Kids in Crisis: More of Ohio’s youth are struggling with mental health problems

Collier’s mom, Marcy Walker, found the note on a day when Collier was home from school. She rushed home to make sure he was OK. Physically, he was. But the note was just a further symptom of the stress Collier had been experiencing since his father’s death.

“Things just felt hopeless, just terrible,” Walker said of the time. “But I’m also grateful to see how community has helped him to begin to heal.”

The Dayton Daily News spoke to kids from across the area to discover how mental illness is manifesting in the region — along with experts, parents, pediatricians and school staff. Across the board, those we interviewed said kids’ mental health appears worse now than before the pandemic.

“We’re definitely seeing more depression and anxiety in the child and adolescent population,” said Dr. Kelly Blankenship, the division chief of psychiatry at Dayton Children’s. “The rates were starting to rise before COVID, but then COVID was like throwing gasoline on a fire.”

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Unfettered access to social media is also worsening mental health, magnifying interpersonal conflicts and making adolescents, particularly teenage girls, feel inadequate.

“Our young people are experiencing a world that’s very different than anything we grew up in,” said Tia Marcel Moretti, chief advisor and deputy director of the Office of Community and Family Resilience at the Ohio Department of Mental Health and Addiction Services (OhioMHAS).

Our findings included:

‘I could have lost you’

Collier is a Central State University student and 2024 Thurgood Marshall High School graduate. He’s now doing significantly better than before.

But in February 2022, he got a text from his dad’s fiancée saying his dad — his best friend — had shot himself.

“I was frozen,” Collier said. “I didn’t know what to think about that. It just came out of nowhere and it was hard to believe.”

Afterwards, it was the only thing on his mind. He spent sleepless nights thinking about his dad. He fell behind in school but had times where he would frantically do schoolwork to catch up.

“But the rest of 2022 and most of 2023 I just wasn’t — I wasn’t all there,” he said. “I was not OK at all.”

Walker, Collier’s mom, noticed. She got him a therapist, but the therapist and Collier did not click.

Walker, who works for Declare Dayton, a Dayton-area ministry nonprofit, reached out to her connections within the faith community and found a pastor, Terence Hayes, who knew Collier’s dad and had known Collier when he was younger and attended his church. They also connected because Hayes lost a parent to suicide.

“One of the things he did say was just to try and go out, see new things, to talk to friends and family and doing those things, that definitely helped,” Collier said. “And I’m forever grateful I was able to talk to him.”

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Collier said he was often with a cousin he is still close with during this time, going on walks, to football games, to the Spaghetti Warehouse downtown and the library. Walker also got him a different therapist.

“I’ve been experiencing a lot more freedom than I used to,” he said. “I’ve gotten better.”

Since that time, Walker said she was thrilled to see how Collier helped other people with suicidal ideation and how he came out of the depression.

“It has been such a blessing to me,” Walker said, addressing her son. “You graduated with honors. You’re going to college. You’re doing great things. And I’m so proud, so proud, because you kind of gave up. And just to think about, I could have lost you.”

Collier is not the only teenager who has struggled with mental health since 2020, and there are multiple reasons for the additional struggles for kids.

“The CDC says that it’s about one in five youth that will experience a mental health issue throughout their childhood,” said Colleen Oakes, manager of the Montgomery County Prevention Coalition.

Three years ago that number was one in six, she said.

“We’re seeing more youth that are experiencing mental health challenges,” Oakes said.

National suicide rates have been increasing since 2007, she said.

The stigma

It’s a problem that hasn’t gone unnoticed by the health professionals who want to help keep children from getting to that point.

In 2021, Dayton Children’s launched the On Our Sleeves movement in the Dayton region to bring additional mental health resources to the community.

“It’s to reduce the stigma around mental health and children and adolescents,” Blankenship said.

Breaking down stigma can mean giving children and teens a chance to ask for help instead of trying to cope alone.

Stigma often comes from a lack of understanding or fear, the American Psychiatric Association says, and it can manifest in different ways, such as public stigma, self stigma or structural stigma, with the latter meaning a systemic issue where organizations may intentionally or unintentionally limit opportunities for people with mental illness.

Stigma can lead to reduced hope, social isolation and a reluctance to seek help, the association says.

Having contact with someone with mental illness can reduce stigma, the association says, adding that when people share their stories and own experiences, mental illness can become less scary and more relatable.

The impact of COVID

Children and adolescents need stability, including schedules and other things they can depend on to be true, such as their parents having jobs and knowing what to expect from school.

“Once COVID hit, everything that everybody knew to be true was now necessarily not true,” Blankenship said.

Suddenly, millions of parents become unemployed. Employment fell by 1.4 million jobs in March 2020 and 20.5 million jobs in April 2020, according to the U.S. Bureau of Labor Statistics.

With their parents losing jobs, some children worried they would lose housing or access to food, Blankenship said. School suddenly went remote with virtual learning. Some family members got sick and even died from COVID.

“It really changed a lot for a lot of children and adolescents,” Blankenship said.

Under remote learning, children lost the opportunity for social learning, such as learning how to connect and talk to others.

“One of the really important parts about school for children and adolescents is that interaction with other kids because they grow socially,” Blankenship said. “They learn to problem solve in social situations. It’s not just about academics.”

For many kids, they lost one to three years of that social growth, she said.

“When they did go back to school, that heightened some more anxiety because maybe they stopped school at 10 because of COVID, went back at 12 or 13, but they really lost those two years of social growth,” Blankenship said.

Those children and adolescents didn’t have to leave their comfort zones when they were mandated to stay home and learn remotely, but that changed once schools went in-person.

That change and being unfamiliar with how to act or talk to others in person resulted in some social anxiety among students.

“They haven’t had to get up in front of their class and perform,” said Tiffany Viel, a school counselor at Dayton Christian High School.

To help children and teens, school counselors like Viel help their students role play interactions, such as how to talk to their teachers in person when they have a question instead of just sending their teachers an email.

More teachers are also going through trauma-informed training to provide context to why children may be acting out or misbehaving in certain situations.

“They’re more aware of the mental health things behind it, and they want to help educate the whole child,” Viel said.

Adverse childhood events

Trauma in childhood, both in and out of the home, can impact health outcomes and cause people to experience poverty later in life, doctors say, bringing attention to how health providers can screen for and encourage resilience when treating children.

Recognizing adverse childhood experiences in patients led Dr. Alonzo Patterson, III ― a pediatrician and the keynote speaker for a recent summit on youth mental health ― to recognize patterns from his own past.

“Some of the experiences I had through my lifetime weren’t always good,” Patterson said.

Parental separation or caregiver disruption, witnessing or experiencing violence, along with experiencing racism and other discrimination are types of adverse childhood experiences that can have a direct correlation to health care outcomes, said Patterson, who grew up in Residence Park in Dayton.

“Residence Park has been on the news three times in the past two weeks for three separate shootings,” Patterson said in late July.

In January, a Dayton Daily News analysis found a record number of kids were staying at St. Vincent de Paul, a local homeless shelter, and a record number of Dayton Public School students were homeless.

The financial toll that adverse childhood experiences can have on families, communities and society total hundreds of billions of dollars each year, the Centers for Disease Control says. The estimated annual U.S. population economic burden of child maltreatment alone, a major contributor to adverse childhood experiences, was $428 billion.

Community trauma

The Dayton region has had its fair share of challenges, even before the pandemic. In 2019 alone, Dayton faced a hate group’s rally and counter-protest events in downtown, the Memorial Day tornadoes and then the mass shooting in Oregon District.

Those events wouldn’t need to have a direct effect on someone to leave an emotional toll.

“Trauma doesn’t have to directly happen to somebody for them to experience those traumatic impacts,” Oakes said.

If adolescents feel unsafe, if they’re unsure what’s going to happen when they go to school, Oakes said that’s very traumatic and can lead to mental health challenges.

“It may change what I do to protect myself. It may change where I decide to go throughout the day. And that’s really that long-lasting trauma that we’re on the lookout for,” Oakes said.

Adults shouldn’t ignore the trauma, she said.

“I think as adults, we try to shield our youth from it, and we don’t recognize how much they’re seeing or how much they’re hearing during the school day from their friends, on social media, on the TV as they walk past,” Oakes said.

Children and teens know more than adults give them credit for, she said.

“There are obviously different ways that you approach a child based on their age, but even just asking them, ‘Hey, did you see what’s going on,’ or ‘What do you know about this,’ can start that conversation to really see how they’re feeling about it,” Oakes said.

It’s not as easy to control violence in the communities, shootings and events like that, which cause those risk factors.

“Those are systemic issues that are going to take years and decades to change,” Oakes said.

What adults can do is institute protective factors.

“That’s what anybody can do in the community,” Oakes said.

One example of a protective factor is for a child or adolescent to have at least one caring adult in their life.

“The number one protective factor to delay substance use or mental health challenges is having one caring adult,” Oakes said.

That adult can be a parent or guardian in the child’s household, but it can also be someone out in the community or at school.

“A lot of times it happens at school, or a friend’s parent that checks in on them, shows that they care, lets them know that they’re a safe space,” Oakes said.

The impact of social media

Even though experiencing or witnessing traumatic events in childhood isn’t new, the experiences are worsened in today’s world with modern technology, according to Patterson.

“Things are magnified even more now in the world that we have, especially when it comes to interpersonal violence,” Patterson said.

Conflicts between youth can follow them home through social media, texting and other forms of technology.

“If I got out school and went home, I didn’t have to worry about what Johnny had to say following me home. But in today’s world, they do,” Patterson said. “They see it all the time because as soon as they turn on that device that they look at, it’s back in their face again.”

When stress is constantly around people, it puts them in a chronic fight or flight response, he said.

“That actually changes how our brain works. It changes how our brain talks to our body. It changes how our body responds from a stress response, and it becomes a vicious circle that goes round and around for many kids for all their lives. And when you look at what it does to us physically, it even changes our genes,” Patterson said.

Trauma-informed care can help health providers and social workers recognize the impact trauma has on children’s development and people’s well-beings, but Patterson also wants to move beyond trauma-informed care to helping children build resiliency and find hope for the future.

“We want them to thrive,” he said. “...We want them to have stable, secure relationships.”

Finding hope for the future

From the moment Moretti was born, she began experiencing adverse childhood events.

“I was born in withdrawal and experienced life in foster care,” said Moretti, who now works for OhioMHAS on resiliency and protective factors for children.

Her mother never received treatment for her substance use or mental health, leading Moretti’s mother to die very young, she said.

“I was homeless as a teenager,” said Moretti.

Moretti was able to finish high school on her own, and her experiences led to her passion in resiliency work for youth. She sought to learn why she did not have negative outcomes from the trauma she went through in childhood like the outcomes other family members experienced.

“When I reflect on that, it’s not because of some magic in me, but the magic in just random adults in my life who whispered possibility and potential to me even if they didn’t know how dire my situation was,” Moretti said.

The adults around Moretti, when she was a child and a teenager, gave her hope for the future. Neighbors, coaches and teachers saw potential in her life and gave her support, she said.

“The research shows these are the things that increase someone’s resolve and resiliency,” Moretti said.

For Collier, coming out of the depressive spiral he was in took time and multiple people. His mom, his friends, his cousin, his mentor and another therapist all helped him get better.

He encouraged those in a similar situation to reach out to others. Even trusting one other person can be helpful, he said.

“You don’t have to tell them everything right away,” he said. “You could start off small until you get really comfortable with telling them a lot of things.”

But sitting with those negative thoughts without a distraction can make it worse, he said.

He suggested going back to old hobbies and trying new things, anything to distract from the negative thoughts.

“It starts off hard,” Collier said. “But slowly, it’ll get it’ll get so much better. You’re going to have those times where you think about all this stuff. But if you do a lot to really try and make yourself happy, after a while you’ll start to focus a lot more on those things then any other thoughts you might have.”

Reporter Cornelius Frolik contributed to this story.