Stephen Ulibarri and Anisha Imhoff-Kerr spoke on youth mental health
advocacy issues at the National Mental Health Association's annual
meeting. Rich Daly
Marley Prunty-Lara, the first youth advocate member of the NMHA Board of
Directors, discusses youth involvement in mental health advocacy with former
first lady Rosalynn Carter. Rich Daly
At age 19, Martha Mora is already an old hand at public advocacy. She
received psychiatric care following drug addiction and attempted suicide at
14, which allowed the teenager to not only recover but eventually assist other
teens in their recovery. The experience also prompted her to advocate for more
effective mental health policy.
Many adolescents being treated for mental illness, Mora said, feel hopeless
and don't believe recovery is possible. The example she and other teens
provide of youth who have overcome their disorder can provide hope for their
peers that recovery is possible. Her involvement in making sure that message
gets out has included the launch of a peer mental health support group for
adolescents under the direction of a psychiatrist and mental health workers in
Speaking at the 2006 annual meeting of the National Mental Health
Association (NMHA), Mora and other youth recovering from mental illness urged
psychiatrists and mental health professionals to support "youth-guided
systems of care." These approaches incorporate adolescents with mental
illness into deciding the design of their treatment plans from the onset of
"These kids are the biggest resource in their treatment plans,"
Mora is one of the growing number of young people recovering from mental
illness who have emerged as a powerful force for change, both in assisting in
their own and others' recovery from such diseases.
Although Mora and other youth advocates said some psychiatrists and mental
health professionals resist an active role for children and adolescents in
designing and advancing their treatment and recovery, local, state, and
national mental health policymakers have begun to recognize its
The 2003 final report of the President's New Freedom Commission on Mental
Health identifies six goals for a transformed mental health system, including
the goal that mental health care is consumer and family driven.
"It is assumed that as a child with serious emotional problems
approaches later adolescence, the youth him or herself will take on the role
of consumer," stated the report.
Since the report, evidence has continued to mount that helping children
remain mentally healthy or recover from mental illness requires more support
from school administrators and government officials and better approaches to
prevention and service delivery. A 2005 report noted that youth detention
facilities are increasingly being used in a "warehousing role" for
youngsters with mental illness. According to a National Council on Disability
report, two-thirds of juvenile-detention facilities are holding youth
primarily because appropriate mental health services are unavailable, not
because the youngsters have been accused of or determined to have committed
offenses (Psychiatric News, December 16, 2005).
A growing pool of data also indicates that youngsters are at high risk for
a range of mental illnesses and related problems, including suicide. In 2004,
22.5 percent of youth aged 12 to 17 said they had received treatment or
counseling for emotional or behavioral problems during the previous year,
according to a survey by the Substance Abuse and Mental Health Services
Administration (SAMHSA). Between 2002 and 2003, approximately one-fifth of
students in elementary and middle schools had received some kind of service
related to mental, behavioral, and emotional health challenges.
New approaches are needed to reach children and adolescents with mental
illness, said Anisha Imhoff-Kerr, a 21-year-old college student with bipolar
disorder who presents mental health awareness courses at New Mexico high
She said the peer approach has encouraged students to reveal traumatic
assaults and other health concerns and get the professional help they
Susan Gallagher, executive director of the NMHA's Sacramento chapter, said
that organization began to involve youth several years ago in efforts to
design and implement new treatment and outreach approaches aimed at other
adolescents. The biggest challenge her program faced was to find meaningful
roles for youth in which they felt they were not token representatives whom
the adults could ignore but instead were there to make an impact on policy or
Gallagher noted, however, that in the first meetings in which youth were
included, some adult participants were afraid that the youngsters would"
ask a challenging or difficult question, [and] then some adults would
say, `We can't have them back again.' "
The efforts of her group and others to get adolescents involved in service
planning and development continue to expand because reforming the mental
health system and improving care depends on the ability to get those it serves
to the policy table, Gallagher emphasized.
Health care leaders have realized that young people recovering from mental
illness also can be effective advocates, capable of jolting jaded policymakers
and politicians from statistical abstractions to the hard reality these kids
"Youth advocates can be extremely candid and give an unvarnished
account of their perspective, and I think that is extremely valuable,"
said SAMHSA Administrator Charles Curie, M.A., in an interview with
Psychiatric News. "It is important to listen and take into
account what they have to say and to encourage them to speak out
Lisa Pedersen, vice president of the board of directors of the Children and
Adolescent Bipolar Foundation, said legislators are often unaware that many
children are affected by mental disorders. "We need to spread the
message that investing in mental health research is really about investing in
our future," Pederson told psychiatrist advocates at APA's 2006 Academic
Consortium in Washington, D.C.
In May SAMHSA cosponsored the first National Children's Mental Health
Awareness Day, which brought youth advocates recovering from mental illness to
speak to members of Congress and their staffs.
Lorrin Gehring, a youth resource specialist in the federal government's
Technical Assistance Partnership for Child and Family Mental Health, suffered
from mental illness and attempted suicide as a child. She told attendees at
the congressional forum that her recovery began after many false starts when a
psychiatrist "really listened to me" and had her join a youth
support group. She urged policymakers to support training for school personnel
to help students with mental health concerns get help and not treat them as a
"Better care is more cost-effective," she said, putting the
complex issues of mental health in language to which every government official
could relate. ▪