By Diane Holder, President and CEO, UPMC Health Plan
As our country continues to assess the lessons learned from the pandemic, we enter an era of rebuilding health systems and reimagining the future of healthcare. The pandemic exacerbated long-standing community health and social challenges and will have lasting effects on the institutions that support our health and wellbeing. One hopeful outcome is a new awareness around mental health, specifically the mental health of our children. While individuals, families, communities, and health systems have long dealt with challenges around youth mental health, the topic has gained a new national attention through the US Surgeon General’s 2021 Protecting Youth Mental Health Advisory.
UPMC recently had the rare opportunity to host the US Surgeon General, Dr. Vivek Murthy, as part of his national tour to explore how communities across the country are supporting youth mental health. He visited the Boys & Girls Club in Lawrenceville and the UPMC Neighborhood Center in Pittsburgh’s East End where youth and local leaders spoke about mental health, trauma, and violence and youth development efforts. He remarked that Pittsburgh and Pennsylvania are known nationally for innovative, community-based approach to addressing youth mental health concerns and called on us all to share our stories as sources of hope for what is working. In a nod to Mr. Fred Rogers, Dr. Murthy reminded us to always “look for the helpers” in times of uncertainty and change.
Addressing Youth Mental Health Concerns as a Community
At UPMC, we recognize the strength of community-based organizations and partner with several of them to meet children and their families where they are to provide the right care and the right time. Here are some examples of the programming available to youth and families grappling with mental health, trauma, and violence.
Community and School Based Behavioral Health Teams
Meeting children and families where they are and providing whole person care to children and their families are key to delivering effective behavioral health services. Almost half (45%) of youth with diagnosed mental health disorders receive services within the school setting. UPMC’s Community Care Behavioral Health Organization brought together a group of behavioral health specialists, county human services staff, parents, and educators to develop a team-led, school-based program to improve youth mental health service access. Today, in Allegheny and 25 other counties across Pennsylvania, 93 teams serve over 2700 youth and families in 70 school districts. These flexible, school-based services provide a single point of contact to support families 24/7. They include clinical interventions, case management, crisis intervention, and training/consultation for teachers and administrators. Families, parents, and teachers report improvements in child behaviors and therapeutic relationships with teams.
Exposure to a traumatic event is associated with increased risk for developing an anxiety disorder, depression, substance misuse, respiratory disease, cardiovascular disease, and cancer at an estimated cost of $748 billion in the US and Canada. Ninety percent of adults report experiencing at least one traumatic event in their lifetime. Mental health providers practicing trauma-informed care acknowledge the role trauma plays in an individual’s health and well-being and incorporate treatment to support recovery from trauma into the care they provide. UPMC’s Community Care Behavioral Health Organization supports trauma-informed care practices and trains clinicians and community partners through a collaboration with Behavioral Health Alliance of Rural Pennsylvania (BHARP) to provide this care to children and their families. This collaborative has trained 2,935 staff across 29 clinics in 23 Pennsylvania counties to provide this best practice therapy. In Pittsburgh, our community partner the Neighborhood Resilience Project led by Reverend Paul Abernathy, incorporates trauma-informed care into its community programming in Pittsburgh’s Hill District neighborhood.
From 2018 to 2019, Blair County in central Pennsylvania experienced a 44.7% increase in violent crime. Both experiencing and perpetrating violent crime is associated with the development of chronic behavioral and physical health conditions. The UPMC Center for High-Value Health Care recently received grant funding from the Pennsylvania Commission on Crime and Delinquency to work with community collaborators in Blair Country to implement a program to train community, school, and behavioral health providers with the goals of enhancing services around recognition and treatment of trauma and mitigation of community violence. In Pittsburgh, the UPMC Neighborhood Center recently hosted a community discussion led by Leon Ford, author of Unspeakable Hope, and former Pittsburgh Police Chief Scott Schubert to foster dialogue between police and neighborhoods.
Addressing Workforce Challenges by Mobilizing Community Healers
During his Town Hall discussion with Charlie Batch at the UPMC Neighborhood Center, Dr. Murthy spoke of the capacity in all of us to be healers. With the post-pandemic demand for mental health services exceeding the capacity of the workforce to meet needs, we are challenged to “think outside the box” of traditional systems to provide care. At UPMC, we support training and employing individuals with lived experience as certified peer support specialists and neighborhood members as community health workers.
Youth Mental Health: Post-pandemic and Beyond
If there is a silver-lining to the pandemic years, it is perhaps the increased awareness of the importance of mental health and the gaps in our society’s mental health infrastructure to support children and their families, and that Western Pennsylvania is offering some unique clinical- and community-driven approaches that we hope will inform Dr. Murthy’s ongoing national conversation about this important public health issue.