What’s Changed the Most in the Mental Health Field? AIR Experts Provide Perspective in Recognition of Mental Health Awareness Month

School therapist with young student
In 2017, 46.6 million adults had any type of mental illness, according to the National Institute of Mental Health. Of those, 19.8 million (42.6 percent), received mental health services in the past year.

Diagnoses of depression and anxiety among children have increased over time, with 5.4% of children aged 6 to 17 having been diagnosed with either condition in 2003, compared with 8.4% in 2011-2012, according to the Centers for Disease Control and Prevention.

Just like physical health, mental health is crucial to everyone’s well-being. Mental health affects everything we do, from our work to how we relate to others and make choices. Awareness of the importance of mental health has increased, as has access to treatment.

AIR’s experts conduct research and evaluation, as well as provide training and technical assistance, to help states, schools, and communities raise awareness and implement strategies to improve mental health. For Mental Health Awareness Month, five of these experts reflected on three of the biggest trends and shifts they’ve observed from their collective years in the field.

1. Attitudes toward mental health and mental health services have changed.

Awareness of mental health has increased over the last several years, and the stigma surrounding mental illness has lessened, though has not entirely gone away.

Frank Rider, senior finance specialist: “I’ve seen a trend toward normalizing mental health needs and issues. It’s been liberating to see our society increasingly realize that every person, every child, has mental health—positive mental health that can be nurtured, threats to positive mental health that can be mitigated, and problems with mental health that can be treated. This is a public health matter.”

Elizabeth Freeman, senior technical assistance consultant: “I do believe stigma is lessening because there are more and more people speaking up about this. Families, children, and youth understand that it’s okay to reach out for help. It means you’re physically and mentally healthy if you ask for help, versus shying away from asking for that help you may need.”

Kimberly Kendziora, managing researcher: “Stigma is lower, but there are populations where that is not the case. That said, there’s been a big shift in recognizing that mental health disorders are treatable, recovery is possible, and it’s not your fault if you’re depressed. It’s not a character flaw.”

2. Schools are now a common setting for mental health services.

In the past, mental health services were provided by practitioners or in community settings, but schools have become a place for students and their families to participate in mental health programs.

Mary Thorngren, managing project specialist: “A big shift I’ve seen, and a really important one, is school-based mental health services. I think most people agree that providing services in schools, with linkages to community providers when necessary, is an absolutely critical part of the continuum of prevention and treatment. In that continuum, you’re talking about programs that would encourage healthy behavior for everybody, programs for students who need a little bit more support, and then services for people who really need a lot more support. When you have a continuum of programs and services in the school setting, it helps to destigmatize because you’re reaching so many different groups of people: professionals in the school, parents and other family members, and students.”

Rebecca Ornelas, technical assistance consultant: “School-based mental health is addressing the missing link in our mental health system. What schools do is give us the opportunity to fill the need for earlier identification and earlier intervention. Implementing these programs and services is a more systematic way of identifying needs children may have and then connecting them to services. The amazing part is that we’re implementing some of these programs within schools and we’re engaging families to build the skills they need to help children at home. Those are the types of things that we haven’t had in the system before. That’s going to be a game changer.”

Freeman: “Everybody understands that if we’re going to meet the needs of children and youth today, we have to go where they are.”

3. We understand more about how children’s brains develop.

Increased understanding of brain and neurological science has provided necessary insight into children’s behavior and mental health.

Ornelas: “Over the past 30 years, there’s been a tremendous growth in knowledge around child development. There have been many advancements in technology and brain science that have really improved the entire field of children’s mental health.”

Kendziora: “There’s an increasing understanding, especially with young kids, that behavior is brain-driven and that brains aren’t finished developing until about 25. I think neuroscience has caught up to behavioral science in terms of understanding the phenomena of behavior issues. And there’s more understanding that kids aren’t necessarily to blame, and should not have lifetime accountability, for the things that they do when they don’t really understand what they’re up to.”

Rider: “There’s been a huge awakening about the dynamic nature of child development, realizing that how we nurture and support individual children can make an enormous difference in the courses of their whole lives. In previous times, conditions like disabilities were understood as static conditions, unchangeable. But especially in the decades of my career, we have seen incredible discovery about the resilience and the plasticity or flexibility of human beings. To me, that’s a great source of hope.”

About the Experts

  • Elizabeth Freeman is a senior technical assistance consultant and clinical social worker and has spent more than 25 years studying children, youth, and family mental health.
  • Kimberly Kendziora is a managing researcher with more than 30 years’ experience studying mental health, conditions for learning in schools, school-based student support initiatives, and social and emotional learning.
  • Rebecca Ornelas is a technical assistance consultant with more than 20 years’ experience in children’s mental health, systems of care, evidence-based mental health services, family engagement, and youth violence-prevention initiatives. 
  • Frank Rider is a senior finance specialist who focuses on mental health services for students. He has been studying the field of mental health for nearly 40 years.
  • Mary Thorngren is a managing project specialist and certified health education specialist, with more than 30 years of experience in managing and providing training and technical assistance to school districts, community-based organizations, and public health and other systems.