The time is now to invest in the mental health system
OpinionGuest columnist

The time is now to invest in the mental health system

What can be more Pittsburgh than having people showing up for each other with kindness?

Photo by dragana991/
Photo by dragana991/

The pandemic compounded the deepening youth mental health crisis.

Almost half of parents said their teen experienced a new or worsening mental health condition during the pandemic, and ERs have seen an increase of 31% in teen mental health visits. These statistics indicate an overburdened system in need of rethinking. Many young people are desperate and struggling to find support.

Through my work with the PA Youth Advocacy Network, I interact with young people across the commonwealth and hear their ideas about how to address this crisis. They express the need for more resources to build resilience, develop skills for coping with stress and trauma, and know how to seek help before a crisis. The creation of more accessible, preventative services will help to normalize seeking support and to address mental health stigma.

But despite the pandemic worsening mental health, we have seen great innovations and a bipartisan cross-system focus on beginning to tackle some of the most pressing mental health challenges youth face.

The Pennsylvania governor’s budget has proposed an investment of $100 million for school-based mental health services. It will be important to make these funds flexible to allow schools to innovate, address students’ needs, and connect with community-based organizations to offer social emotional skill-building and health education.

The priorities youth have shared include peer support and student-led initiatives, increased access to mental health professionals, safe and supportive schools and the education about mental health in schools. Other states have invested significantly toward these goals, including New York’s investments to realize mental health education and Ohio’s
$675 million investment over two years to double school-based mental health services.

With the launch of the national 988 Suicide Prevention and Crisis lifeline to handle mental health calls, it’s important to build out the crisis continuum in the community. This includes preventive services, crisis stabilization centers, and mobile response teams. The governor’s budget calls for one-time funding for initial build-out of 988, developing a sustainable funding mechanism, and increases for county-run mental health services.

Teens have also shared that clinical spaces can feel overwhelming. That is why models like Headspace in Australia and The Living Room have proven effective to address mental health in the community outside the traditional hospital setting.

Initiatives like Friendship Circle’s The Beacon and UpStreet have been designed from these successful models and built to meet the unique needs in our community. The Beacon will offer a wellness space for teens to address mental health through programming and skill-building strategies to help well before a crisis. UpStreet provides free mental health support for teens in an accessible format.

One major challenge of building out the crisis continuum is the behavioral health workforce shortage. There are initiatives underway in the region to support the workforce, including the new BH Fellows program, which seeks to support frontline staff employed by Medicaid eligible providers. To build up the workforce, we will also need to develop career pathways and look at reimbursement and parity in insurance.

The need for mental health services is greater than our current behavioral health system can support. This leads us to evaluate different models to encourage workforce development and expansion. One model is community-initiated care, which seeks to

train the public in low-level mental health interventions and develop connections to higher levels of care when needed. Other countries have successfully implemented this model.

With funding from the Jewish Healthcare Foundation, the Teen Mental Health Collaborative formed during the pandemic to facilitate opportunities for youth-serving organizations to share their approaches to providing emotional supports for teens. Since the initial grant phase, the Collaborative’s training and convenings are aligned to promote approaches for community-initiated care.

The work of the collaborative organizations leads to better health outcomes for youth. We are advocating for these organizations to be considered as part of the health system. Their services are saving insurers money by addressing the social determinants of health and should be eligible to be reimbursed. Although there has been some progress in this arena, larger system change efforts are required.

Dr. Vivek Murthy, the surgeon general, released an advisory on youth mental health, calling for a multisystem effort to address teen mental health. He shared in a recent post, “This is our time to recommit building a world, where everyone can get the care they need, where no one feels ashamed to talk about mental health and where we address the root causes of this crisis.”

What can be more Pittsburgh than having people showing up for each other with kindness? This gives me great hope that investments in community support for mental health can flourish here. We have already begun cross-system collaborations and innovations. With an increased focus on teen mental health and with teens by our side as partners, we have the potential to reimagine and transform behavioral health supports. PJC

Sarah Pesi is a policy associate at the Jewish Healthcare Foundation. Learn more at

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