2022-2023 CHAIR’S INITIATIVE

Strengthening Youth Mental Health

The United States faces a nationwide youth mental health crisis. The roots of this crisis existed before COVID-19, but the pandemic has both exacerbated and highlighted the scope of the challenges in addressing this issue. The time is right and the need has never been more apparent to discuss proven and innovative solutions for states.

Governor Murphy and Governor Polis Join Forces To Tackle Youth Mental Health Crisis

The second roundtable of the 2022-2023 NGA Chair’s Initiative: Strengthening Youth Mental Health was held on January 24-25, 2023, in Santa Monica, California. During the two-day roundtable, NGA Chair New Jersey Governor Phil Murphy and Colorado Governor Jared Polis held discussions with parents, physicians, pediatric psychologists, educators, policymakers and other mental health experts. Over the two days, roundtable discussions unpacked the Initiative’s second pillar focusing on themes of building a foundation of diversity and equity in addressing stigma, reducing the stigma of mental health and seeking help, and increasing awareness around youth mental health.

Compared to previous generations, young people today are much more open to talking about mental health and want to play an active role in reducing the stigma surrounding mental health challenges to promote mental wellbeing. Throughout the convening, the young leaders in attendance shared impassioned stories of both their own mental health struggles and the many ways in which youth are organizing to break the stigma. Despite this progress, stigma continues to be a major barrier to young people reaching out for help. Although half of mental health disorders begin by age 14, treatment is often delayed by a decade or more as youth and their families grapple with feelings of fear and shame. Stigma is a reality across different settings: cultural disconnects or generational divides within the home can make it difficult to talk about mental health, and misconceptions continue to pervade attitudes in educational settings, places of worship, and workplaces. Bias, conscious or unconscious, within the healthcare system, can also have a stigmatizing effect on those who need respect, understanding, and support from providers.

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Solutions To Break The Stigma And Support The Conversation Around Mental Health

Governors can increase awareness and reduce stigma by supporting:

  • Existing community-based mental health organizations’ awareness-building efforts: Ensuring funding and other resources get to organizations with deep knowledge of their communities’ mental health challenges
  • Targeted anti-stigma campaigns with a focus on storytelling: Developing efforts driven and co-designed by young people, that reach young people on social media, and are focused on diverse populations, including youth of color and Indigenous youth, LGBTQIA+ youth, youth involved in the foster care system, etc. Governors can also humanize mental health by using their platforms to share their personal journeys with mental health
  • School mental health curriculums: Growing capacity for mental health literacy for youth and their families by implementing age-appropriate awareness of the spectrum of mental health, bolster mental wellbeing, and encourage youth to seek help, as well as adopting family engagement plans and public-private partnerships to tap into the knowledge and support of thought leaders in the private or nonprofit sector
  • Suicide stigma reduction: Normalizing discussing suicide and suicidal ideation, making them less “scary” and unbroachable topics by training youth peers, as well as the adults who live and work with youth, on appropriate and compassionate responses to someone who is experiencing intrusive thoughts can help to reduce the silence around suicide
  • Sensitivity training for adults interacting with youth: Enabling sufficient support, care, and treatment for youth experiencing mental health challenges through bias, sensitivity, and cultural responsiveness training for healthcare professionals, educators, and others
  • The power of peer networks: Recognizing a recent Active Minds survey that found that 67% of young adults first tell a friend they are feeling suicidal before telling anyone else – supporting the development of a diverse mental health workforce of peer supporters and community health workers to complement  a workforce that is able to provide culturally competent care when and where families need it at the level that is needed; including through trainings on mental health identification and crisis management
  • Crisis services that meet youth where they are: Protecting young people’s privacy and enabling trust through innovative services such as anonymous text lines or apps and in building youth-specific crisis response systems including home-crisis models
  • Delivery systems improvements to promote trust and safety: Addressing the experience patients have when they seek care after breaking the stigma of seeking help, including addressing the trust gap between patients and the health care system
  • Increased awareness of people working in programs that support the well-being needs of youth: increasing awareness of youth mental health among all state systems and agencies that touch the lives of youth and their families, including public health staff, human services staff, youth employment systems, out of school time staff, justice, or housing and child welfare systems
  • Safe and supportive school environments: Implementing mental health awareness and stigma-reducing tools in schools such as anti-bullying measures and adding information on seeking mental health (988) to student IDs, utilizing yearly school climate improvements surveys to understand current youth needs; incorporating trained peers into campus programming; and considering alternatives to exclusionary discipline

governors and states meet on prevention and resilience in youth mental health

On October 18-19, 2022, in Salt Lake City, Utah, National Governors Association (NGA) Chair New Jersey Governor Phil Murphy and NGA Vice Chair Utah Governor Spencer Cox held the first of four roundtables to discuss the 2022-2023 NGA Chair’s Initiative: Strengthening Youth Mental Health. A strong state contingent was represented, including Alabama, Arkansas, Minnesota, New Mexico, and Pennsylvania. States were joined by over fifty community leaders, academic experts, and representatives from partner organizations and funders.

The convening centered on practical solutions for the first of the initiative’s four pillars: prevention and resilience building. Discussions forged connections across the public and private sectors, shared best practices across states and territories to amplify their impact, and aligned on ways that Governors can further support youth mental health.

Key themes on prevention and resilience were unpacked across three discussions that centered the voices of those with first-hand experience of youth mental health from different perspectives; focused on applying the brain and behavioral science of resiliency, specifically to provide opportunities to build and rebuild mental health in youth; and oriented the group towards practical and implementable solutions. Credentials spanning academia, government, business, and community service were interwoven with personal stories of delegates’ lived experience.  

Despite the immense challenge, the roundtable discussion coalesced around hope: evidence shows that prevention and resilience building in childhood and adolescence can fundamentally change the trajectory of a child and family’s life. Given supportive environments and the right skillset, the effects of adverse childhood experiences (ACEs) and exposure to toxic stress can be successfully managed to prevent mental health challenges from developing or worsening. Strengthening youth mental health, starting with prevention and a focus on resilience, needs to be a key priority within all levels of government, and across all sectors of society.

About the Initiative

Governor Phil Murphy’s 2022-2023 Chair’s Initiative is focused on four key pillars to address youth mental health:

Addressing Prevention and Resilience Building

Providing youth with the supports and tools necessary to cope with stressors and challenges, helping them to thrive and reduce likelihood of engaging in unhealthy or damaging behaviors.

Increasing Awareness and Reducing Stigma

Promoting awareness of mental health resources and foundational mental health knowledge by expanding easy access points to education, helplines and state services.

Insuring Access and Affordability of Quality Treatment and Care

Addressing the barriers that prevent youth from accessing care including ensuring high quality care is available in the places, spaces, and timeframes that youth want and need, and that costs and lack of insurance coverage do not prevent access.

Training and Supporting Caregivers and Teachers

Examining not just the core issues around youth mental health, but also considering the impacts of youth mental health challenges, including the tie-in to academic recovery.

Expanding existing training and supports so that those caring for and interacting with youth daily have the tools and understanding to identify mental health needs and how to facilitate access to supports for youth

Improving Maternal and Infant Health

In addition, First Lady Tammy Murphy is leading an effort focused on maternal and infant health (MIH). This has been a significant area of focus in New Jersey throughout the Murphy Administration and this effort seeks to elevate and expand the conversation around maternal and infant health nationwide.

The four pillars of this effort are:

  • Centering Women’s Voices in MIH Policy – This area focuses on the importance of integrating the voices of mothers and women of color in the policymaking process, making sure they have a seat at the table before the table is even built.
  • Improving and Utilizing Maternal and Infant Health Data – Improving data systems by incorporating qualitative data on maternal health experiences, linking state data and increasing accessibility to data to improve accountability.
  • Expanding Access and Quality of Care – Identifying ways for states to ensure citizens have access to high quality maternal and infant care, including various MIH Medicaid policies that states can look to implement.
  • Elevating Innovative MIH Polices, Programs and Technologies – Identify and highlight innovative and novel approaches to MIH policy, including highlighting effective programs and examining the role of technology to improve MIH outcomes.

Improving and Utilizing Maternal and Infant Health Data In Maternal And Infant Health

A second roundtable on improving Maternal and Infant health was held in January 2023,in Santa Monica, California. First Lady Murphy hosted a conversation on improving maternal and infant health (MIH) data collection, use and reporting. Colorado Governor Jared Polis, California First Partner Jennifer Siebel Newsom and North Carolina First Lady Kristin Cooper also spoke at the event to highlight holistic efforts to support children and parents, focusing on efforts to improve birth outcomes and reduce overall maternal and infant mortality and morbidity, an issue of national importance. The meeting included a conversation with a panel of experts, including Dr. Neel Shah, Carole Johnson, Dr. Socia Love-Thurman, Alexis Cobbins and Dr. Ndidiamaka Amutah-Onukagha. The panelists focused on improving and utilizing maternal and infant health data systems by incorporating data on maternal health experiences, linking state data and increasing accessibility to data to improve accountability. Learn more about the roundtable.

Centering Women’s Voices In Maternal And Infant Health

Centering women’s voices in the policy making process is key to addressing the MIH crisis. In the United States, MIH disparities are tied to systems and policies that have historically overlooked women’s voices, especially Black, Indigenous and Latina women. First Lady Murphy is committed to working with policymakers and experts in this space to address these disparities at the root, starting with elevating women’s voices and implementing solutions in partnership with those most disproportionately affected. By actively centering women’s voices, Governors and state leaders can work to reduce disparities in MIH outcomes and make their states safer places for pregnant women, babies, mothers and families.

The first roundtable of the Initiative was held in mid-October 2022. More information and a read out from the Convening is available here.

2022 Summer Meeting Panel on Youth Mental Health & Maternal and Infant Health

Insights – Youth Mental Health & Maternal and Infant Health

NGA has collated a variety of resources from stakeholders to assist Governors and their staff with strengthening youth mental health, and improving maternal and infant health. These resources leverage the expertise of NGA partners to provide insights to assist with delivering specific program areas and cross-program tools and best practices.

BCG

Shifting Upstream: State Actions to Support School-Based Mental Health Screening

Addressing the US’s youth mental health crisis requires us to screen more children for relevant conditions to enable appropriate intervention earlier. Universal screening can be advanced by meeting kids where they are: in schools.

Learn more…

BCG

inseparable

America’s School Mental Health Report Card

School mental health services play an important role in supporting youth and helping every child thrive. This report highlights what each state is doing to support school mental health services and provides policy recommendations and examples of policy pacesetters from across the country.

Learn more…

inseparable

Funders for Adolescent Science Translation

Supporting Adolescent Health and Development

A brief highlighting the specific findings on youth behavioral health from two National Academies of Sciences, Engineering, and Medicine reports: The Promise Of Adolescence: Realizing Opportunity For All Youth and Promoting Positive Adolescent Health Behaviors And Outcomes: Thriving In The 21st Century.

Learn more…

Funders for Adolescent Science Translation

Elevance Health

Addressing Maternal Health Disparities: Doula Access in Medicaid

This report discusses how women using doulas in Medicaid have fewer inpatient hospital admissions during pregnancy, are more likely to attend their postnatal visit, experience lower odds of cesarean delivery, have lower odds of postpartum depression or anxiety, and have lower overall costs compared to women not using doulas.

Learn more…

Elevance Health

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