The mental health challenges New York City youth face post-COVID-19

According to the Center for Disease Control’s’s recent Youth Risk Behavior Survey, U.S. teens are experiencing the highest rate of mental illness, with marked declines since the pandemic. 

The report notes the longstanding impact of social isolation, leading to higher levels of depression and social anxiety among U.S. teens, most notably among females. To combat this worrying trend, specialists are looking to address mental health needs within families, school systems and integrative models to identify youth mental health needs across New York City. 

Traci Donnelly, CEO of The Child Center of New York, stressed the steady decline of childhood and youth mental health since pre-pandemic levels. 

“In reading the CDC report, [mental health] has always been declining since 2010 at a continuous rate, and it continued to grow during the pandemic. [Mental health] access during the pandemic was not available to a lot of folks, so we shifted to telehealth really quickly. But I think what we're seeing now is that [mental health] has been disproportionate for female teens. That’s what I think is alarming.” 

Donnelly quoted factors such as missed milestones leading to declining levels and the  impact of social media on young women: 

“We've been seeing a real increase in eating disorders for teens as well. And we actually created a program which is funded through SAMHSA –  an intensive outpatient program for teens and we operate after school, where they can come in and relate to their teams before they go into therapy.” 

Donnelly stressed the efficacy of group settings when approaching youth mental health, informally or within school systems to demonstrate the normalcy of mental illness. Cultural proximity remains key to positive mental health outcomes by employing staff who are knowledgeable of specific cultural biases and struggles faced by communities of color. 

“It’s tremendously important. I mean, we're not just hiring people who speak a language. We provide services in 26 languages at any given time, but we're rarely recruiting just because you speak the language. We want to know that folks are in the same communities, shopping in the same supermarkets, attending the same faith base places, understanding what that assimilation is like and also what are the cultural differences.” 

Additionally, recruiting staff who understand the intricacies of intergenerational family structures help ease stigmas in both children and families around mental health services. By integrating families within the mental health treatment process of children and teens, Donnelly observed less resistance with treatment extending beyond youth to inter-spousal issues. 

Janine Domingues, clinical psychologist at the Child Mind Institute and senior director of school and community programs for professional training, echoed the importance of family participation within youth mental health. 

“We always talk about mental health as, ‘you're as happy as your unhappiest child’. I see family, certainly as a system. It's almost like everybody's like riding a bike together. So if one person is not riding in tandem, you see the effects. Parents and caregivers are also doing their best with the tools they have, but also trying to take care of themselves. We always incorporate family within our treatment planning, but also as part of our mission in providing education to the public.” 

Domingues noted the reinforcement of mental health avenues within schools, such as equipping educators and staff with specialized training to better allocate resources to students in need within existing school frameworks. 

“Our primary focus has been how we can empower schools to provide resilience building and coping skills and also recognize symptoms in their students so they can triage and get students care that is needed both within the school and also within the community.” 

Working with schools help educators and families utilize existing resources to identify early warning signs and increase access to aid: 

“Our mission in school and community programs is working with high need communities, and being able to see schools as a point of access. Oftentimes, students usually get their first point of contact around mental health in schools. [We need] programs that continue to boost at all different levels, such as mental health infused education and training— that doesn't need to just be psychologists, psychiatrists or social workers, but potentially how to infuse some of that education with teachers and other professionals. It’s about thinking creatively about getting mental health infused in different areas [of the education system],” said Domingues. 

Stephanie Cadet, director of clinical services at The Door, encouraged the growth of flexible, non-traditional safe spaces in approaching youth mental health needs. 

“We have found that young people can always identify their needs in the moment when they come to a place that feels safer where their friends occupy.” 

By providing integrated services through flexible safe spaces that remain attentive to young people’s needs, Cadet stresses that these alternatives to traditional mental health services are less forceful and better aligned with youth. 

“The mental health that exists outside the Counseling Center is ready in real time at any moment, to meet a young person where they're at to start the process. Because of the flexibility we have, we have staff that are available and can be around to process without having to formally sign up for counseling,” said Cadet. 

As youth cope with the long-lasting effects of trauma from the pandemic, with youth homelessness and drug use on a steep rise, many are facing highly unstable and unsafe situations— leading some female teens to experience higher levels of sexual violence.  

“I think particularly or at least how I see it show up in the young people that I've engaged with, [female teens] engage in sex work, to be able to have places to stay. So I don't think it's just necessarily within the school system. I think young women and Fems across the city have to find spaces for themselves and sometimes the way to access that is putting yourself in an unsafe situation,” said Cadet. 

In reaching out to meet youth’s mental health needs, specialists point to necessary changes in the rhetoric used to address young people. 

“First of all, youth have been criminalized over the past. The importance of having spaces is that young people aren't immune to what's going on throughout the world. I think we often paint them as aloof to those things, and not being affected by that. Primarily, we need to listen to what young people are asking for and what they need, and create spaces of belonging without criminalizing young people for being young people,” said Cadet. 

While specialists gather to aid struggling youth, the needs of mental health professionals can’t be neglected. 

“Our people are some of the most underpaid people in the city doing emergency response work. And we're constantly fighting year over year for them to get significant increases and to get increases that are like two and 3%, when inflation is 8.5% is a slap in the face for people that never went home during COVID,” said Donnelly. 

From the added effort of increasing mental health support within families, schools and creating integrative spaces – nonprofit youth specialists are urging city officials to increase necessary funding to ease the burden on this strained workforce.