From modern-day stressors, like social media, 24/7 texting, and constant location tracking—to more traditional ones, like homework, family turmoil, and bullying—today’s youth are living with a volatile mixture of societal pressures. And though the human psyche is equipped to handle enormous stress, when these pressures are intense, incessant, or novel (think coronavirus), they can increase one’s risk for mental health disorders.
Prior to the pandemic, a 2019 Cincinnati Children’s Hospital Community Health report was already pointing to problems for area youth. Roughly 35,000 children were being seen each year at the hospital for a mental health diagnosis, and another 14,000 were being diagnosed in the hospital’s outpatient clinics. More recently, the Cincinnati 2030 Planning survey showed awareness of the issue deepening; respondents aged 22–45 said they thought teen (and adult) mental health would be “the most significant health and social service concern” facing Jewish Cincinnati for the upcoming decade.
Toward the end of 2019, Jewish Family Service of Cincinnati (JFS) sensed similar trends when it developed a three-year strategic plan and concluded that the number one unmet need in the community was serving the mental health of our youth.
In early 2020, the Jewish Federation of Cincinnati created the COVID-19 Relief Fund in response to the pandemic’s impact on the Cincinnati Jewish community. Established in partnership with the Jewish Foundation, Jewish Home of Cincinnati, and individual community members who donated, the fund immediately began accepting grant applications. In a short span of time, it received three separate and distinct requests for funding to support mental health first aid training for local youth.
Suzette Fisher and Sherri Symson cochaired the COVID-19 Relief Allocations Committee, which prioritized and distributed the grants. Fisher—a former president of the Federation who has served on the boards of the Federation and JFS, and numerous other committees—was already familiar with JFS's strategic goal to implement a youth mental health initiative. Thus, she was well positioned to connect the dots and recognize that COVID had profoundly affected youth mental health. To expedite JFS's research and planning efforts, Fisher and Symson aligned the committee behind a planning grant aimed at youth mental health.
JFS's Youth Mental Health Committee was soon created to conduct research and offer its recommendations. JFS was exceedingly fortunate to have two highly-qualified professionals volunteer for this committee: Robert Kahn, MD, and Jeffrey Epstein, PhD. Kahn and Epstein both work at Cincinnati Children’s Hospital Medical Center, where Epstein is the Director of the Center for ADHD, and Kahn is the Associate Chair of Community Health for UC’s Department of Pediatrics. Kahn is also a national expert in convening strategic planning around public health questions.
Leveraging this expertise, the committee determined that youth mental health services are hard to access in large part because the labyrinth of offerings is extremely difficult to navigate. “We kept hearing stories from families about how it could take 30 or 40 phone calls to find a psychologist who’s available to see a child in need,” Fisher said. Because of this complexity, families were getting frustrated and discouraged. “You can really get lost in the rabbit holes,” she added.
JFS CEO Liz Vogel suggested that though the coronavirus exacerbated problems for community youth, it also exposed problems that weren’t being addressed. “Youth mental health issues are so common and widespread, but, until the pandemic, it wasn't talked about very much,” Vogel said. “So all of a sudden COVID creates this pressure on people and we can't hide it anymore. This is definitely going on.”
Vogel explained how mental health care can be just as specialized as any other division of health care, and that matching the patient to the right provider can often be the biggest challenge of all. “Beyond the intricacies of specialized care, providers aren’t always covered by the family’s insurance plan, leading to care that can be prohibitively expensive,” Vogel said. “But even if all that gets worked out, there is still the issue of finding someone who has the capacity. Many counselors and therapists are simply overwhelmed with the pent-up demand emerging from COVID-19. And that’s why Leah is here.”
“Our Jewish community collaborates so well and with such ease—and mental health care can come through youth groups, like BBYO, USY, Hillel, synagogue, rabbis, religious schools, day schools, as well as your traditional mental health providers. It doesn't have to come from just one place.”
—Leah Marcus, Director of Youth Mental Health Services, JFS
Vogel was referring to Leah Marcus, JFS's first Director of Youth Mental Health Services—a role directly supported by the Federation’s COVID-19 Relief Fund. Vogel explained how Marcus, who was hired in May, immediately applied her deep experience as a mental health professional to benefit local families. “Leah has already responded to inquiries from community members who are concerned about the wellness of their children,” Vogel said. “She's here to help people access the appropriate level of care, but her expertise also allows her to provide support until a teen can be connected up with the best long-term solution.”
Marcus believes her role is to bring cohesion to the strong, but often underused initiatives that currently serve the Cincinnati Jewish community. “The families I've worked with so far have made incredible efforts on behalf of their children,” Marcus said, “but they are looking for an additional boost to help them navigate the more complex resources in our community. I am someone they can work with to brainstorm and identify how the community can wrap services around them and help support them.”
Through their research, the Youth Mental Health Committee found this type of support is best provided through a “continuum of care” that goes beyond the individual, patient-therapist approach—to a model that is more interdependent, complementary, and nuanced. By hiring Marcus, a clear proponent of this model, JFS took the next step in implementing this strategy.
“The traditional, siloed-care model doesn’t offer a family the benefit of collaboration between resources,” Marcus said. “With a community-care model, a family can build layers of resources—along a continuum—that can provide additional support as they go through their mental health care journey.”
Marcus said there are a number of congregations and community resources already thriving in our region, but what’s missing is a way to coordinate them. “Our Youth Mental Health initiative incorporates the strengths of our community to enhance traditional services and broaden our ability to collaborate,” she said. “Our Jewish community collaborates so well and with such ease—and mental health care can come through youth groups, like BBYO [B'nai B'rith Youth Organization], USY [United Synagogue Youth], Hillel, synagogue, rabbis, religious schools, day schools, as well as your traditional mental health providers. It doesn't have to come from just one place.”
Marcus emphasized how important the Youth Mental Health initiative is to JFS and its leadership. “This is a priority for JFS, and I think that’s important for our community members to know,” she stressed. “Everybody I've spoken to is excited that JFS will be taking this on so that mental health can begin getting addressed in the Jewish community,” she concluded.
Fisher seemed to echo Marcus’s viewpoint. “COVID exacerbated problems, and it is essential to get this program up and running before the school year begins this fall,” she said. “We want our youth-facing, Jewish professionals and educators well trained, supported, and prepared for when kids come back to school—returning to programming and extracurricular activities. I feel like this is the beginning of the Jewish community providing our youth, teens and young adults with something they fundamentally need—and our parents with support when they're overwhelmed by all the information they're given about their child's mental health.”