By Douglas Riddle, PhD, DMin, FAPA, Curriculum Director of The Carol Emmott Foundation

It is widely acknowledged that the COVID19 pandemic affected the mental health of adolescents, but the extent may be news to you. In 2021 nearly 1/3 of students experienced poor mental health and 22% considered suicide, according to the Centers for Disease Control and Prevention. One in 10 students attempted suicide.

Our September featured CEF community member is on the front lines of this reality. Dr. Garima Singh, Carol Emmott Fellowship Class of 2022, is the Chief Medical Officer at Burrell Behavioral Health and its parent company Brightli, one of the largest community mental health centers, serving patients in Missouri, Illinois, Kansas, Oklahoma, and Indiana. Triple board certified in child and adolescent psychiatry, general psychiatry, and addiction medicine, Garima is tackling the special challenges of rural and underserved areas.

“I always wanted to do pediatrics,” she told me in January, but an encounter with a young girl who’d been sexually assaulted and the consequent complex Post Traumatic Stress Disorder, including hearing voices and hallucinating the perpetrator, “changed my career.” Child psychiatry was her new direction and she has become an expert on autism and how to deliver mental health care in tough environments.

She notes that adolescent suicide is now an epidemic following the pandemic impact on the social lives of young people. It also reduced the stigma associated with mental health which has led to startling increases in the demand for care. In the face of a deep shortage of child psychiatrists and allied providers, many adolescents can’t see a professional simply because there aren’t enough. This situation is exacerbated by distance and rural communities which often are dealing with multiple deficits in caregivers.

Garima took this situation of increasing demand and extremely limited resources and led her organization in a series of innovative moves to address it. Some of the creative initiatives have included greater reliance on the whole care team and ensuring professionals are working to the full scope of their credentials. It included ensuring that kids can be seen wherever makes the most sense, whether at the office or home or school. She’s led a major investment in telephonic and virtual consults.

Sometimes these virtual interviews have been more effective than in-person visits. Garima tells of one young person she’d seen for 7 years who had not been comfortable disclosing to the parents or the doctor that he was actually a girl. It was something she could address on the phone. Garima notes that the young lady is graduating from high school with a straight A average and will be going to college this spring. “Finally I feel like I am who I needed to be.”

Other initiatives include more investment in school-based services with outpatient therapists in multiple locations going directly to schools. Also, social workers as part of the care team helping families directly. Garima has worked to activate all parts of the communities under her care to collaborate to create change.

Her creativity and commitment has led to significant improvements in care. Wait times to see a provider were reduced to weeks rather than months. The climate of creative care has resulted in a better workplace. In fiscal year 2024, they had 97 % physician retention, 147,353 medically focused visits, 12,000 addiction medicine and crisis stabilization visits with 95% patient satisfaction. Her team is involved in multiple initiatives to expand access to care and improve clinical outcome.

Garima encourages us as parents, family friends, and educators “if you have a gut feeling that something is not right, intervene. Ask questions.” She notes that what’s important is spending quality time with those around us, not providing solutions, but ensuring that others know we are listening to them. We can all be part of the solution.