Dying to Ask for Help: An Overlooked Crisis

Dying to Ask for Help: An Overlooked Crisis

Dying to Ask for Help: An Overlooked Crisis in Mental Health Services Education Writers Association May 2019 Michael A. Lindsey, PhD, MSW, MPH Executive Director, NYU McSilver Institute for Poverty Policy and Research NYU Silver School of Social Work Aspen Health Innovator Fellow, The Aspen Institute Rylan Thai Hagan Carl Joseph Walker-Hoover Gabriel Taye Seven Bridges 2009 2017 January 2019 From: Suicide Trends Among Elementary School-Aged Children in the United States From 1993 to 2012

JAMA Pediatrics, 2015;169(7), doi: 10.1001/jamapediatrics.2015.0465 Toxic Masculinity: We rear boys differently Toxic Messages Man up Fight it off Be tough Boys externalize behaviors Antisocial behaviors and attitudes mask depression Misinterpret symptoms Lindsey, Brown, & Cunningham, 2017 Depression Looks Surveyed 800+ Black Different adolescents in DC, Baltimore, Philly, Chicago, and St. Louis What depression symptoms look like among Black adolescents

somatic complaints interpersonal relations positive affect depressed affect I felt sad I felt lonely Lu, Lindsey, Irsheid, & Nebbitt, 2017 Lifetime Disorder-Specific Mental Health Service Use by Race/Ethnicity (Merikangas et al., 2011) Mood Anxiety ADHD Behavior Substance Use Hispanic .47

(.29-.78) .24 (.090.65) .80 (.361.80) .75 (.401.41) 2.09 (.726.11) NonHispanic Black .23 (.14-.40) .60 (.341.08) .58 (.221.52) .77 (.401.45) 1.56 (.2310.56) .68 (.391.20) 1.57 (.406.10) Other

NonHispanic White 2 3 (p)p)) .61 (.221.68) .47 (.26-.83) .32 (.14-.73) 1.00 1.00 1.00 1.00 1.00 36.1 (.000) 14.8 (.002) 8.3 (.040)

3.2 (.361) 2.2 (.525) Setting-Specific Mental Health Service Use by Race/Ethnicitya (Costello et al., 2014) MH Specialty General Medical Human Services CAMb Juvenile Justice School Any AOR 95%CI

AOR 95%CI AOR 95%CI AOR 95%CI AOR 95%CI AOR 95%CI AOR 95%CI Hispanic 1.04 .52-2.08 .81 .41-1.60 .66 .23-1.91

.43 .16-1.18 1.14 .49-2.61 .51 .25-1.03 .75 .51-1.12 NonHispanic Black .39** .22-.70 .64 .31-1.31 1.39 .75-2.59 .36* .17-.74 .67 .25-1.84

.95 .51-1.75 .63 .43-.93 Other .40** .20-.79 1.55 .70-3.45 .51 .17-1.48 .50 .18-1.33 .69 .21-2.27 .88 .36-2.20 1.17 .49-2.78

Non-Hispanic White (Reference Group) a Analyses were adjusted for all demographic variables in the table and number of disorders alternative medicine *p<.05, **p<.01, ***p<.001 b Complementary and 465 ninth-graders in Baltimore City (M = 14.78) Half of sample had identified MH needs; only 20% recd MH tx NETWORK INFLUENCE + association between

perception of networks support and SMH service use. SMH services for internalizing MH problems higher for youth larger social networks. PES in Philadelphia, PA: n=1,621 Black adolescents 73% voluntarily arrived Odds of a voluntary arrival increased as the level of impairment decreased

Arrival based on nonurgent reasons It Matters: Mental Health and Academic Outcomes 3 The absentee and tardy rates than students without mental health disorders 83 % Score below the mean in reading, writing, and math 10 % Of high school terminations attributable to mental health disorders

Research, Advocacy and Policy Launched on April 30, 2019 on Capitol Hill Articles appearing in Bonnie Watson Coleman (NJ-12), Chair Alma Adams (NC-12) Emanuel Cleaver II (MO-05) Danny Davis (IL-07) Alcee Hastings (FL-20) Jahana Hayes (CT-05) Eddie Bernice Johnson (TX-30) Barbara Lee (CA-13) John Lewis (GA-05) Ilhan Omar (MN-05) Ayanna Pressley (MA-07) Congressional Taskforce Members

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