identity. Their efforts have also been aimed at building a platform for broader youth organizing.

The youth from Sacramento were re-inspired during the convening about the urgency of critical social changes. Top among them is their understanding that living under systems of oppression (such as white supremacy and toxic masculinity) can deeply affect mental health. Their ultimate objective is the liberation of all marginalized people.

In Washington, DC…

The on-going work of CCS in Washington, DC has been principally through the operation of Wayne Place, an 18-month transitional housing program for 18-24 year olds. Wayne Place came to be, in part, because of a push from DC’s participation in CCS. A collaborative effort, it is jointly funded and operated by DC’s Department of Behavioral Health and the Child and Family Services Agency. A third partner—a community-based nonprofit called the Far Southeast Collaborative—is the primary provider of services.

Since its opening in March 2015, Wayne Place has served a total of 59 young adults. Among these, 87% were successfully discharged, meaning they reconnected to and are living with family members, obtained their own housing through employment, a housing voucher or some other assistance, or found another stable living arrangement. Wayne Place generally operates at full capacity with a short waitlist of about 4-6 young adults. Residents have access to a wide array of on-site workshops, from financial literacy and employment readiness to life skills and civic engagement.

“I made many long-lasting friendships with the other youth attending the conference and have kept in touch to share what each of us is doing in our community to improve foster care, mental health awareness and treatment services for youth.”