The Tennessee Attorney General has joined a bipartisan group last week to urge the U.S. Surgeon General to slap a warning label on social media platforms to protect young people’s mental health.
Surgeon General Dr. Vivek H. Murthy called for such labels in June with an op-ed piece in The New York Times. In it, Murthy said, ”the mental health crisis among young people is an emergency — and social media has emerged as an important contributor.” Risks of depression and anxiety are nearly doubled for adolescents who spend more than three hours per week on social media, Murthy said.
Murthy rang the alarm bell on social media use last year in a detailed advisory on youth and social media. Parts of it went broad, what you’d expect in a scientific paper from the government. For example, it reads “scientific evidence suggests that harmful content exposure as well as excessive and problematic social media use are primary areas for concern.” But the report also gets into the nitty-gritty of real harms.
”Despite social media providing a sense of community for some, a systematic review of more than two dozen studies found that some social media platforms show live depictions of self-harm acts like partial asphyxiation, leading to seizures, and cutting, leading to significant bleeding,” reads the advisory. “Further, these studies found that discussing or showing this content can normalize such behaviors, including through the formation of suicide pacts and posting of self-harm models for others to follow.”
Twenty other studies reviewed by the Surgeon General found social media could “perpetuate body dissatisfaction, disordered eating behaviors, social comparison, and low self-esteem, especially among adolescent girls.”
Last week, Tennessee AG Jonathan Skrmetti added his voice to this effort. He joined a letter with some unlikely allies — liberal havens like California, Massachusetts, and more. It also had red-state support from typical allies like Mississippi, Alabama, South Carolina, and others.
“Algorithmic social media platforms have had a devastating effect on kids’ mental health,” Skrmetti said in a statement. “The evidence of the damage done by these platforms continues to mount. My office is in litigation against several social media corporations and remains committed to ensuring that this entire industry does right by our kids.”
But do government warning labels work? That is, if these platforms come with a new box on the screen telling kids they are harmful, will they change their behaviors? A couple of historical examples say no, or not really, or it’s hard to say.
The most-famous warning labels came after a similar Surgeon General’s advisory on cigarettes in 1964. By 1965 cigarette packs carried those warnings that say “smoking may be hazardous to your health.”
Do they work? One recent study says no.
“Placing graphic warning labels on U.S. cigarette packs did not have an effect on smoking behavior; however, these findings suggest that they may enhance other tobacco control strategies to reduce cigarette smoking,” reads the summary of a 2021 report in the journal Substance Abuse and Addiction.
For the study, 357 smokers were given different packs — some with the warning label, the others were blank. After three months, there was no difference in smoking behaviors.
Another famous government warning label may have induced children to consume even more of the product that label deemed harmful. Any 90s kid is familiar with the black-and-white label on some CDs that read “Parental Advisory Explicit Lyrics.”
The idea for those stickers came not from a doctor nor a child behavioral professional but from a group of four women married to lawmakers. The “Washington Wives” famously included Tipper Gore, married to Al Gore from Tennessee. Together, they convinced Congress the stickers would shield kids from the sexually explicit lines in Prince’s “Darling Nikki” or AC/DC’s “Let me Put My Love Into You.”
Did those stickers work? Hard to say. Just as there was little data to prove the music was actually harmful, little data seems to exist of the sticker’s effect on protecting children. Frank Zappa told a congressional panel that the legislation for the stickers was “an ill-conceived piece of nonsense that fails to deliver any real benefits to children…”
As for any word from any government agency, a curious (and probably old) memo from the Washington State Attorney General says ”most experts and critics alike, feel the label is too vague and that it doesn’t offer any information at all.”
”Critics also say that ratings can cause a ’boomerang’ or ’forbidden-fruit effect’ and may actually attract children,” reads the memo.
Baptist Memorial Health Care and Shelby County Government will host a free community mental health and wellness expo on Thursday, September 19 from 4:30 p.m to 7 p.m. in the Dr. H.E. Garrett Sr. Auditorium on Baptist Memorial Hospital’s Memphis campus.
Officials said this event is an example of their commitment to equity and diversity in the healthcare space, with resources specifically tailored for Black people. Dr. Joy Harden Bradford, a licensed psychologist, author, and host of the “Therapy For Black Girls” podcast will be the keynote speaker.
Miska Clay Bibbs, chairwoman of the Shelby County Board of Commissioners said that mental health is an important issue in the county.
“The mental wellness, particularly of women, directly affects the well-being of families and the greater community and deserves our attention and support,” Bibbs said in a statement.
Research from Johns Hopkins Medicine said women are at least twice as likely to “experience an episode of major depression as men.” They also said African American women are only half as likely to seek help.
Dr. Keith Norman, vice president of government affairs for Baptist, said much of the work the organization provides is in response to the needs of the community, which are measured through its Community Health Needs assessment. This helps determine the major disparities faced by Mid-Southerners.
“Mental health is a rising concern in all of those markets,” Norman said. “We don’t want to overlook the emotional and mental wellness of the individuals who live in our footprint.”
The Covid pandemic has proved to be a major factor in pushing conversations surrounding mental wellness to the forefront. Norman said that isolation caused people to be further away from resources and important relationships. He also said the pandemic shed more light on poverty disparities in the southeast.
These inequities can hit minority communities harder, especially when looking at the impact of racial trauma. The year 2020 not only brought the pandemic, but saw the murder of George Floyd, which many witnessed through video and non-stop media coverage.
“We had to really come to grips with this issue and how violence and vulnerability were going hand in hand,” Norman said. “In our region, here in Memphis, we saw crime begin to go up even higher because people were isolated and confined. Issues that they did not deal with were now coming forth in a confined space.”
Officials hope that this will not only increase dialogue about mental health, specifically in the Black community, but that this will encourage people to seek help and eliminate stigma.
“The African American community often deals with faith as the remedy for emotional wellness,” Norman said, speaking from his role as a pastor as well. “We are encouraging African American practitioners and patients to make the connection — there’s nothing wrong with therapy. There’s nothing wrong with talking through things — especially when you feel the touch of mental health on your emotional wellness.”
From Left to Right: Shaneika Smith, Cathy Emerson, and Kache Brooks.
Photo Credit:Youth Connect
Youth in Shelby County now have access to free therapy services through a partnership with the Shelby County Youth and Family Resource Center(SCYFRC) and The Braid Foundation.
The two organizations have joined together to launch Youth Connect, a service offering up to 12 free individual and group counseling services during the summer, after school, and on the weekends as needed.
Youth Connect officially launched in late May after years of planning and input from youth in the community. This service is available for anyone ages 13 to 18.
Dr. Shaneika Smith, co-executive director of the Braid Foundation and licensed professional counselor, and Cathy Emerson, co-founder of The Brain Foundation and school psychologist, say they have a combined 14 years of mental health practice in the Memphis area, which led them to work towards removing stigma around mental health and breaking down barriers to accessing mental health care.
On the private practice side, Smith said her and Emerson noticed that the idea that people had access to mental health services just because they had insurance wasn’t true.
“There’s one issue where a lot of our youth and families are not insured, but then there’s another issue where if you are insured you can have an insurance claim that does not cover mental health services at all,” Smith said.
Both Smith and Emerson worked in the school system and saw this as a recurring and consistent issue. This is also the extension of work started in 2020 where over 80 “youth-serving organizations” came to address youth mental health through the Coalition of Youth Mental Health.
“They’re the ones who really propelled this work,” Emerson said. “We were already seeing higher rates of suicide attempts, hospitalization due to self harm or self injurious behavior in Memphis and Shelby County — and now we add a pandemic to that.”
Emerson said this was how the work started, and after procuring the funding, they were able to lay the groundwork for what is now Youth Connect. She emphasized the support of Shelby County government by not only partnering with a nonprofit, but by creating Kache Brooks’ role, youth mental health coordinator at SCYFRC.
“Partnering with a nonprofit is one of the beauties [of this partnership.] Yes, serving the youth and getting people the help they need is the whole purpose of this work, but I think another highlight of this is that this is truly a blend of the community and government coming together to do something to address a need in a holistic, durable way,” Emerson said.
Emerson also said an important part of bringing this project into fruition was to have the voice of the people they’re helping. She said it was essential for both The Braid Foundation and SCYFRC to have a youth voice. Part of this was doing outreach work and conducting youth-centered surveys. They also wanted to know if there was there truly any stigma surrounding youth and mental health services.
Smith added that a lot of the times when programs are made for youth, the designers make assumptions about what is needed. By including youth input, they not only found out more about the needs of the community, but they found that their clients wanted to take an active approach to their mental health needs.
“As someone who works with youth, they even proved me wrong in the things that they wanted and the things they needed. That’s why youth voice is really important in this,” Smith said. “Some of the gaps that we see is with them and sharing with adults in their lives which therapy can really help them do…They’re talking to each other, and there’s not this stigma amongst each other about that.”
After surveying close to 250 young people in Shelby County prior to the launch, Youth Connect found that 46 percent of participants said they were “likely to extremely likely” to utilize therapy, while 84 percent said they would “not think negatively about someone who was in therapy.”
“One thing that we noticed is that with young people, the conversation is definitely there. They’re a lot more open than people might expect. That’s not to say that there isn’t any stigma at all, but I think a lot more young people are a lot more self aware than we give them credit for and open to bettering themselves in their mental health journey,” Brooks said.
This emphasize on self awareness and agency is evident in the application process as well, as Youth Connect encourages those interested to fill out the forms on their own.
“It’s your body, it’s your emotions, it’s your experience –don’t you want to have control over what that process looks like for you?” Emerson said. “What we know is when you are empowered to have responsibility for your own mental health and do the work and show up, that is going to have the long-lasting effects that therapy is supposed to have.”
For many of us, chasing down the total eclipse of the sun on Monday was a bucket-list thing, and, like all such now-or-never matters, it exacted a cost.
Coming back to Memphis from Hardy, Arkansas, where my son Marcus and I went early on Monday to rendezvous with daughter Julia and friends to see the natural much-ballyhooed natural spectacle firsthand, turned into an eight-hour drive, beginning at 3 p.m. after a delightful Thai lunch at Hardy and ending at close to 11 p.m. at home.
I bring this up because it occurs to me that this is how it always goes with bucket-list things. Putting it simply, you pay a price for them.
For those in government, public progress is a bucket-list matter, it dawned on me, and I suddenly saw a speech I’d heard the previous week in exactly that light.
This was Shelby County Mayor Lee Harris addressing a group of Germantown Democrats about the things he is determined to accomplish in this, his second and final term in office. He was first elected in 2018, and the first term was something of a wrangle. As is so often the case, it takes a while to get the hang of the people and the problems.
Harris told the Democrats: “I’m going to show [that the] county mayor’s office and Shelby County government is a huge organization. And it does a variety of things. You know, it’s a $1.6 billion budget, thousands of employees, so many, many, many programs.”
Announcing he would focus on three areas — public safety, healthcare, and education — the mayor did a little recapping and quickly swung to his main point of the evening.
“One of the things that is important that I’m working on right now is a residential mental health facility. And so it’s the idea that we have a problem in Memphis and Shelby County. And the problem is, there’s not enough access to mental health care.
“One of the key problems right now is [that there are] about 2,000 people in detention right now. And more than half of them have a mental health care need. The DEA [Drug Enforcement Administration] might want to move those cases; the judges might want to move those cases forward. But a lot of those cases can’t be moved forward until the individuals have 14 days of stabilization. So they’ve got to get access to healthcare; they’ve got to get their prescriptions. They’ve got to see a healthcare provider. … And so we’re a little bit behind in some ways, right?”
Harris went on to propose a new 60-bed facility for Shelby County. “And we will be able, upon arrest, to move individuals that need those services immediately to the mental health facility, and away from the traditional jail detention facility. One of the benefits of that is that it creates a lot of opportunities for collaboration among our criminal justice stakeholders.
“So the cost of doing all this is probably about $400 a day, right? Right now as a person in our jail or detention facilities it’s about $100 a day. By contrast, the cost for this kind of specialized care is dramatically more. But a portion of those individuals would be better served by getting treatment, and having their cases in advance, you move a few of those 508 cases. Our expectation is that over time, the county will save money.”
The bottom line: “So it costs us at least $20 million. But people have been talking about this for a very long time.“
So far, Mayor Harris has enjoyed a resourceful second term, working for the most part with a same-minded county commission. He has arranged for a long-needed expansion of the Regional One Health facility and the equally overdue creation of two new public schools.
The proposed new mental health facility, which he has since asked the commission to engage with, would raise things to the level of a perfecta.
Just to let you know he’s got that and more on his political bucket list, and he’s working on them.
MacKenna Stang and Melissa Ceren (Photo: Courtesy Mid-South Fly Fishers)
Fly-fishing has been around for centuries, with evidence of its existence going back to antiquity. By the time the 18th and 19th centuries rolled around, it became a pastime for wealthy white men in England and the U.S. Today, in the 21st century, the sport is still dominated by white men, but avid fly-fishers are looking to change that. The Mid-South Fly Fishers, for their part, are taking active steps to becoming more inclusive, like with their Fly-Fishing for Wellness event this Sunday.
For the event, the club will be joined by Colorado-based Melissa Ceren, “The Fly Fishing Therapist,” and MacKenna Stang, a fly-fishing influencer and women’s advocate, who will speak on the benefits of fly-fishing for better mental health and using fly-fishing to build community and well-being among women, respectively. Ceren will also lead a therapeutic exercise.
“My piece in it is that I’m a mental health therapist and fly-fishing guide,” says Ceren. “So I combined the two a lot because obviously it feels good to be in the outdoors. It’s nice, and I actually was having a conversation the other day that although fly-fishing can be relaxing, it’s not always just relaxing, like you get a knot and you lose fish and it can be really frustrating and sometimes you want to snap your rod. But all that to say is that it builds confidence in skills and resilience, which is transferable obviously outside of fishing, too.”
“There’s just so many different tactics you can use in fly-fishing,” adds Stang. “You just have to be skillful with it and it makes it more rewarding. … So, I wanted to connect with people who had the same passion for fly-fishing and learn from them and inspire other women to join the sport, and social media just kind of took off and I’m very grateful for it.”
For both women, they hope to engage fly-fishers — men and women — and those who just might be curious about fly-fishing. “This is all about inclusivity,” Stang says.
As for the Mid-South Fly Fishers, Drew Harris, the club’s vice president, says, “we really have three kind of core areas that we exist to support and it’s fellowship, education, and conservation around fly-fishing.” And with that, Harris says, comes a great sense of community. “We’ve formed these kind of relationships, friendships, and bonds around fly-fishing that have been really great and nurturing in all aspects of my life.” He has even had his two young daughters join him in fly-fishing. “I wanted to develop a community and kind of have them tag along with me so that they can grow up around it.”
And the Mid-South Fly Fishers give back to the community, too, through conservation efforts and by supporting the Veterans Affairs hospital in Memphis by teaching veterans how to fly-fish as a way to manage trauma and promote well-being. In fact, several items such as a Wrangler and Crosswater will be up for auction this Sunday, with all funds going to support the program.
Tickets for Sunday’s event can be purchased at msff.org and include a complimentary beer.
Information released by Mental Health America, a national nonprofit “dedicated to the promotion of mental health” through public education, research advocacy, public policy, and direct service, showed that out of 151,781,326 people in the male population of the U.S., about six million are affected by depression.
Mental Health America said that male depression often goes undiagnosed, and is one of five major mental health problems affecting men. Others include anxiety, bipolar disorder, psychosis and schizophrenia, and eating disorders.
According to Rick Harrell of RH Counseling Services in Memphis, men are less likely to seek out mental health services. A January 2023 report from Statista estimated that 12.1 percent of U.S. men received mental health treatment or counseling in the past year (2021).
“A lot of that comes from the various stigmas that come along with getting help,” said Harrell. “[Like] if you seek out help in some way, you’re crazy, or all the stigmas that come with that. Men also internalize things more than women do, and they try to just deal with it on their own.”
The information compiled by Mental Health America states that some of the reasons men fail to seek help are societal norms, reluctance to talk, and downplaying of symptoms.
While these stigmas have always existed, Harrell said that there has been more of an emphasis on mental health lately, which has resulted in more men enrolling in counseling services.
A poll issued by East Tennessee State University (ETSU) showed that the mental health of Tennesseans was impacted by the COVID-19 pandemic. A poll conducted by the Applied Social Research Lab at ETSU concluded that “4.6% of Tennesseans were symptomatic of anxiety and 27.1% were symptomatic of depressive disorder.”
While the pandemic undoubtedly had an effect on mental health, it also led to more people seeking out counseling and therapy services. The National Library of Medicine reported that as of September 2020, men sought out these services at a higher rate than women.
Harrell has seen this in his own practice, as well. He said that in his 24 years of practice, he’s seen a majority of his male patients coming as a result of being pushed or ordered to attend — as a result of a court order or couple’s counseling. He has recently seen a shift, where more men are coming on their own accord.
“I have seen over the last few years, post-pandemic, more men take the initiative to seek out therapy on their own,” said Harrell. “I think we’re becoming more knowledgeable about it, and I think the stigmas that have been associated with getting mental health services — we’re beginning to dispel some of those things.
“It’s okay to not be okay, but it’s not okay to stay not okay,” said Harrell. “Knowing that there’s help out here, and you can heal from the issues. I think when we keep it in the forefront and we continue to dispel the myths and the stigmas that center around mental health and educate our communities, we begin to make some improvements in that space.”
I experienced my first deep loss at 5 years old — a great-aunt committed suicide. My young mind couldn’t make sense of it. We used to spend afternoons together, taking walks in the neighborhood. Most memories have faded now, but I do recall her smiling and laughing. I could never understand why she chose to end her life. After that day, every time I’d visit or pass that house, I’d envision her outside, wrestling with the idea, and ultimately pulling the trigger. It was a lot for a child’s brain to process.
In my early twenties, I lost three friends to suicide — by hanging and by gun. Later, a person very close to me slit her wrists. I remember receiving the phone call and rushing to the hospital, where she told me, essentially, that she’d failed that time, but I’d eventually have to let her go — she wasn’t meant for this world. In an unbelievable turn of events, after being medically treated, she was sent to jail (please see editor’s note at the end of this article). Not released to go home, to family, to be with friends for encouragement and support. She spent about a month in the county jail before being transferred to a mental health facility and eventually being diagnosed with borderline personality disorder. Why jail was ever a step in this situation always baffled me — what a place to be when you’re already in such a fragile state. (I’m grateful to report today, all these years later, that she is healthy, happily married, and living a full life.)
These losses and experiences have been on my mind of late, as May is Mental Health Awareness Month. Of course, mental health challenges don’t always lead to suicide or suicidal ideation. They can present in the form of emotional outbursts, isolation, mania, insomnia. Anxiety, depression, substance-abuse disorder, obsessive-compulsive behavior, and post-traumatic stress disorder are among the technical terms for such diagnoses. And many of us have either struggled with one or more of the aforementioned or know someone who has.
There is often a stigma surrounding mental health, which can make it difficult to address. How do you treat yourself if you’re experiencing overwhelming stress or incredibly low lows? Do you reach out to friends or family? Do you go to therapy? Do you consider discussing with a doctor? Do you hold it all in and wait for the storms to pass?
If a loved one expresses anxiety or depression and shares with you stories of their battles, do you lend a sympathetic ear? Or do you tell them in short to buck up, buttercup — “It’s all in your head. You can control that. Just use your willpower, honey. You’re stronger than this.” (Don’t do the latter, please.) Sometimes, a person needs only for you to sit with them in silence, be present alongside their sadness or stresses — not offering solutions, just your attention.
It’s never an easy path to navigate in either situation, whether it’s you or another person going through it. But it’s important to look for signs and symptoms, and address them as soon — and as gently — as possible.
Throughout the pandemic and subsequent lockdowns, many people’s mental health took a hit. During the peak and aftermath of Covid, suicide and overdose rates swelled. This could be attributed to heightened instances of domestic violence as people were forced to stay home; loss of income due to society shutdown; increased anxiety and depression amid endless news reports and statistics, and confusion and fear of the virus. We experienced collective trauma, leading to loneliness and even cognitive and behavioral changes that some have yet to recover from. And while, in the grand scheme, the worst of that is behind us, many are still finding it difficult to engage in the same ways they did pre-pandemic.
We all handle life’s challenges differently. We carry our own traumas. No two brains function the same when it comes to confronting or working to overcome mental health crises.
Think of your own internal landscapes, how they ebb and flow, and use this knowledge when interacting with others. You never know what weight someone’s carrying with them.
If you find yourself in a dark place today, remember that your success rate for making it through tough days so far is 100 percent. Hang on, hang in.
You are enough. You are worthy of love. You are never a burden. And there are many beautiful tomorrows — sunrises, sunsets, smiles, handshakes, hugs, hot meals, cool breezes, soft blankets, so many lovely things — waiting for you around this bend.
Help is available 24/7 if you need it. Call or text 988 or visit 988lifeline.org.
*Editor’s note: Since publishing this article, it has come to our attention that the person who attempted suicide had their civil rights violated by being detained. Attempted suicide is not illegal in the United States.
Angry outbursts in public seem more frequent. Anxiety thrums like a background hum. Everyone knows someone struggling with substance abuse, and opioid overdoses are distressingly common. Maybe you are having trouble getting out of bed, connecting with other people, and experiencing anything but sadness and dissociation.
It’s not an illusion. According to the National Institute of Mental Health, before the Covid-19 pandemic exploded in March 2020, 21 percent of all Americans — approximately one in five — had some form of mental illness. At the height of the pandemic, that number rose to 40 percent. Last March, the World Health Organization (WHO) reported that the pandemic had led to a 25 percent increase in depression and anxiety worldwide. “Loneliness; fear of infection, suffering, and death for oneself and for loved ones; bereavement; and financial worries have all been cited as stressors leading to anxiety and depression. Among health workers, exhaustion has been a major trigger for suicidal thinking,” the WHO report read. Furthermore, “The latest Global Burden of Disease study shows that the pandemic has affected the mental health of young people, and that they are disproportionately at risk of suicidal and self-harming behaviors.”
Laurie Powell, CEO of Alliance Healthcare Services (Photo: Courtesy Laurie Powell)
Laurie Powell, CEO of Alliance Healthcare Services, has been on the front lines of behavioral healthcare since 1993, when she started as a therapist in Orange Mound. In August 2020, Powell’s husband died of cancer at the height of the pandemic. She and her two sons were unable to visit him in the hospital. “I just saw on the news that in the United States more people have died from Covid-19 than any other country, and that was kind of hard to hear,” she says. “Now, think about what that is doing to all of those families, how it’s impacting so many on a personal level. I didn’t think my husband would die at age 61. And there are so many stories out there just like that. Many of our staff, if you talk to them, every third person here is going to say either they treated someone whose family member died because of Covid, or because they were so depressed.”
It’s not just Covid. The last two and a half years have also seen an increase in gun violence. “This morning, I got the call at 4 a.m. from one of the community residents to tell me about the shooting of seven people up by the hospital, up the street from our house,” says Charlie A. Caswell Jr., executive director of Legacy of Legends CDC and Shelby County commissioner-elect for District 6.
“We had a mental health epidemic that was recognized by the Center for Disease Control before the pandemic of Covid,” he says. “But I believe the Covid pandemic has produced a new wave in our community, and a large part goes back to last year. It’s been pressed down on people even more now that people tried to get back to doing business as normal, when normal was not even normal! People who didn’t have access to mental health counseling have to deal with what they were already dealing with, and now it’s even more on top of that.”
Dr. Lucas Trautman is a psychiatrist, youth sports coach, and the medical director of Professional Care Services, a community mental health network in rural West Tennessee. When schools closed in 2020, he says, “decreased in-person social connectivity really hurt the public school students’ development because they were out of school for a whole year. I really think that was a developmental detriment, even though we were trying to keep them safe and their families safe. But decreased social connectivity can probably be directly linked to some of this as well.”
Charlie A. Caswell Jr., Shelby County commissioner-elect for District 6 (Photo: Courtesy Charlie Caswell)
No One to Talk to
Today, those who need help the most are having trouble finding it. Alice (who requested a pseudonym to maintain her privacy) is a mother who spent nine months seeking help for her pre-adolescent, who was suffering from intense post-traumatic stress disorder (PTSD). “There are only a handful of places, and they’re all booked up — and none of them take TennCare,” she says.
Employer-based health insurance and Medicare will typically pay $65 for a one-hour counseling session. But due to low reimbursement rates and the spiraling hassles of dealing with insurance companies, many psychiatrists and therapists in Shelby County no longer accept health insurance of any kind. Adolescent care sessions can run from $150 to $175 an hour. “The crisis here in Memphis is that we have so many people living in poverty; there aren’t enough providers who take a sliding scale or who will take insurance at all,” Alice says. “The breakdown in those systems is so much more evident now.”
Dr. Trautman agrees. “We do have a child mental health problem or crisis in Memphis. It’s a public health crisis because of the lack of availability of mental health services but also just because of poverty. We live in an area that socioeconomically struggles, historically. And so I think all those things kind of go together. Why are they having a hard time? Well, they’ve been economically precarious all their lives.”
“Every child living in poverty has elements of PTSD, anxiety, and depression,” says Alice.
According to figures provided by the Tennessee Department of Mental Health and Substance Abuse Services, 7.1 percent of Tennesseans — approximately 378,020 people — suffer from serious mental illness. In Shelby County, 13.7 percent of those seeking treatment in 2019 were uninsured and served by the Tennessee behavioral health safety net. “Looking at the need for services during the pandemic, we actually saw a decrease,” says Matthew Parriott, director of communications for the Department of Mental Health and Substance Abuse.
During fiscal year 2019, Alliance Healthcare, who contracts with the state to provide mobile crisis services, performed 16,317 patient assessments. In fiscal year 2022, which included the worst days of the pandemic, Alliance performed 12,878 assessments — a 21 percent decrease.
Powell says those numbers don’t tell the whole story. “A lot of the calls we get are from emergency rooms, and people were not going to emergency rooms because of the pandemic.”
In contrast, between April and May 2020, the number of calls to the Alliance outpatient help-line tripled. And those call numbers have remained elevated. In July 2019, 540 people in crisis called the help-line; in July 2021, that number was 1,268. Last month, the Alliance crisis line fielded 1,052 calls. “We do have the largest crisis services in the entire state, and probably one of the largest in the country,” says Powell.
Furthermore, “I know that we’re seeing people with more needs,” says Powell. Even as the number of individuals served across the Alliance system went down by about 7 percent between 2019 and 2022, the number of services provided — things like case management, individual and group therapy, and medication — increased by 3.9 percent.
Powell says there is a shortage of mental health professionals, making it more difficult for everyone to receive the care they need. “I’ve looked online, just to check myself, and some of them say, ‘Not taking new patients.’ I used to never see that. There’s just not enough to go around. We’ve had people leave mental health to go into, like, medical social work because they said, ‘I’m not sure if I can continue to be a therapist right now.’”
Dana Wilson, president and CEO of Bridges USA (Photo: Courtesy Dana Wilson)
The Search for Solutions
In January 2020, Dana Wilson became president and CEO of Bridges USA, a 501(c)3 nonprofit that seeks to “unite and inspire diverse young people to become confident and courageous leaders.” Wilson, who had been working with youth leaders at Bridges for more than a decade, already had her sights set on youth mental health when the pandemic struck. “I think the writing was already on the wall prior to the pandemic,” she says. “I don’t want to say the pandemic created a mental health crisis — we’ve been in this for a while.”
Bridges used part of the initial round of funding from the federal CARES act to study access to mental healthcare. “What we found in that initial research was that, while there are services technically available, most of the time you don’t know how to get to them. There’s no coordination system. It seems very fragmented. If someone says, ‘I need this thing,’ and someone over there says, ‘I could do that thing’, there’s no way to get those two together easily or fluidly.”
Another issue uncovered in the early sessions with the Shelby County Youth Council was addressing the shame attached to mental health treatment. “We need to talk about destigmatizing mental health,” says Wilson. “It’s okay to not be okay.”
Abdullah Elahi, an upcoming senior at MUS (Photo: Courtesy Abdullah Elahi)
Abdullah Elahi is an upcoming senior at Memphis University School. “There wasn’t that much of an emphasis on mental health before the pandemic,” he says.
When he became a Bridge Builders Change Fellow, he says, “It really opened my eyes because I was like, oh my goodness, this is something that me and my friends are struggling with so much. … My group is called MEM: Mental and Emotional Health Matters. What we do is try to bring mental health resources to the Shelby County Schools. The other goal we have is, we want to break the stigma surrounding mental health.”
Alice, who struggled to find help for her child, says, “If we don’t provide mental healthcare in the schools, kids aren’t going to get it.”
Among the needs in the schools are early intervention access, says Wilson. “There might be funding and support if you have a diagnosis, but if you don’t have a diagnosis and you’re struggling, you just might need a few counseling sessions to help you get through whatever the situation is. Especially during the pandemic, there was a lot of situational anxiety and depression.”
Mental health professionals also need to be “culturally competent” to meet the needs of their patients. “There’s definitely a need for more Black and Brown therapists,” says Wilson. “In Memphis, for example, the vast majority of the people that we could find were mostly white, middle-class women — a very traditional [demographic] for social work and therapy. There’s a lack of people who can treat students who are non-gender-conforming, LGBTQ+ students who experience mental health issues at a higher rate, statistically.”
The third major reform Bridges identified was the need to stop the criminalization of children for their mental health issues. “Unaddressed trauma is part of what is driving the school-to-prison pipeline,” says Wilson. “If a young person’s getting in trouble in school and there’s not adequate intervention early enough, then the student gets suspended or does something that’s not acceptable and gets pushed out of school. If you get suspended multiple times from school, you’re more likely to drop out.”
Once out of school, troubled adolescents can get pulled into serious, even violent, criminal behavior. Dr. Trautman says the problem is made worse by what he calls “easy access to lethal means.” He and many other specialists believe that the urge to charge teen criminals as adults is misguided and counterproductive. “There’s a mountain of data which shows that the adolescent brain is still very moldable and not set in stone. With proper intervention, you can change their habits. You can change the way of thinking. You can help them integrate into society and be more productive members and also happier. I mean, you’re not riding around killing people because you’re happy and well-adjusted.”
Signs of Progress
Among the reforms MEM advocated was establishing “reset rooms” in schools. “They’re spaces in schools in which students can go if they’re feeling stressed-out,” says Elahi. “They can reset and calm themselves down, center and ground themselves.”
The advocacy was effective, and now reset rooms, staffed with counselors, are a common feature in Shelby County Schools. “They feel really proud of doing it, but the students are the ones who said, ‘We need this,’” says Wilson. “And that’s part of decriminalization, because you’re getting someone the support they need before they get to a point where they can get in trouble for having a problem.”
In October, Dr. Trautman’s group Professional Care Services is opening a new Memphis child and adolescent psychiatry facility at 6601 Poplar Avenue, which will accept health insurance. “Right now, we have three [doctors], but we will grow to the need,” he says.
The state is committing significant new resources to mental healthcare. “Our current fiscal year budget which just started on July 1st is truly historic,” says Parriott. “Thanks to the generosity of Governor Lee, the Tennessee General Assembly, and our federal partners, we have more than $560 million to support the mental health and substance use prevention, early intervention, treatment, and recovery needs of Tennesseans — most of whom have no means to pay. We’re especially excited about the $18 million we received for provider rate increases. This funding has already gone out to our contracted community mental health and substance use disorder providers to allow them to increase pay rates for staff retention and recruitment. We’ve heard from folks across the state that this funding is already making a huge impact.”
Alliance Healthcare will soon be opening a new telehealth center in Binghampton. “A lot of people reaching out to us have access barriers, so we’ve increased telehealth during this pandemic,” Powell says. “That’s exploded. We went from maybe 5 percent telehealth to 80 percent telehealth during the pandemic, and some people really want to continue telehealth. So we’re going to offer that, if that would remove the barrier to getting help.”
Is therapy by videoconference as effective as a traditional office visit? “I think it depends on the person and the age,” says Powell. “Kids really like it.”
Caswell, a longtime advocate for mental health in the Black community, launched his successful run for county commission “to go upstream and push policy changes that address many of those issues we face downstream. … I would say to the community as a whole, we have to be intentional. Shelby County can become a trauma-informed, trauma-responsive community. That means, for all of the employees and the work that we do, we do it with more empathy and more understanding, coming out of this pandemic. If someone is coming in for help or calling for help, it’s not because something is wrong with them. We ask, ‘What happened to them?’”
Mental health concerns seem to be on everyone’s minds these days, as evidenced in this week’s cover story, and Virginia Murphy, founder and executive director of Playback Memphis, has found that true within Playback’s group of professional artists who bring audience stories to life with improvisation, dance, and music.
“We consider our work to be healing work,” she says, “but we were in a moment when we recognized even within our own very healthy organization, by most respects, we had a number of stories where mental health was a central character. … And we didn’t really have a direct way of talking about that with each other. That was true before 2021, before the pandemic, and now it’s kind of on steroids.”
As such, the group has turned its attention to seeking clarity for the sake of mental health and has invited the community to join in this pursuit with its Listening for a Change Week. “It’s an initiative on our part to explore new pathways and partnerships for mental health and healing through the arts,” Murphy says. “We know that we have this incredible therapeutic tool, and we feel like it’s an untapped resource in our community.”
For the Listening for a Change Week, Chesney Snow, a New York City-based, award-winning performing artist and pioneer in beatbox culture, will lead a choreopoem workshop, open to the public, this Thursday. The workshop will give insight into sharing personal stories and using art as a medium for social healing. The event will also include excerpts of Snow’s original choreopoem performance, The Unwritten Law, which explores the artist’s personal journey “from a legacy of incarceration to fatherhood, homelessness to Harvard, to ultimately starring on Broadway.”
After the workshop, Playback will host a free community gathering with Snow at 5:30 p.m. at the Frayser Community Development Corporation garden. You do not have to attend the workshop to join, and light refreshments will be available.
On Saturday, Snow will join in a Playback performance with audience members sharing a personal story or reflection for the ensemble cast of actors, dancers, musicians, and poets to reimagine on the stage. “It’s done in the service of building empathy and awareness,” Murphy says. “You may share a story and see it played back and may see something you hadn’t really considered before. … Not everyone shares, and if you’re in the role of witness, that’s a really important role as well. It helps a lot with perspective.”
After the performance, Jennifer Balink of Kindred Place will facilitate a conversation to reflect on the shared experience of the performance. Murphy says, “We want people to walk out after and feel like they are taking away something that will nourish and support them out of the theater.”
Choreopoem Workshop led by Chesney Snow, Frayser Community Development Corporation, Thursday, August 25, 2-5 p.m.
Listening for a Change: Memphis Matters, TheatreSouth at First Congregational Church, Saturday, August 27, 7 p.m.,$10-$30.
I was going to write something sad and ranty in this space, something to the effect of arg! everything is terrible — because, frankly, it feels that way. But I don’t need to detail at length all the horrific stuff going on in the world or how the dollar no longer means much and we’re being bled dry just to eat, put gas in our cars, and have roofs over our heads. I’ll spare you the talk about how our essential workers are — still, and maybe even more than ever — overworked and underpaid, and how our bodies and livelihoods will soon be (more) at the mercy of politicians and corporations while the rich get richer and the rest of us scrape by and hope that we can access affordable healthcare and homes and have the freedom to choose what’s best for ourselves. Things just feel a little … precarious. But we won’t talk about that.
I recently went to visit family down South in my hometown of Greenwood, Mississippi. My pawpaw Clark was set to have surgery the following week, and such procedures are trickier on the elderly. I’d hoped to watch Dirty Dancing — the original with Patrick Swayze, of course — with my granny Clark (it’s our favorite movie), but she wasn’t feeling up to it. We instead spent time chatting and catching up. Things are much quieter there, simpler, slowed-down. Not that crime and drugs and inflation and rising rent and home prices haven’t touched the small community. The place isn’t what you’d call idyllic, to be sure, but there’s a big difference between meandering through a country town inhabited by fewer than 14,000 people and traversing the daily grind in a sometimes rough, always-on city like Memphis.
I spent a couple nights with my dad and brother while I was there. My brother is a wheelchair-bound 32-year-old with severe cerebral palsy. My dad takes care of him — baths, diapers, feeding, outings, entertaining and supporting in the best ways he can. Their address is on one of the “county roads” on the outskirts of town. My dad built (literally) the house he lives in, on my pawpaw’s land. It’s not your typical house. To me, it always looked like maybe it was supposed to have been a big garage or shop at first, but became an actual living space with a kitchen and bathroom and bedrooms. It has concrete floors and is filled with antiques and road finds — a real hodgepodge — and the yard looks a bit like Sanford & Son Salvage. My dad can’t work much these days since he cares for my brother with only a few hours of outside help from the “sitters” (they’re nurses).
One afternoon, my dad and I climbed into a beat-up ATV, and he drove us over to a nearby creek. I held onto the “oh shit” bar while he zoomed up the gravel road and down the side of a little-too-vertical (for me) levee. Unafraid, that man. No reservations. In his already muddy boots, he walked right through the water, in places up to his knees, as I, unprepared, maneuvered the muck in my city shoes. We talked about the state of things, how I sometimes have trouble navigating days, especially since the pandemic basically dismantled everything we thought we knew. In the wake of all that was flipped upside down, some of the pieces no longer fit. Whatever normal was, it isn’t that anymore. So many things seem … broken. He talked about prayer and gratitude, and I said I might give the former a try.
There’s peace to be found there somewhere. Not specifically in that creek or the Delta town itself, but in that state of mind. Live gently and simply and without fear, love the life you have, give thanks.
I know I said I wasn’t going to write something sad in this space, but I’m known to be overly sentimental. My pawpaw ended up canceling his aneurysm surgery. He’s not one to slow down much and has decided, it seems, he’d rather go on his own terms — while feeding his dog out at the hunting camp or hamming it up with folks at the grocery store — than risk losing his life or mobility on a surgeon’s table. In the weeks since our visit, my granny received a tragic diagnosis — cancer in her lungs and liver — and was put on hospice. It doesn’t look like we’ll get in another viewing of Dirty Dancing. But I’m grateful for the many times we watched it together, and for all the precious memories with my Clark grandparents; for my brother and dad and what they’ve taught me through positivity, perseverance, and the wisdom that only comes from living in the present, not clouded by material wants or looking too far beyond the scope of what we can control.
