Oregon ranks among the worst states for youth mental illness and access to care. William Brangham went there and found a system facing heavy burdens, but one searching for solutions. It’s part of our new series, “Early Warnings: America’s Youth Mental Health Crisis.” A warning: this story includes discussions of suicide and depression.
The transcript of the show is provided below.
Amna Nawaz: It’s been over a year since the U.S. surgeon general issued a dire warning about the state of young Americans’ mental health.
To dig deeper into that crisis, William Brangham recently traveled to Oregon, which ranks among the worst states for youth mental illness and access to care. He found a system facing heavy burdens, but one searching for solutions.
It’s part of our new series Early Warnings: America’s Youth Mental Health Crisis.
And we want to let you know in advance this story includes discussions of suicide and depression.
William Brangham: It feels like a rec room with string lights and beanbag chairs. And it often sounds like one. But what’s happening here is a unique approach to helping young people who are in crisis.
This is the call center for YouthLine in Portland, where teenagers field calls from other teenagers who are struggling.
Volunteer: Still really brave of you to reach out about something so difficult.
William Brangham: A group of Volunteers staffs the help line daily. They take calls, texts and chats, and the issues they hear about run the gamut.
Volunteer: Because it sounds like you have a long time and you really care about her.
Fiona, YouthLine Volunteer: They reach out when they’re experiencing a crisis. That can mean lots of things. That can be something smaller, like relationship struggles or friendship issues, family issues, but it can also mean, like, more acute crises, like self-harm or suicide.
William Brangham: Each Volunteer gets more than 60 hours of training, and master’s level supervisors are constantly on standby in the room, listening in and reading along, ready at a moment’s notice to step in if a conversation gets too serious.
Related: Oregon YouthLine
Mia, YouthLine Volunteer: We’re not medical professionals. We’re like a sidekick, really. There’s like — and they’re — like, the person has the option to choose what they want to do.
They’re like the hero of the story. We’re just there to assist them to make that choice.
Emma Cooper, left, chats with another volunteer in this March 2021 file photo at Oregon YouthLine, a confidential teen-to-teen support and crisis system where teens connect via text, chat, email and phone.
Courtesy of YouthLine
William Brangham: Research suggests that teens cope better with stress when they interact with their peers, rather than adults.
So, the Volunteers, listen, empathize, and, if needed, help figure out a plan for getting care. Only in rare cases did YouthLine need to contact emergency services.
Fiona: We just have a much better perspective on what it’s like to be a teenager today and the complexities that comes with and the strain that that can put on your mental health.
William Brangham: And the need is clearly growing. YouthLine started over 20 years ago, and, in 2013, it received roughly 1,400 contacts, many coming from in state.
But, by 2021, things had exploded, with almost 25,000 annual contacts from all across the country.
But is it a good idea to have teens field these calls? And what impact might that be having on the Volunteers themselves?
Emily Moser is YouthLine’s director.
Emily Moser, Director, YouthLine Programs: Woven into all of the mentoring, all of the training are these — these safeguards for these young people, that we have contact information for their parents. We can reach out to them if they need to.
They do check-ins every day after every shift. We underestimate the capacity of what young people can do to help other young people. As adults, it’s easy for us to say, they can’t do that. But they can.
Related: PBS NewsHour
William Brangham: Seventeen-year-old Aditi Khanna has been a YouthLine Volunteer for about 10 months.
Aditi Khanna, YouthLine Volunteer: Everyone tries to go immediately towards, like, solving something. Like, you can’t always solve everyone’s issues. And just telling them that you hear them, I think that’s the biggest difference between what we’re trying to do and what anyone else is.
William Brangham: Like many who work here, Aditi herself has faced some mental health challenges. She was diagnosed with depression and anxiety in seventh grade.
Aditi Khanna: It is so much harder than you would like imagine it to be, right, because it’s like — it feels like lifting like 1,000 pounds just trying to get up.
William Brangham: The news came as a shock for Aditi’s mother, Sangeeta.
Sangeeta Khanna, Mother: I love my kids. They get everything.
William Brangham: What could they be?
Sangeeta Khanna: What could the depression be about? Like, my heart sank immediately. I said, no.
William Brangham: Aditi started therapy, tried medication, and saw a drastic improvement.
Now not only does she Volunteer with YouthLine. She says she can also sense when something seems off with friends or classmates.
Do you think there is a real crisis among young people now?
Aditi Khanna: Oh, completely. I think that it is very rare that I meet someone and that they’re not struggling with their mental health.
William Brangham: A state audit in 2020 found Oregon’s youth mental health system left many children and their families in crisis due to, among other issues, severe staff shortages, poor data, and fragmented delivery of care.
And that was even before the pandemic exacerbated those issues.
Nick Kintigh, Randall Children’s Hospital: We have this huge massive influx of families needing services all right now and at the highest need right away.
William Brangham: Nick Kintigh is a pediatric psychiatric social worker at Randall Children’s Hospital in Portland, where they saw a surge of young people who had attempted suicide.
Nick Kintigh: We’re not specifically a psychiatric hospital. But, at one point, if I remember right, my supervisor told me that our hospital census was 33 percent psychiatric kids.
William Brangham: Wow, a third.
Nick Kintigh: A third of our entire hospital at one point was acute psychiatric kids needing a higher level of care. And our staff is not equipped to manage that.
William Brangham: And it’s not something you budgeted for the year before?
Nick Kintigh: No, or trained. And so you have certain floors with highly trained nurses and pediatricians taking care of infants and babies with RSV.
And now those nurses are having to taking care of a 17-year-old with a suicide attempt that is highly aggressive and angry.
William Brangham: Eighteen-year-old Sam Adamson began having suicidal thoughts when he was just 11.
Sam Adamson, Teenager: I would say there were a rare amount of times where I felt truly happy.
William Brangham: The scariest part, he said, was when the idea of suicide became almost second nature.
Sam Adamson: Wondering why I’m having dinner. Oh, I have to work on this. I want to kill myself. I want water. And you just skip over this massive thought. When you look back on the fact that you were thinking I want to kill myself in a very subtle second, that’s terrifying.
William Brangham: Sam’s mom, Jessica, says finding the right care for him was terrifying too.
Jessica Adamson, Mother: We are very fortunate to have insurance, to be part of a health system that is very well-resourced in mental health resources. And, frankly, I have a job in health care where I knew how to… (CROSSTALK)
William Brangham: You knew how to navigate.
Jessica Adamson: Right.
And even with all of that, when you call and you’re told that it’s six weeks, at a minimum, before they can see you, that just seems impossible.
William Brangham: Last year, when Sam was a senior, he called his parents from school.
Jessica Adamson: He said: “I want to go and jump off of the fourth floor.”
And there is something about hearing your child who, at the very moment where he should have the most hope and opportunity, wants to stop participating in the world. It was scary. It broke my heart.
William Brangham: Sam went to the emergency room and ultimately enrolled in an intensive outpatient treatment program at Providence St. Vincent Medical Center in Portland.
Sam Adamson: It only happens for a certain amount of weeks. You essentially take it like a class, and studied the content that they gave me and took notes.
William Brangham: These are tools that you use…
Sam Adamson: Yes, I use it on a daily basis.
William Brangham: Is that right?
Sam Adamson: Yes.
William Brangham: Daily basis?
Sam Adamson: I still have the notes upstairs in my backpack that just flip through. I remember some of the details about what I talked with my therapist., but what I do remember is us going over what strategies to use during certain occasions.
If I didn’t have those things, I don’t think I would be sitting here today. But the fact is, that makes me a miracle. And miracles don’t always happen. That gives me a mix of anger, frustration, and also a bit of fear and a bit of pain, just knowing that there are people who aren’t that lucky.
William Brangham: Organizations YouthLine are trying to fill the gaps and help more people get care. They’re looking to broaden the diversity of their Volunteers and expand nationally.
Despite difficult calls and long days, Volunteers like Aditi Khanna find the experience invaluable.
Aditi Khanna: Even if it’s just that tiny push or pull that someone who needs — off the ledge, and it can be that for one person, then we have done what we need to do.
After I’m done with YouthLine, if I can go like, yes, I was able to help one person from committing suicide, that’s, like, all I need for the rest of my life.
William Brangham: For the “PBS NewsHour,” I’m William Brangham in Portland, Oregon.
Geoff Bennett: A reminder that anyone experiencing a mental health crisis can get help by calling the Suicide and Crisis Lifeline at 988.
Amna Nawaz: And the “NewsHour”'s own nationwide network of student journalists has also been tackling the issue of teen mental health as part of their award-winning podcast “On Our Minds.”
Check it out.
Narrator: Teenagers, we’re Olympic athletes. We’re young inventors. We’re musicians. We’re activists.
Narrator: We come from so many backgrounds and are the most connected we have ever been.
Narrator: But we have our own set of challenges.
Narrator: Depression, anxiety and stress are on the rise.
Narrator: Thankfully, we’re not in it alone.
Narrator: “On Our Minds” is a podcast about the teenage experience.
Narrator: Like a resource and an outlet so that they can better understand themselves.
Narrator: Made by teens for teens.
Narrator: Each season includes two team hosts and covers topics such as grades.
Narrator: Coming out.
Narrator: Eating disorders.
Narrator: Self-esteem.
Narrator: Cultural identity.
Narrator: And all the things we as teenagers face.
Narrator: Student reporters from across the country produce stories.
Narrator: We also talk with psychologists, musicians, authors and athletes to get advice about mental health and well-being.
LeBron James, Los Angeles Lakers: It can become overwhelming.
Narrator: There’s a lot on our minds, and talking about it helps.
Narrator: “On Our Minds” is a project of a “PBS NewsHour” Student Reporting Labs.
Narrator: Listen wherever you get your podcasts.
To receive help from YouthLine, call (877) 968-8491, text “teen2teen” to 839863 or go to oregonyouthline.org for chat and email options. Teens are available to help daily from 4 to 10pm PT and adults are available all other times.