The data on adolescent health and educational success in the US is of great concern. High rates of depression, alcohol and drug abuse, teen pregnancy, youth violence, and low college graduation rates compared to other industrialized nations indicate that something is missing in our support for young people.  Adolescence has become a perilous rite of passage for many youth. We need a new culture of adolescent wellbeing across the United States that builds skills, resilience, and opportunities for a healthy path into adulthood.

• We know that US teens are more stressed than ever before. In a 2013 survey, teens reported higher stress levels than adults and many also reported feeling overwhelmed, depressed or sad as a result of stress (Bethune, 2014).
• Fifty percent of mental health disorders have their onset by the age of 14 and seventy five percent emerge before the age of 25 (Kessler et al, 2005).
• The adolescent brain is especially malleable to both positive and negative influences and the period from 12-25 is the last critical opportunity to affect the healthy development of our young people (Steinberg, 2014).

The Stanford Center for Youth Mental Health and Wellbeing is built on 3 core components:

• Early Support Services: Symptoms in response to anxiety, depression, and trauma are generally the first mental health problems for which young people need support. Yet such early mental health supports are scarce. In developing a new early access and intervention model in the United States with the allcove program, Stanford will create clinical sites where young people ages 12-25 feel comfortable independently accessing early support and mental health guidance in safe and comfortable environments, a critical first step toward developing a national youth model for public mental health.
• Linkages to Clinical Expertise for More Serious Mental Health Conditions: Due to issues of stigma or lack of understanding about mental health issues and symptoms, young people often first seek help when symptoms have become more serious. Strong linkages with Stanford clinical services allow for rapid intervention and support for young people experiencing many of the mental health challenges of adolescence. These clinical programs include: 
  • Severe Anxiety and Mood Disorders: Enhanced clinical services and support for young people and families for treatment of mood disorders, especially those with depression and suicide risk. 
  • Eating Disorders: Providing early support for young people with eating disorders allows for community intervention and decreases the need to miss school due to hospitalization or needs for extended care away from home. 
  • Early Psychosis: The INSPIRE Clinic at Stanford provides treatment for young people with symptoms of early psychosis.  In addition,the National Prodrome and Early Psychosis Program Network (PEPPNET), facilitated by Stanford, ensures clinical sites across the country working in this field are connecting with cutting edge training, treatment programs, and cross-site collaboration, allowing for rapid referral to specialist treatment and decreasing the potential impact of untreated psychosis.
  • Trauma Prevention and Early Intervention: Adolescence is a time when many young people face traumatic events as a result of abuse or violence, necessitating rapid intervention to minimize the long-term consequences of traumatic events.  
  • Assessment, Diagnosis, and Triage Program: A core component under development is a clinical assessment service that provides a day long, multi-disciplinary assessment for young people and their families. This collaborative process will provide a roadmap towards wellness and healing, which includes recommendations on the appropriate support within the continuum of care for that young person. 
  • Integration With Primary Care: Primary care providers are often in the best position to detect early symptoms of mental health conditions, but many lack the training or clinical time needed to follow up on these concerns. In partnership with the Stanford Health Care System and Stanford Children’s Health, the Stanford Center for Youth Mental Health and Wellbeing seeks opportunities to increase the capacity of primary care providers to support early identification and treatment of mental health issues.

• Parent Education & Outreach: In partnership with community based organizations and schools, the Stanford Center for Youth Mental Health & Wellbeing develops programs to help families build the skills and awareness to recognize signs of distress, to engage in healthy parent-child communication, and to support the overall mental health of their children. Examples include Stanford Communication Health Interactive for Parents and Others (CHIPAO) and panel events such as Supporting Your Child During the Transition to High School.
• School Partnerships: Schools are where adolescents and young adults spend most of their time. Academic success depends upon the ability of students to be attentive, focused, and ready to learn.  School collaborations around wellness and mental health support ensure our young people are able to benefit from their educational opportunities and thrive as young adults.
• Stigma Reduction: Through a variety of community-based events and dialogues facilitated by Department faculty, including focus groups, the Stanford Center for Youth Mental Health and Wellbeing works toward breaking down the stigma associated with mental health and accessing mental health services. 
• Suicide Prevention and Postvention Services: The Stanford Center for Youth Mental Health and Wellbeing Initiative provides leadership and clinical consultation to schools in addressing suicide response and prevention related issues.
• Screening, Early Intervention and School-Based Health Services: Schools frequently lack on-site health and mental health services provided by licensed mental health and health professional from the community. Through a recent agreement giving Stanford access to the tools previously developed and utilized by the Columbia TeenScreen program, Stanford is now developing new approaches for linking young people with early mental health issues to on-site providers. 
• Linkages to School-Based Support: The Stanford Center for Youth Mental Health and Wellbeing collaborates with other teams within the Department who are leading innovative school-based programs promoting protective skill development. These include supporting secondary school students through the practice of meditation and yoga and through leadership and mentorship programs that allow young people to reach beyond themselves and learn at an early age to grow by giving to others. These programs help to decrease stigma and support mental health literacy thereby helping to provide critical suicide prevention support and link young people to early services through peer connections.
• Community College Early Support Program: Fewer than 13 percent of community colleges provide psychiatric services for students, despite increasing mental health problems among community college students. With expertise in identifying and treating those at the earliest stage of illness, the Stanford Center for Youth Mental Health and Wellbeing is well positioned to build a community college outreach program to link students with appropriate clinical services.

• Mental Health and Technology: Young people often seem to prioritize screen time over face time.  Many are also using social media and new technologies to reach out for peer support and guidance around mental health needs.  In addition, telehealth is expanding as a model for providing direct clinical care, supervision for primary care and school staff, and didactic training. A core element of the Stanford Center for Youth Mental Health and Wellbeing is to utilize innovative technologies to support adolescents, young adults and their families.
• Technology Linkages to Clinical Care: With the proliferation of web applications and text lines designed to link young people to services and crisis support, it has become increasingly important to coordinate these with local services to ensure young people have real-time access to safe and appropriate guidance as they reach for technology in times of trouble.
• Telebehavioral Health Support: Whether provided locally, regionally, statewide, nationally or internationally, telehealth offers a medium for expanding access to mental health support for young people and their families. Direct clinical services and consultation and training for school and primary care partners are some of the ways the Stanford Center for Youth Mental Health and Wellbeing is developing telehealth models to expand behavioral health support for young people.
• Assessment of and Guidance on Mental Health Technology: While there are a proliferation of websites, apps and text lines with a mental health focus, there is no current program that evaluates, reviews and provides guidance for young people and families on the safety and efficacy of the various mental health tools available. The Stanford Center for Youth Mental Health and Wellbeing has the experience to evaluate and then build on this framework of technology support that young people and families can trust to ensure safe and appropriate connections to mental health support.