Alarm bells
Our investigation flagged a number of worrying trends that have plagued youth across the country for years. Perhaps the most alarming: Suicide rates for youth and young adults between the ages 10 to 24 increased 52.2% between 2000 and 2021. Suicide is now the second-leading cause of death for this age group.
Our region, in particular, faced unique challenges that exacerbated the national trend.
Student mental health started to trend downward in 2016, coinciding with the opioid epidemic. Then, in 2019, tornadoes destroyed hundreds of homes in northern Montgomery County, devastating hundreds of families and disrupting the fabric of the local community. Nine people were killed in a mass shooting in the Oregon District that same year.
Our region barely had a chance to catch its breath before the 2020 COVID-19 pandemic shut down schools and workplaces across the country.
Too much screen time
The pandemic introduced a host of unprecedented challenges for youth and educators. Virtual learning meant more time in front of screens at a time when cellphones, tablets and other technology were already becoming more and more common in households.
Our reporting looked at the effects of social media on the brain and the dangers it can pose to developing minds.
“When people get ‘likes,’ or even the notifications for ‘likes’ on their phone, your brain does release dopamine...It’s a reward chemical, so it makes you feel happy. It makes you feel satisfied,” Dr. Fadi Tayim, division chief of Premier Health’s Brain Mapping Center at the Clinical Neuroscience Institute, said.
“That drive is very similar to the foundations of those developing a habit or an addiction,” he said.
The dangers of that addiction and its effects on a teenager’s self-esteem were evident in a recent contributed column from Samya Camp, a junior at Meadowdale Career Technology Center.
“Having to see someone so perfect online and then not being able to love what you see in the mirror can have a great impact on someone’s mental state, especially in school,” she wrote.
Access to care
Of the problems faced locally, the time and effort it took to get a first appointment with a provider after they first noticed there was a problem with their child was often the most challenging.
In talking to local parents, our reporters found that getting their child in front of the right health care provider proved to be a lengthy, arduous process, often worsened by poor community conditions.
The experiences of Dayton resident Raya Anderson and her son, Amir or Oakwood junior Kay Handler have shown that it can take up to a year or more to finally get an appointment with a care provider.
Nearly 123 million Americans live in areas deemed to be a mental health professional shortage area, according to the Health Resources and Services Administration (HRSA), a federal agency that falls under the U.S. Department of Health and Human Services. In Ohio, about 4.8 million people live in an area with a shortage of mental health professionals with about 30.4% of the need being met.
Inequality
Community member focus groups conducted by the Health Policy Institute of Ohio in 2023 highlighted challenges with addressing mental health issues in disadvantaged communities that include lack of access to basic needs such as housing and well-paying jobs, unsafe living conditions and lack of transportation to follow-up appointments and other services.
Economic disadvantage varies widely from one local school district to the next, the assessment says, from a low of 2.1% in Oakwood schools to a high of 99.9% in Trotwood-Madison and Northridge. In Dayton schools, 93.1% of students were economically disadvantaged in 2021-2022.
Dayton, Trotwood-Madison, Jefferson, Northridge and Mad River schools have the highest percentages of students who are economically disadvantaged and chronically absent. Students in these districts may need extra support to succeed and be healthy, according to the assessment.
Legislative action
New laws have passed ranging from how often kids access phones in schools to funding for a new mental health facility in the Dayton region. However, at least one of the laws that passed earlier this year requires that social media companies get consent from parents for kids under 16 to use their services is still tied up in courts, according to the Ohio Attorney General’s Office.
This editorial board supports two bills from area legislators still pending in lame duck Ohio legislative session that could impact kids’ mental health. Both the bills are still in committee and the session ends at the end of December.
H.B. 7 includes a number of provisions aimed at supporting Ohio’s youth, even before birth. The bill is called the Strong Foundations Act. State Rep. Andrea White (R-Kettering) is one of the primary sponsors for the bill. For mental health providers, H.B. 7 would allow use of age-appropriate Medicaid codes. It would also appropriate $5 million in fiscal year 2024 and $3 million in fiscal year 2025 to support stable housing initiatives for pregnant mothers and to improve maternal and infant health outcomes.
H.B. 7 also requires the Ohio Department of Health to determine if changes could be made to the Special Supplemental Nutrition Program for Women, Infants and Children (WIC) enrollment and benefit distribution processes. The bill would appropriate $2 million in both fiscal years 2024 and 2025 to support these efforts of modernizing Ohio’s WIC system, which mothers currently have to go in-person to apply for. H.B. 7 has passed the House and is currently in the Ohio Senate Finance Committee.
State Rep. Willis Blackshear (D-Dayton) introduced H.B. 38 in April 2023 in the Primary and Secondary Education House Committee. It would authorize school districts to allow students in grades K-12 to take up to three mental health days as excused absences from school. The excused mental health absences would not count against truancy regulations already in place, but the bill would allow school districts to maintain local control if there were districts that did not want to implement this measure.
What parents can do
Ann Marie Scalero, Kettering Schools Program Manager for South Community Behavioral Health, said that seeing kids struggle can be hard for parents, which leads to anxiety and stress. There can be financial struggles with a kid needing more medical attention, and parents might have trouble focusing at work since they’re worried about their child.
As a parent or guardian, it’s important to start with taking care of yourself. Practice self-care and develop your own coping strategies to protect your mental health and to model behavior for your children..
Prevention can also help parents connect with their children before a mental issue develops or worsens.
When children reach out to their parents for help with their mental health, experts say listening is key.
“A lot of times parents go into problem solving mode to try and help, but have not really listened to/heard the child,” said Dr. Kelley Blankenship, the division chief of psychiatry at Dayton Children’s Hospital.
“Prevention is so important in making sure parents are talking to their kids,” Blankenship said, directing parents to Dayton Children’s On Our Sleeves program, which offers free access to supportive materials to open dialogue and boost mental health.
Firm limits on screen time and access to technology are key. Previously, the American Academy of Pediatrics suggested limits in hours, but the organization now simply suggests limiting screen time as much as possible, especially for younger kids. Now, the recommendations include screen time with educational programming, and most of all, guardians closely monitoring what kids are doing on screens.
Making progress
Just as there is no single cause for the mental health crisis, there is no “silver bullet,” no single legislative proposal, community effort, company or initiative that will solve it.
But that shouldn’t stop us from attacking the crisis from as many angles as possible.
Continuing to reduce the social stigma around mental health is important. In our interview with Greenville High School senior Charlie Pope, she said that medication was part of the help she needed in order to manage her depression, but to get to the point where she could ask for help, she needed to overcome the stigma around mental health.
“If you have a broken arm, you’re not going to question if like, ‘Oh, Sammy doesn’t have a cast on his perfectly good arm, so I’m terrible for having to have a cast on my arm.’ It’s because you have different needs, and your arm’s broken,” Charlie said.
Throughout our investigation, it became increasingly clear that kids’ access to social media and screen time, if not carefully monitored and controlled, can lead to developmental issues, issues with self esteem and other mental health concerns. Further research on this topic will help guide better policy for our children.
We heard time and time again how difficult it was for those in our area to get an appointment with a health care provider. It is inexcusable for a parent to have to wait a year or longer to get the help their suffering child needs. This is a critical workforce issue that will require creative solutions from our higher education institutions, healthcare organizations and many others to address.
As with many other social ills, mental health issues are made worse when combined with poverty. And the City of Dayton has one of the highest poverty rates in the country.
Brittany Boulton, vice president of Groundwork Ohio, said that young children are especially susceptible to influences from caregivers and environmental factors. Adverse childhood experiences or forms of childhood trauma like poverty, neglect and abuse can disrupt their development from a young age.
“Research shows that early prevention efforts such as quality childcare and home visiting programs can yield really high returns because they improve educational outcomes, they reduce behavioral issues and avoid more expensive crisis interventions later on in life,” Boulton said.
If poor mental health isn’t addressed early on, it can affect a child’s performance in school and into adulthood.
“Child mental health issues tend to continue into adulthood, which has implications in terms of employment and how well the person can function,” said Becky Carroll, director of policy research and analysis at the Health Policy Institute of Ohio.
To be continued
As overwhelming as the youth mental health crisis might feel, it’s just one component of a larger mental health discussion that our region is failing to effectively address.
In one of our other recent investigations, we found that more than a third of group homes where kids from across Ohio are sent by the state because of delinquency or they are victims of abuse or neglect are now located in Montgomery County, putting a strain on local courts and emergency services and raising concerns about the health and safety of children housed there.
We published an editorial earlier this year that discussed the broken “pink slip” process, which rarely leads to commitment. Police routinely pink-slip people they believe to be a danger to themselves or others — under the impression those people will be committed and forced into treatment — but 96% of the time those people are released without mandated treatment.
And instead of reinforcing the mental health services our county requires, mental and behavioral health agencies and other support services in Montgomery County are facing budget shortfalls and cutting services.
But we can’t afford to lose hope. There’s too much at stake with future generations looking to us — their elected leaders, their teachers, their media, their parents — for help and guidance.
Wyatt Kayler, a sophomore at Dixie High School in New Lebanon who struggled with depression, wrote: “Get help and reach out so you don’t have to be alone.”
In the fight for better mental health, none of us in this community are alone. With a clearer understanding of the challenges ahead, everyone in our region can work towards a more hopeful future — together.
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