- [Announcer] Funding for Governors' Perspectives with Kent Manahan has been provided by: NJM Insurance Group, [lively music] serving the insurance needs of residents and businesses for more than 100 years; the Robert Wood Johnson Foundation, committed to helping Americans lead healthier lives and get the care they need; Seton Hall University; Seton Hall School of Law; and by Connell Foley LLP.

[lively music] [bell dings] - [Kent] Students of all ages are under pressure.

Kids were struggling with mental health issues before the pandemic, but COVID brought even more stress, fear, and uncertainty.

Health and educational professionals report pressures and anxieties among young people haven't gone away.

- It's pretty obvious after having spent a year post-COVID that our kids need to enhance their ability to regulate their behavior, to develop strong relationships with their peers and with the teachers who serve them, and to build a sense of self-confidence that I think they lost much of for the year-and-a-half they were not in school.

- [Kent] Over the last couple of years, numerous reports on students and COVID have been issued, expert testimony on the pandemic and its impact has been given.

And books explaining the complications and how to deal with the lingering effects of COVID have been written.

- You'd think that a lot of people would expect that now we're outta the pandemic, so it's gonna be a lot easier on us, and the mental health levels should be going back up.

But that's not the case.

- [Kent] It's been a difficult time for young people of all ages, say the experts.

And the impact on their lives, mentally, academically, and socially lingers as evidenced in studies showing reading and math scores have declined sharply.

Medical professionals believe the pandemic has changed everything, and the health of our kids in all aspects of their lives must be a top priority.

- We need more support in our schools.

Teachers can't do it alone.

We need more psychiatrists in the buildings.

We need more counselors.

We need more social workers because that is unfortunately where children spend most of their day and where you'll be able to see some of these signs.

- [Kent] Here are some of the findings of the US Surgeon General's Advisory on Youth Mental Health released last year.

Since the pandemic began, rates of psychological distress among the young have increased.

In 2021 and into this year, one in six children in the United States, ages two through eight have had a diagnosis with a mental health or developmental disorder.

In New Jersey, Governor Murphy has highlighted the issue of youth mental health, signing legislation requiring public schools to include mental health instruction in kindergarten through 12th grade.

Recently, the governor announced a statewide student mental wellness support infrastructure offering prevention strategies for those in need.

And last September, the legislature allocated 12 million in funding as part of a collaboration to help prevent a growing mental health crisis.

- We've seen an increase in youth who are connecting with the system who really do need that higher acuity need for care management services, for more intensive in-community services, and that we are responding to that need, and then, in the last several weeks, we're also seeing an increase in request for mobile crisis response services.

- [Kent] In July, Governor Murphy assumed the role of chair of the National Governors' Association announcing his lead initiative.

- We are all aware of the youth mental health crisis in our country.

It is a crisis that the pandemic did not create but exposed more fully.

It is one that we must tackle together and tackle now.

- Governor, welcome to the program.

- Great to be with you, Kent.

Thank you for having me.

- Well, we appreciate it.

And Governor, we all know that our future depends on our youth, and many medical experts today are saying our young people are in a crisis.

I'd like to ask you about your initiative and how you think it will significantly impact a change in this situation that we're in for young people right now.

What's your approach?

Give us the nuts and bolts.

- Yep.

And by the way, I approach this, Kent, both from my position as governor of New Jersey, and we should talk about what we're doing in New Jersey, and also, as the Chair of the National Governors' Association, which is a bipartisan organization.

And when you become chair, each chair has an initiative and as does one's spouse, and so I've chosen strengthening youth mental health, my wife, by the way, not the subject of our conversation today is focused on maternal and infant health, which has been a passion of hers now for many years.

- You were recently sworn into that position.

- I was this past summer.

- And this has been your focus, you've announced to the other governors, and I know you've taken up a campaign, and I wanna get to that, but let's lay a little groundwork on what the youth initiative consists of here in New Jersey and how you're taking it nationally.

- Yeah, well, we're doing a lot in New Jersey, and I think the first thing that has to be said is that we need to do a lot: the evidence is overwhelming that our kids have suffered.

We know they've suffered in the curriculum part of their life and their test scores, et cetera, but we know, probably, more importantly, that they have suffered in their mental health.

So, we have used state money, we have used federal money, we've created new programs, we've proposed new programs, and I'll give you an example of that because that really gets at the crux of the challenge before us, and again, I don't think anybody is arguing that we don't have a challenge here, I've met not one person.

So, right now, as a state, historically, we've done a very good job addressing the kids in our schools who have been deemed to have a mental health challenge, and we do a really good job of that, probably we have the number one public education system in America, and I think at this, in particular, we're really good at that.

The problem is that it touches probably only two or 3%.

- The program currently being used.

- Only two or 3% of our kids.

- So, how is this initiative going to change that?

- So, this is a program with 15 hubs and spokes that would touch all of our kids, basically, embed the fact, acknowledgment, that we have a mental health crisis among our kids, and that's now out for proposal and discussion.

And it's maybe not on either or either, maybe the old model still continues to be effective, but we blanket on top of that a model that would touch every one of our kids.

- Well, let's talk about that model in the sense that there's research development, training, hiring of people, it's a huge effort, there has to be follow-up, and of course, adequate funding.

Governor, are you sure that the state has the finances to do this in the way they're laying out?

A thorough job because it is a crisis for our kids.

- The answer is we have to.

That will be my answer, and we enjoy, thankfully, a great relationship with our legislature.

We have a great relationship as well with our congressional delegation, and I wanna give them a shout-out for attracting the amount of financial support to New Jersey for programs like this and more broadly.

But the answer has to be yes, there's nothing more precious.

That's where you started our conversation and I couldn't agree more: there's nothing more precious; there's nothing more important to us than our kids, and they are our future.

- Well, with 600 school districts or just about in New Jersey, 1.3 million students, give us an idea of how this can be up and running given the urgency of the matter, when can it get underway?

- Well, I think we're already doing a fair amount.

So, whether it's federal money we put to work or state money, we already have programs that are up and running today that are very successful and are backstopping both programs that preexisted COVID and a lot more investment in programs since COVID.

This broad blanketing, I would hope can be up sooner than later, I would hope, we're talking about next school year.

So, this is in the here and now, and it has to be in the here and now.

- Well, governor, you are aware, I'm sure, of the concerns that have been raised by some school district personnel, by medical professionals, and by some Democratic members of the legislature.

They're concerned that those existing programs, which you mentioned, might have to go away because funding won't be available and they also would like to be more included in the process, which you're describing for the new initiative.

Can you reassure them?

- You bet.

On the latter, the so-called stakeholder engagement process, our folks are really, the professionals who work with me in this front are really good at that, so I'm highly confident that that's not just going to happen but it is happening.

And as I said it's not a foregone conclusion that we can't have both the current approach at least to in some form or fashion, as well as embedding this more broadly, as I mentioned, as a blanket over the entire system.

Now, what we're trying to do, we should talk about the National Governors' Association piece of this.

We're trying to look at this in a series of pillars.

- Explain that to us.

- Yeah, so, but let me go to the end of the story.

When I finish being the chairman next July in Atlantic City, I might add, our hope is to have a playbook for all American governors to be taken off the shelf and say, "These are the variety of ways that we can tackle strengthening mental health among our youth."

And we break this down into pillars, we travel around the country to make sure we get a good regional approach: we started in Salt Lake City in the Mountain West; and then, we'll be moving probably out West, upper-Midwest, South; ending up in Jersey.

- This is you meeting with other governors.

- Me, my vice chair, who's a Republican, by the way, remember this is a nonpartisan organization.

- Yeah, but all the governors- - All the governors are welcome.

And so we, along with professionals, the good news is the governors are not pretending to know all the answers here, nor should we ever, so this is getting around with folks who have lived experience.

So we started, for instance, in Salt Lake, Utah.

- You started in Utah with Governor Spencer Cox.

- Spencer Cox, the governor in Utah, who's terrific, by the way.

- A republican.

- A rising Republican star.

He was our host.

And the first words we heard were from a young woman who has huge mental health challenges and is a student, so we should never become abstract, we should never think, not only that we know all the answers, but let's hear from the folks who are living this, and that's a big part of how we approach this.

- What are you hearing from other governors in terms of cooperation on this effort?

And what's going on in their states and how they're handling it?

Because I'm assuming this is all part of bringing it all into the force so you all share bipartisan effort that maybe we don't see enough of right now.

- God forbid, right?

And it's sharing of best practices, and as you rightfully point out across the aisle, so part of the reason why, you're in Utah, for example, they've got some pretty cool programs that are up and running.

The governor himself talked about the notion of ACEs, adverse childhood experiences, that he himself went through some trauma as a kid, and that he had to work that through, so, a lot of firsthand experiences, and the pillars are things like, how do you prevent it?

How do you destigmatize it?

How do you make mental health services accessible and affordable?

And then, how do you teach the teachers, as it were, the caregivers, the educators who are on the front line?

What can we do to bolster them?

So again, in this notion of blanketing this crisis, you not only have the mental health professionals, but you unleash an army of folks who may not be mental health professionals, but boy do they know kids because they're educators, they're some other staff person at a school, they're a caregiver, whatever it might be.

So, those are an example of some of the pillars: we share best practices; we learn from both lived experience, from individuals who are going through it; as well as the very best professionals on the planet who deal with mental health challenges.

And you hope that the end of the day, you structure, as I said, that playbook, that is that folks could take off the shelf and say, "Listen, I now know how to approach this."

- Of course, governor, you've led the state through the pandemic.

At one point, I think, you pointed out that your briefings, which were televised on YouTube for all of the state to see if they wanted to tune in with all the updates.

You said about 250 of them, I think, you said it was more than any other governor in the country.

- I believe that's correct.

- Let us know from your perspective, how did that influence this initiative and all that's gone into it in your understanding of the crisis that our kids are in?

- Yeah, that's a great question.

I mean, we were living it ourselves in so many respects.

First of all, we memorialized fellow New Jersey residents who we had lost every one of those press conferences, I think, something like 800 folks we saluted in every one of those cases.

Not most, but everyone, I spoke to the family of each of those people before we memorialized them.

So, at a personal level, hearing their story, people always say, "Those must have been challenging conversations."

I said, "Wait a minute, I'm not the one who lost a loved one.

The burden is living with the folks who I'm speaking with."

But you learned a whole lot about what they went through.

And then, more broadly, we were constantly in touch with educators, superintendents, principals, kids, my own kids, they also went through what all other kids went through, they were learning remote.

- Homeschooling, yeah.

- Homeschooling, you're on a screen.

So, we all went through this together.

And so this is the furthest thing from abstract that I've ever been around probably.

- So, you're a dad with children who did homeschooling.

- Yep.

Both in high school and college.

- And you led the state during the pandemic.

What was the aha moment for you when you realized just how serious this was for young people, obviously, others as well, but for our youth?

- I can't give you a moment and time, but it was early.

So, the first thing you realized back in January, February, March of 2020, the first wave that comes at you is the threat to physical health, the threat to public health, people getting sick and dying, that's the first wave that washed over us.

It wasn't long after when you started either living the challenges that our kids were living or anecdotally hearing about it, or hearing from educators, moms and dads, who have always and always will be at the table.

It didn't take long until you realize, you know what?

We've got a two-dimensional learning experience as opposed to a holistic action, live experience.

We had a digital divide.

So some kids, most of them in our neediest communities who didn't have even the ability early on to learn remotely, which we closed, I'm proud to say.

So, it didn't take long.

I'd say spring of 2020.

- So how much of an impact do you think that the homeschooling situation had for these kids?

- It's significant.

- They were isolated.

They were not with friends.

They were not with their teachers.

They were not in a school building.

Maybe, often, left alone because parents had to work, and difficulty learning situations, what can you tell us about that?

And from your administration's work and the knowledge you gathered: how did that impact these kids?

- Yeah, I mean, meaningfully, there's just no other way to put it.

You measure it from the strength of their mental health, all the way to their math, and reading tests.

The evidence is overwhelming.

I'd say two things: number one, we didn't have a choice, people were dropping, we didn't know anything, we being not just New Jersey, anybody in the world.

- The whole country.

- The whole country.

- Oh, and the whole world.

- The whole world did not know what we were dealing with.

So you had no choice.

You did not have any sense of either the risk that you'd be putting people in front of or the risk mitigants that ultimately were available to us: vaccines, masking.

- The schools had to be closed.

- You had no choice.

You had no choice.

Secondly, the other comment I make is I sit here as an optimist.

I believe that the monies, the programs, the human resilience, the character that I think is unique to New Jersey, I think all of that is a cocktail that will allow all of us, God willing, or at least, I hope most of us, to get back up on our feet, whether we're young, middle, or old, and I believe that day will come sooner than we think, but right now, we have work to do.

- Teachers were impacted, of course, in this whole situation as well.

And they were dealing on the front lines, often, when school was back in session, and certainly, during the remote learning process.

How are they being taken into account in this initiative?

Give us an example.

- Yeah, well, first of all, God bless them all because educators, moms, and dads, let's just stop there for a moment, in addition to our precious kids, they went through hell and back, and let's take our hat off to each and every one of them.

I think the most important part of, particularly, the National Governors' Association initiative, those pillars that I mentioned, that last one, I think, to me, is potentially the most consequential, which is, essentially, teach the teachers, train up the folks who are at the front lines all ready for many hours a day in touch with their kids, they know their kids as well as anybody- - They see the stresses.

- They see it.

And the only people who probably see it more are mom and dad.

And so they're already attuned, they're already doing this.

Let's make sure we maximize their abilities, in particular, to prevent, but also if it's too late to prevent, to make sure we don't destigmatize, that we know where to send the kid and his or her family, that the mental health support that they need is accessible and affordable, so, I think that's probably the most powerful part of this.

That's an addition, by the way.

Separate conversation: enormous mental health stress among our educators than what they went through, they themselves have suffered this.

And we have to keep that in mind as well.

- Will there be enough money for all of this?

- I hope so.

And I think there will be, because so far we've been able to prove that we've been able to cobble together what we need at the state level and at the federal level.

This is not germane to our conversations, per se, but it is relevant to say that New Jersey's fiscal strength as we sit here today is quite strong, and you couldn't say that about New Jersey for many decades, but you can today.

- Well, I do wanna point out, governor, that you signed legislation mandating in K through 12 schools to have part of the curriculum: mental health.

And give us an idea of how that's going, what's the update on that?

- Yeah, I'd say it's relatively early to tell.

We're only two months into the school year.

But I think so far so good.

I think it's another step to embed the notion of mental health into all of our beings.

For too long, you've had a very different treatment of physical health and mental health, and there's been a stigma associated with mental health, you've had different insurance coverages for physical versus mental health, you've had a whole lot of reasons why the two realities are starkly different and they're treated different, they're thought of differently.

We have to end that; we have to get that in the rearview mirror as fast as we can.

- What do you personally hope for, for the future of our kids, given all that they've lived through, here in New Jersey, across the country and around the world?

But let's keep it home-based.

- Yeah, listen, first of all, I hope that we continue to have really well-educated, mentally, physically strong kids who are happy, who are looking at their 100 years ahead of them, I think that is gonna become increasingly happily the norm for those who are the kids today, let's get 'em best educated as possible, get 'em into the best physical and mental health space, make sure they are as happy as they can be.

And that, to me, would be my wish, and all of that sooner than later.

- How will you bring that to your position as chair of the National Governors' Association?

- No magic wand, but I think that playbook that I talked about with those four pillars of let's prevent it.

If we can't prevent it, let's make sure we treat it properly and we never stigmatize it, let's make sure mental health support is accessible and affordable, and let's broaden the army that is out there for our kids, beyond just the mental health professionals, but to everybody who touches their lives, educators, support professionals, caregivers, so, that we're all an army there for our kids.

- So, what's next in accomplishing that as chair?

You've laid out a road trip with other governors, and how do you carry it forth over the next year?

- So, we get till next July, as I mentioned, we had one stop already in Utah, and then, we'll tackle each of those pillars I went through in a series of other meetings that'll be coming up, and we'll do that regionally because we don't want to get just one perspective, because you get a lot of pockets of really good activity going on.

So, traveling to these communities is important, related to the whole reason why we're doing this, we don't wanna do this virtually, we wanna be physically face-to-face.

And then, there's a lot of good work that goes on in between these meetings, it's not like we show up every other month with nothing in between, there's a lot of research that's going on, a lot of learning from the prior sessions, and again, we're building that playbook toward next summer.

- What will be the message that you'll bring as the chief executive of this state who's faced COVID head-on in a densely populated state?

What will be the key message that you'll bring?

- The most densely populated state I might add.

In the state, we got clobbered over 34,000 blessed souls lost to this awful pandemic.

I think the lesson we'll bring is both pride and humility: pride that we've done a lot already on mental health; and I'm proud of either what we've actually done or what we're now in the process of doing; but I think at the same time, a humility that we don't have all the answers, that we can learn from other states, we can learn from our kids, most importantly, we can learn from professionals.

And so there's a spirit of open-mindedness, almost a sponge-like notion that we take into this as well.

- Governor, as we begin to close out this interview, what would you say is your message to all those young kids out there who have been through all of this?

And their parents are looking to you, and as they get older, they'll know more about you and be looking to you: what's the message for them?

- That we're here for them.

That their moms and dads, their educators, the government, the professionals, that we're here for them, that we've got their back, that we feel their pain.

We know what they've gone through, and we're committed to holding their hand and working with them until we're all back on our feet.

- We started out this interview saying that our future is our youngsters and their wellbeing.

And governor, you've indicated that is your message for the rest of the state, and we thank you for your perspective.

Thank you for being our guest.

- Thank you for having me, Kent.

- We appreciate it.

- [Announcer] Funding for Governors' Perspectives with Kent Manahan has been provided by: NJM Insurance Group, [lively music] serving the insurance needs of residents and businesses for more than 100 years; the Robert Wood Johnson Foundation, committed to helping Americans lead healthier lives and get the care they need; Seton Hall University; Seton Hall School of Law; and by Connell Foley LLP.

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