ON THIS MONTH'S EDITION OF CONNECT-NEW YORK, WE EXPLORE THE UNIQUE MENTAL HEALTH CHALLENGES FACING YOUNG PEOPLE IN THE EMPIRE STATE - AND CONSIDER THE SHORT- AND LONG-TERM APPROACHES TO MEETING THEIR NEEDS.

ALL THAT, AND MUCH MORE, COMING UP NEXT.

WELCOME TO CONNECT-NEW YORK, I'M DAVID LOMBARDO - HOST OF WCNY'S THE CAPITOL PRESSROOM, A DAILY PUBLIC RADIO SHOW BROADCASTING FROM THE STATE CAPITOL.

ON TODAY'S SHOW WE'RE GOING TO HIGHLIGHT THE RANGE OF MENTAL HEALTH STRUGGLES FOR KIDS AND TEENS IN NEW YORK, AND CONSIDER THE TOOLS THAT COULD HELP THEM SURVIVE - AND THRIVE.

TO DO ALL THAT - AND MORE - WE'RE JOINED BY A PANEL OF INDUSTRY STAKEHOLDERS AND EXPERTS, INCLUDING CATHY LOVEJOY CHIEF PROGRAM OFFICER AT LAKEVIEW HEALTH SERVICES - ELIZABETH NOLAN - CHIEF OPERATING OFFICER FOR HILLSIDE CHILDREN'S CENTER - AND A MEMBER OF THE NEW YORK COALITION FOR CHILDREN'S BEHAVIORAL HEALTH.

DR. JESSICA COSTOSA-UMINA - PROGRAM DIRECTOR OF UPSTATE MEDICAL UNIVERSITY'S ADOLESCENT INTENSIVE OUTPATIENT PROGRAM - AND FINALLY, DR. RICH O'NEILL - A PROFESSOR OF PSYCHIATRY AND BEHAVIORAL SCIENCES AT UPSTATE MEDICAL UNIVERSITY, WHO YOU ALSO KNOW AS HOST OF WCNY'S CYCLE OF HEALTH.

OWE JESSICA, I WANT TO START WITH YOU AND THIS IDEA THAT KIDS IN THAT K-12 RANGE ARE ACTUALLY EXPERIENCING MORE DIFFICULTIES WHEN IT COMES TO MENTAL HEALTH TODAY THAN, SAY THEIR PEERS OF THE PAST.

IS THAT THE REALITY, OR ARE WE JUST, AS A SOCIETY, MORE COGNIZANT OF THE CHALLENGES THAT KIDS FACE?

>> HONESTLY I THINK IT'S PROBABLY A LITTLE BIT OF BOTH BUT I DEFINITELY CAN SAY WE HAVE BEEN SEEING A LOT MORE YOUNGER KIDS K-12 COMING IN THROUGH UPSTATE AND ALL OF OUR DIFFERENT PROGRAMS WE HAVE.

SO WHETHER IT'S THROUGH OUR CONSULTATION LIAISON SERVICE THROUGH THE E.D., WHICH SPECIALIZES IN WORKING WITH KIDS THAT ARE COMING THROUGH TO THE E.D.

WITH MENTAL HEALTH PROBLEMS , WHETHER IT'S NOT, PEOPLE REACHING OUT TO OUR PROGRAM THAT HAVE PEOPLE THAT ARE 10, 11 YEARS OLD THAT NEED EXTRA SERVICES OR TEACHERS REACHING OUT AND SAYING HEY, WHAT DO WE NEED TO DO HERE, HOW DO WE HELP THESE KIDS AND FAMILIES.

>> IN ADDITION TO THE ANECDOTAL STUDIES, THERE IS DATA COLLECTED EVERY YEAR ON YOUTH BEHAVIOR.

DO THEY SEEM TO INDICATE GROWING TRENDS AND PROBLEMS THAT WE SHOULD BE CONCERNED ABOUT?

>> YES, ABSOLUTELY.

SO THERE HAS BEEN SOME RECENT DATA THAT HAS COME OUT THROUGH THE CDC THAT HAS BEEN LOOKING AT, YOU KNOW, THE INCREASE BETWEEN 2011 AND 2021 AND IT'S REALLY INTERESTING BECAUSE THIS IS THE FIRST DATA WE HAVE SEEN SINCE COVID AND WE HAVE SEEN ABOUT A 48% INCREASE WITH HIGH SCHOOL STUDENTS WHO ARE EXPRESSING DEPRESSION AND EXPRESSING HOPELESSNESS.

WE HAVE SEEN ABOUT ALMOST 30% INCREASE IN HIGH SCHOOL STUDENTS WHO HAVE THOUGHT ABOUT MAKING A SUICIDE ATTEMPT.

AND ONE IN 10 HIGH SCHOOL STUDENTS WHO ACTUALLY HAVE MADE AT LEAST ONE SUICIDE ATTEMPT WITHIN THE LAST YEAR.

>> WELL, KATHY ARE THOSE STATEWIDE TRENDS, ARE THOSE THINGS THAT YOU ARE SEEING AND HEARING ABOUT LOCALLY IN THE COMMUNITIES THAT YOU SERVE OR MAYBE YOU HAVE A MUCH BETTER PICTURE AND THINGS ARE JUST GOING GREAT IN THE AREAS THAT YOU GUYS SERVE.

>> I WOULD SAY WE ARE SEEING VERY SIMILAR.

WE REPRESENT MANY OF THE RURAL COUNTIES AROUND THE FINGER LAKES REGION.

SO ACCESS TO SERVICES IS OFTEN NOT AVAILABLE IN THOSE RURAL COUNTIES.

SO SOMETIMES THOSE STRUGGLES CAN BE EXACERBATED BY JUST THE ACCESS TO THE SERVICES AND CLINICIANS WHO REALLY ARE, YOU KNOW, HAVE THE EXPERTISE AROUND MEETING SOME OF THOSE NEEDS.

>> LIZ, SAME STORY?

>> ABSOLUTELY.

HILLSIDE SERVES CHILDREN AND FAMILIES BOTH IN THE COMMUNITY AND RESIDENTIAL AND WE ARE SEEING SPIKES IN ACUITY LIKE KIDS WITH REALLY CHALLENGING BEHAVIORS.

AND I THINK IT HAS TO DO WITH A LOT OF THINGS, AND SOME OF IT IS WHAT WE KNOW ABOUT, THE IMPACT OF THE ENVIRONMENT ON KIDS AND THEIR MENTAL HEALTH AND FAMILIES , ACES, ADVERSE CHILDHOOD EXPERIENCES SO KIDS HAVE BEEN THROUGH SO MUCH IN THE PAST FEW YEARS, THE PANDEMIC CERTAINLY EXACERBATED A LOT OF WHAT WAS ALREADY AN INCREASING NEED BEFORE THE PANDEMIC.

SO, YES, IN OUR EXPERIENCE IT IS REPLICATED ACROSS THE STATE.

I THINK ANOTHER ISSUE IS THAT WE ARE HAVING DIFFICULTY SERVING KIDS AND PROVIDING SUFFICIENT SERVICES, ACCESS TO SERVICES IS NOT WHAT IT NEEDS TO BE.

SO PROBLEMS THAT MAYBE WOULD BE ABLE TO BE ADDRESSED AT A LOWER LEVEL, RISE TO AN INCREASED LEVEL OF CRISIS AND RESULT IN KIDS NEEDING MORE INTENSIVE SERVICES THAN THEY WOULD HAVE IF WE WERE ABLE TO PROVIDE COMMUNITY SERVICES.

>> AND ONE OF THE THINGS, WHEN YOU SAY PROVIDING SERVICES AT A LOWER LEVEL, THAT LOWER LEVEL IS FAMILIES.

AND SINCE, YOU KNOW, 50% OF PEOPLE END UP IN DIVORCE NOW, PARENTS, ABOUT 25% OF OUR KIDS IN THE UNITED STATES GROW UP IN SINGLE PARENT HOUSEHOLDS.

AND SO THEY DON'T HAVE THE SUPPORT AND THOSE HOUSEHOLDS TEND TO BE IMPOVERISHED, ESPECIALLY IN THE MIB OR THE COMMUNITY.

SO THEY END UP, THESE KIDS DON'T HAVE THAT BUFFERING OF THE FAMILY TO LOWER THE STRESS.

AND IN SOME WAYS, I THINK THEIR ANXIETY LEVEL AND DEPRESSION IS LIKE I CANARY IN THE COAL MINE, THEY'RE SAYING HEY, OUR SOCIETY IS NOT SUPPORTING US THE WAY BEE NEED TO.

WE ARE NOT AT THE CENTER OF YOUR UNIVERSE, WHICH WE THEY'D TO BE.

>> EXACTLY RIGHT.

>> ABSOLUTELY.

>> I DO THINK ONE POSITIVE IS THAT DURING THE PANDEMIC, I THINK PEOPLE BECAME MORE WEAR OF MENTAL HEALTH.

JESSICA SAID BOTH.

I TOTALLY AGREE.

WHEN I USED TO SAY WHAT I DID, PEOPLE WOULD, MIGHT GET A BLANK LOOK.

NOW WHEN I TALK ABOUT BEHAVIORAL HEALTH, MENTAL HEALTH, WELLNESS, YOU KNOW, WHAT SUPPORT WE NEED TO PROVIDE TO FAMILIES AND CHILDREN, PEOPLE RECOGNIZE THE NEED AND SEE IT'S A CHRONIC PUBLIC HEALTH ISSUE.

>> AGREED.

>> LIZ MENTIONED THE PANDEMIC.

BUT ARE THERE OTHER FACTORS THAT LEAD TO THE CONDITION THAT WE ARE SEEING RIGHT NOW?

ARE THERE OTHER INFLUENCES THAT KIDS ARE OR DEALING WITH THAT WEREN'T PRESENT 10, 20, 30, 100 YEARS AGO.

>> SURE, THAT'S A GREAT QUESTION.

SOME OF WHAT RICH WAS SAYING WITH JUST THE MAKEUP OF THE FAMILIES NOWADAYS AND HOW VERY OFTEN YOU ARE COMING FROM SINGLE PARENT HOME, NOT HAVING AS MUCH SUPPORT AS BEFORE.

BUT ALSO I THINK ANOTHER LAYER TO THAT HAS TO ALSO DO WITH SOCIAL MEDIA AND I ALSO THINK SOME OF IT HAS TO DO WE CANS PECTATIONS THAT-- EXPECTATIONS THAT OUR TEENS AND CHILDREN ARE BEING PUT IN AND THE EXPECTATIONS THEY HAVE AND IT BLOWS MY MIND.

I THINK I WAS A PRETTY GOOD STUDENT BUT DURING COVID I HELPED MY DAUGHTER WRITE AN ESSAY FOR ELA AND I THOUGHT TO MYSELF, I DIDN'T WRITE AT THIS LEVEL UNTIL I WAS IN COLLEGE.

SO I THINK THE EXPECTATION ARE HARDER AS WELL AND THERE IS MORE OF A FOCUS ON, LESS OF A FOCUS ON MENTAL HEALTH AND WELL-BEING AND MORE OF A FOCUS ON ACHIEVEMENT AND THAT'S ALSO A CONCERN.

>> WHAT IS IT ABOUT SOCIAL MEDIA THAT MAKES IT PROBLEMATIC, AT LEAST IN SOME FORMS?

>> SO SOCIAL MEDIA IS-- IT'S TRICKY BECAUSE THERE ARE PROs AND CONS TO MEED YASM THE SURGEON GENERAL SAID THE SAME THING.

SOME IN WAYS, SOCIAL MEDIA CAN BE HELPFUL.

YOU CAN FIND SOMEBODY WHO CAN SUPPORT YOU THAT MAYBE YOU ARE NOT GETTING SUPPORT IN SCHOOL, YOU DON'T HAVE A LOT OF FRIENDS IN SCHOOL, YOU DON'T FEEL CONNECTED.

YOU CAN FIND OTHER WAYS TO FEEL CONNECTED THAT ARE POSITIVE.

THERE ARE POSITIVE THINGS THAT ARE PRO-MENTAL HEALTH ON SOCIAL MEDIA.

THAT BEING SAID ON SOCIAL MEDIA THERE CAN BE A LOT OF NEGATIVE THINGS.

BULLYING IS MORE LIKELY TO OCCUR ON SOCIAL MEDIA.

PART OF IT IS THAT YOU DON'T FROM TO SEE THE PERSON FACE TO FACE AND SAY SOMETHING TO THEM.

YOU ARE TEXTING SOMETHING AND SENDING IT OFF.

>> ANONYMOUS.

BLIND TO THE REAL PERSON.

YEAH.

>> AND THEN THERE ARE LOTS OF DIFFERENT SITES AND DIFFERENT INFORMATION THAT TEENS HAVE ACCESS TO THAT ACTUALLY CAN DECREASE THEIR MENTAL HEALTH.

VIDEOS THAT TALK ABOUT THINGS LIKE SELF-HARM OR HOW TO PERFECT YOUR EATING DISORDERS.

THERE ARE LOTS OF VENUES OUT THERE THAT SUPPORT NEGATIVE BEHAVIORS FOR TEENS.

>> IF I COULD JUST ADD ALSO, ECONOMIC INJUSTICE, RACIAL INJUSTICE, THERE ARE SO MANY PRESSURES ON FAMILIES AND KIDS RIGHT NOW.

>> SO YOU SAY THAT, BUT I THINK ABOUT THE HISTORY OF AMERICA OVER THE LAST 100 YEARS.

WE HAD WORLD WAR II, PEOPLE SAW THEIR PARENTS GO OFF AND DIE.

THEY SAW THEIR OLDER SIBLINGS GO OFF AND DIE.

IF YOU WERE A BLACK PERSON GROWING UP IN THIS COUNTRY, YOU DEALT WITH SEGREGATION, YOU DEALT WITH LYNCHING.

YOU KNOW, THE IDEA THAT LGBTQ PEOPLE FACE CHALLENGES TODAY IS TRUE BUT THINGS WERE A LOT WORSE 10, 20, 30 YEARS AGO.

SO IS IT THE CASE THAT THINGS ARE ACTUALLY WORSE ON THOSE FRONTS?

I MEAN WE TALK ABOUT WAR TODAY, BUT YOU KNOW, Dr. RICH, YOU HAD TO GO UNDER A DESK PROBABLY AT SOME POINT AND PREPARE FOR THE POSSIBILITY OF NUCLEAR FALLOUT.

>> LET'S TALK ABOUT THAT, BECAUSE WE DID.

WHEN I WAS A KID, THAT WAS RIGHT AFTER YOU KNOW, THEY WERE STILL DOING ATMOSPHERIC ATOMIC BOMB TESTS.

AND WE USED TO HAVE TO CRAWL-- THEY WOULD DO FIRE DRILLS, YOU WOULD HAVE A BOMB DRILL.

GO UNDERNEATH THAT DESK AS IF THAT COULD HELP ANYTHING, RIGHT?

BUT I WAS THINKING ABOUT THAT THE OTHER DAY.

AND THINKING THAT, YOU KNOW, IT REALLY WASN'T THE CENTER OF MY UNIVERSE.

IT WAS LIKE WE HEARD ABOUT IT AND WE WOULD DO IT AND THEN I WOULD GO HOME AND I LIVED IN A FAMILY WITH TWO PARENTS.

I LIVED IN A NEIGHBORHOOD WHERE EVERYBODY HAD TWO PARENTS.

AND THE KIDS ALL GOT TOGETHER OUTSIDE AND PLAYED ALL THE TIME.

SO IT WAS A CHILD-FOCUSED UNIVERSE.

AND SO I FELT SECURE.

I FELT SAFE IN MY FAMILY.

SO I DIDN'T THINK TOO MUCH ABOUT ATOMIC BOMBS, RIGHT?

I THOUGHT ABOUT IT, YOU KNOW, I WAS A LITTLE WORRIED, BUT NOW THESE KIDS ARE GROWING UP WITH JUST ONE PARENT WHOSE PROBABLY OUT OF THE HOUSE, VERY STRESSED ALL THE TIME BECAUSE THEY'RE TRYING TO WORK PLUS BE A PARENT.

AND THAT IS AN EXHAUSTING JOB.

AND SO THEY DON'T HAVE THIS SENSE OF SECURITY.

SO THEY'RE ANXIOUS AND THEY'RE DEPRESSED AND NO SURPRISE TO ME.

I HAD THE PARENTS.

I HAD THE FAMILY.

I HAD THE KIDS.

KIDS DON'T EVEN GO OUT AND PLAY WITH OTHER KIDS NOW.

>> THAT'S THE SOCIAL MEDIA PIECE.

EVEN JUST ADDING ON THAT, I THINK ABOUT THE GENERATION OF THE LOCKHEED CHILDREN WHICH IS-- LOCK KEY CHILDREN, I GREW UP WITH.

YOU HAD A KEY, CAME HOME, MADE YOURSELF SOMETHING TO EAT, WATCHED TV AND DID YOUR HOME WORK BUT YOU WERE BY YOURSELF.

NOT HAVING THAT SUPPORT AND THAT SORT OF CHANGE IN FAMILY IN THE WAY FAMILY FUNCTIONS STARTED HAPPENING QUITE SOMETIME AGO AND I THINK THAT SUPPORTIVE LAYER IS NO THE THERE FOR TEENS.

I THINK ESPECIALLY IF YOU ARE LOOKING AT RACIAL DISPARITY AND YOU ARE LOOKING AT AFRICAN-AMERICAN COMMUNITIES OR COMMUNITIES WHERE THERE ARE PEOPLE OF COLOR, YOU ARE REALLY SEEING A LOT OF DISSOLUTION OF FAMILY THAT IS HAPPENING.

THAT SUPPORT AND COMMUNITY IS NOT THERE.

>> EXACERBATED BY THE MASS INCARCERATION THAT STARTED IN THE 90s AND THOSE KIDS ARE ALL GROWN UP NOW WITHOUT A FATHER AND IF YOU DON'T HAVE TWO PARENTS, YOU ARE MUCH MORE LIKELY TO DO POORLY IN SCHOOL, TO BE INVOLVED IN THE CRIMINAL JUSTICE SYSTEM AND NOT MAKE VERY MUCH MONEY YOURSELF LATER ON.

SO YOU ARE IN POVERTY, IT'S GENERATIONAL.

IT'S A REAL PROBLEM.

>> I WAS GOING TO JUST BUILD LIZ MENTIONS, ACES, ADVERSE CHILDHOOD EXPERIENCES.

AND YOU KNOW, I HAD A VERY SIMILAR CHILDHOOD TO WHAT RICH DESCRIBED SO I HAD A FAIRLY LOW SCORE WHEN YOU CONSIDER ADVERSE CHILDHOOD EXPERIENCES BUT WHEN YOU HAVE DIVORCE, SINGLE PARENT, POVERTY, OR ANY TYPE OF DISPARITIES THAT INCREASES YOUR ACCEPTS TIFFT TO SOME OF THE THINGS THAT WE ARE TALKING ABOUT.

AND AGAIN, THOSE ACES-- THOSE CHILDHOOD EXPERIENCES HAVE EXPANDED AS THE YEARS HAVE GONE BY.

THEY REALIZE MORE AND MORE THINGS THAT CAN CREATE AND RAISE THE RISK FOR SUBSTANCE ABUSE, BEHAVIORAL HEALTH CONCERNS, INCARCERATION.

SO I THINK IT'S REALLY IMPORTANT TO UNDERSTAND THAT RELATIONSHIP AND, YOU KNOW, THE MORE OF THOSE EXPERIENCES A CHILD HAS, THE GREATER RISK THAT THEY ARE AT.

>> CAN I BUILD ON THAT FOR A SECOND.

ONE OF THE THINGS, NOT TO GET POLITICAL, BUT I'M GOING TO GET POLITICAL.

WE NOW HAVE A FORMER PRESIDENT WHO TAKES PRIDE IN LYING AND DECEIVING PEOPLE AND ASSAULTING WOMEN.

WHEN I WAS A KID, AGAIN, POLITICIANS WERE TRUSTED FIGURES.

THEY WERE TRUSTED TO TELL THE TRUTH TO PEOPLE.

AND THAT WAS REASSURING TO ME.

I THOUGHT PRESIDENT KENNEDY WAS GREAT, YOU KNOW, THOSE PEOPLE WERE REALLY OUT TO PROTECT US.

AND NOW WE HAVE THE SENSE LIKE THE POLITICAL SCENE IS AN ABSOLUTE NIGHTMARE AND THE KIDS SEE THIS ALL THE TIME ON SOCIAL MEDIA.

SO THEY'VE GOT TO BE WORRIED ABOUT THAT.

>> RIGHT.

>> YES.

>> THE MORAL COMPASS IS DEFINITELY OFF.

>> THE MORAL COMPASS.

>> YES.

>> LOOKING TO YOUR LEADERS, HELPING YOU DECIDE WHERE YOUR MORAL COMPASS IS, I THINK DEFINITELY COULD BE OFF.

I DID JUST WANT TO ALSO SAY CATHY JUST WHAT YOU WERE SAYING TO TOUCH ON WHAT YOU WERE SAYING BEFORE WHEN YOU WERE TALKING ABOUT ACES AND I THINK ABOUT WHEN WE THINK ABOUT THESE UNDERSERVED COMMUNITIES AND BLACK COMMUNITIES AND THE CONCEPT OF COMPLEX TRAUMA, RIGHT, WHERE YOU ARE LIVING IN A COMMUNITY WHERE THERE IS VIOLENCE.

I'VE WORKED WITH TEENS THAT ARE AFRAID TO WALK TO SCHOOL, YOU KNOW.

THERE IS SO MUCH GOING ON AROUND THEM.

>> AND GUNS EVERYWHERE.

>> AND GUNS EVERYWHERE AND THEY'RE ACTUALLY TALKING ABOUT THE SAME CDC REPORT I WAS JUST SPEAKING OF.

THERE HAS BEEN AN INCREASE AMONGST THE BLACK COMMUNITY OF TEENAGERS IN DEPRESSION AND SELF HARM BEARS AND SUICIDE BEHAVIORS AND I THINK IT'S A REFLECTION OF WHAT YOU WERE SAYING.

>> ABSOLUTELY.

WHAT IS GOING ON IN THE ENVIRONMENT.

>> CATHY MENTIONED THIS IDEA OF THE ACES, SORT OF ASSESSMENT TOOL IN TERMS OF TRYING TO HIGHLIGHT RISK AND ROOT IT OUT.

LIZ, WHEN YOU THINK ABOUT THE TOOLS THAT WE HAVE AND FRAMEWORK WE HAVE FOR ACTUALLY ACCESSING WHETHER PEOPLE HAVE PROBLEMS OR ASSESSING WHETHER PEOPLE HAVE PROBLEMS, DO WE HAVE ENOUGH ACTIVE PEOPLE MONITORING THIS.

ARE PARENTS AWARE, ARE TEACHERS AWARE?

THE ANNUAL DOCTOR'S VISIT?

WHAT ARE THE WAYS FOR WEEDING OUT MENTAL STRUGGLES PEOPLE ARE HAVING.

>> AND PROVIDING THE NECESSARY SUPPORT.

>> JUST KNOWING THERE IS A PROBLEM.

>> GREAT QUESTION, DAVID.

NO, I WOULD THINK IS THE ANSWER.

WE HAVE THE TOOLS.

I THINK WE HAVE LOTS OF VERY PROMISING PRACTICES.

I THINK WE KNOW WHAT TO DO.

I THINK THERE IS A LOT OF HOPE BECAUSE WE DO BETTER UNDERSTAND AND KNOW WHAT TO DO.

BUT OUR SYSTEMS ARE VERY UNDER RESOURCED AND EVEN THE PRIMARY DOC, THAT IS A BIG-- THAT'S A SIGNIFICANT RESOURCE, THE PRIMARY DOCTOR IN A KID AND FAMILY'S LIFE BUT NOT EVERYBODY HAS ACCESS TO PRIMARY CARE, DOESN'T HAVE SUFFICIENT INSURANCE TO ACCESS THEIR PRIMARY DOC AND MANY PHYSICIANS ARE AFRAID OR NOT WELL TRAINED TO DEAL WITH THE MENTAL HEALTH ISSUES.

THEY COULD BE.

SO I THINK WE, THERE IS A ROLE FOR ALL OF US.

YOU MENTIONED THE SURGEON GENERAL'S REPORT.

THE FANTASTIC POSSIBLE SOLUTIONS, THE ROLE FOR MEDIA IN PUBLIC EDUCATION, DESTIGMATIZING MEBT SO THAT PEOPLE ASK FOR HELP.

LETTING FAMILIES KNOW WHO TO CALL, WHERE TO GO FOR HELP BECAUSE FAMILIES, I THINK, ARE THE BEST RESOURCE FOR THEIR CHILDREN.

AND GETTING, AS YOU SAID, GETTING AN EARLY SO KIDS HAVE ACCESS TO BE SCREENED AND TO GET SERVICES.

BUT I WILL SAY THE CHILDREN'S BEHAVIOR HEALTH SYSTEM HAS BEEN UNDER RESOURCED FOR YEARS.

AND THE PANDEMIC JUST MADE IT WORSE AND NOW WE HAVE SIGNIFICANT PROBLEMS WITH WORKFORCE.

AGAIN, WE ALL KNOW WHAT TO DO.

HILLSIDE AS WELL AS OTHER PROVIDERS ACROSS THE STATE PROVIDE A LOT OF VERY, VERY EFFECTIVE COMMUNITY-BASED PROGRAMS RIGHT IN FAMILIES HOMES, BUT WE HAVE A LOT OF TROUBLE RECRUITING AND RETAINING A QUALITY WORKFORCE.

A LOT OF THE SOLUTION IS FOR ANYBODY LISTENING IS ENCOURAGING PEOPLE TO GO INTO HUMAN SERVICESES WHETHER IT'S PHYSICAL HEALTH OR MENTAL HEALTH FIELD BECAUSE THE NEED IS DESPERATE.

>> WE ARE GOING PIVOT NOW TO SOME OF THE RESPONSES TO THE CHALLENGES WE HAVE TALKED ABOUT AND FOR START ES, TO DO THAT, WE ARE GOING TO HIGHLIGHT A CRISIS RESPITE PROGRAM HERE IN SYRACUSE FOR KIDS AGES 5-18.

AND OUR PRODUCER SUSAN BITTER HAS A STORY ABOUT THIS NEW INITIATE.

-- ABOUT THIS NEW INITIAL IDENTIFY.

>> THIS IS A SHORT-TERM PROGRAM FOR ANY KID IN THE AREA WHO IS UNDERGOING A MENTAL HEALTH CRISIS.

THEY CAN COME AND STAY WITH US FOR A SHORT PERIOD OF TIME, RECEIVE SOME SERVICES DURING THEIR STAY AND THEN RETURN HOME FOLLOWING THAT.

CRISIS IS A VERY INDIVIDUALIZED THING THAT WOULD VERY GREATLY, BASED ON INDIVIDUAL CIRCUMSTANCES.

THE SHORT DEFINITION MIGHT BE A SUDDEN CHANGE THAT IS NEGATIVELY IMPACTING THEIR WELL-BEING.

THAT MIGHT LOOK LIKE DEPRESSION, ANXIETY, THINGS THAT ARE HAPPENING INSIDE THEM.

IT COULD LOOK LIKE BEHAVIORAL OUTBURSTS, DEFIANCE, THINGS LIKE THAT THAT ARE GOING OUT INTO THE WORLD.

>> MENTAL HEALTH CRISIS WITH A YOUTH COULD BE SOMETHING THAT THEY'RE STRUGGLING WITH AT SCHOOL, COULD BE SOMETHING THEY'RE STRUGGLING WITH IN THE HOME WHETHER IT'S WITH THE PARENT OR OTHER SIBLINGS.

I THINK SOME OF THE ISSUES I'VE SEEN YOUTH STRUGGLE WITH SO FAR IS YOU GOT SOME SOCIAL ANXIETY, YOU'VE GOT SOME EMOTIONAL, PHYSICAL THINGS THAT YOUTH ARE GOING THROUGH.

I THINK IT'S DIFFICULT FOR YOUTH.

THEY'RE TRYING TO FIND THEMSELVES, WHO THEY ARE, WHAT THEIR IDENTITY IS.

I THINK A LOT OF TIMES THAT CAN BE DIFFICULT FOR CHILDREN SAND TO MODEL AFTER THINGS THAT WE ARE SHOWING THEM AND DOING WITH THEM.

SO WE DO OUR BEST TO TRY AND HELP THEM IDENTIFY WHEN THEY'RE HAVING A CRISIS AND WHY.

>> I WORK TEACHING SKILLS, SUPPORTING THEM THROUGH THEIR SITUATIONS.

PROVIDING THEM WITH INDIVIDUAL GROUP FAMILY THERAPY, RECREATION , BASIC LIFE SKILLS AND TRY TO KIND OF HELP THEM LEARN NEW STRATEGIES TO COPE WHEN THEY'RE STRUGGLING THROUGH THEIR SITUATIONS.

>> WE TRY TO MAKE SURE THAT IT'S NOT A HUGE TRANSITION FOR YOUTH WHEN THEY COME HERE, WHETHER THEY HAVE JOBS, WHETHER THEY HAVE EXTRA DRINK LAR ACTIVITIES AFTER-- EXTRACURRICULAR ACTIVITIES AFTER SCHOOL.

WE PICK THEM UP AFTER SCHOOL AND MAKE SURE THEY ARE AT SCHOOL ON TIME.

WE HAVE AK DIFTS OFF GROUNDS, THE YMCA, THE ZOO, ARTS AND CRAFTS, DIFFERENT KINDS OF ACTIVITIES HERE.

>> KIDS COME IN IN THEIR DIFFERENT AGES, SKILLS, ABILITIES AND YOU CAN'T JUST USE ONE APPROACH BECAUSE IT DOESN'T WORK FOR ALL.

SO HAVE YOU TO KIND OF MEET KIDS WHERE THEY'RE AT, INDIVIDUALIZE YOUR APPROACHES, LEARN SKILLS AND ABILITIES FROM KIDS THROUGH ENGAGEMENT.

AND TRY TO-- IT CAN BE CHALLENGING.

>> THE MAXIMUM LENGTH OF STAY IS 21 DAYS FOR THIS PROGRAM.

BUT ON AVERAGE KIDS ARE HERE ABOUT 14 DAYS.

BY AND LARGE, THOSE CHILDREN WHO STAY LONGER, THEY DO SEE A DRAMATIC DECREASE IN THE INTENSITY OF THEIR SYMPTOMS BY THE TIME THAT THEY'RE DISCHARGED.

>> I ALWAYS REMEMBER ONE, WE HAD A YOUTH HERE A WHILE BACK.

DIDN'T WANT TO BE HERE, DIDN'T WANT TO COME INSIDE.

WAS A LITTLE BIT OF A STRUGGLE WITH THE FAMILY GETTING HIM TO COME IN AND BUY INTO THE PROGRAM.

HE STAYED THE ENTIRE THREE WEEKS THAT WE HAVE AND HE DIDN'T WANT TO LEAVE WHEN IT WAS TIME TO LEAVE.

SO I ALWAYS TAKE PRIDE IN THAT WHERE, YOU KNOW, AT FIRST YOU DIDN'T WANT TO BE HERE AND NOW YOU DON'T WANT TO LEAVE HERE.

SO IT MADE ME FEEL LIKE WE DID SOMETHING SUCCESSFUL WITH THIS YOUTH.

>> SOME KIDS DO FIND THAT THEY NEED TO RETURN TO THIS PROGRAM AFTER THEIR FIRST STAY.

IN SOME WAYS, THE FACT THAT YOUTH AND FAMILY WANT THEIR CHILDREN TO RETURN TO OUR CARE IS A SIGN OF SUCCESS BECAUSE WE WERE ABLE TO PROVIDE AN ENVIRONMENT WHERE THEY FELT SAFE, WHERE THEIR NEEDS WERE GETTING MET.

>> EVERY CHILD THAT I DO THAT WITH LEAVES WITH POSITIVE VIBES AND POSITIVE STORIES FROM CHILDREN'S CRISIS RESPITE.

YOU KNOW THE KIDS ARE LEAVING HERE FEELING LIKE THEY'RE DEVELOPING SKILLS, THEY WERE HEARD.

THEY HAD SOME FUN WHILE THEY WERE WITH US.

THIS FACILITY IS SOMEWHAT UNIQUE FOR THIS AREA.

THERE IS ANOTHER CHILDREN'S CRISIS RESIDENCE THAT'S LICENSED AT THE HUTCHINGS PSYCHIATRIC CENTER RUN BY THE STATE.

BUT OUTSIDE OF THAT, WE ARE THE ONLY PROGRAM THAT IS DOING THIS FOR ABOUT AN HOUR IN ANY GIVEN DIRECTION.

THE CHALLENGE HAS BEEN HAVING A GREATER NEED IN THE COMMUNITY THAN WE HAVE THE CAPACITY TO MEET.

PARTICULARLY TOWARD THE END OF THE LAST SCHOOL YEAR, WE SAW FAR MORE REFERRALS THAN WE COULD ACTUALLY ACCOMMODATE WITH OUR EXISTING 12 BEDS AND SO WE ARE HOPING TO ADD ADDITIONAL BEDS WITHIN THE NEXT YEAR OR SO.

LIFE IS CHALLENGING SO, YOU KNOW, SOMETIMES LIFE PRESENTS A SITUATION AND WE HANDLE THEM ALL DIFFERENTLY.

OUR KIDS MAY DISPLAY A LITTLE AGGRESSION AT HOME, MAY HAVE SOME SORT OF ISSUES GOING ON WHERE THEY MAY WANT TO HARM THEMSELVES OR OTHERS AND, YOU KNOW, THERE MAY BE SOME SORT OF DIAGNOSIS, MENTAL HEALTH WISE THAT WOULD WARRANT A STAY WITH US.

AND OUR JOB IS TO KIND OF KEEP THEM SAFE, HELP THEM DEVELOP NEW SKILLS, REBUILD RELATIONSHIPS WITH FOLKS THAT THEY MAY BE STRUGGLING WITH AND ULTIMATELY TEACH HELP AND SUPPORT.

>> SO CATHY, WE JUST SAW A CONVERSATION ABOUT THE IMPORTANCE OF CRISIS INTERVENTION.

CAN YOU EXPAND A LITTLE BIT ON WHAT IT MEANS TO PROVIDE THESE SERVICES AND WHY THEY ARE SO CRITICAL FOR KIDS IN NEED?

>> SURE, AND I CAN-- WE DON'T NECESSARILY PROVIDE THEM BUT WE ABSOLUTELY ARE ALWAYS LOOKING FOR THEM FOR THE FAMILIES AND THE KIDS THAT WE SERVE.

AND THEY'RE ALWAYS, ALWAYS HARD TO TAP INTO.

AND ESPECIALLY IN A RURAL COMMUNITY WHERE OFTEN TIMES A FAMILY MAY HAVE TO GO TO AN HOUR DISTANCE JUST TO FIND A PROGRAM WHERE THEY MIGHT BE ABLE TO GET THOSE, THAT HELP.

BUT IT REALLY IS, AGAIN, ESPECIALLY IF YOU ARE TALKING ABOUT A SINGLE PARENT HOME THAT WE HAVE TALKED QUITE A BIT ABOUT.

ALTHOUGH AGAIN, WE HAVE KNOWN SOME REALLY VERY HEALTHY, LOVING , YOU KNOW, TWO-PARENT HOUSEHOLDS THAT HAVE HAD THE SAME CONCERNS.

AND SOMETIMES YOU JUST JUST NEED TO BREAK THE CYCLE FOR THE CHILD AND THE PARENTS AND JUST THE AVAILABILITY OF THAT IT'S VERY HARD TO COME BY.

OFTEN TIMES PROVIDERS ARE SEEKING, YOU KNOW, OUTSIDE PROVIDERS OR, I'M SORRY, LIZ, FOSTER HOME TYPE MODEL TO HELP OUT AND IT TAKES SOMEBODY SPECIAL TO OPEN YOUR HOME.

>> IT DOESN'T HAVE TO BE AN INSTITUTIONAL RERESIDENTIAL SETTING.

THERE COULD BE A FOSTER HOME, PEOPLE ARE WILLING TO PUT UP FAMILY SO A FAMILY CAN GET A BREAK FOR A SHORT TIME.

THAT'S THE IDEA OF SOME PROGRAMS, RIGHT?

>> YES.

ABSOLUTELY A STATE PROGRAM WAS TO FUND OVERNIGHT RESPITE IN ROCHESTER HILLSIDE USES FOSTER FAMILIES TO PROVIDE THAT RESPITE.

AND I KNOW HERE IN, WE JUST TALKED ABOUT THE 'EM ELMCREST PROGRAM THEY WERE FULL AS SOON AS THEY STARTED.

WHAT IS IMPORTANT AN ARRAY OF CHOICE.

FAMILY CHOICE IS CRITICALLY IMPORTANT AND SOME FAMILIES DON'T WANT TO HAVE THEIR CHILD WITH ANOTHER FAMILY.

THEY WOULD RATHER HAVE THEIR CHILD BE MORE OF A PROGRAM, STRUCTURED PROGRAM 24/7 STAFFING SO HAVING THAT ARRAY OF SERVICES IS CRITICAL.

AND YES, FUNDING ALL THE DIFFERENT OPTIONS IS CRITICALLY IMPORTANT.

>> JESSICA, CATHY MENTIONED THE CHALLENGES OF RURAL COMMUNITIES AND I KNOW YOU LAUNCHED A PROGRAM BACK IN 2020 AND AT THE TIME I THINK THE ONLY OTHER PLACE PEOPLE IN CENTRAL NEW YORK COULD GET THESE SERVICES WAS IN SARATOGA SPRINGS.

SO CAN YOU TALK A LITTLE BIT MORE ABOUT YOU KNOW, MAKING THESE SERVICES MORE ACCESSIBLE IN TERMS OF GEOGRAPHY?

>> ABSOLUTELY.

AND YES, IN 2020 WE STARTED AN INTENSIVE OUTPATIENT PROGRAM AND ACTUALLY OMH OUTPATIENT PROGRAM, THE ONLY ONE IN THE STATE.

>> ONLY 19 MILLION PEOPLE.

>> PEOPLE COME TO US FROM WATERTOWN, PEOPLE THAT COME TO US FROM ALBANY.

AND IT'S DEFINITELY NEEDED SERVICES SO DURING COVID WE DID SOME OF OUR GROUPS AND WORK ENVIRONMENTALLY.

THAT WAS HELPFUL.

WE HAD PEOPLE FROM NEW YORK STATE-- NEW YORK CITY THAT ATTENDED OUR PROGRAM BECAUSE THEY COULD DO IT VIRTUALLY.

BUT THERE DEFINITELY IS A NEED.

WE CONSTANTLY HAVE A WAIT LIST.

WE WORK WITH KIDS THAT ARE 12 TO 18 YEARS OLD AND I THINK SOMETHING DIFFERENT ABOUT OUR PROGRAM IS THAT WE HAVE A REALLY STRONG PARENT GUARDIAN FAMILY PIECE.

SO EVERY SINGLE PERSON THAT IS IN OUR PROGRAM, THEY HAVE TO HAVE A GUARDIAN OR PARENT INVOLVED AS WELL.

AND WE ARE WORKING WITH THEM TO TEACH THEM DIFFERENT SKILLS TO GIVE THEM SOME EDUCATION AND GIVE THEM SUPPORT, TRYING TO CREATE A COMMUNITY WHERE THERE ARE OTHER PEOPLE THAT ARE STRUGGLING WITH SIMILAR ISSUES AND CONCERNS SO THEY'RE NOT FEELING LIKE THEY'RE ALONE, YOU KNOW, THAT THERE IS SOMETHING WRONG WITH THEM OR HOW THEY'RE PARENT CAN, THAT THEY HAVE A COMMUNITY OF PEOPLE SUPPORTING THEM.

>> AND DO THEY STAY IN THE HOME AS THEY RECEIVE THE SERVICES AND THEN COME OUT?

IS THAT IMPORTANT.

>> INCR EDBLY IMPORTANT.

THAT'S A HUGE FOCUS FOR US.

WE TRY TO KEEP THE TEENS IN THE HOME AND WE TRY VERY HARD NOT TO HOSPITALIZE OR SEND TO THE E.D.

UNLESS WE HAVE NO OTHER OPTIONS.

SO WE WORK VERY CLOSELY WITH FAMILIES AND TEENS OF HOW CAN WE KEEP YOU HOME AND KEEP YOU HOME SAFELY.

WE WILL SEE YOU FOUR TO FIVE TIMES A WEEK EVERY SINGLE DAY IF WE NEED TO, BUT WE WOULD LIKE YOU TO STAY HOME.

AND PART OF THE REASON FOR THAT IS, YOU KNOW, WHEN YOU ARE IN A HOSPITAL SETTING, ALL THE THINGS THAT ARE CAUSING THAT STRESS IN YOUR LIFE, YOU KNOW, THAT'S ESCALATING YOUR SYMPTOMS AND MAKING IT HARD FOR YOU TO COPE AND MANAGE, YOU ARE NOT EXSUPPOSED TO NAT IN THE HOSPITAL SO YOU ARE NOT LEARNING THE SKILLS OF HOW TO MANAGE THAT IN WHEN YOU ARE IN THE HOSPITAL.

AND ALSO SOMETIMES WHEN TEENS COME OUT OF THE HOSPITAL, THEY FALL BEHIND WITH WORK, THEY HAVE TO IF I CAN OUT HOW TO TELL THE TEACHERS AND HOW ARE THEY GOING TO TELL THEIR PEERS WHIR THEY HAVE BEEN AND THEY FEEL EMBARRASSED AND IT CAUSES A LOT OF PROBLEMS.

>> SO YOU FOCUS ON TEACHING THE TEENS SOME SKILLS SO WHILE THEY'RE IN THEIR HOUSE, THEY HAVE THAT STRESSOR OR CHALLENGE TO DEAL WITH AND THEN THEY CAN TRY OUT THE SKILL ON SITE.

>> ABSOLUTELY.

>> AND THEN COME BACK TOMORROW THE NEXT DAY WHEN THEY SEE YOU OR TWO DAYS LATER AND THEY SAY WELL THIS WORKED AND THIS DIDN'T WORK.

>> YEAH, WE CALL IT GENERALIZING SKILLS.

>> GENERALIZING, FROM YOUR OFFICE OUT INTO THE WORLD.

>> AND WE WILL HAVE THEM PRACTICE IT IN OUR ROOM.

WE TEACH THE PARENTS ALL THE SKILLS THAT WE TEACH THE TEENS.

SO THIS WAY, AGAIN, YOU KNOW, HAVE YOU SOMEBODY IN YOUR LIFE THAT YOU LOVE THAT IS GOING THROUGH THIS IMMENSE, YOU KNOW, EMOTIONAL DYSREGULATION AND DOING THESE BEHAVIORS THAT ARE DANGEROUS AND IT'S GOING TO GET YOU UPSET AND MAKE YOU FEEL OVERWHELMED.

OFTEN TIMES WE ARE SEEING THE PARENTS, HEY, HERE ARE SOME SKILLS YOU CAN USE TOO AND YOU CAN CALM YOURSELF DOWN AND CALMLY RELATE TO YOUR TEENAGERS WHICH IS A CHALLENGE IN AND OF DISWHRTS LET ME SAY A WORD ABOUT FAMILY BECAUSE EVERYTHING YOU SAID IS SO IMPORTANT JESSICA AND COMMUNITY-BASED SERVICES WE KNOW KIDS THRIVE IN THE COMMUNITIES WITH THEIR FAMILIES, NOT WITH RESIDENTIAL ALTHOUGH RESIDENTIAL IS AN IMPORTANT PART OF THE SYSTEM OF CARE AS IS HOSPITAL.

I JUST WANT TO SAY A WORD ABOUT FAMILY PEER SUPPORT AND YOUTH PEER SUPPORT.

THAT'S ANOTHER POSITIVE IN OUR STATE AND OUR COUNTRY AND OUR STATE IN PARTICULAR HAS A STRONG FAMILY PEER MOVEMENT SO THAT'S LINKING A PARENT, WHOSE CHILD IS OR DEALING WITH A BEHAVIORAL ISSUE WITH ANOTHER PARENT WHOSE CHILD HAS RECEIVED SERVICES FROM THE SYSTEM WHO HAS LIVED EXPERIENCE.

IT IS SO POWERFUL.

SO IT'S TEACHING SKILLS, BUT IT'S ALSO JUST THAT SUPPORT.

LIKE I HAVE BEEN THERE.

SOMETIMES WE HAVE FOUND FAMILIES TENDENCY TO ENGAGE IN SERVICES IN THE FIRST PLACE IS SIGNIFICANTLY HIGHER IF A FAMILY PEER ADVOCATE ACCOMPANIES THE OTHER SERVICE PROVIDER.

AND SAME WITH YOUTH PEER ADVOCACY IS, YOUTH BEING ABLE TO VISUALIZE, I CAN GET TO THE OTHER SIDE.

THERE IS SOMETHING I CAN DO.

>> THIS PROGRAM WAS HELPFUL TO ME, MAYBE IT WILL BE HELPFUL TO YOU AS A FELLOW PARENT AND IT'S NOT SO WEIRD.

I'M NOT A WEIRD PERSON.

>> THERE IS NO SHAME.

>> STIGMA.

>> THE MORE WE CAN TALK ABOUT BEHAVIORAL HEALTH AS PART OF THE CONTINUUM OF WELLNESS AND JUST HEALTH, YOU KNOW, THE BETTER.

THAT IT'S NOT...

THERE IS NOTHING TO BE ASHAMED.

>> TEETH CLEANED, PHYSICAL CHECKUP AND HAVE YOUR BRAIN LOOKED AT, TOO.

WHAT ABOUT FUNDING FOR THESE SERVICES?

CATHY, IS THIS SOMETHING YOU STRUGGLE WITH ON A DAY-TO-DAY BASE TOYS PROVIDE SERVICES TO THE COMMUNITY, A COMMUNITY THAT MIGHT RELY ON MEDICAID OR DOES STATE GOVERNMENT AND FEDERAL GOVERNMENT JUST MAKE IT RAIN BECAUSE THEY KNOW THESE ARE IMPORTANT SERVICES AND THEY NEED TO CREATE GOOD PRODUCTIVE ADULTS FOR THE FUTURE.

>> RUNNING FOR OFFICE?

>> HOPING... WHO KNOWS.

[LAUGHTER] >> IF WE WERE HERE TALKING ABOUT HOW RICH THE FUNDING OPPORTUNITIES WERE, I THINK SOME AT LEAST OF OUR CHALLENGES MIGHT BE ADDRESSED.

AGAIN, WE WOULD STILL NEED THE PEOPLE TO FILL THAT ROLE.

BUT CERTAINLY FUNDING, YOU KNOW, FOR US IN PARTICULAR, WE OFTEN RELY ON COUNTY CONTRACTS AND DOLLARS THAT THEY CAN EARMARK AND PASS ALONG TO US.

YOU KNOW, THERE ARE SOME MEDICAID REIMBURSABLE SERVICES.

ANY SERVICE IS INVALUABLE.

I WOULD SAY IT IS ALL WELL WORTH THE MONEY.

>> HOW ARE MEDICAID REIMBURSEMENT RATES?

WE HEAR ACROSS THE HEALTHCARE SYSTEM THAT THE RATES ARE NOT REFLECTIVE OF THE ACTUAL SERVICES.

>> ACROSS THE BOARD, YES.

>> AND I WOULD SAY THAT LOOKING AT THAT AND INVESTING IN THOSE RATES AND INVESTING FUNDING IN OTHER PROGRAMS IS CRITICALLY IMPORTANT.

THE GOVERNOR'S BUDGET-- THE WHOLE ADOPTED BUDGET LAST YEAR HAD A NUMBER OF VERY POSITIVE PIECES, INVESTMENT IN SCHOOL-BASED MENTAL HEALTH CLINICS IN COMPANY COLA, NOT AS HIGH AS WE ADVOCATED FOR.

>> NOT REFLECTIVE OF ACTUAL INFLATION.

>> AND THERE ARE MANY PROVIDERS WHO ARE GOING OUT OF BUSINESS RIGHT NOW WHO ARE CHOOSING TO GET OUT OF THE SERVICES.

THEY MAY NOT-- SOME HAVE GONE OUT OF BUSINESS.

SOME ARE GETTING OUT OF THE RESIDENTIAL FIELD.

GETTING OUT OF PROVIDING THE COMMUNITY-BASED MENTAL HEALTH SERVICES, THE MEDICAID FUNDED MENTAL HEALTH SERVICES BECAUSE YOU CAN'T JUST SUSTAIN IT.

SO WE NEED AN INVESTMENT THAT MAKES THE WHOLE SYSTEM RICH, LIKE THAT IS SUSTAINABLE.

AND THEN WE CAN ATTRACT THE WORKFORCE.

THERE HAVE NOT BEEN THE INVESTMENTS IN THE NOT-FOR-PROFIT SECTOR THAT THERE HAS BEEN IN THE HOSPITAL SIDE, FOR EXAMPLE, EVEN IF THERE ARE MORE INVESTMENTS NEEDED THERE, THE INVESTMENTS IN THE COMMUNITY-BASED NOT-FOR-PROFIT SECTOR HAVE NOT EVEN REMOTELY KEPT UP WITH THE COST OF ACTUALLY PROVIDING THE SERVICERS.

WE WOULD HAVE A MUCH BETTER CHANCE-- I KNOW-- WE ALL KNOW THERE IS A HUGE WORKFORCE ISSUE RIGHT NOW REGARDLESS.

BUT WE WOULD HAVE A MUCH BETTER CHANCE OF COMPETING IF WE COULD PAY A LIVABLE WAGE.

>> I AGREE.

THE WAGES ARE NOWHERE REFLECTIVE OF THE LEVEL OF RESPONSIBILITY OF THE PEOPLE WHO ARE PROVIDING THOSE SERVICES.

AND THEY'RE INTEGRAL TO ANY, YOU KNOW, A CHILD'S ABILITY TO GET WELL.

AND THE RATES JUST ARE NOT REMOTELY REFLECTIVE OF THAT LEVEL OF RESPONSIBILITY.

>> WOULD YOU AGREE THAT AT THE LARGER SYSTEM LEVEL OF THE COUNTRY AS A WHOLE, THAT PROVIDING, WHAT ARE THEY NOW CALLING THEM, SNAP, FOOD STAMPS, FOOD FOR KIDS BECAUSE I KNOW.

>> MEET THE BASIC NEEDS.

>> 20% OF MINORITY KIDS ARE HUNGRY AT TIMES.

AND IF YOU WANT SOMEBODY TO FEEL INSECURE, JUST TAKE AWAY THEIR FOOD.

>> OH GOSH, YEAH.

>> SO I THINK ONE OF THE BASIC THINGS IS AS A COUNTRY, WE HAVE TO COME TO GRIPS THAT WE SHOULD NOT HAVE HUNGRY KIDS IN OUR COUNTRY.

WE ARE THE RICHEST COUNTRY IN THE WORLD.

WHAT IS WRONG THAT WE ARE NOT GIVING PEOPLE ENOUGH FOOD TO EAT?

>> RIGHT.

>> ESPECIALLY LITTLE KIDS, YOU KNOW, AND THEN WE ARE SENDING THE MOTHERS OUT INTO THE COMMUNITY TO WORK SAYING YOU SHOULD WORK MORE.

AND THEY DON'T HAVE ENOUGH FOOD WHEN THEY COME HOME.

>> AND HOUSING CRITICALLY IMPORTANT ALSO.

ABSOLUTELY.

TO GO BACK TO FUNDING FOR A MINUTE.

ONE OF OUR ADVOCACY POINTS ALSO AND WORKFORCE, COMBINING THE TWO, NEED MORE QUALIFIED WORKFORCE TO GET FOLKS IN.

NEED TO DIVE THE WORKFORCE BUT THEY CAN'T AFFORD TO INCUR THAT KIND OF DEBT OR DON'T HAVE THE UP FRONT RESOURCES.

SO DIVERSIFYING THE WORKFORCE WILL GIVE US A STRONGER WORKFORCE AS WELL.

>> 100% AGREE WITH YOU.

I CAN'T TELL YOU HOW MANY TEENS COME THROUGH OUR PROGRAM THAT WANT SOMEBODY THAT LOOKS LIKE THEM, IT IS SO MUCH EASIER FOR THEM TO SORT OF ESTABLISH THAT RAPPORT AND ESTABLISH THAT TRUST.

THEY FEEL LIKE THAT PERSON CAN UNDERSTAND WHAT THEIR LIVING EXPERIENCE IS LIKE.

>> YES.

>> AS SOMEONE WHO TREATS ADULTS, WHAT IS THE CONSEQUENCE OF IGNORING EVERYTHING WE ARE HEARING AT THIS TABLE TODAY?

I HAVE TO IMAGINE THAT A LOT OF THE CHALLENGES AND STRUGGLES THAT YOU SEE IN ADULT PATIENTS, A PRODUCT OF CHILDHOOD TRAUMA.

I MEAN IS IT FAIR TO SAY THAT IF WE DON'T ADDRESS THESE THINGS NOW, WE ARE GOING TO BE BACK HERE 20 YEARS FROM NOW SAYING, YOU KNOW, THERE IS A REAL PROBLEM WITH ADULT MENTAL HEALTH THESE DAYS.

IS IT FAIR TO SAY IT'S THAT CLEAR OF A CONNECTION?

>> IT'S LIKE THAT.

I MEAN IT'S ABSOLUTELY PEOPLE WHO ARE NOT SUPPORTED AS KIDS, THEY DON'T DEVELOP THE ABILITY TO SOOTHE THEMSELVES, CALM THEMSELVES, THEY'RE ANXIOUS.

THEY DON'T ABILITY THE ABILITY TO DEVELOP GOOD RELATIONSHIPS AND RELATIONSHIPS ARE NUMBER ONE IN LIFE, YOU KNOW.

IF OUR ABILITY TO RELATE TO OTHER PEOPLE IS CENTRAL, SO IF YOU DON'T DEVELOP THAT AS A-- AND IT STARTS EVEN BEFORE DAY ONE, EVEN BEFORE YOU ARE BORN.

IF YOU ARE NOT BEING TAKEN CARE OF IN THE WOMB, AND IMMEDIATELY AFTERWARDS, YOU ARE REALLY GOING TO BE IN TROUBLE LATER ON.

I JUST READ SOMETHING THE OTHER DAY THAT THE NUMBER OF NEURONS THAT GROWS EVERY MINUTE, NO KIDDING NOW-- BILLIONS OF NEURONS GROW IN THE CHILD FROM BIRTH TO THE NEXT FEW MONTHS EVERY MINUTE OR FEW MINUTES, RIGHT?

AND SO IF WE ARE NOT HAVING AN IMPACT ON THOSE NEURONS EARLY ON WHERE THE BRAIN IS SAYING, OH YEAH, I'M GOING TO BE TAKEN CARE OF, MY PARENTS ARE THERE, PEOPLE ARE GOING TO TAKE CARE OF ME, THEN THOSE PEOPLE ARE NOT GOING TO GROW UP BEING ABLE TO CALM THEMSELVES, BEING ABLE TO DEVELOP THE RELATIONSHIPS THAT ARE CENTRAL.

SO, YEAH, THOSE ARE THE FOLKS WHO END UP, YOU KNOW, IN MY OFFICE AND THEY'RE SAYING, YOU KNOW, YEAH-- AND I'M ALWAYS ASKING, WHAT WERE THE ADVERSE CHILDHOOD EVENTS THAT HAPPENED TO YOU?

YOU KNOW THAT'S ONE OF THE KEY THUNKS.

YOUR PARENTS GET DIVORCED?

WERE YOU SEXUALLY ABUSED, PHYSICALLY ABUSED AND-FOR-GOD'S SAKE, DON'T BEAT YOUR KIDS ALL YOU PEOPLE OUT THERE IN THE WORLD, PHYSICAL PUNISHMENT IS A TERRIBLE THING TO DO TO KIDS IT JUST DECREASES THEIR I.Q.

ENOUGH ABOUT THAT.

BUT THOSE THINGS HAVE TO BE THERE IN PLACE.

OTHERWISE YOU SEE THESE FOLKS GROW UP AND THEY END UP IN JAIL.

AND IT COSTS $95,000 A YEAR TO HAVE SOMEONE IN PRISON SO HOW ABOUT GIVING THOSE FOLKS $200 A MONTH FOR FOOD, RIGHT?

THAT'S WHAT $2,000 A YEAR?

THAT'S A NO BRAINER TO ME.

>> AND JESSICA, SPEAKING OF MORE COST EFFECTIVE SOLUTIONS, TAWR TALKING ABOUT HOW MUCH BETTER IT IS FOR THE CHILD TO BE IN THE COMMUNITY, IF WE ROBUST IN COMMUNITY SERVICES WE COULD PREVENT THE HOSPITALIZATIONS OR USE IT MORE APPROPRIATELY AS PART OF A SYSTEM OF CARE, SAME AS RESIDENTIAL THAT HILLSIDE AND OTHER COALITION MEMBERS PROVIDE.

IT'S ESSENTIAL FOR A BRIEF PERIOD OF TIME WHEN THE CHILD'S NEED IS ACUTE.

BUT WE SHOULD HAVE SUCH ROBUST COMMUNITY-BASED SERVICES THAT EITHER A CHILD NEVER NEEDS RESIDENTIAL OR HOSPITALIZATION OR THEY NEED IT, THEY GET THE TREATMENT THEY NEED AND THEN THEY'RE ABLE TO RETURN TO THE COMMUNITY, KNOWING THAT THERE ARE ROBUST SERVICES TO WRAP AROUND THAT FAMILY AND I WILL SAY ANY KIND OF FAMILY.

FAMILIES COME IN ALL TYPES AND ALL NEED SUPPORT TO SUPPORT THEIR CHILDREN.

>> AND LIZ MENTIONED, A PHRASE RIGHT THERE, WRAP AROUND SERVICES.

AND I THINK THERE IS THIS IDEA, AT LEAST HISTORICALLY THAT YOU GO TO YOUR DOCTOR TO GET MENTAL HEALTH SERVICES.

BUT I THINK, FOR EXAMPLE, SCHOOLS, ARE NOW THIS ONE STOP SHOP FOR EVERYTHING.

IT'S WHERE YOU CAN GO FOR YOUR DENTIST, GO FOR LUNCH FOR THE WEEKEND.

YOU HAVE TO MEET KIDS WHERE THEY ARE, RIGHT, CAGHTY?

>> EXACTLY.

AND AGAIN I THINK IT'S REALLY-- IT IS CERTAINLY FROM THE TIME I WAS IN SCHOOL, I CAN SAY IT'S A POSITIVE, JUST THE AWARENESS OF REALLY STRENGTHENING THE SUPPORTS AVAILABLE TO KIDS IN SCHOOL.

THEY SPEND SO MUCH TIME OF THEIR LIVES IN THAT ENVIRONMENT.

AND I CAN SEE, AND CERTAINLY IN OUR REGION, THE EXPANSION OF IN SCHOOL MENTAL HEALTH SERVICES THAT ARE BEING MADE AVAILABLE.

AND AGAIN, WE'VE TALKED ABOUT PARENTS WHO ARE THERE TRYING TO WORK, THEY'RE TRYING TO TAKE CARE OF THEIR KIDS THEY'RE WORKING SINGLE JOBS, THEY MAY HAVE TO DRIVE AN HOUR TO TAKE THEIR CHILD TO PROVIDERS, SO ALSO JUST THE ACCESSIBILITY IS JUST INVALUABLE.

>> AND DAYCARE.

AND PRE-K.

I MEAN THERE IS A HUGE AMOUNT OF DATA SHOWING THAT PRE-K SERVICES HELP KIDS INTELLECTUALLY,.

>> GOOD PRE-K. >> MEANINGFUL.

BUT SOME PRE-K... >> YOU GOT TO HAVE A GOOD SERVICE, RIGHT?

BUT IT REALLY HELPS.

>> I THINK YOU ARE BOTH SPEAKING ALSO TO THE NEED OF TRAINING AND BETTER TRAINING BECAUSE I DO BELIEVE, YES, YOU CAN HAVE PEOPLE IN SCHOOLS THAT ARE INVOLVED IN MENTAL HEALTH, BUT IF THEY DON'T REALLY QUITE UNDERSTAND WHAT IT IS THEY'RE LOOKING AT AND WHAT IT MEANS, BIG 5 HAD SO MANY TEENS THAT I HAVE WORKED WITH THAT SAY THEY'RE HAVING AN OFF DAY AND WISH THEY WEREN'T AROUND IF I MORE AND THEN THEY DON'T WANT TO TELL ANYBODY WHAT IS GOING ON FOR THEM.

SO TRAINING IS CRITICAL, TRAINING WITH TEACHERS, TRAINING WITH MEDICAL PROVIDERS.

REALLY NEEDS TO HAPPEN AS WELL.

>> JESSICA, CONVERSELY ON THE OTHER SIDE OF THE SPECTRUM, THERE IS ANY REASON TO BE CONCERNED ABOUT KIDS WHO ARE QUOTE UNQUOTE CODDLED.

THEY'RE ASKED TOO MANY TIMES, HOW ARE YOU DOING, IS EVERYTHING OKAY?

THEY'VE HAD OBSTACLES IN THEIR LIFE REMOVED FROM THEM.

DO WE NEED TO WORRY ABOUT CREATING KIDS THAT ARE HARDENED THOSE THAT RAN AROUND BACK IN RICH'S DAY AND DIDN'T HAVE TO REPORT BACK TO THEIR PARENTS.

>> MY DAY?

[LAUGHTER] >> PUNCHING BAG FOR ME, RICH.

I APPRECIATE YOU COMING IN FOR ME.

IT WAS THE LATE 1940S, A DIFFERENT TIME.

KIDS WERE RESPONSIBLE FOR THEMSELVES AND DO WE NEED TO PREP THEM FOR THAT IN ANY SHAPE OR FORM OR IS THAT A STRAW MAN ARGUMENT FROM PEOPLE WHO, YOU KNOW, LIVE JUST A DIFFERENT LIFE AND ARE NOT COGNIZANT OF THE CHALLENGE KIDS FACE TODAY.

>> I HEAR THAT ARGUMENT ALL THE TIME.

THERE IS A BALANCE BETWEEN MAKING SURE YOU GIVE YOUR CHILD THE SUPPORT THEY NEED TO GROW INTO THE TYPE OF CITIZEN YOU WOULD LIKE THEM TO BE, VERSUS NOT GIVING THEM THE OPPORTUNITIES TO FIGURE OUT THINGS ON THEIR OWN.

THERE IS DEFINITELY A BALANCE BETWEEN THE TWO.

AND I THINK THAT CAN BE A CHALLENGE AS WELL IN WORKING WITH FAMILIES TO SORT OF UNDERSTAND, OKAY, SO WHEN ARE WE LEANING TOO MUCH ON GIVING THEM TOO MUCH FREEDOM AND RESPONSIBILITY AND NOT ENOUGH SUPPORT AND WHEN ARE WE KIND OF SORT OF HOVERING OVER THEM AND NOT LETTING THEM... >> THE HELICOPTER PARENTS.

>> EXACTLY.

>> NEVER GIVE A CHANCE TO FALL OFF THE THING AND DISCOVER HEY, THAT HURTS.

>> THAT'S THE BEST WAY TO KNOW NOT TO FALL OFF THE THING, RIGHT?

>> AND WHAT ABOUT ACTUALLY ACCESSING HELP IF YOU OR SOMEONE WHO THINKS YOU NEED SERVICES?

I KNOW NEW YORK ROLLED OUT AND NATIONALLY, THE 988 HOT LINES.

DOES ANYONE HAVE THOUGHTS ON THAT AS A TOOL CONNECTING PEOPLE WITH LOCAL SERVICES AND WHAT THEY HAVE HEARD ABOUT THE EFFECTIVENESS OVER THE LAST YEAR IN WHICH THAT HAS BEEN WIDELY UTILIZE ADD CROSS NEW YORK?

ANYBODY HAVE ANY FEELINGS ABOUT THAT?

>> JUST THAT ANY WAY WE CAN MAKE IT EASY FOR PARENTS TO MAKE A PHONE CALL IS GREAT.

I WAS GOING TO MENTION 211 WHEN I WAS THINKING AS WE CAME INTO THIS INTERVIEW.

IF ANY PARENT IS LISTENING TO THIS, AND SAYING, YOU KNOW, I DO.

WE HEAR ALL THE TIME, PEOPLE DIDN'T REALIZE THERE WERE SERVICES, DIDN'T REALIZE THERE WAS HELP OUT THERE.

SO 211 HERE IN SYRACUSE, BUT 988 IS SOMETHING EASY TO REMEMBER.

>> AND KIDS CAN EVEN TEXT 988.

I'M JUST LEARNING TO TEXT MYSELF BUT THEY CAN TEXT TO 988 AND GET SOME IMMEDIATE COUNSELING THROUGH A TEXT.

>> TEENS WOULD PREFER TO TEXT.

AND OUR PROGRAM WE HAVE PHONE COACHING SO THEY CAN REACH OUT TO THEIR PROVIDERS PRETTY MUCH 24/7 OUTSIDE OF REGULAR CLINIC HOURS SO THAT WE CAN THEN AGAIN HELP THEM GENERALIZE THOSE SKILLS.

>> THEY CAN HELP THEM NOT MAKE A DECISION OR DO A BEHAVIOR THAT'S GOING TO BLOW UP THEIR LIFE AND MAKE THINGS WORSE AND INSTEAD DO SOMETHING SKILLFUL BUT DO I FIND EVEN WHEN OUR TEENS ARE REACHING OUT TO US IN THAT WAY, TEXTING IS MUCH MORE COMFORTABLE FOR THEM THAN TALKING ON THE PHONE.

>> AND ARE PEOPLE PREPARED TO TALK TO KIDS IN TERMS THAT THEY UNDERSTAND?

CAN YOU TALK ABOUT WHAT IT REQUIRES TO HAVE A CONVERSATION?

DO I INTO ED TO-- DO I NEED TO SAY SLAY OR I'M NOT A MILLENNIAL NOW.

THESE KIDS ARE A MYSTERY TO ME.

I WATCHED EUPHORIA AND THAT CREEPED ME OUT.

>> TEENS ARE THERE I OWN UNIVERSE.

SO I THINK ESPECIALLY THE TEENS, THE MORE THAT YOU CAN SORT OF SHOW SOME SORT OF UNDERSTANDING AND NON-JUDGMENTAL SORT OF APPROACH WITH THEM SO EVEN IF YOU DON'T QUITE KNOW WHAT IS GOING ON IN THEIR LIFE, YOU ARE NOT COMING IN WITH ASSUMPTIONS AND JUDGMENTS, YOU ARE OPEN AND GENUINE AND HONEST.

>> RIGHT, BECAUSE TEENS CAN SMELL IT A MILE AWAY IF YOU ARE NOT BEING AUTHENTIC.

SO I THINK THAT'S MOST IMPORTANT, NOT REALLY KNOWING, HAVING TO KNOW ALL THE DIFFERENT NEW FADS OR LANGUAGES.

I HAVE ONE TEEN WHO, SHE LOVED TO JUST EDUCATE ME ON THE DIFFERENT SOCIAL MEDIA AND EMOJIS AND SNAPCHAT.

HAVE YOU HEARD OF THIS OR SHE WOULD DO SOMETHING AND SHE WAS TEXTING AND I WOULD WOULD BE LIKE WHAT IS THAT?

AND SHE WOULD LAUGH AND SAY NEXT TIME I SEE YOU I'M GOING TO PULL UP A VOID YO' AND SHOW YOU.

THAT WAS FUN FOR HER TO SHARE THAT WITH ME.

>> A LITTLE BIT ONE UP ON YOU, RIGHT?

ONE UP ON HER IN LOTS OF WAYS BUT SHE GETS ONE UP... >> I DO THINK OBVIOUSLY IT'S IMPORTANT THAT PEOPLE LIKE KIDS, THAT THEY LIKE TEENS.

I MEAN THAT'S PROBABLY OUR MOST IMPORTANT CRITERIA IN HIRING BECAUSE IT'S NOT EVERYBODY.

SO I AGREE WITH YOU 100%.

IF THEY LIKE KIDS AND ARE HONEST AND READY TO SERVE THEM.

I WILL THOUGH ADD THAT THAT'S WHERE YOUTH PEER ADVOCATEDS ARE SO GREAT.

>> YOUTH... >> YOUTH PEER ADVOCATES.

IMMEDIATELY ADJACENT, YOU KNOW, 21, 22, 23.

THAT HAVE BEEN THROUGH THE SYSTEM SO THERE IS THAT BUT THIER ALSO STILL A KID.

>> SAVVY TO THIS STUFF.

>> AND SO IT'S REALLY IMPORTANT THE KIDS FEEL HEARD IS MOST IMPORTANT PIECE.

>> I THINK JUST, YOU KNOW, TOUCHING ON SELF CARE, FOR ANYONE WHO WORKS IN THE FIELD, MANY PEOPLE COME TO THE FIELD BECAUSE THEY'RE NOTORIOUSLY BAD ABOUT TAKING CARE OF THEMSELVES AND IT FEELS GOOD TO TAKE CARE OF OTHER PEOPLE.

WE ALL HAVE BAGGAGE.

WE ALL COME INTO EVERY ENVIRONMENT WITH THAT BAGGAGE AND IF WE DON'T TAKE CARE OF OURSELVES, ESPECIALLY IF WE ARE JUST GOING INTO SOME REALLY DARK PLACES WITH SOMEONE WE ARE WORKING WITH AND DON'T KNOW HOW TO GET OURSELVES OUT OF THAT DARK PLACE, IT REALLY CAN BE HARMFUL TO THE PERSON WE ARE TRYING TO SERVE AND OURSELVES.

>> AND WE DO FIND MANY OF OUR STAFF HAVE THE SAME KIND OF EXPERIENCES THE KIDS HAVE HAD SO WE HAVE TO BE SUPPORTING OUR WORKFORCE.

>> AND WHAT ABOUT BURNOUT FOR THE WORKFORCE?

ARE THERE THE SUPPORTS OUT THERE FOR THE PEOPLE WHO ARE TRYING TO BE THAT SHOULDER FOR KIDS IN THESE VULNERABLE SITUATIONS.

>> I WOULD SAY WE CAN DO BETTER.

WE TALK ABOUT IT AT HILLSIDE ALL THE TIME HOW TO BETTER SUPPORT OUR STAFF.

THEIR JOBS ARE HARD.

THESE ARE KIDS WITH VERY, VERY SIGNIFICANT NEEDS AND AT TIMES BEHAVIORS AND THEY'RE ABSORBING A LOT OF PAIN, YOU KNOW, ALL DAY LONG.

SO WE DO A LOT INTERNALLY TO SUPPORT OUR WORKFORCE, BUT WE CAN ALWAYS TWO BETTER.

>> I COMPLETELY AGREE.

WELLNESS IS A HUGE FACTOR FOR US.

FOR OUR PROGRAM EVERY WEEK, WE MEET FOR TWO HOURS AND THAT WHOLE ENTIRE TWO HOURS WE ARE MEETING IS REALLY TO SUPPORT EACH OTHER.

WHAT IS YOUR BURNOUT LEVEL.

WHERE ARE YOU?

WHAT DO YOU NEED FROM US?

ON TOP OF THAT EVERY MONTH WE ARE TRYING TO MAKE SURE WE ARE DOING SOMETHING FUN THAT BRINGS US TOGETHER AS A GROUP.

CELEBRATING A BIRTHDAY, CELEBRATING A HOLIDAY BUT WELLNESS IS SUCH A HUGE PART OF THE WORK WE DO FOR EXACTLY THE SAME REASONS YOU ARE SAYING.

YOU ARE OR DEALING WITH THESE FAMILIES AND TEENS THAT ARE EXPERIENCING THESE INCREDIBLY PAINFUL AND SCARY SITUATIONS AND YOU ARE THE PERSON THAT'S THERE TRYING TO HELP THEM.

AND DEFINITELY CAN TAKE A TOLL.

>> YEAH.

>> SO WE HAVE BEEN FOCUSING PRIMARILY ON THE WAY THAT INDIVIDUALS CAN CONNECT WITH OTHER PEOPLE AND TRY TO HELP THEM THROUGH THESE SITUATIONS.

WHAT ABOUT PHARMACEUTICALS?

IS THERE A ROLE THAT THEY SHOULD BE PLAYING THAT THEY'RE NOT?

ARE WE ADEQUATELY TAKING ADVANTAGE OF THE MEDICATION THAT IS OUT THERE?

ARE WE STOO RELIANT ON MEDICATION?

WHAT DO YOU THINK ABOUT THAT ISSUE AND NOT ALL AT ONCE.

TAKE YOUR TURN.

>> MY PHILOSOPHY IS TREATMENT FIRST.

TREATMENT SHOULD BE THE FRONT LINE OF WHAT YOU ARE USING.

>> WHAT DOES THAT MEAN.

>> WORKING WITH SOMEONE INDIVIDUAL THERAPY, FAMILY THERAPY, WHATEVER IT IS BUT IT'S THE PSYCHO THERAPEUTIC PIECE IS ESSENTIAL.

MY WORRY IS ALWAYS PEEP THAT JUST TAKE MEDICATIONS TO DEAL WITH ANXIETY OR DEPRESSION AND THEY'RE NOT REALLY LEARNING, YOU KNOW, HOW TO DEAL WITH WHAT IS HAPPENING IN THEIR LIFE.

THEY'RE JUST RELYING ON THE MEDICATION TO MAKE THEM FEEL LESS ANXIOUS OR LESS DEPRESSED.

I'M VERY TREATMENT FORWARD IN OUR PROGRAM AS WELL.

WE ALWAYS USE-- THE ONLY TIME WE USE MEDICATION IS MORE OF AN, OKAY, WE ARE WORKING WITH SOMEBODY AND THE ANXIETY IS SO INTENSE THAT THEY'RE NOT AVAILABLE FOR THE TREATMENT.

HOW DO WE GIVE THEM SOMETHING TO DECREASE THE ANXIETY TO BE MORE AVAILABLE FOR THE SKILLS AND THE TREATMENT MOVING FORWARD.

>> WE HAVE BEEN HEAR, AND I JUST RECENTLY TALKED TO A FAMILY MEMBER WHO JUST SAID I NEED A PSYCHIATRIST FOR MEDICATION.

SO WE TALKED A LITTLE MORE AND THERE WAS SO MUCH GOING ON AND IN THE YOUNG PERSON'S LIFE.

TO ME THE PERSON WAS ISOLATED, HAD NO FRIENDS, HAD SOME INTELLECTUAL DISABILITIES THAT WERE GETTING IN THE WAY OF MAKING FRIENDS.

I WAS LIKE, HE NEEDS FRIENDS IS WHAT HE NEEDS.

BUT TO GET TO THE FRIENDS, INTO EDS SOME THERAPY.

AND THEN, YES, THERE IS A ROLE FOR MEDICATION.

MEDICATION IS A TOOL.

IN SOME CASES IT'S ABSOLUTELY ESSENTIAL BUT I AGREE 100% IT HAS TO BE IN THE CONTEXT OF ALL THE OTHER WORK AND WE USE A PHRASE YOUTH AND FAMILY DRIVEN CARE, YOUTH LED CARE THAT THE FAMILY AND YOUTH HAVE TO UNDERSTAND THE SITUATION AND UNDERSTAND THE ROLE OF THE MEDICATION AND BE PART OF THE DECISION WITH THEIR DOCTOR IF THEY'RE DISCUSSING MEDICATION.

BUT IT HAS TO BE IN THE CONDECKS OF TREATMENT-- THE CONTEXT OF TREATMENT.

>> YOU ARE SAYING THE LARGER SYSTEM THAT THE CHILD LIVES IN, YOU HAVE TO REALLY LOOK AT THAT LARGER SYSTEM BECAUSE YOU CAN KIND OF SWAMP THE KID WITH MEDICATIONS, WHICH MAY BE APPROPRIATE IN SOME SITUATIONS, AND SAY THE KID IS THE PROBLEM RATHER THAN LOOKING AT THE BIG SYSTEM.

THIS KID HAS NO FAMILY, NO FOOD, NO PARENTS IN THEIR LIFE.

>> HOMELESS.

>> HOMELESS.

WE DIDN'T EVEN TOUCH ON THAT.

AN ENORMOUS NUMBER OF PEOPLE NOW.

>> UNDERSTANDABLE AS NOT A SILVER BULLET IN PART BECAUSE IF YOU WATCH TV, YOU SEE ADVERTISEMENTS FOR THIS.

IF YOU ARE STREAMING TELEVISION, YOU ARE GOING TO BE SEEING THINGS PUSHED AT YOU, SOME ANXIETY DRUG OPPOSED TO NECESSARILY HAVING CONVERSATIONS WITH PEOPLE OR SOME SORT OF LONGER TERM... >> GETTING WELL, STAYING WELL IS WORK FOR ANYBODY.

SO IT IS A LOT EASIER TO TAKE A PILL AND HEAR YOU THINK IT'S GOING MAKE YOU BETTER BUT THAT'S JUSTED NOT THE CASE AND IT'S A LITTLE SCARY, ACTUALLY.

UNDERSTAND WE DO TRY WITH KIDS TO KEEP MEDICATION, LIKE YOU SAID, KEEP MEDICATION AS PART OF THE ANSWER BUT REALLY WITH DISCRETION.

BECAUSE KIDS ARE EVOLVING PEOPLE.

THEY'RE STILL DEVELOPING WHO THEY ARE, YOU KNOW, IS IN PROCESS.

IT HAS TO BE A VERY, VERY CAREFUL PROCESS.

>> AND THEIR BRAINS ARE STILL DEVELOPING.

AND I AGREE, YOU KNOW,THERE ARE A LOT OF COMMERCIALS TO TALK ABOUT HEY USE THIS ANXIETY MEDICATION AND YOUR LIFE WILL BE PERFECT.

I THINK THIS IS WHERE THE EDUCATION PIECE NEEDS TO COME BACK.

WHEN WE ARE WORKING WITH FAMILIES, THEY'RE EDUCATING THEM.

WE ARE GOING HAVE YOU MOO IT WITH OUR PSYCHIATRIC NURSE PRACTITIONER OR PSYCHIATRIC PSYCHIATRIST WHO SO THAT YOU CAN GET AN EVALUATION AND CONSULT AND IF WE THINK MEDICATION WILL BE HELPFUL FOR YOU, WE WILL RECOMMEND IT.

AND IF WE DO NOT THINK MEDICATION WOULD BE HELPFUL WE WILL EXPLAIN TO YOU HOW COME.

AND EVEN IF WE ARE RECOMMENDING MEDICATION, IT IS PART OF THE PACKAGE, IT IS PART OF THE TREATMENT PLAN.

IT IS NOT THE TREATMENT.

>> YOU ARE REALLY THINKING YOU DIAGNOSE THE FAMILY SYSTEM.

YOU DON'T JUST DIAGNOSE THE KID.

>> OF COURSE NOT.

>> JUST THE KID IS NOT THE PROBLEM.

WE ARE TALKING ABOUT THE BIGGER PICTURE.

THEY LIVE IN A WEB.

>> WHICH IS IMPORTANT FOR PEOPLE TO UNDERSTAND ABOUT SERVING CHILDREN.

CHILDREN DON'T COME AS JUST A PERSON, THEY COME WITH THE FAMILY, THE SCHOOL, THE GRANDMOTHER... ACTUALLY WE HAVE A PROGRAM WE ARE IMPLEMENTING HILLSIDE AND OTHER PROVIDERS ACROSS THE STATE WITH THE YOUTH ACT, A COMMUNITY TREATMENT IS AN EVIDENCE-BASED PRACTICE FOR ADULTS AND NOW THE STATE MADE AN INITIATIVE LAST YEAR, ROLLING OUT YOUTH ACT AND WHAT WE ARE FINDING IN VERY ROBUST DIALOGUES AMONGST PROVIDERS AND WITH THE STATE IS, YOUTH ACT CAN'T BE DESIGNED EXACTLY LIKE ADULT ACT BECAUSE YOU ARE WORKING WITH THE WHOLE FAMILY.

IT'S A COMMUNITY-BASED PROGRAM WHERE THE CHILD'S NEEDS ARE AT A LEVEL THAT HISTORICALLY THEY MIGHT HAVE GONE TO RESIDENTIAL BUT WE ARE TRYING TO KEEP THEM IN THE COMMUNITY WITH THE FAMILY.

AND WHAT OUR CLINICIANS AND TEAMS ARE FINDING IS THAT THEY'RE TREATING THE WHOLE FAMILY.

THEY'RE NOT JUST TREATING THE CHILD.

THEY CAN'T GO INTO A HOME AND JUST TREAT THE CHILD.

SO WE ARE ADVOCATING THAT IT HAS TO BE FUNDED AT A MUCH HIGHER LEVEL THAN ADULT AS DO MOST CHILDREN SERVICES.

>> FINALLY, AND WE ARE ALMOST OUT OF TIME, BUT LIZ, AS SOMEONE WHO IS PART OF A STATEWIDE COALITION, WHAT ARE I DON'T ARE REALISTIC EXPECTATIONS IN THE SHORT-TERM AND THE LONG-TERM IN TERMS OF TURNING THIS SITUATION AROUND?

IS THIS SOMETHING THAT WE CAN EXPECT TO SEE SIGNIFICANT CHANGES IN A YEAR OR TWO WITH THE RIGHT INVESTMENTS OR IS THIS SOMETHING WHERE WE NEED TO HAVE MORE REALISTIC OR LOWER EXPECTATIONS, I GUESS, IN TERMS OF HOW FAST WE CAN ADDRESS THESE CONCERNS.

>> THAT'S A GOOD QUESTION.

WE WILL KEEP EXPECTATIONS HIGH BUT WOULD I SAY WE HAVE TO MAKE SIGNIFICANT INVESTMENTS IN THE ENTIRE SYSTEM TO SEE, TO MOVE THE NEEDLE AND IT'S DIRE, YOU KNOW.

EARLIER IN THE CONVERSATION, DAVID SAID WHAT IS GOING TO HAPPEN IF?

IT'S ALREADY HAPPENING.

KIDS AND FAMILIES ARE SUFFERING.

SO WE NEED A VERY SIGNIFICANT INVESTMENT AND LAST YEAR, AS I SAID, THERE WERE SOME REAL GAINS.

THIS GOVERNOR IS CALLING OUT CHILDREN'S BEHAVIORAL HEALTH IN A WAY IT HASN'T BEEN CALLED OUT BEFORE.

BUT WE HAVE TO INVEST TO MAKE THE ENTIRE SYSTEM STRONG AND SUSTAINABLE NOT TO SAY WELL YOU GOT A RATE INCREASE LAST YEAR SO NOT THIS YEAR.

THE RATE HAS TO BE HIGH ENOUGH TO PROVIDE A QUALITY SERVICE.

SO I WOULD SAY I'M OPTIMISTIC BECAUSE THERE IS GOOD DIALOGUE AND GOOD WORK GOING ON BETWEEN THE NOT-FOR-PROFIT SECTOR, AND GOVERNMENT AND IT'S A DIRE SITUATION THAT NEEDS INVESTMENT NOW.

>> AND WHEN WE TALK ABOUT RATES FOR PERSONNEL.

THIS IS NOT NECESSARILY DIRECT SERVICE PROFESSIONALS WHO MAY NOT HAVE LIKE A MEDICAL DEGREE OF ANY MEANINGFUL CONSEQUENCE BUT THIS IS THE WHOLE GAMUT, RIGHT?

>> ABSOLUTELY.

>> ALL SORTS OF TRAINED PERSONNEL.

>> PSYCHIATRISTS, CLINICIANS, TEACHERS, NURSES DIRECT SERVICE PROVIDERS.

>> WE ARE ABOUT TO HEAD OUT BUT AS SOMEONE WHO IS LIVING THIS ON A DAY-TO-DAY BASIS, ARE YOU OPTIMISTIC RIGHT NOW OR DO YOU GO HOME AT THE END OF THE DAY AND REALLY NEED A STIFF DRINK OR MAYBE BOTH?

>> BOTH.

NO, I'M JOKING.

ACTUALLY I'M OPTIMISTIC.

I REALLY THINK THERE HAS BEEN A SHIFT IN AWARENESS TO MENTAL HEALTH PROBLEMS AND I THINK THAT THAT IS CRITICAL YOU KNOW, JUST REFERENCING SOME OF THE THINGS YOU WERE SAYING BEFORE AND PEOPLE WERE JUST LIKE HEY, YOU KNOW, EVERYBODY'S FINE.

NOBODY NEEDS HELP.

WELL, PEOPLE WERE STRUGGLING, YOU KNOW.

>> THE KIDS ARE NOT ALL RIGHT.

>> THE KIDS ARE NOT ALL RIGHT.

EXACTLY.

THERE IS MORE AWARENESS AND THAT IS NICE TO SEE THE SHIFT.

IT'S NICE TO SEE MENTAL HEALTH INTEGRATED INTO THE SCHOOL SYSTEMS.

IT'S WONDERFUL TO HAVE THE PROGRAM WE HAVE AND HAVING PEOPLE THAT ARE TRAINED AND ENTHUSIASTIC AND REALLY WANTING TO WORK WITH THIS POPULATION AND GETTING FAMILIES INVOLVED AND UNDERSTANDING HOW IMPORTANT FAMILIES ARE UNFORTUNATELY THAT'S ALL THE TIME WE HAVE TODAY.

MY THANKS TO CATHY LOVEJOY - OF LAKEVIEW HEALTH SERVICES - ELIZABETH NOLAN - FROM THE HILLSIDE CHILDREN'S CENTER - DR. JESSICA COSTOSA-UMINA - OF UPSTATE MEDICAL UNIVERSITY- AND DR. RICH O'NEILL - YOUR HOST OF WCNY'S CYCLE OF HEALTH.

IF YOU OR A LOVED ONE, YOUNG OR OLD, IS STRUGGLING WITH MENTAL HEALTH, YOU CAN CALL OR TEXT 9-8-8 AT ANY TIME FOR RESOURCES AND SUPPORT.

TO REVISIT THIS EPISODE - OR DIG INTO THE CONNECT NEW YORK ARCHIVES - VISIT W-C-N-Y DOT ORG SLASH CONNECT NEW YORK.

ON BEHALF OF THE ENTIRE TEAM AT WCNY - I'M DAVID LOMBARDO - THANKS FOR WATCHING.