Cost, stigma and time hamper care

For Nhi Huynh, a University of Berkeley freshman, high school was marked by the constant pressure of trying to manage her life in an academically competitive environment. She was taking college level courses and leading several clubs — and in spring of her junior year campuses closed and cut her off from academic and social support.

“I was really burnt out at the end of senior year, and I wasn’t taking care of myself well and my relationships suffered because of it,” Huynh said.

She is typical of thousands of Bay Area high school students who spend 30 hours a week in classes and dozens more on sports and activities outside of the classroom. This challenging load can easily lead to sleep deprivation, illness, depression and anxiety.

The unrelenting expectations and strict work ethic have led to a massive need for teen mental health services. The pandemic heightened these stressors. Additionally, personal factors and barriers keep people from seeking help. For many, these challenges include not being able to afford services and facing cultural and family issues such as stigma and traditions.

Cases of teen anxiety and depression have risen with the pandemic, and school districts like San Jose’s East Side Union High School District are scrambling to offer counseling and other support to students, staff and parents. (Photo illustration by Mya Hammond, Mosaic Journalism Program) 

The nonprofit Mental Health America, which promotes mental health awareness, documented more than 88,400 cases of depression and anxiety nationally over what would have been expected from January to end of May 2020, as the COVID-19 pandemic was beginning.

Its survey reported that rates of both anxiety and depression nearly quadrupled..

Those figures do not surprise local mental health experts, like Shashank Joshi, a doctor and Stanford professor of psychiatry, pediatrics in education, said that 20% of youth will experience depression “that will really take them out of the things they enjoy doing in their life.”

High school counselors have taken notice. Before students returned to campuses of San Jose’s East Side Union High School District, “the district realized that coming back from COVID not only students but also teachers and parents would need some mental and emotional support,” said Donnise Powell, mental health and wellness specialist at Silver Creek High School.

The state is working with school districts to respond to the statistics. In particular, East Side hired many case workers and mental health and wellness specialists. State legislation requires school districts to come up with protocols on handling student mental health.

Santa Clara County’s School Linked Services Initiative also connects students and their families throughout the county with services at their schools, including mental health counseling.

However, students are often not reaching out to take advantage of these resources.

“We can have services available for young people, but they may not access them for different reasons,” says Stanford’s Joshi. “There may be stigma, there may be shame if they live in a community or come from a family where mental health is not talked about.”

Even if a teenager overcomes the cultural or community stigmas, they may face economic barriers.

Therapy and counseling are costly.

Even at U.C. Berkeley, where they connect students to therapists, not all can afford it. “You have to pay for them, and because I am low income, I can’t be doing that right now,” Huynh said.

“I also struggle with ‘do I need it?’ and I think everyone should try it out, but I think mentality can be a barrier. And if you are a minor, it could be hard to bring up to your parents.

“I am Vietnamese and mental health is not really talked about. So there is this social stigma and I do think it is getting better, but it does depend on the communities you are a part of.”

On high school campuses, “It’s nice to have guidance counselors who have the bandwidth to be able to meet with you about social and emotional aspects or struggles of your life before you’re having a crisis of depression or anxiety,” Joshi said.

“School mental health is one way that we can buffer the real challenge that we have in our society of not enough therapists, not enough psychiatrists, and not enough doctors to go round.”

Mental health: Bay Area teens grapple with cost, stigma and time

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