Why Oregon is the worst-ranked state for youth mental health

John Yang:

Depression and anxiety among adolescents was already at crisis levels before the pandemic, but it surged amid the isolation, disruption, and hardship of COVID. Earlier this month, William Brangham traveled to Oregon to find why it ranks as one of the worst states for youth mental health illness and what's being done to help those in need. His reporting is part of our new series, "Early Warnings: America's Youth Mental Health Crisis."

William, thanks so much for joining us today. Why Oregon? Why did you go to Oregon?

William Brangham:

Well, there's an organization called Mental Health America, and every year they put out annual survey ranking how states provide care to mental illness and how severe the crisis is. And Oregon, unfortunately, ranks dead last in the country as far as young people who are struggling with their mental illness and their access to care. It's the highest rate of young people in this country with one serious depressive episode. It is the third highest number of children with substance abuse disorders and ranks 42nd in the country for those children with those depressive episodes not getting care.

And so there are a bunch of reasons why this happened. A recent state audit looked at several different factors staffing shortages, poor data, and just overall lack of beds. We, in fact, in our reporting found that in the entire state, there are only 40 beds for the most acute children who need this kind of care.

And there's also this issue of Oregon being a rural state. I mean, there are several major cities, and the majority of people live in those cities, but a lot of the state lives in places where it's hours to care. Mental health officials tell us once they discharge those people, they're going back to communities where there may not be a single psychiatrist in town to help them.

John Yang:

This must put tremendous burden and pressure on the families. What sorts of stories did you hear?

William Brangham:

We heard so many different parents and families talking about this struggle. One mother, whose name is Laura, we didn't end up filming with her, but she told us a harrowing story. She adopted three children from within her own family. Each of those children had suffered terrible, all manner of abuse.

Her 15 year old daughter one day said to her, I'm thinking about killing myself. I tried to drown myself in the tub last night. And so, Laura goes on this quest to instantly try to find care for her, and every single doctor and psychiatrist she called said almost as a matter of course, we are months out before we can take care of you. And Laura was in a bit of a panic.

This is a woman who works at a hospital as an administrator. She's someone who family members and friends would call her and help them troubleshoot health insurance issues, and she couldn't even get care. She described this as feeling like a murderer had taken her child. And every moment of every day she thought, is my daughter going to die? Is she going to not come home today?

And we heard a very similar set of stories. She eventually did get care, but it was a long, hard road, and she is just one of tens of thousands of families and parents.

John Yang:

There was a bright spot in your reporting. You found a program that does show hope.

William Brangham:

That's right. This is an organization called Youthline. It is a call in line for teenagers who are in crisis. But the people who are answering those phones or texts or chats are other teenagers themselves.

And the theory behind this is, and there's some evidence backing this up, is that teenagers who are struggling are much more likely to talk to other teenagers than, no offense to people like you and me. And the idea being these kids will answer those calls. They will answer those chats, albeit with a good deal of training. But this organization has seen an incredible spike in growth from a few thousand calls per year to now tens of thousands of calls per year.

And so Youthline is trying to grow this model and to diversify their base of volunteers who are working for them, go into native reservations and try to make this program go national in the near future.

John Yang:

William Brangham thank you very much for sharing your reporting.

William Brangham:

My pleasure, John. Thank you.