Children & Youth Behavioral Health Initiative (CYBHI)

Children and Youth Behavioral Health Initiative — Transcript

Introduction — Dr. Sohil Sud

Hello, I’m Doctor Sohil Sud. It is my honor to lead the Children and Youth Behavioral Health Initiative, California’s comprehensive and coordinated effort to ensure that our children have the resources and support they deserve to be at their best.

As a pediatrician, I’ve seen what happens when we fail our kids. I’ve cared for youth struggling with anxiety, self-esteem, and addiction. I’ve seen firsthand why we cannot let these issues fester to the point of serious injury and self-harm. But I’ve also witnessed just how resilient youth can be if we listen to them, build the system of care that addresses what they’re asking for, and provide the help they and their families want in the way they want it. When we do that well and meet our kids where they are, we support our youth through tough times and set them up to succeed and to thrive.

California’s Children and Youth Behavioral Health Initiative, the largest of its kind in the world, exists for that very purpose: to ensure that California’s kids know that they are not alone and that the support they deserve is ready and available. The initiative provides more and better professional resources, more access to these services, more coverage of these services, more equity built into the provision of these services. But also you, me, we — we are all a part of this wellness transformation.

So whether you’re a dad like me, a teacher, an uncle, an aunt, a grandparent, a friend, I ask you to support our children and our youth. Check in on them. In this day and age, kids have complicated lives. Even if you think someone in your life is okay, consider talking with them and letting them know their resources are available if they ever feel isolated, anxious, lonely, or down. Share your struggles. Acknowledge that life isn’t always perfect or easy. Together, we can reduce the stigma around mental health and elevate the importance of caring for ourselves and one another.

The following video is intended to explain the Children and Youth Behavioral Health Initiative, help you understand some of its critical elements, and inform you of how you can make a difference. Thank you. And be well.

The Case for Transformative Work

We know that children and youth are struggling with their mental health every day. And yet we also know that just doing more of what we’ve always done, because they’ve told us, is not enough. It’s not good enough. And so we have to do transformative work.

I do think it’s so important to start just being grounded in what we know the data is, because that data, of course, is representative of the stories of millions of children and youth in California and across the nation, and even globally, who are struggling with mental and behavioral health issues. And certainly what we see in California is that there have been trends for over a decade now of worsening mental and behavioral health for children and youth. Certainly the public health emergency and the COVID-19 pandemic exacerbated those problems. But really it’s very paramount.

And in California specifically, about 284,000 young people are dealing with depression. 66% of those kids with depression in California do not get the help that they need when they need it. And the suicide rate for young children, even as young as 10 to 18, has increased over 20% from 2019 to 2020 — so really a significant increase. We know we have to really tackle these issues.

We have increasing numbers of youth in schools telling us that they are struggling with chronic sadness and anxiety, and that that is affecting their ability to carry out their daily lives. And we know that these issues can affect all children and youth, and they do — of all identities, of all backgrounds. But we also know that there are some groups that are disproportionately impacted: our youth of color, our BIPOC youth, our LGBTQ+ youth, our youth from low-income and underserved communities.

Reimagining How Kids Get Care

I think what we’re doing with the Children and Youth Behavioral Health Initiative is really trying to put some systems into place that will reimagine how kids get care by bringing services and supports to more non-traditional spaces. So really, we talked about in the behavioral health system meeting people where they are — and meeting kids where they are means meeting them in the digital space, meeting them in schools, and making services available pretty much at any time of day when they need to reach out.

The work of the Children and Youth Behavioral Health Initiative is so incredibly important to improving the well-being of our kids and to their thriving. If we focus on our children and youth and support them in their well-being early, we can make a difference for their entire life.

This work is personal to me. Both of my kids, who are now in their young adulthood, have had their own struggles with mental health challenges, and it’s been a challenge to navigate the behavioral health delivery system. And so it really helps to drive me to make spaces available for kids who don’t have access to care, whose parents may not be knowledgeable or supportive — to make services available to kids where they are, so they can get access to the critical help that they need when they need it, and so that they don’t have to continue to suffer in silence without getting support from trusted adults in their life. And so that is what grounds us in really taking on this work, which is really a holistic, transformational approach to improving mental health and well-being of California’s children.

A Multi-Sector, Whole-Child Approach

The approach is meant to be a multi-sector, multi-year, and multi-billion-dollar transformation that really addresses this coordinated — we have to address the whole child, which means it’s an integrated approach.

So it includes the Children and Youth Behavioral Health Initiative. It includes work in K-12 education to improve how we deliver education services through the Community Schools model. It looks at how we deliver healthcare generally and the improvements we’re making to California’s Medicaid program. It also addresses the issues of workforce and says we have to make sure we have the right workforce in place that we need. And we have had youth absolutely tell us they want a workforce that looks like them, speaks their language, comes from their community, and understands their experience. And so not only building a larger behavioral health workforce, but a more diverse, representative workforce, is critical.

So all of those are these multi-pronged strategies that are a part of the Governor’s Master Plan for Kids’ Mental Health. And then at the core of that is the Children and Youth Behavioral Health Initiative.

We have the opportunity frequently to lead on behalf of the nation by doing things first that other states haven’t done, or thinking about how to transform our healthcare delivery system in ways that even the federal government hasn’t yet contemplated. So it takes really close working relationships with the Centers for Medicare and Medicaid Services and with other states as we learn about how to do this work.

Equity at the Center

We have made equity central to our approach in the Children and Youth Behavioral Health Initiative. That means in the way we are engaging youth, the way we are using data, and the way we are approaching changing our systems to be explicitly focused on reducing inequities by particularly focusing on those groups that we know are the most underserved. And this also includes working with communities to hear what they have to say and help shape our work, and in the evaluation of the Children and Youth Behavioral Health Initiative. It really has to be a choice that you make on a daily basis: to keep equity at the center of the work, to keep youth at the center of the work, and to keep driving towards those equitable outcomes.

Listening to Young People

It also takes listening to young people. We’ve had the opportunity to listen to over 300 youth across the state of California, from diverse communities, share their stories with us and advise us on bringing digital services and supports to California’s youth — how that should look and feel and work and function.

And what they want is safe communities where they can learn from each other and lift each other up. They’re very aware of some of the negative impacts of social media, but kids live in their phone. And really, part of what we’re doing with the Children and Youth Behavioral Health Initiative is to create safe spaces for young people on their phone, with app-based care, coaching, and peer communities where they can come together and do exactly what they’ve told us they want: to share their stories with other youth, to connect with near-peers who are trained professionals, and to get the support that they need.

Looking Ahead

And that takes time. But that is what gives me hope, and that’s what I see happening in the next 5 to 10 years — that we will have made significant progress in creating this more integrated, youth-centered, equitable, prevention- and well-being-oriented system that really meets the needs of our children and youth and supports their well-being. And so that’s what I see happening. And what is exciting is almost every day I hear from our partners that they see that starting to happen.

I’m so proud to be working on this initiative, and as a parent, it’s really comforting to know that California is so invested in making children well and healthy and safe, investing in social and emotional learning and support, and that we’re really thinking about the whole child. It’s about bringing the community together to serve a whole child and their family.