Youth are the key to reimagining California’s approach to mental health

Op-ed by Kassy Poles and Dr. Mark Ghaly as seen in Capitol Weekly

Across California, youth struggle with mental health. A CDC survey found nearly half the state’s high school students had ongoing feelings of sadness or hopelessness, a rate that has risen by more than 50 percent since 2015. People feeling the most impacted by this crisis are youth who already face major barriers — such as youth of color, those living in low-income communities and LGBTQ+ youth.

We have both experienced this crisis from different perspectives. A youth advocate and advisor who has dealt with the mental health system firsthand, who knows what it’s like to experience depression while being told that she’s not sick enough for care. And a pediatrician and father with decades of experience helping kids impacted by mental illness, who now leads the California Health and Human Services Agency. And we have reached the same conclusion: California must reimagine its approach to mental health, and young people must be at the table as collaborators and co-creators as we do.

When systems don’t involve people with lived experience, it creates a disconnect between what they think works and what’s actually happening. To really understand the challenges facing our youth mental health system, you need to have experienced them, or to talk to someone who has.

They might tell you about going years without care because providers didn’t return their calls. Or, after finally getting approved for a crisis appointment, being let down by the system when told it wouldn’t be available for weeks. They might tell you about struggling with stigma around mental health and how intimidating it is asking for support. They may say they don’t always feel comfortable going to an adult and connect better with people their own age, and they might tell you how hard it is finding help from someone who speaks their language, understands their identity and comes from their community.

To really understand the challenges facing our youth mental health system, you need to have experienced them, or to talk to someone who has.

Youth mental health matters. We share a vision of a system that’s designed for and with young people and families, one that makes them feel seen, represented and understood, so they can heal and find joy. A system where they can get help when, where and in the way they need it. A system that is based on love and compassion.

To create this system, the voices of youth and families must be elevated. That means designing solutions with youth not just in mind, but in the room, incorporating their voices at every level, from goal setting to program design to evaluation. It means reframing how services are accessed and provided, so there is no wrong door for help. It means going beyond clinical approaches to support wellbeing and helping the adults in young people’s lives. And it means rethinking what treatment looks like, where it’s offered and who provides it.

This transformation is more than possible. In California, where we lead the nation in investing in youth mental health, it’s happening. The five-year, $4.7 billion Children and Youth Behavioral Health Initiative, which serves as the core of Governor Newsom’s Master Plan for Kids’ Mental Health, is reimagining the way California serves youth and families while also connecting those who need help now to mental health resources and other support.

Just as important as the money being spent on these efforts is the fact that they’re being guided by the voices of hundreds of young people and families. Youth are doing everything from contributing to the design of a virtual services platform to helping define a new Wellness Coach role and serving on the initiative’s evaluation advisory group, to highlight just a few examples.

The more young people and families get involved, the more it will propel this movement forward, so that their voices are impossible to ignore.

Though our experiences and backgrounds may differ, our goal is the same — a system guided by youth and families that gives them what they need to heal and be well. The transformation our state is investing in and that Governor Newsom has prioritized will benefit all Californians and can serve as a blueprint for other states.

Amid a nationwide mental health crisis, we have a once-in-a-lifetime opportunity to create lasting change. This opportunity affects everyone’s future, and our young people can’t afford for us to miss it — in California or across the nation.

Kassy Poles is a youth mental health advocate for California Children’s Trust and a member of the Children and Youth Behavioral Health Initiative Evaluation Advisory Group.

Dr. Mark Ghaly is Secretary of the California Health & Human Services Agency.