Danielle 17 days, 4 hours ago

@ekaye - Thank you so much for sharing your perspective. You noted many of the opinions that our Mental Health Ambassadors have been sharing in our Roundtable Discussions which we will be sharing to the site bi-weekly, starting next month. You narrowed in on one specific concern, the fear of judgement, but you approached it from a unique lens and I want to echo back what caught my attention. As a young person, you had a fear of 2 things, 1) If you took advantage of the services available to you through the school, you feared that your confidentiality could be broken, resulting in your parents finding out. The root of the fear was that, despite your parents "being educated about mental health", you were worried about how they might react to your specific concerns and/or your sharing them with someone else. This underlying fear about your parents' potential reaction likely also kept you from being able to access other available resources that might require their consent or involvement. 2) You carried guilt that your concerns didn't meet some undefined measure of what is considered "serious enough" to ask for help. You also outlined how you observed these similar feelings in school-aged research participants, noting that there appeared to be 2 barriers for that group: 1) A perception that their peers were thriving and that revealing that they had emotional concerns could alienate them from others or open them up to judgement and, 2) Finding the in-school resources, who are often the most easily accessible for young people to not be relatable. I have a few questions, but first, I do want to acknowledge and congratulate schools who have shifted the way that in-school counselors and psychologist show up for students. When I was in school, while the counselors and psychologists were there to support some of the more extreme scenarios in students' personal/familial/emotional lives, these professionals were primarily focused on educational services, such as testing for learning disabilities and helping prep and plan for college and vocations. That said, it sounds like there may still be some barriers to students engaging with these professionals. Here's what I'm curious about: When it comes to minors, what is and is not appropriate regarding a child's mental and emotional health and revelations for school professionals to keep confidential vs. what they should be obligated to share with parents/guardians?How do we educate people, particularly young people, about the purpose and goals of seeking support so that we remove the idea that your concerns need to be "serious enough" to get help? Anything that is weighing on us is important enough to seek help. It may be that you need a single conversation to help you through a recent argument with your parents or a friend or that you need ongoing support to help with feelings that have bothered you for a while. How do we help communicate that every person is different and validate that however they are feeling is real to them?How much does social media impact our beliefs that others are thriving and add to the belief that we are the only person who is going through a bad time?What would it look like or what needs to happen for in -school resources to feel more relatable to young people?

ekaye 12 days, 20 hours ago

Thank you so much for your insights into my post, Danielle! To answer your question about confidentiality and when it becomes a provider's obligation to involve parents; I think it's extremely difficult to draw a clean line. On one hand, it is incredibly important for a child to feel that they can come to a provider and honestly express what they are experiencing, especially if those feelings could eventually pose a risk to their well-being. However, I have heard people express that they sometimes censor their true feelings out of fear that their parents will be told or that what they share will lead to an intervention they aren't prepared for. At the same time, the child's safety ultimately has to remain a priority for providers. I don't think there is necessarily a clean-cut answer, but I wonder if part of the solution could involve greater transparency with the child about confidentiality and its limits from the beginning. If a provider becomes concerned about something that needs to be shared with a parent, when appropriate, perhaps the child could be included in that process rather than feeling that the decision is happening without them. For example, a provider could help guide a conversation between the child and their parents so that the child has support in expressing what they are experiencing. I think involving young people in that process when possible could help preserve some of the trust that is so important in encouraging them to continue seeking support. Another point you brought up that I found really interesting was how we can normalize seeking help and make support feel more accessible and relatable to young people. One approach I have found particularly interesting is peer-support counseling, where trained students can provide support to other students. I think talking to another young person who understands some of the social realities a student may be facing could help reduce stigma and bridge some of the disconnect that can exist between students and providers. Peer support obviously isn't a replacement for professional mental healthcare, but I think it could serve as an approachable first step toward seeking additional support when needed. Thank you again for your response!

Danielle 11 days, 4 hours ago

This is a really thoughtful response. Thank you @ekaye ! I appreciate that you brought up transparency. It is an ethical responsibility of providers that work with youth and most licensing bodies have standards for school counselors, community counselors, etc that lay out privacy limits that must be shared at the start of the relationship, not just for youth, but any client. However, I think this conversation serves as a great reminder for all professionals who work with youth to be mindful of this concern and potentially reset expectations at the start of each session and/or if a young person seems to be headed down the path of sharing something that may trigger the need for disclosure, they could say something like, "I want to remind you of my duty to disclose certain things to your parents. I definitely want to hear what you are about to share and can help you through how we bring your parents into the conversation, but understanding that this is a sensitive subject for you, I don't want you to feel betrayed...." I also like that mentioned peer support. This is a very important form of support, especially when we hear from many people who are struggling with emotional concerns that they don't feel like they can open up to their closest family and friends. Organized, trained and qualified programs that offer peer support are definitely a high-value way for people to feel seen and heard. Highly successful examples of this model can be seen in AA, NA, and similar programs.