Concern about the mental health of our students has been increasing over the years, especially with the rise of COVID. But where did it start? And what's being done to address it?

Today on the Heinemann Podcast we are joined by Executive Director of NAMI New Hampshire Susan Stearns to discuss the response to rising concern surrounding student mental health.

If you or someone you know is experiencing mental health struggles, visit nami.org for support.

Below is a transcript of this episode.

Steph: All right. So welcome, everyone, back to The Heinemann Podcast. We're happy to be back for another season tackling the most important topics in education. Today we are talking about the rising concern surrounding mental health in our schools, what's causing it, and what's being done to address it. Joining us in conversation is Susan Stearns of the New Hampshire chapter of The National Alliance on Mental Illness, or NAMI. Susan, welcome to the show.

Susan: Thank you. I'm really pleased to be with you today.

Steph: We're so happy to have you. I'd love to start with just hearing a little bit you, your role at NAMI NH. And for folks who are listening who aren't familiar, what does NAMI do as an organization, both nationally and then locally?

Susan: I am the executive director. I've been in this role as executive director since January. Prior to that, I served as the organization's deputy director. And I've been employed here for the last nine years. But I am someone who's been part of NAMI New Hampshire for two decades now, and that's because I have loved ones living with mental illness, and I've lost loved ones to suicide, so it's work that's very near and dear to me. NAMI New Hampshire is a grassroots organization working improve the lives of all people affected by mental illness and suicide through support, education, and advocacy.

Last year we served 40,000 folks, only made possible because of our tremendous cadre of committed volunteers throughout the state, over 200 over them, who provide a host of volunteer led support groups, education programs, many of which are indeed NAMI national signature programs, such as Family to Family, which is a life changing eight week program for families who have an adult loved one living with a mental illness. I've taken it myself and it truly changed how I interacted with my loved one and helped improve our relationship, as well as helped me better navigate the system and help them navigate the system. That is a NAMI national signature program and we're so proud to be able to offer that here in New Hampshire.

Similarly, we offer NAMI Basics, which is a similar program provided for parents and caregivers of kiddos experiencing significant mental health challenges. We also have a program called Peer to Peer, again through NAMI National, we're able to offer this signature program. And that is individuals themselves, adults living with mental illness, trained to teach this education program to their peers.

We have support groups for folks who have an adult loved one living with mental illness, support groups for parents and caregivers of kiddos with mental health challenges, support groups for adults, peers, living with mental illness. We also have support groups for survivors of suicide loss. Virtually all of those are available remotely using Zoom, which has increased access for some folks who would not otherwise have been able to get to them. So those are just a sampling of some of our programs, and we're so grateful to be able to offer those here in New Hampshire.

I think folks may have seen recently the roll out nationwide of the 988 mental health crisis line, great resource. Here in New Hampshire, we were really ahead of the curve. In January of this year, on January 1st, the state of New Hampshire implemented the New Hampshire Rapid Response Access Point. And that's a different number from 988.

They can also determine if perhaps you need a crisis stabilization appointment at your community mental health center in the next day or two, and certainly make the determination if you or your loved one should go to the emergency department. So it's not to rule that out, but there are options.

Steph: Just out of curiosity, who is involved in the crisis teams? Are those social workers

Susan: Every community mental health center, we have 10 in the state, they're regional, has a mobile crisis team. And they're typically made up of masters level clinicians, some bachelor's level clinicians, usually a peer support specialist, so someone who has lived an experience going through this, receiving mental health services here in New Hampshire. Typically, a team of two will come out to your location if mobile crisis is determined to be the correct response. I have heard fabulous things about folks. They will call you to make sure they're at the right place, so they don't knock on your neighbor's door and say, "Hey, Stephanie, it's the mobile crisis team. Oh, it's not Stephanie."

So they're a wonderful resource, and then the Rapid Response Access Point, when you call, is staffed by different folks, who that's all they do is respond to those calls. They'll do the assessment, and they can offer, if it's appropriate, the mobile crisis team to come to you.
For your educators too, I have heard that in some cases, they can deploy mobile crisis to a school, so it's a great resource for schools to call. And I always say, "It's a resource, even if you're not sure what you need, that you can contact them."

Steph: So can you talk to me a little bit about what mental health concerns you see coming to the forefront, specifically in our schools?

Susan: So I want to preface this with, we hear a lot about that America's youth are facing a mental health crisis. We've seen reports from The American Psychiatric Association a year ago, the US surgeon General, just to name a couple, who called attention to this. But it's important to realize pre COVID, our youth were facing a mental health crisis. It's only been exacerbated. Our system was already strained, somewhat fragile in some places. And COVID has made that worse. We definitely are seeing an increase of folks reaching out trying to get resources for their child. We hear from educators all the time. And I'm using educators broadly. We hear from coaches, for example, athletic coaches. We hear from obviously guidance counselors, teachers, parents, the whole gamut, because everyone has recognized the impact this has had on our youth.

And it has varied. You may have some children who really thrived going to school remotely, and even within the same household, then others who struggled with that isolation. And we know that kids have lost some ground because of the two years of interrupted schooling, or erratic schooling, perhaps is a better ... And that's been a challenge. We are seeing increased reports, particularly of young girls, who increased self harm, self injury. We're seeing increased suicidal ideation, especially amongst our youth of color, young Black males. But we are seeing that across the gamut.

We do here at NAMI New Hampshire have our Connect Suicide Prevention program, which is something that we ... So that is a NAMI New Hampshire homegrown program. It is a nationally recognized best practice for suicide prevention, and we have used it for a number of years with a lot of our partners here in New Hampshire, and actually throughout the country, and some cases, internationally. We also have through that program our Connect Youth Leader program, which actually, with school personnel, and it could be a teacher, a dean, a guidance counselor, whoever, as a leader, we're able to come in, train youth leaders, who then are able to spread those messages, safe messaging around suicide prevention in the school.

And truly, the work that they're doing is life changing and life saving. And they're doing it as peers. It really is remarkable. They talk about how the cafeteria personnel, they train them and outreach them. And those personnel even will say, "Thank you. We hear you in the line, and the things you're saying to each other. And we don't know how to respond."
So our Connect Suicide Prevention program is something that we are able to offer to schools. That is what we call a socio ecological model, meaning that it really is based on the community. So in this case, it would be the school communities trained. So yes, you would be training your custodial staff, your lunch staff, your bus drivers, so those folks who everyone interacts with kids, and they're really important to the safety net that we have for our kids. Everyone who is part of their lives, and that's everyone in that school.

Steph: The socio ecological model you mentioned really struck me. Something I've noticed over the course of my own life is a real shift in the conversation around mental health and mental illness as a private thing, something that's at home, to a much more public conversation. And I was struck when you mentioned that it's not just teachers who are interacting with students and picking up on some concerning things, or noticing behavior. That is also coaches and cafeteria staff, as you mentioned. Is this part of why school has become such a focal point for mental health when we're thinking about our students? I mean, they're spending so much time there around so many different types of people.

Susan: Absolutely. The reality is, during the school year, in some households, probably school staff have eyes on their kids more than the parents. And just because parents get home, they make dinner, they do all those things that you have to do. I was a single mom and I know. I strove to be in touch with my children as much as I could, but the schools were incredibly important partners. And they see things that we parents don't see. There's really some interesting recent research indicating that educators are actually even more concerned about adolescents' mental health than their parents are. And I think, this is my thought, that is because they see them so much more and see them in these different settings. And so they have an opportunity to catch some of these things that perhaps parents don't see.

Interestingly, the same report found that more educators reported a child coming to them with a mental health concern than parents did. There's a lot of research that shows that trusted adult outside the family is often the linchpin for a child's mental health and provides that important safety net, or soft place to land, or a place, our LGBTQIA plus kids, a place to test that with before they may have that conversation at home. Educators report more often than parents that those issues around sexuality and gender identity are much greater impact for kids' mental health than parents see. And I think part of that is because often, teachers have provided that place that you can test it out before and see. How will this go? And for some kiddos, we know home may never be the place that they can have that conversation. And having someone who can affirm who you are, especially if you're in a household where that's not safe, that is life saving.

Educators are critical to our kiddos. There's no question. And I realize it puts a tremendous burden on them. And it puts a tremendous burden on them as we've all gone through this. The pandemic has been a collective trauma for all of us. But it also has to remind us that our educators, they've gone through the same collective trauma. They are also having to do, take care of themselves, their loved ones, and yet, they're still in that role because they've always been our helpers, especially with our kids. Right? There's no question it's tremendously difficult.

Getting back to where you first started with this, the openness that we're seeing though, and this has definitely been changing, we've seen this here at NAMI New Hampshire throughout the pandemic. More and more people who have never before sought mental healthcare for themselves or their children are reaching out to us. They're presenting at our mental health practices throughout the state, or sometimes even in emergency departments, folks who say, "I've never had to seek this kind of care before." But they're talking about it. It is a much more normalized conversation, and I think part of that is because of the collective trauma. But I think for many of us, there's even if this is not something that we have done, work that we've done, or really had impact in our lives in the past, we can see it's almost like it's understandable what everyone's gone through that more folks would be struggling. Right?

That's an opportunity because for so long, people have not gotten treatment, not gotten care for their kids or themselves because of the stigma. And if we can bring mental illness and suicide out of the shadows, we can truly improve lives and even save lives.

Steph: What role are our young people playing in this? Like you said, there has been this sort of collective trauma. And I'm sure that students are really speaking out and being very open with their experiences. Can you speak a little bit to that?

Susan: There's no question that we are seeing our young people almost leading the way here in this work to dispel the stigma and end the discrimination. I think that is, in part, they're young. That's always an advantage, perhaps more willing to take some chances that older folks might not. But I think too, they really are recognizing the impact that not just the pandemic has had, but things like climate change. Our young people are so in tune with what is happening in terms of climate change and how that impacts their futures. And they recognize that's a significant source of anxiety for many folks, but especially our young folks. Justice issues around race, LGBTQIA issues, ethnicity, our young people, they're actively working to build the world they want to live in. And they are truly leading the way in many respects with these conversations.

We have found that when we work with our youth leaders, they truly step in and lead the conversation. And interestingly, they often through that leadership, push our educators and our school leaders to be more open and to be more receptive to doing something a different way, perhaps, because it will help people feel better, help people take care of themselves. I had the opportunity to attend a round table offered by one of our senators. And there were youth leaders there from a number of places in the state, who frankly gave me such a tremendous sense of hope. I am inspired by them all the time. We need to listen to them. They do know what's going on. And we need to give them credit for understanding that. And we need to also allow them to push us to think outside of our box, so to speak.
I think we often, we hesitate to have some of these conversations because of stigma, because of how societally, we have really given the message of, you should repress these things, or you shouldn't talk about them. And the reality is, sometimes you need to step outside of that comfort zone and have those conversations. I'm not going to say they're difficult even. They feel difficult, but I think once you engage in them, and so many educators do this so well, and they understand it, that recognizing that it doesn't feel so good maybe to start that, but the outcome of that can not only be critically important for providing that safety net for the youth.

But it also, for the adult having that conversation, I think often gives you back also a moment of self reflection, as well as thinking about, and this happens to me all the time when I interact with our youth leaders is: What am I doing for myself? What am I doing for my loved ones? Am I practicing what I preach? I think those are really important things for us to make sure we're doing. There's an expression about our goal is to help those who are struggling and push on systems that may make it difficult to do that.

Steph: Yeah, absolutely. And I'm so, so happy that you touched on not only the weight of COVID, which we've talked about, as you said, climate change, sexism, racism, all these other forms of bigotry and structures. And you're so right, we can take care of ourselves and each other as much as we can. And I think at the end of the day, that's a lot to carry around. It's a lot to carry around the burden of climate change and a pandemic, on top of our daily stressors.

Susan: Yes. And I think that's important to remember because it is a lot. And no one of us should be trying to shoulder those burdens alone. And so having those relationships, and those relationships, they're diverse throughout our lives and how they play out, but recognizing how important that is, that even for the most introverted person, and I think a lot of people discovered this during COVID, I had a lot of introverted friends who were like, "I'm not that introverted." But even the person who says, "I'm a die hard introvert," still needs to be part of a community, and they still need those supports. They may not need as large a community. They may not want to have as much interaction on a daily basis, for example. But you need that soft place to land.

One of my children when they were younger and going to see a therapist, I remember the therapist saying, "I only worry about kids that have fewer than two friends." That really two friends, it's not that one friend isn't great, but one friend can't always be the only one to support you. So I thought that was a really good way to think about it. You can't just expect that one person is going to be able even to support you. And I see that in my own personal life. I'm lucky to have friends and family, and there are those that I would take one thing to versus another more often.

Steph: I think that piece on community and building relationships is a beautiful point to wrap up on. You've told us so much about these community building programs that NAMI New Hampshire has. Is there anything coming up that you would like to plug for people who are listening?

Susan: One of the things I would be remiss not to mention is that on October 8th of this year, we will have our 20th annual NAMI Walks New Hampshire. This is the state's largest mental health and suicide prevention awareness raising event. We are back in person this year. There is also a virtual option, so if folks aren't comfortable with that, they can participate virtually, share a photo with the hashtag stigma free in the 603. And we'll pick that up on Sunday, the 9th on social media and share that. But on the 8th in Concord we will have our annual walk. It's free to register. You can register online through our website, naminh.org.

One of the most impactful things is, last time we did this in 2019 in person, we had over 2000 people who came out to participate. It is for folks who've been impacted by mental illness and suicide, an incredibly affirming moment to be with all these folks who have experienced similar things. And it really is about making sure people recognize that mental illness affects everyone. Suicide affects all of us at some point in some way. And we need to make sure that policy makers understand how important it is to ensure adequate services. And I think a lot of your listeners probably can attest to having difficulty with their students accessing those services. This is an opportunity for us to come together and really raise that awareness and welcome folks. And again, you can find out more on our website, naminh.org.

Susan Stearns is Executive Director of NAMI New Hampshire (National Alliance on Mental Illness). She has worked in the non-profit sector in New Hampshire for over 30 years, advocating for families, children, and individuals with disabilities. Her personal experience advocating for loved ones in both the child and adult mental health systems drives her passion for transforming New Hampshire’s system of care in order to improve the lives of all Granite Staters affected by mental illness and suicide. Susan does this work because no mother’s child should have to fear seeking help for a medical condition because of stigma. She is a member of the Governor’s Commission on Disability, Governor’s Advisory Commission on Mental Illness and the Corrections System, the Commission to Study the Incidence of Post-Traumatic Stress Disorder in First Responders, the Advisory Board to the NH Judicial Branch Steering Committee on Diversity & Inclusion, the Oversight Commission on Children’s Services, the Board of Directors of the Lakes Region Mental Health Center, the New Hampshire Justice Involved Veterans Task Force, the Hillsborough County Coalition on Mental Health & Justice, and the New England Advisory Team for the region’s SAMHSA-funded Mental Health Technology Transfer Center.