What Can States Do to Tackle Youth Mental Health? | MGH

What Can States Do to Support Youth Mental Health? feat. Senator John C. Velis

States mental health - Quote from State Senator John Velis over gray background: "The Three most difficult words for any human being to say are also the most courageous: 'I need help.'"

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Posted in: Multimedia, Podcast

Topics: Child + Adolescent Development, Culture + Society

To address the youth mental health crisis, we need to approach it from different angles – including access, education, and legislation. So, what are states doing to make a difference?

Tune in below, or wherever you stream!

Today, Gene and Khadijah are joined by special guest Senator John C. Velis of Massachusetts. Senator Velis shines light on current efforts in Massachusetts to better utilize schools for prevention and early intervention, to help increase the behavioral health workforce, and more. He also generously shares some of his personal mental health journey.

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Transcript

SPEAKERS

Gene Beresin, MD, MA; Khadijah Booth Watkins, MD, MPH; Senator John C. Velis.

Senator Velis  00:01

The three most difficult words for any human being to say are also the most courageous. I need help. And if if when that person raises their hand and says I need help, we need to be there as a system as a state, collaborating with our friends in the nonprofit sector, in the hospitals and everything to be there when they need it.

[INTRO MUSIC]

Gene  00:28

Welcome back to Shrinking It Down: Mental Health Made Simple. I’m Gene Beresin.

Khadijah  00:33

And I’m Khadijah Booth Watkins.

Gene  00:35

And we’re to child and adolescent psychiatrist at the Clay Center for Young Healthy Minds at the Massachusetts General Hospital. Today, we have a very special guest joining us to talk about youth mental health crisis from a legislative perspective.

Khadijah  00:49

And that’s right, we’d like to welcome to the show Senator Velis.

Senator Velis  00:52

Great to be here. Thanks for having me. And I really want to thank both of you for the work that you do. We need more of you for sure. But I’m sure we’re gonna get into that here shortly.

Khadijah  01:02

So, Senator John C. Velis represents the Hampden and Hampshire districts of Massachusetts. That’s in Western Mass for the for those of you who don’t know – which I include myself in that bucket not that long ago. This includes his hometown of Westfield and eight other cities and towns relevant to our conversation today. He’s the chairman of the Joint Committee on Mental Health, Substance Use and Recovery. He’s also the chairman of the Joint Committee on Veterans and the Vice Chairman of the Joint Committee on Elders Affairs. He is a lawyer, a Veteran of the US Army Reserves, and currently a Major in the in the Massachusetts Army National Guard.

Gene  01:36

And I have to add a couple of things.

Khadijah  01:38

Of course you do.

Gene  01:40

Well, I’m familiar with this committee, because my daughter, Caitlin, was the house attorney under Liz Malia when she was running it, but it wasn’t called recovery. So I think that’s an important addition, it was the Joint Commission for mental health and substance abuse. That’s one thing. And the second one is, you’re a parent, right?

Senator Velis  02:04

I am indeed, I’ve got a one year old who’s turning to this Thursday.

[HAPPY BIRTHDAY MUSIC]

Khadijah  02:08

Oh, wow.

Senator Velis  02:09

Crazy, crazy, crazy little guy like who I like, who I love dearly, but he certainly keeps myself and my wife. Busy. That is for sure. But yes, I do.

Khadijah  02:21

Oh, happy birthday.

Senator Velis  02:23

Thank you very much. I will pass it along. His name’s Carson.

Khadijah  02:26

So cute. So, Senator, we’re pleased to have that you could join us today. And for those of you are listening, maybe you weren’t aware, but in September, Senator Velis and his co-chair representative Adrian Madaro, hosted leaders from the Mass General Brigham system at the State House for a special forum on Youth Mental Health. I was honored to be included in that conversation. And I was really moved by the efforts that you’re making to help find legislative ways to address the mental health challenges that so many kids and families are facing. So maybe we could just start off a little bit with you sharing why mental health, and in particular youth mental health, is a priority of yours?

Senator Velis  03:03

Yeah, of course. It’s a great question. And I’m even going to rewind it a little bit further, to how I found myself, as chair of, of this committee, you know, I myself, my own personal lived experience, really, really, really, really, really struggled with substance use disorder with alcohol and drugs as well. And, you know, I got, I got sober coming up on seven years, February 20, 2017. And what’s happened with me is I’ve kind of I’ve, I’ve undergone this transformation, if you will, from an intellectual standpoint, where these issues really, really, really, to say they fascinate me would be a profound understatement. So I really kind of initially showed my interest in this almost in the SUD side of the house, if you will. And then I get named the chair of this committee, which obviously encompasses mental health, substance use, as well as other things as well as recovery, as we already talked about. And I’ve just been fascinated by the challenges, the complexities, the nuance, of mental health in general, particularly as it relates to kids. We just talked a little bit about it, you know, this has been a passion of mine for some time right now. And also, you know, I just shared that I’ve got a, I got a little guy right now. And it just there’s nothing that I don’t know how to word this, other than to say that, you know, the way that our kids our youth are feeling, right, I think is really, really important. And I think it’s, I think we are in the throes of some really difficult times in that space. And I can think of nothing more sad than a young kid who was struggling with things that they have going on in their lives. And there’s so much overlap with the SUD space as well, but it’s just a, it’s a fascinating field that I that I absolutely love. And I hope to be the chair of this committee for a very long time.

Gene  05:06

First of all, I think you exemplify what we wish everybody would do. And that is, is to destigmatize mental health disorders, you’re coming out with your history is a model for all of us that the data shows that in the course of a lifetime, one and two will have a psychiatric disorder. 50% begin before age 14, and, and 75%, before 26. But even now, stigma and keeping these things under wraps is really the name of the game for most people. So, I’ve really, you know, it’s so good to hear folks just being open and honest about this. And I wish everybody that had a problem like this. I mean, so thank you. Thank you.

Senator Velis  05:19

You know, it’s that, in that vein, it was somebody out from the eastern end of the state, they’re coming out in a very public way. You know, somebody who I credit with helping save my life in the former the former mayor of Boston and Marty Walsh. I did not, I did not serve with Marty. He was a rep and he got elected mayor right before I got elected state rep. But I had read the coverage about his struggles, everything he had gone through. And that kind of gave me the courage, I would say, to to reach out to him. So, I didn’t know him at the time, I didn’t have his cell phone. So I literally called the Boston Mayor’s office and said, “Hey, I want to talk to the Mayor.” And the nice lady who answered the phone was kind of almost confused. But anyway, long story short, you know, Marty calls me back and it just started just a beautiful friendship that I that I value incredibly. And it’s his, it’s Marty coming out. And then reading about it in The Boston Globe and stuff like that, which caused me to reach out to him. So I think it’s, I think if we do this thing, right, and those of us who are in this thing, kind of raise their hand and say, “Yeah, me too. I got that.” You know, the hope is that, you know, someone who’s out there will will see it and say, “Huh.” Ao I think it’s I think there’s a lot of value in, you know, in coming out and sharing your story. And I think it pushes back on something that still really exists out there that stigma, of course.

Khadijah  07:35

And to Gene’s point, I think, you know, these, these conversations just really allow us to encourage other people to have conversations and empower people to have conversations that that they can find so incredibly meaningful and helpful on their journey, whatever, whatever the journey is, but so many people are afraid, because of the stigma and the shame to even speak about it. But when we speak about it, and give it life and give you permission, if you will, to kind of speak on it to that. And I think it’s just so incredibly important to the work overall that we’re doing here that you’re doing there as well.

Gene  08:09

So, when we hear about youth mental health and Massachusetts, it’s often focused on the greater Boston area. So can you tell us a little bit about the districts who serve in Western Massachusetts, how they reflect or how they’re different from Boston and the surrounding suburbs? And in particular, please let us know about the clinical needs of young people and families in your district?

Senator Velis  08:33

Yeah, so I think I think it varies, I think that’s a really important question. You know, my district, I’ve got everything from the urban, you know, places like Holyoke, Massachusetts, the city, suburbs, you know, a place like my hometown, Westfield, West Springfield, and then the rural is well, Russell and Montgomery. And I think kind of in reverse order. One of the biggest challenges, I think, in the rural spaces is that is the is the real lack of providers, I’m talking about half the travel miles and miles, assuming you can even get a provider, right, which is a challenge across the state, you know, with the waiting lists that are out there, it’s actually having to go travel several miles to, to if it was going to be an inpatient type of type of interaction to go. And I think that’s a really big problem. So, what you ultimately end up see happening is that really primary care physicians and pas and things of that nature, by default, ended up being that behavioral health provider. And and I guess, right, better than nothing, but certainly not optimal, right. So, a big part of my focus is, you know, the parts of the state that, you know, historically, you know, I think the entire state is lagging in many respects in the behavioral health space, but I don’t want to I don’t want to minimize how good we are in Massachusetts, but it’s definitely uneven playing field. So, you certainly see that in the more rural communities.

I mean, I remember when I first decided to run for the state senate seat, I was doing a question and answer and this place called Granville, which I no longer represent because of the last census and the redistricting. And one of the one of the participants, one of the people attending it to find out what I had to offer, asked me a question. And the question was really, you know, what are you going to do about the fact that the lack of broadband Internet access, and on any given night, around 7 o’clock, you’ll see a bunch of cars in a parking lot around the cell tower, because they’re not getting that service in their home. So, they all have to go to this parking lot to be closer to the cell tower, so they can get access. And that really was kind of a, just a wake-up call in terms of like, the unevenness of the stuff that’s out there, and really, in any space, but certainly very pronounced in some of these more rural communities. So that that’s one of the things I think that that keeps me up at night.

Then look, and then many of the challenges are the same, right, we’ve got the, we’ve got the ED boarding going on, we’ve got the fact that you really, you’re lucky to be very candid with you, you’re lucky if you can call someone up and say, “Hey, my, my son, my daughter, my kid needs a provider, this is what they’re going through.” And if you’re able to get that in, you know, less than a 3-month time period, I think that’s being really, really charitable. And I just think that’s a colossal failure system. Why? Because the reality is, as you folks know, better than I do, I mean, the, the three most difficult words for any human being to say, are also the most courageous: “I need help.” And if if when that person raises their hand and says, I need help, we need to be there. As a system as a state, collaborating with our friends in the nonprofit sector, and the hospitals and everything to be there when they need it. So, it’s, it’s different, but the real pronounced ones, is in the in the rural side of it.

And then and then in the urban side, Holyoke is a community that is predominantly Latino. And, you know, one of the concerns I have that if you look at the providers that are out there, in many instances, they don’t look like the kids who are going and getting the help. And I think for any number of reasons, that’s problematic for lived experience, for willingness to really share your story, we need to do a much better job ensuring that our providers in many instances look like the people who are getting help. So, there’s a lot of things, there’s a lot of similarities. I don’t want to say that it’s, you know, just two vastly different countries are out there. But some of the some of the challenges that we face, as you know, are system wide or statewide. Yeah.

Khadijah  12:55

And in some past interviews that we’ve listened to, you’ve mentioned that you’ve done a lot of listening sessions with K through 12 students at their schools, throughout your districts. Can you tell us what you’re hearing from them? And specifically, like, what do they see? Or how do they see their biggest mental health challenges?

Senator Velis  13:14

Yeah, it’s funny I, so I go in there. And typically, what I do is I’ll do I’ll do 2 hours at a school, do the first hour with the kids. And then I’ll do the second hour with the, with the providers. So, the adjustment counselors, the guidance counselors, and any other any other school person that wants to be there in the kids, that I’m interacting with a couple things. And it’s, it’s truly fascinating, it’s truly special. But every time I leave the school and walk to my car, again, I’m going to use that “S” word, that sad word, because I’m noticing the kids are freely saying like anxiety and depression, you know, so even get into things like suicidal ideations that they’ve had to gone through in their experiences, and COVID, and all of that. So I leave sad.

But at the same time, you know, some of these kids, many of these kids, and I want to try to do is I break the ice. So, what I’ll go in there, a lot of times, I’ll leave with that. I’ll say something along the lines, something crazy that I know that’s gonna get them like really into it and just laughing. I’m gonna say like, “I want you to raise your hand if you think it’d be a good idea for me to file a bill to ban TikTok or banned SnapChat.” And it’s like, I just started like World War III, when I say that. But what’s fascinating is what happens after that, right? So, they talk about it, and they say, “No, no, no, no, you can’t do that.” And I said, “Well, wait a second. How many of you participate in, in social media?” And then of course, they all raise their hands, you know, and then I’ll say, “How many of you think it’s good for your mental health?” And not a hand goes up, maybe one will go up. And they’ll say something along the lines, which I tend to agree with that, you know, for many marginalized communities or just communities of support that are out there. They’re able to find them through social media, but then they get into the number of hours that they spend on and then they get into how, you know, it might prevent them from going to the gym, or it might prevent them from going to bed before 2am. And most importantly, in my opinion, it prevents them from kind of getting out and engaging in social connections, right, these things that we’re genetically wired to do. But then we just have this all just inclusive conversation. And many of my takeaways are like –

Look, I hear a lot about stigma. But I’ll tell you what, this class that I’m with, and this was district wide, right, so again, going to the urban, to the rural and everything in between, you know, much more willing to freely and openly say, “Hey, I’m struggling,” you know? And I’ll be honest, I’m not sure I would have said that back when I was their age. So So I think in many respects, we’ve made some good I don’t want to say great, but good strides in the stigma space, because kids are saying, they said it to me, I’m not reading this, they’re telling me this, and many schools that I’ve been to. But it’s what, it’s what comes after that, that, you know, keeps me up at night. It’s the, you know, it’s the social media stuff that’s kind of dominating them. It’s the fact that it follows them into the school. It’s that social affirmation that they’re constantly seeking, with how many likes they get, how that exacerbates depression, anxiety, and then it gets real kind of sad, when some of them talk about, you know, about a year and a half ago, I was thinking of I was thinking of taking my own life and in many of them will describe some really innocuous coincidental thing that led to them, ultimately not taking their own life.  Or, or their experiences and trying to take their own lives. So there’s just a lot out there.

But you know, just great conversations, I didn’t know if they’re going to be willing to talk to me, when I went into these things. Here I am, I’m coming in as a state senator, I represent them, you know, I would have been like, I’m not saying anything to this person, they’re going to tell my teacher, my principal, next thing I know, I’m gonna be down in the office, my adjustment counselor, and there was none of that. So, so a mixed of emotion, but again, you know, willing to share, but at the same time saying things that that I didn’t talk about, with my friends, you know, when I was coming up, you know, however many years ago, so mixed baggage, but it just further was validation that we’ve got, you know, whether we will call it a behavioral health, youth behavioral health crisis, epidemic, whatever you want to call it, there was something going on out there. And as you know, both know better than I know, you know, a lot of people I think attributed, sometimes exclusively, I’ve been at conferences before where people will say, you know, this has been caused by COVID, in the pandemic and all that stuff. And, you know, as you know, I mean, certainly exacerbated. But there’s it wasn’t caused by that this thing has been going on for a while. But that isolation certainly did not help and exacerbated it in the kids were freely admitting that.

Khadijah  18:06

I’m curious, because you didn’t mention you spoke to some of the adults in the school to where they also open? And did they have concerns similar to the kids? What were their concerns different?

Senator Velis  18:16

They were more concerned… So, we also have this, as you know, we’ve got this, we’ve got this crisis amongst our educators, right, and the providers, right, just the, the numbers, the workload, etc. But every school that I went to, they were they just wanted to talk about the chaos. They obviously talked about things that obviously segue into them as well – we need more of us, we need more resources, we need the ability to, to if we have a kid who presents with some really serious things going on, that is beyond our work, or our expertise, if you will, we need to be able to get with someone in a very timely fashion to get that person help. And that’s a big concern that they then talked about, you know, we don’t want to tell them to go to the emergency room, because they’re going to be there for a while. And that’s not good for any number of reasons. But then they talk about, hey, this, this, this kid needs to talk to somebody, there’s a lot going on. And I’ve got 10 kids outside my office who need to talk to me as well. Right? This is beyond the scope. And it’s all great, we’ll see, we’ll see  John Velis 6 months from now. It’s not the answer. That’s not an answer. That’s not an answer that works. So a lot of that stuff.

And then also, I mean, you also hear too from the providers, you know, the social emotional learning component of this, right, like, I don’t think we do a good enough job in our curriculums talking about this stuff. It’s just, and I think and that’s a whole other podcast, I think. But you know, there’s some real rigidity when it comes to let’s change curriculums out there. There’s a whole lot of different forces that might not want to see that happen in won’t allow that to happen in a timely way. We should be talking about this stuff nonstop, from a very young age and at the risk of a very flawed analogy, you know, I always talk about, and I was talking about a similar type of podcast the other day about this, but in the substance use space. And it was, look, we spend a lot of time there’s a lot of there’s a lot of schools that are still doing D.A.R.E. And look, I was a proud graduate of D.A.R.E. I spoke at a dear graduation the other day. But the reality is we’ve got empirical data that says that dare doesn’t work. It just isn’t the best type of getting in there, and prevention and talking about it. And I’m now going back to the mental health space. I think a lot of what we’re doing right now is kind of stuck in that antiquated D.A.R.E. mentality where we if we truly want to destigmatize this, what’s the best place to do this in terms of what we in the army call a force multiplier, which is the most benefits from a single event and it’s the school, right? We’ve got 90% of our kids are in our public schools. My mom’s a teacher in Holyoke – I should say, a recently retired teacher. And what she would always say to me is Johnny, my problem is my concern is that from the time my kiddos leave, to the time, they come back in the morning, what have they eaten, what have they been exposed to, and all that stuff. So school is a really great opportunity for us to get with our kids and see what’s going on. We just have to fix some of the behavioral health stuff going on in our schools.

Gene  21:30

I think it’s a great point. From my standpoint, as a as a child psychiatrist, I think you’re right. The kids are really leading the way in terms of being more open and honest, than the adults. Absolutely. But let me ask you this. from a legislative standpoint, how can we incorporate a social emotional learning platform? Which I agree with you. I think it should be from toddlerhood through college, K through college. What what can be done to actually bring this to fruition?

Senator Velis  22:08

So, I had a meeting last week, or I guess it was two weeks ago, with Secretary Tutwiler, our new Secretary of Education, he obviously came out and said, you know, a big priority of the Healey administration is mental health in schools. And it was this very topic in they were at the stage. And by the way, I think I think that guy’s absolutely aces. I think he’s great for the Commonwealth of Massachusetts. He said, look, we’ve got a weird dynamic going on in the Commonwealth right now. Here’s where we’re at. We’re at the stage now, where we’re trying to figure out what is going on there. To the question that you that you raised initially about the differences between say, Boston and Metro Boston and out in my area, he’s like, and this is his words, not mine. This is this is the wild west out there in terms of what schools are currently doing to actually help from a behavioral health standpoint. So, they’re kind of in the fact finding, what are we what’s out there? What are schools doing? And then it’s going to try to get some uniformity out there and kind of say, look, whether it’s Russell, or whether it’s Boston, this is what the expectation is, this is what we’re going to do. And there’s some really good bills that are out there right now that kind of capture this, right, it’s, let’s create kind of this commission out there and there, where their sole job is going to be to kind of look at the behavioral health needs of our students K – 12. And implement curriculum.

Now, when I when I first heard that when I came in front of our hearing, I had a lot of questions. And one of my questions initially was like, whoa, wait a second here. Let’s let’s let’s pause for a second because again, going back to what you both have correctly identified, Boston is different from Russell, Springfield is different from West Springfield. Amherst is different from Northampton. You know, anytime I hear about some one of these commissions, that’s going to be tasked with implementing, you know, the behavioral health guidelines and curriculum for the state of Massachusetts, my first thought is, wait, who’s going to be on this commission? Because if it’s not a reflection of our entire Commonwealth, both from a racial standpoint, a socio-economic standpoint, a geographic standpoint, then I’m going to have real problems with this. And I raised much of this in the back-and-forth in my question and answer with the witnesses who are testifying. And they assured me that no, we’re – we hear you loud and clear that, you know, providers need to look like the kids, providers need to look like the patients. You know, what goes on in Western Mass is different from what goes on east of Worcester. So, I think there’s a lot in play. And I think that this administration is deeply committed to it in the way that we left it. Secretary Tutwiler and I was, you know, they’re going to kind of finish up that deep dive. We’re working on our end insure more, on bills that are in front of us with the voting them out favorably voting them not out favorably. And the hope is that we can get to a consensus on some really, really good policy stuff here. And then I think there’s been things that have been done right.

One of the proudest things I’m proud of anyway, you folks know more than me, it’s not good at all, I’d be interested in your take – but, you know, obviously, the MCPAP, is seeing MCPAP that we use with our pediatricians in schools. You know, the state of Texas came out and said, well, let’s emulate this in the schools, let’s kind of set up the same thing where we have schools where if kids go to school and present with something that might be beyond the scope, or beyond the capacity of this guidance counselor or adjustment counselor, they’re going to be able to pick up the phone and call – just like MCPAP – and kind of get some guidance and answers. So, we put in, I sponsored a budget amendment to put in a pilot program for that the rollout in the Commonwealth to see if we can kind of put a MCPAP in the schools, and it passed. So, we’re in the process of rolling that out as well. So, I think there’s any number of ways to do it. And I think we’re doing many of them and on the verge of doing many of them. We just got to figure out what’s going on out there. And the best way to proceed and recognize all the nuances and complexities based on where you are in the state.

Khadijah  26:21

I mean, we definitely think schools are the place to be. And if we think about most kids, then most of their waking hours in school, whether it’s for academics, or social things, or sports. And so there’s so much that can happen in schools. But I think if we really think about this thoughtfully, this could be a way to really kind of take a preventative approach to mental health, as opposed to the reactive approach that has is where we are here today. And so, in that same vein in terms of thinking about prevention, because we do know, in all of medicine, prevention is the way to go. And that’s gonna give us the best outcomes. You know, we try to because –

Senator Velis  27:01

I love you saying that, by the way, because I think any number of areas in treatment, treatment treatment, yes, but prevention is the thing that is left out of so many conversations, if you asked me. Sorry, I interrupted.

Khadijah  27:14

No, and we agree wholeheartedly. And the other thing I think that goes along with prevention is education. So, if you don’t know, you know, what to look for when to worry what to do, if you don’t know the signs and symptoms, you can act, and I think if parents knew, they would be able to respond, and on behalf of their kids earlier, maybe before they even need someone like me or Gene. And so, you know, that’s why we feel so strongly about education, we’re doing a lot to put education out there, because there’s just not enough providers. And so I guess in that same vein, as we try to do this and put out education for parents to take advantage of to us to be able to support themselves and their children. Do you see any opportunities for helping to increase the behavioral health workforce? Um, again, I think schools can be a place because, you know, while they’re students, they’re also parents and caregivers, that could be a captive audience as well. But in terms of the workforce piece, do you have any thoughts about opportunities to increase the workforce? And I think MCPAP is amazing.

Senator Velis  28:12

Yeah, I do. So, I am blessed to have right up the road from where I am Westfield State University. And the new president, I asked her, I said, Look, I want to come to your school. And I want to talk to I want to talk behavioral health. And I want to talk about it in the workforce context. And I want to talk about it in the How can we get more? How can we create a pipeline, if you will, from K – 12, to college, to the workforce in behavioral health. So, I walked into this room that I thought was going to be me and like 5 people, and the President had gotten 200 people there. And it was aspiring RNs, social workers, nurses, psychiatrists across the board. And I very early on in my, whatever I was doing back and forth with the students, I asked them to raise their hand, I said, “Raise your hand if you’re thinking about going into behavioral health.” And I expected a mixed bag. And I’m looking around the room and I didn’t see a hand go up.  So I asked the question again, thinking they didn’t hear me. And oh, they heard me. And there were literally zero hands that went up out of every single person that was there. And I said, Wow. And meanwhile, I had in the back of my hand, my head, I knew what we were working on. And we’re getting ready to roll out the Behavioral Health Trust Fund the $200 million that we released for scholarships, loan repayments and stuff like that. So I raised my hand and I said, “Okay, I guess no one wants to go into it. Let me ask you this. If the state of Massachusetts were to somehow incentivize with again, scholarships, loan forgiveness, etc. How many of you would consider going into it?” And virtually all of their hands went up, which is fascinating to me and it tells me that she Students, you know, aspiring whatever, they’re taking a hard look at, you know, things like, Hey, can I afford to live in Massachusetts where I live? Hey, can I can I take on this type of student debt? If when I get out, I’m not going to be able to be able to pay that debt back and also get an apartment, also get a house down the road, etc.

So, So, to answer your question, yeah, we’ve spent just in the past year $200 million, to try to entice people and incentivize people as part of the Behavioral Health Trust Fund that went out. But that’s just scratching the surface, right? There needs to be more and more and more of that. But I think it’s a really good start, right? We need people to want to go into this field, and we need to want people to go in and say, hey, I can afford to live right? The cost of housing is skyrocket. It’s impossible to separate any of these issues from each other anymore, because they’re truly having an impact on the workforce. And then, and then look, let’s be honest, I mean, I think there’s the wages too, right? And there’s been a lot of really smart people that have said to me, “Look, you guys can do all you want about loan forgiveness, scholarships, and stuff like that. But if the reimbursement rates and the wages are such, you’re still going to have a challenge of people going into this.” And again, I don’t have to tell you folks that you know, this is leading this is intimately tied to things like ED boarding, this is intimately tied to the fact that we can’t staff beds, this is intimately tied to the fact that it takes months to get a provider to be able to see you and talk to you. So there’s any number of things.

So your question, I hope I’ve answered with what we’ve done. But I don’t think you can do enough in this space, because this isn’t getting better. So we need to continue to invest money in this right now. I think this topic we’re talking about the way that I’ve kind of phrased it is that behavioral health is the most important topic that not enough people are talking about is the way that I’m kind of phrasing and explained to people. And I think there’s a lot of people talking about right. And I think that’s good. And I think we’re pushing back on the stigma and the number of people that are talking about it. But I still think that if you were to go up to, you know, a random 20 people anywhere in the state of Massachusetts and say, what are the top three biggest challenges in Massachusetts right now – housing and many different things, you may get some who say behavioral health – I would argue it’s right at the top. Because look, if you don’t have your, you know, if you don’t have your mental health, right, in my opinion, anyway, all the other things you’re gonna I think, you know, all the other things, you know, are going to be difficult, right? If you’re kind of, you know, dealing with something, and you’re not getting the adequate help for in early interventions. I think it’s really, really important that we make the focal point of our efforts, schools, but also in other ways, too. You know, I think data tells us right, that the earlier we intervene, the better off we are, and maybe prevent some of the downstream impacts of mental health and behavioral health. So yeah, be building up the workforce is a really big deal right now, priority number one of mine, because it’s tied to so many of these other things.

Khadijah  33:13

I love the idea of motivating and incentivizing people financially and asking for a friend that is this going to be retroactive, like, can you go back and access the trust, but you can answer me later. But the other idea of this pipeline, I think, is also kind of really important, because, in part, you know, when sometimes when I think about when we say behavioral health or mental health work, sometimes kids don’t even know what exactly that looks like. And so, I think, thinking about exposing them early and given them experiences and talking about careers, but I think about doctors say at my school, the psychiatrist did not come to the doctor’s day, or, you know, a psychologist did not come to us. It was the cardiologists or the internists. And I think really exposing kids early on to this field. And what this field has to offer is another thing that can be really helpful.

Senator Velis  33:59

We’re trying to we’re trying to set up – to your point we’re trying to set up, you know, and I’m doing it through the communities that I represent Westfield State, Holyoke Community College, really the schools that are at least out here anyway. Kind of the real pipeline to these fields, and trying to get them to go into schools much younger than high school, right? Like, hey, this is the path that I’m taking. This is what it’s about, because we’ve also seen, the more someone knows about this field, they’re more inclined to kind of get into it, because I think it really lends itself to inviting people that want to help other human beings. So, I think that yeah, I think that pipeline is a really big thing. And you can tell your friend, we can talk about that, we can get all of the information to your friends about the way that you get involved with seeing if their eligible, the answer is yes.

Khadijah  34:56

I will let her know.

Gene  34:57

And I might add another, another l element to this. peer counseling is a is an incredibly powerful force. You know, the Students Against – I was a spokesperson for Students Against Destructive Decisions for a long time. You know, we’ve seen it work effectively in the 12 step program. We’ve seen it work effectively in schools and in colleges. And so why not? Why not engage the students under supervision, with some empowerment to help other kids? So what do you think about that?

 

Senator Velis  35:35

I think it’s absolutely underutilized. And I think that peer support, which I think is what we’re talking about – some variation of that – and peer support is the most powerful. And I want to be, I want to be careful here, right? I I don’t want to conflate my biases with empirical evidence. But here’s what I can tell you. Back to my experience in the SUD space. My parents tried any number of things to help me out, get the help that I needed. And I was like, Yeah, sure, good. Got it. I’ll go talk to this person, I’ll go talk to that person. And I would always go back drink, and use, all that stuff. What got to me, ultimately, was another human being who also was in the throes of an addiction, who sat down with me and said, “John, I’m not judging you, I’m not doing anything. Let me tell you my story.” And what I can tell you is that I could feel my body and my mind, as he was talking to me, disarming, whereas before I had this protective, like shield and body armor on, because I didn’t want to be vulnerable. Now I’ve got another human being telling me about their common experience with exactly what I was going through. I think peer support is the most powerful thing out there, whether it’s the mental health side, the substance use side, or anything out there, we need to be investing in those programs. And so, so fast forward, what we’re just talking about before, you know, a big part of that, you know, when we go to the schools, and we talk to people, is having someone come in there and say, “Look, this is my experience, this is my story. This is what I was going through, this is what I did.” Right? Kind of going back to that, Oh, wow. There’s a human being who also I thought I was alone. I didn’t want to share this with anybody. And it turns out, I am not, that is incredibly powerful. And it’s tough to quantify that it’s just an intangible that has remarkable results.

Gene  37:36

And if part of the social emotional learning program that you’re advocating, we – and I know that you said this, because I read in the in the Gazette – that that physical health and mental health are assuming the same playing field, and that, that education, about mental health illnesses, challenges, socio economic forces, cultural forces, that are all part of this, that are integrated into the curriculum, and not necessarily just in special classes. But that, you know, in biology, learn about it. In history, learn about it. In sociology, learn about it. So we could weave it into the entire curriculum. But you know, we’re short on time.

But if you could share a message with Massachusetts parents about child and teen mental health, what would it be as a state senator? What would it be as a parent?

Senator Velis  38:38

A message to other parents about mental health as a Senator and as a human being.

Gene  38:44

Exactly.

Senator Velis  38:45

I mean, I guess, toughest question yet so far. So I’m relatively new to the latter one. And I can just tell you that, like my son, Carson is without a doubt, the most important thing in this world to me, I love them in a way that I never thought I could not love another, another, another anything. And, and I think that’s a big part of it, right? I think it’s just letting your kid know, how much you love them. And I just think that’s a really big part of it. And I think it’s – you know, they’re gonna mess up, they’re gonna have they’re heartbroken, they’re gonna fill in the blank. All that stuff is going to be there, and just being there as a parent, whether it’s to cry on to laugh on or whatever. I know this sounds so corny, but I just think it’s so, I just think it’s so important right now. And I think a lot of times, we get into trouble in many instances where that’s not there. And in many instances, it’s not there. So I just think that’s a really important thing.

And then as a State Senator what I would say is that to tell your kid is that – you know, the one thing that I say, and I don’t even know if this is coming from me, as a State Senator, but it’s… You know, I love, I love telling people, you know, again, the three hardest words or the also the most courageous words. “I need help.” Right? There’s no shame in this right? We want to get you to a point where you can live your best life, whatever that may be. So just, encouraging your kiddo to, if they need help to come forward and be understanding, be compassionate, be empathetic about it, I’ve kind of conflated it because I feel like I answered both those questions more as the parents space, if you will. But I just think that’s a really, really important component of what’s out there. And also be mindful –

So we’re working on something and we didn’t talk about it at all. But, you know, be mindful, I think, I think social media is, is really, I think social media is really bad. I’m just gonna come out and say it. And this is a whole nother podcast right now. But I think, I think the way that our kids are targeted with algorithms, I think it’s, I think it’s sad. And I think it’s shameful. So I guess what I would say is that, you know, just be mindful parents of, you know, the amount of time your kids spending on social media, you know, what networks, what providers they’re joining. Because there’s a lot of stuff going on beneath the surface, that I think there’s some pretty compelling evidence is exacerbating the challenges many of our kids face right now. So just keeping an eye on the social media stuff, I think could be very helpful as well, I, you know, lost lost Connections is a big thing that I see out there, right, we’re, again, we’re genetically wired to be with each other. There’s nothing that drives me more crazy when I walk into a classroom. And I see 4 kids next to each other, and they’re all staring at their phone, on their social network instead of talking to the person that’s right next to them. Encouraging that I think is really, really important.

Gene  42:02

And I might add one other thing, as we wrap up. Parents and caregivers of adults of all kinds are digital hostages, as well, to pay too much attention to their phones. And what kind of role models are we providing our kids? When at the dinner table, a text comes in? And instead of kind of putting the phone in a basket and putting it aside? We shouldn’t be doing that.

Senator Velis  42:30

Listen, I we talked about it before, like a big part of my recovery is I try to be a try to be an honest person. Marty taught me that. And I strive for that right progress, not perfection. And I guess I’d say this, like, you know, there have been times where, you know, at the end of the day, eight o’clock, 830 I’m sitting, maybe watching a little TV, a show that my wife’s into. And then someone will send me a text message about, you know, a media request or issue that’s out there. And it’s like, I want to pick up my phone and respond to this. But I’ve got my wife there, you know? If it was earlier in the night, my little guy there, you know? So that’s a great point, right? We lead by example, because social media is for all of us. 100%. But I just think the concern for me anyways more with the kids because they’re so impressionable and so vulnerable. But your point is phenomenal. Right? Like, be that be that example.

Khadijah  43:27

Well, Senator, thank you so much for joining us today. We really, really appreciate it and appreciate your vulnerability and the passion that you bring to this, this topic. And I think we thoroughly enjoyed the conversation that we had with you today and really appreciate the conversation that you’re encouraging parents to have with their kids.

Senator Velis  43:46

I was just gonna say thank you for having me. And I appreciate you again and have a blessed, Have a blessed remainder of your day.

Gene  43:52

And thank you, and thanks to everybody at home for listening. We’ll be back here on the third Thursday of next month. And we hope our conversation will help you have yours. I’m Gene Beresin.

Khadijah  44:05

And I’m Khadijah Booth Watkins. We’ll see you next time.

[OUTRO MUSIC]

Khadijah  44:12

So, Senator as you’re anything you’re looking forward to in the next week or so?

Senator Velis  44:18

My son’s birthday, he started discerning he started to on Thursday. I can’t wait to I can’t wait to be there even though it pains me that he’s going to be two years old. I always want him to be one years old. But my  kids my kids birthday. I’m absolutely looking forward to.

[HAPPY BIRTHDAY MUSIC]

Khadijah  44:34

That’s awesome. Well enjoy Happy birthday to him again and enjoy the journey.

 

***

Music by Gene Beresin

Episode produced by Sara Rattigan

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Khadijah Booth Watkins

Khadijah Booth Watkins, Associate Director

Khadijah Booth Watkins, MD, MPH, is associate director of the Clay Center for Young Healthy Minds at Massachusetts General Hospital (MGH), and the Associate Director of the Child and...

To learn more about Khadijah, or to contact her directly, please see Our Team.

Gene Beresin

Gene Beresin, Executive Director

Gene Beresin, MD, MA is executive director of The MGH Clay Center for Young Healthy Minds, and a staff child and adolescent psychiatrist at Massachusetts General Hospital. He is also...

To learn more about Gene, or to contact him directly, please see Our Team.