Welcome! We are glad you are here to learn more about Adolescent and Young Adult (AYA) mental health as it relates to state Maternal & Child Health (MCH) programs. AYAs are defined as people who are 10-17 years old (adolescents) and 18-25 years old (young adults). This set of four e-learning modules is developed for Title V staff interested in how they can leverage their jurisdiction’s MCH block grant program to improve systems of mental health care for AYAs. Each of the four modules functions as a standalone learning experience, and users can navigate between each module at their leisure, and in the order they prefer. Within each module, learners will find an introduction and background to the topic, key resources, examples of MCH programs in action, a summary of takeaways, and an opportunity for individual reflection on the content that’s been covered. The four modules in the series include:
- Innovation in Service Delivery
- Emerging Topical Issues in AYA Mental Health
- MCH Workforce Capacity and Skillsets
- Integration of Mental Health into Primary Care for Adolescents and Young Adults (AYAs)
Before diving in, let’s talk about why we are doing this.
A National Crisis
AYAs grow in many ways – physically, emotionally, educationally, and socially. Healthy growth in each of these ways is equally important so each person can become their best self. Our environments do not always support the emotional or mental health of AYAs. Things like depression, thoughts or acts of suicide, and drug or substance misuse may keep a person from growing in ways that helps them, and may actually harm them. Information shows us that the mental health concerns of AYAs have gotten worse in the last few years. From 2009-2019, the number of AYAs reporting experiencing challenges with their mental health increased at an alarming rate:
- Among high school students, it was reported that persistent feelings of sadness or hopelessness increased by 40%, to more than 1 in 3 students in 2019;
- Those seriously considering suicide increased by 36% and those with a suicide plan increased by 44%.
- That same year, one in five students seriously considered suicide.
The Covid-19 pandemic made many of these concerns even worse. We all had to change from what we each thought to be normal – including our daily routines being with people important to us. These abrupt changes made mental health concerns worse for many people, including AYAs. Unfortunately, some AYAs were victims of abuse and had trauma while sheltering in place. Some lost parents, caregivers, relatives, or friends to Covid-19. The increase in mental health concerns for since the pandemic has been very large. In 2020, AYAs went to the emergency room many more times for mental health concerns than in 2019. More AYAs said they had increased anxiety, stress and uncertainty. All of this led to a Declaration of a National Emergency in Child and Adolescent Mental Health in 2021. This declaration was made by national associations that serve AYAs. The US Surgeon General also issued an advisory about the problem and recommendations for action. As MCH professionals, it’s important to remember that like each one of us, AYAs are people first. A one-size-fits-all approach does not work. We must remember that each AYA may also be part of other groups that experience stigma, discrimination, and lack of the supports and services needed to be their best selves. Things like being a person of color, or a person with a disability, or experiencing homelessness, or living in a rural area, or any combination of the many types of people and situations that make up our diverse nation. The voice and views of AYAs must be part of the solution to the problems we will talk about.
Mental Health in MCH
State Title V MCH programs have spoken up about and led the work to support the needs of women, children, and families. These programs have provided funds, built and supported partnerships, and helped coordinate services. These all work to connect health services with other supports people need. For AYAs, Title V has worked to increase services to prevent health concerns, reduce injuries, transition to adult care, and respond to other issues that come up. Most recently, there has been a focus on and funding for mental health concerns for AYAs. Some of these are from the Maternal & Child Health Bureau (MCHB):the AYA Behavioral Health Collaborative Improvement and Innovation Network (COIIN); the AYAH National Resource Center, MCHB Pediatric Mental Health Care Access (PMHCA) program; and the Telehealth in MCH Public Health Systems grants as part of the COVID-19 CARES Act. The crisis for AYAs’ mental health can be addressed by state Title V programs. These programs can lead or coordinate ways to slow, stop, or treat the crisis. MCH agencies and partners are coming up with new ways to do what is needed. Each of these sections is meant to help Title V/MCH professionals get better at supporting the needs of AYAs with mental health concerns. You will find materials, ideas, and learn about best practices. Take, try, and use them in your states and communities. They should guide and help you to offer better supports and services, make policies that work, and support AYAs to be their best selves. This learning series is organized in four main categories:
- Getting health professionals on board: Integration of Mental Health into Primary Care for AYAs
- What is happening, and how bad is it? Topical Emerging Issues in AYA Mental Health
- What can we do better? Innovation in Healthcare Service Delivery
- How can we support professionals to learn and do more? MCH Workforce Capacity
Each section has a short summary that tells you what the section is about. There is a list of what you will know when you are done with the section. Tools and resources are included in each section. You will be able to do recap and reflection exercises. These help you understand what you have learned. Most importantly, there is the voice of AYAs throughout. Each section can be done on its own. So choose what you most want to learn about, and get started! Together, we can help AYAs become their best selves.