Troop 5596 gathered around tables at the Methodist church in Justin, a community about 25 miles north of Fort Worth, on an afternoon in late April. Groups of two and three girls were huddled over worksheets, talking about awareness and anxiety—and there was a lot to say.
Sydney Judge, 9, listed “sisters” and “state testing” as her top stressors. Audrianna Guerrero, 10, asked her how she feels when she's stressed.
“Like I'm going to blow up,” Sydney said. “I feel disappointed. Sometimes I feel like no one believes in me.”
Her troop leaders, Rebecca Bartolomeo and Michelle Smith, asked her what she does when she feels that way.
“I go up to my room and play with my giant stress ball,” Sydney said, “or I go down to the garage and hit the punching bag.”
As the night went on, the Girl Scouts put together mindfulness kits: plastic pencil cases filled with candy, colorful stickers, and little books with activities to do when feeling anxious.
These activities are part of it Okay to Say mental health repair program. It began in 2019 as a partnership between the Girl Scouts of Northeast Texas and community organizations such as the Meadows Mental Health Policy Institute and UT Southwestern Medical Center.
One note, this story is about suicide.
Jennifer Bartkowski, CEO of Girl Scouts of Northeast Texas, said the agency saw a need for mental health programming for children during the COVID-19 pandemic. According to a recent survey of high school students by the Centers for Disease Control and Prevention (CDC), 37 percent of students experienced poor mental health during the pandemicand felt disconnected, which increased feelings of hopelessness and sadness.
“We found very quickly that the girls were dealing with this uncertainty with a lot of challenges,” Bartkowski said. “They felt isolated. They felt anxious [and] stress at record levels. They felt like they didn't know what to do or where to go.”
The goals of the program are to create space for conversations about feelings and give girls the skills to ask for help when they need it to prevent serious outcomes. For example, the CDC reported that during the pandemic, US girls ages 12-17 were admitted to emergency departments for suicide attempts 50 percent more often than in 2019.
“If anything, I want girls to be able to recognize that they don't feel good,” Bartkowski said. “Mental health challenges can lead to health challenges, which can then lead to suicidal ideation and ultimately death. If we can stop this scenario before it goes down that path, that's the goal of the Girl Scouts.”
Community prevention efforts aim to intervene before a crisis
Bartkowski acknowledges that the program does not replace treatment or treatment facilities, but works as part of a continuum of care for youth who may struggle to access the services they need.
“I think there's a gap in all mental health services across the spectrum, but the Boy Scouts can't fill it all,” she said. “Where we fit in well is in that kind of prevention space where we can give girls the skills they need on the front end and then secondarily give them [and volunteers] the skills they need to recognize when there is a change in behaviour.'
Deborah Cohen is one assistant professor of psychiatry at the University of Texas at Austin and co-directs the Center for Youth Mental Health, which takes a research-based approach to resources for youth at risk of developing serious mental illness. Symptoms may appear in children as as early as age 11 for anxiety disordersbut many experience them between the ages of 15 and 26, she said, often when they transition from pediatric to adult care.
“During this age, people tend not to connect with their health care providers,” Cohen said. “What we're finding is that a lot of people end up with untreated disease for a period of time, basically as a result.”
Texas is one of only ten or so states across the country with young people who do higher rates of mental health issues and less access to care. Cohen also said that most mental health services, including those in Texas, are part of state-funded public health resources such as North Texas Behavioral Health Authorityor provided through private treatment and psychiatric clinics.
“Some of them are not insured, they are [paid for in] cash, it's expensive,” he said. “People are just finding that they can't get services, that there's no one there to really provide them with what they're looking for. They can't even get through the door.”
A study from Georgetown University Health Policy Institute in 2019 the national rate of uninsured children was found to be 6 percent. Texas' rate is more than double that, at 13 percent, meaning nearly 1 million children statewide lack health insurance.
Cohen said there are gaps in mental health care not only because of affordability and insurance coverage, but also because so many programs focus on serious, chronic problems in adults rather than children.
Northeast Texas' Okay to Say program is part of early intervention strategies. These community-centered programs are designed to improve mental health literacy and build skills, resilience and support networks that could help prevent a crisis in the future.
“It's not just important for us as adults to learn these things,” Coens said. “It's important for us to have these conversations to learn how to look out for each other.”
Creating space for mental health conversations and building resilience
Back in Justin, Sydney Judge and her troopers packed up their new mindfulness kits and prepared to head home. Sydney packed a box of “blue-green sea foam” filled with glitter and water into her backpack as part of the kit. It is a sensory jar that can be used as a stress relief tool.
“I love building kits like this,” Sydney said. “When [state testing] it's stressing me out, can I do a little shake, do a little squeeze, because our teachers will let us bring it to school. They are too good not to leave us.”
Assistant Troop Leader Michelle Smith rearranged the chairs as the girls slowly left the church. The next meeting will conclude the troop repair program, with an activity about asking for help. They will also make aromatherapy play dough to take home as a stress reliever.
Smith said seeing the girls at the beginning of the pandemic versus now is a miracle.
“They were sad, they weren't talking, they definitely weren't interacting with each other because everyone was scared,” he said. “And now, everyone's laughing, we go camping and they hold hands and sing songs together. This is what childhood is supposed to be.'
She said the program helped open up conversations about mental health, even between herself and her children.
“They have the resiliency that they learned in dealing with the pandemic, now they can identify their feelings, they can talk about it and they know where to go to get help,” Smith said. “And they can share it with other people. Is there anything stronger than that?'
The Okay to Say program launched statewide in 2020. Nearly 6,000 girls in Texas have earned their patches so far.
This story has been updated with new information provided by Girl Scouts of Northeast Texas.
For resources and support, call the National Suicide Prevention Lifeline at 1-800-273-TALK.
KERA is part of it Mental Health Parity Partnershipa group of newsrooms covering challenges and solutions to access to mental health care in the U.S. Partners in this project include The Carter Center, the Center for Public Integrity, and newsrooms in Arizona, California, Georgia, Illinois, Pennsylvania, and Texas.
Do you have a tip? Email Elena Rivera at erivera@kera.org. You can follow Elena on Twitter @elenaiswriting.
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