To ease a mental health care workforce shortage, surround adolescents with support

The Foundation's Bree Bess was a contributor to this article about mental health originally featured on BCBS.com.

Nearly 150 million Americans live in a federally designated mental health practitioner shortage area. The shortage is especially acute for adolescents. But there’s growing evidence more of them need care now more than ever.

One answer is to expand the circle of people—beyond psychiatrists and psychologists—who can help. Here are two unique approaches, in two very different states: South Carolina and Wyoming.

Empowering schools, peers and parents to fill the gaps

“Only 64% of South Carolina schools have access to full or part-time mental health clinicians,” says Bree Bess, program officer for the BlueCross BlueShield of South Carolina Foundation. Bess says it’s difficult to fill the positions, in part because of a lack of providers. But the need is urgent. “We have seen some horrendous statistics around youth mental health,” says Bess. “Suicide is the leading cause of death for people ages 10 to 24 in South Carolina.”

Bess says the Foundation partnered with schools and community organizations to identify where it could make the most impact. They decided to invest in providing college students career pathways to work as mental health counselors in a school environment, equipping parents with more tools and knowledge to help their kids at home and empowering students to support their peers.

Preparing students for careers in school mental health

First, the Foundation funded internships and practicum experiences for college students majoring in fields like psychology and sociology. “The idea was to prep them specifically for a school environment,” says Bess. “They spend their days working alongside a mental health counselor, and, in turn, help that mental health clinician find time to do more prevention work.”

Bess says the interest from college students was overwhelming. “We proposed five positions and received over 100 applications,” she says. Interns have already begun working in schools.

Empowering peers and parents

Next, the Foundation targeted schoolwide mental health awareness by starting a pilot peer support program for students in seven communities. The peers will serve as another resource for students who might be struggling.

Rounding out support for kids in school are programs for parents. “Although students do spend a lot of time in school, we wanted to empower parents to help at home,” says Bess. The Foundation is supporting the University of South Carolina Institute for Families in Society, which offers a program called Teen Triple P. It offers a continuum of both universal and targeted training for parents to help them address common adolescent social, emotional and behavioral challenges. “The idea,” says Bess, “is to say to parents, ‘Here are things you can try at home.’”

A caring adult can change a child’s trajectory

Bess says mental health solutions for adolescents are a major focus of the Foundation’s work, but that focus is on holistic solutions. “It’s important to build access, to build up the workforce, says Bess. “But we also need to support all of the caring adults in an adolescent’s life. It’s been shown that a caring adult can mitigate the effects of childhood trauma.”

Tapping social work students to teach kids resilience

Kids in Wyoming may face another barrier to accessing help. “We’re taught to be ‘cowboy tough.’ There’s a stigma around talking about mental health here,” says Blue Cross and Blue Shield of Wyoming President and CEO Diane Gore. But Gore says the statistics show the suffering is real and access to help is limited.

Bleak adolescent mental health statistics

Wyoming has the highest suicide rate in the nation, and it’s one of the leading causes of death for people between the ages of 10 and 34. Nearly a fifth of adolescents report episodes of major depression. Finding help is hard. There’s a severe shortage of mental health professionals in most Wyoming counties.

Much like the BlueCross BlueShield of South Carolina Foundation, Gore says the Blue Cross and Blue Shield of Wyoming Caring Foundation saw an opportunity to help youth build resilience before a crisis.

Boys and Girls Club embeds social work students

In October 2021, the Foundation teamed up with the University of Wyoming Division of Social Work to embed students in Boys and Girls Clubs in the state’s capitol, Cheyenne. The students help club members develop mindfulness and resiliency skills. There’s also a suicide prevention initiative for clubs across the state. The message from social work students to the kids in the program: it’s OK to not be OK. If a club member needs for extensive help, the social work students can be the front line, recommending referrals and alerting parents.

“Mental health resources outside of the Club can be costly, have extensive waitlists or be generally inaccessible for parents who work during the day or lack reliable transportation,” says Gore. “Through this new program, the Club strives to close the mental health gap and ensure that all youth have access to the care they need. The program directly benefits Club members, while also fostering the next generation of mental health professionals.“

Gore says the Foundation is also trying to bolster the pipeline of rural mental health practitioners. It’s funding two Doctorate in Nursing scholarships for students who aim to practice psychiatry in Wyoming.

Communities rally resources, despite a workforce shortage

In South Carolina and Wyoming, communities cannot wait for the mental health care workforce shortage to ease. It’s not certain the shortage will ease, or how soon, or where professionals might choose to practice. And kids need help now.

So grantmaking organizations, health insurers, schools and communities are putting their heads together to rally other resources. Data from pilots in both states will reveal what’s working and what’s missing. Improved mental health for adolescents and better access to help are the main goals. But some programs may bring another benefit: leading students to choose careers in adolescent mental health.

Blue Cross and Blue Shield of Wyoming and BlueCross BlueShield of South Carolina are independent licensees of the Blue Cross Blue Shield Association.