As a warning to listeners & readers. This story includes the topic of suicide. If you or someone you know may be considering suicide, call or text 988 for the National Suicide Prevention Lifeline.
Na is 14. She loves science and is a talented artist. She’s creative and loves gaming. Over the past few years, she’s also had severe mental health challenges. She’s been hospitalized and, ultimately, landed in an in-patient facility in another state, hundreds of miles from her home.
Her mom, Brittany Cotton of Rockford, says that every step of the way, youth mental health services have been inconsistent, inadequate or unavailable.
“This whole situation [with] the services being so difficult -- the overall feeling is isolation. That’s the hardest part of all of it is feeling like you're the only one facing this, you have nobody having your back," said Cotton.
In late 2021, a coalition of some of the country’s top pediatricians declared the youth mental health crisis a national emergency — and it isn't going away any time soon.
For many kids like Na, the first person to notice something wrong is a teacher. Since the pandemic, the majority of public schoolssay they’ve seen an increase in students seeking mental health support.
Schools have tried to step up in many ways. In Illinois, the state launched a hotline called “Safe2Help” that allows students to raise red flags about themselves or friends they’re worried about. Students can take mental health days off from school. Many schools have used pandemic-relief funding and secured federal grants to hire more counselors, social workers and school psychologists.
Genevieve Maltby is a school social worker at the Harlem School Districtin Machesney Park. She says they have seen an increase in student need, but NOT an increase in staff to meet that need. So, social workers like Maltby are forced to react to student incidents, instead of proactively helping students before a major problem develops.
“It's a bit like triage in war," she said. "Because really, at the high school level, I don't have time to sit with a student for a lengthy amount of time. So it's really just about getting quick fixes -- and that's not effective at all.”
Even with many so short-staffed, school-based support can be genuinely helpful. According to her mom, it was for Na.
“The schools would sit down and try to talk to her try to work through things. Often it wouldn’t work and they had to get me involved, but they would take more time to check in on her than any of the services we were involved in," she said.
Back at Harlem, Maltby says one misconception people have is that school social workers commonly provide one-on-one behavioral therapy to students. At Harlem, they don’t. But, they partner with community organizations and agencies so they can refer students out for therapy.
Sometimes, therapists from those agencies come in and provide treatment at Harlem High School. But. as Maltby says, "Not as many as I think we should. I think that's an area we could provide more services for. But, that being said, when we do offer that it fills up quickly and then we're short-staffed again because they don't have the people either.”
That’s another crucial point. Even if kids are referred out for therapy -- it might be a while before they actually see a therapist due to long waitlists. And if that child is in a mental health emergency and threatening their own life -- advocates say that waiting can be very dangerous.
Marshmallow’s Hopeis a non-profit in Rockford that provides youth mental health counseling and mentorship.
Laura Kane is the founder and executive director. Kane created Marshmallow’s Hope after her son, Zachary, died by suicide in 2018.
“The reason why Marshmallow’s Hope exists is because of the lack of services and the waitlists that other entities in the community were struggling with," she said.
Three years ago, the organization started as a mentorship program for kids struggling with mental health. But then a child they were mentoring attempted suicide and they couldn’t get them into therapy for months.
“We had a second child who attempted and then they couldn't get him into services until June -- so six months of a waitlist," she said. "That child attempted again and, at that point, I petitioned Winnebago County, and I was like, ‘We need to do something. I need to hire a therapist.’”
And Kane says those situations were not outliers.
“It was a six-month wait on average to get them into therapy -- and that's deadly," she said.
Those waitlists still exist, but groups in the Rockford area like Marshmallow’s Hope and the National Youth Advocate Program can provide immediate, short-term counseling while kids in crisis wait for long-term therapeutic options.
Brittany Cotton says she wishes it had existed in early 2020 when Na needed help the most. At that point, they were caught up on waitlists, and then, once they finally got a good therapist, staff turnover and inconsistent sessions made progress more difficult, especially as the pandemic was unfolding and COVID interrupted services.
Kane says that the number of kids requiring mental health services has skyrocketed with the pandemic. They currently have nearly 170 children receiving services. 90% of those kids have attempted suicide.
She says that while the need has increased, the number of community support services has not.
There have been a few improvements. The National Youth Advocate Program came to Rockford about a year ago. They also have a Mobile Crisis Response Team that responds to crisis calls.
But overall, Kane sees the northern Illinois community in worse shape now than before the pandemic -- especially when it comes to in-patient services.
“That's the number one need," she said. "We have nowhere for kids in our local community to go to an inpatient hospital stay if they're in a high crisis like that.”
MercyHealth closed its in-patient mental health unitat Javon Bea Hospital in Rockford.
Medicaid often doesn’t cover in-patient youth mental health services, unless the child has a co-occurring substance use disorder. Rosecranceis a behavioral health treatment center in Rockford. They used to have funding to help provide youth in-patient care without substance use.
Sadie Cobio is the Assistant Administrator of Community Behavioral Health Services at Rosecrance. She says a change in the center’s funding source has made that more complicated.
“Our residential services are specific to primary substance use, which honestly goes back to the funding source," she said. "Rosecrance is happy to provide this service for either, but, from a funding perspective, they really have to be primary substance use.”
Kane, at Marshmallow’s Hope, says there also just aren’t enough beds at hospitals like SwedishAmericaneither. So, when a child is in crisis and needs to be hospitalized, even when they have a plan and the means -- sometimes there is nowhere to send them.
Amber Shappard is the engagement specialist with the Rockford Mobile Crisis Response Team -- part of the National Youth Advocate Program. She agrees with that.
“We don't have it really anywhere to send them to because resources are so limited," said Shappard.
Cotton says it’s happened to her daughter Na in the past, and it nearly did again this year when she needed to be hospitalized because of her mental health.
“It's a terrifying time to try to get help," she said. "[There’s] more and more children. We've been told that beds were completely full, and like four different hospitals, when SwedishAmerican would check -- they were always full, always full. So, we got lucky. This year, we got lucky to get her in.”
Her daughter was in the hospital for about two weeks. But after she was released, Cotton knew that she needed the full-time support of a residential facility.
Without in-patient services available locally, Cotton, like many parents, was forced to explore sending her daughter to an out-of-state facility. But to do that, she not only needed to figure out which one she could pay for, which was the best-equipped to handle her daughter’s case, and was in a place she was somewhat comfortable with -- they also had to deal with more wait lists. Once again, it took months.
And trying to work out which facility might work for your child’s needs -- it’s really hard. In general, Cotton says maneuvering between services and making sure everyone knows the medications her daughter is on and what the diagnoses are -- it’s a huge burden on parents and caregivers.
She says making sure agencies, insurance companies and hospitals have the right documents can feel like a full-time job in and of itself. And it’s on top of the stress and worry about her daughter’s well-being.
“As a parent, you will have to do paperwork as if you're going to be facing a criminal case, I swear you do," she said.
After months of waiting and after time in the hospital, she finally got Na into a residential center a few months ago. It’s in Missouri, hours away from her family and friends.
“We get a 10-minute conversation at night," said her mom. "If I'm lucky.”
It hasn’t been a great experience — Cotton knows residential centers can be rife with abuse and mistreatment — but it is round-the-clock support. She says they’ve been told Na will be home in six months, but she’s not sure. And when she does get back, she knows her daughter will still need support. She’s still just a teenager.
And while she’s grateful for the community organizations she has found during this journey, she thinks more people should know about what services are available. And Cotton says there needs to be a lot more investment in youth mental health resources -- for both kids and their families.
Because whether that investment comes or not, the youth mental health crisis isn’t ending any time soon.
