Building a Mental Health System Young People Can Find, Trust, and Stay Connected To
Across this series, one message has emerged again and again: young people are asking for help, but too many encounter barriers before they ever receive the support they need. They have described wanting mental health care but not knowing where to start, worrying about being judged when seeking support, experiencing interruptions in care because of housing instability, and struggling to find providers who understood their identities and lived experiences.
Together, these insights reveal an important truth: improving youth mental health requires more than simply expanding access to care. While it is essential to strengthen the behavioral health workforce and ensure enough clinicians are available and properly trained to support the needs of transition-age youth (ages 16-24), workforce growth alone cannot address every barrier young people experience. Young people also need access to a behavioral health system that is easy to navigate, culturally responsive, and designed to help them remain connected to care over time.
Young people are sharing their truth. It’s time for agency officials and policymakers to act on it.
Young People Need a System They Can Find
Even though the District offers multiple ways for young people to connect with behavioral health services, one of the clearest findings from our survey of over 100 youth was that many still do not know where to begin or encounter barriers that prevent them from accessing and maintaining the services they need.
Even though the District funds or operates behavioral health services for young people at schools, hospitals, homelessness service providers, community service providers, the child welfare system, the juvenile justice system, and the Department of Behavioral Health (DBH) itself, getting connected to and staying connected to the right services remains a challenge for many young people. Multiple access points are a strength, but only when those pathways are connected through strong coordination so that no matter where a young person starts, that initial point of contact is capable of guiding them to the care they need. This type of coordinated approach reflects what the Substance Abuse and Mental Health Services Administration (SAMHSA) describes as a “no wrong door” approach.
By adopting a “no wrong door” approach, the District could strengthen referral coordination and navigation efforts to provide young people with more effective pathways to ongoing behavioral health services. Unfortunately, referral processes vary between mental health service providers, eligibility and payment requirements differ, and on top of it all, young people are expected to navigate multiple agency and private sector options on their own. This can make accessing care overwhelming for young people, especially for those already experiencing stress, instability, or crisis.
The Department of Behavioral Health could implement a “no wrong door” approach by providing for and requiring intake specialists at community service providers, ensuring that they are compensated for the time they spend connecting a young person to the appropriate provider, if a particular program is not working out, and developing standardized intake forms and questionnaires so that young people do not have to go through multiple invasive and burdensome intake processes. All of these changes are realistic goals and achievable in the short-term, and would make it easier to connect young people to the right kind of care.
Additionally, the District should build off of what is already working. For example, the Department of Behavioral Health could do more to bring behavioral health services into spaces young people trust, especially for those who are housing insecure or homeless. Recently, DBH partnered with DC Doors, a youth homelessness services provider, to place behavioral health staff at their drop-in center several days a week to conduct brief assessments and connect young people to ongoing care. This has met young people where they are at, rather than expecting those most likely to be in need of services to seek out care on their own.
The partnership between DBH and DC Doors has improved access to initial assessments and referrals, but young people still have to transition to another provider for ongoing therapy and treatment. While not a comprehensive solution, it calls attention to the fact that DBH could expand this approach to other providers and highlights how these partnerships could be further strengthened to more directly connect young people with the care and services they need.
Young People Need a System They Can Trust
Finding a service that works for a young person in need of care is only the first step. Young people must also trust that the care they receive will be responsive to their needs and experiences. Thankfully, the District has recognized that adolescents and young adults require different approaches than children or older adults and has responded by investing in specialized behavioral health services for transition-age youth. Specifically, policymakers have made investments in developmentally appropriate care through the Transition to Independence Process (TIP) Evidence Based Treatment Model and Transition-Aged Youth Choice providers, clinicians DBH has designated as specially trained to meet the needs of young adults. Having a system and providers specifically for youth is important and delivers better services and outcomes for the youth who access it.
However, as of February 2026, just six clinicians completed TIP training, and DBH anticipates that only two community based organizations will qualify as TAY Choice providers serving transition-age youth. Furthermore, DBH does not publicly report the total number of clinicians who specialize in serving transition-age youth, making it difficult to understand how workforce investments are keeping pace with need. Greater transparency about the TAY workforce is urgently needed, and if DBH does not proactively publish this information, policymakers should require it through oversight.
Policymakers can play a more active role in addressing the workforce shortage too. Broadly, social work workforce shortages continue to affect the District’s larger behavioral health system. DC Health recently reported that the number of Licensed Graduate Social Workers (LGSWs), an important entry point into the behavioral health workforce, declined by more than 15% between January and September 2025. An immediate solution to increase the District’s supply of social workers would be to pass legislation introduced by At-Large Councilmember Robert White to join the Social Work Licensure Compact, which once in effect, would allow social workers licensed in neighboring states like Maryland and Virginia, or any of the 30 states where the Compact has been passed, to serve District residents. While the Compact could help expand the pool of available providers and reduce barriers to recruitment, it is only one part of the solution. Continued investment in recruitment, supervision, retention, and specialized training will also be necessary to build a behavioral health workforce equipped to meet the needs of all residents, but especially young people.
On top of expanding the workforce, agency officials and policymakers must also ensure providers have the skills needed to effectively serve the young people who seek their care. This can be accomplished by ensuring DBH continues investing in training that prepares clinicians to provide trauma-informed, culturally responsive, and affirming care across diverse identities and experiences, including age, race, sexual orientation, gender identity, and housing instability, so regardless of which provider a young person sees, they are met with care that is respectful, responsive, and equipped to support their unique needs.
Using Data and Youth Voice to Strengthen Systems
These efforts must also be coupled with better data to guarantee that the District is making the right investments and policy changes to meet young people’s mental health needs. Administrative and quantitative data can tell an important part of the story, such as how many young people receive services and, when paired with qualitative findings about how young people experience care, together they can provide a more complete picture of whether the system is working and where it needs fixing. Tracking measures such as referral completion, wait times, patient experience, and reasons for disengaging from care can help identify where barriers exist and whether intended improvements are actually leading to better outcomes. It can also be helpful in determining where policymakers need to shift or dedicate more resources.
Our survey is one example of qualitative data that helps capture how young people experience mental health challenges and navigate access to care, and how this information might be used to help inform improvements to the system overall. Surveys and focus groups can help tell a story that quantitative data cannot, such as why barriers exist—describing confusion navigating services, difficulty finding a trusted provider, and challenges staying connected to care during periods of housing instability. Those insights are difficult to capture through administrative data alone, but they are critical to designing effective solutions. District agencies and programs can and should build on this approach by regularly collecting youth feedback through surveys, focus groups, advisory councils, and other quality improvement efforts, so that young people’s experiences continue to inform how behavioral health services are designed, delivered, and evaluated.
Conclusion
Across the last few blogs, young people have made one message clear: they want support, and they have helped us better understand the barriers that stand in their way of receiving it. The encouraging news is that their stories also provide real insight into how some of those barriers might be knocked down.
Expanding the behavioral health workforce remains essential, but it is not enough on its own. Building a stronger behavioral health system means reducing the burden on young people to navigate services alone through stronger referral pathways, better coordination across providers and agencies, continued investment in providers with expertise serving transition-age youth, and using data and youth feedback to continuously improve care.
Ultimately, building a stronger system requires continuing to listen to young people themselves. Their experiences show us where the system is succeeding, where it is falling short, and what it will take to ensure every young person can access the support they need. Their experiences also reaffirm that mental health cannot be separated from the broader conditions shaping young people’s lives. Our survey findings made clear that housing stability, supportive relationships, economic security, and affirming communities all influence whether young people are able to seek care, remain engaged, and thrive.
When young people ask for help, they deserve more than a list of services—they deserve a behavioral health system that is coordinated, responsive, and built around their lives.
Take Action
DC Action is calling on District leaders to strengthen the youth behavioral health workforce, create pathways for providers with lived experience, expand peer-to-peer support, and bring mental health services into the spaces young people already trust.
If you believe young people in DC deserve timely, culturally responsive mental health care they can find, trust, and stay connected to, add your name to our petition calling on the DC Council, the Department of Behavioral Health, and the Mayor to take action.
Sign the petition here.