Testimony of Rachel White, Senior Youth Policy Analyst, before the Committee on Health

DC Action Public Testimony Logo
February 1, 2023
Testimony
Person Testifying: Rachel White
Title: Senior Youth Policy Analyst, DC Action
Testimony Heard By: DC Council Committee on Health
Type of Hearing: Performance Oversight Hearing

An infographic with a quote from Rachel White

Good morning, Committee Chair Henderson and members of the Committee on Health. Thank you for the opportunity to address the Council today by providing testimony regarding the performance of the Department of Behavioral Health. My name is Rachel White and I am DC Action’s Senior Youth Policy Analyst. At DC Action, we use research, data, and a racial equity lens to break down barriers that stand in the way of all kids reaching their full potential. Our collaborative advocacy initiatives harness the power of young people and all residents to raise their voices to create change.

Through our Youth Economic Justice and Housing Coalition, we advocate with youth and youth-serving organizations in the District of Columbia for policies, funding, and programs that expand access to comprehensive support and services that disconnected youth and youth experiencing homelessness need to successfully transition into stable and productive adulthood. We are also the home of DC KIDS COUNT, an online resource that tracks key indicators of child and youth well-being.

One of our priorities is dismantling the pipeline from youth homelessness to chronic adult homelessness, which can only be done through intentional investments into positive youth development systems throughout the District. By investing early and helping young people find stability, we are cutting off a primary contributor to chronic adult and family homelessness. For every day a young person waits for housing, they are 2% more likely to re-experience homelessness later in life. This is a cumulative statistic. Two days of waiting is equal to 4% more likely to re-experience homelessness as an adult. One way to disrupt the youth to adult homelessness trajectory is by making it easier for youth in the District to access mental health support.

People living with impaired mental health and disorders are more susceptible to three key factors that can lead to homelessness: poverty, disaffiliation, and personal vulnerability. Behavioral issues may lead them to withdraw from friends, family and other people, creating a vacuum of support and fewer coping resources in times of trouble. Mental illness can also impair a person’s ability to be resilient and resourceful; it can cloud thinking and impair judgment. For all these reasons, people with mental illness are at greater risk of experiencing homelessness, which is why it is imperative that they can access support.

We are pleased to report that in the past year we have held quarterly meetings with the Department of Behavioral Health, resulting in DBH representatives meeting with youth homelessness providers to educate them about how District youth experiencing homelessness can access mental health support. These conversations highlighted the existing gaps in service access for youth experiencing homelessness and DBH committed to working to close these gaps if allocated the appropriate funding. Existing behavioral health supports are missing the mark and not meeting the mental health needs of youth experiencing homelessness. According to youth experiencing homelessness and their service providers, there is a lack of accessible, youth-friendly, and culturally competent mental health services throughout the District. This gap acts as a major barrier to youth achieving long-term stability.

Per the 2019 DC Youth Count survey, 1300+ unaccompanied youth reported experiencing homelessness. Keep in mind that was before the pandemic. Service access data received from DBH highlights that only 288 transition aged youth (16-24) experiencing homelessness received mental health services from DBH. It is unknown whether this data is disaggregated by accompanied versus unaccompanied youth. Not only are youth experiencing homelessness and youth homelessness service providers expressing mental health access issues, but data from DBH supports this claim as well.

As a coalition, we are currently researching a mobile mental health model that will provide mental health services where youth physically congregate, making services more accessible. This model will be detailed in the upcoming budget hearing. Accessing services would help transition youth into DBH community services for long-term support and address youth trauma, substance abuse, and medication management, all of which will decrease the likelihood of sustained or future homelessness. Recognizing that the children, youth, and families served by the public behavioral health care system in the District are primarily individuals of color, improving our system is a matter of equity. Improved access to behavioral health services is proven to be transformative for children and families and can boost the long-term overall health and productivity of communities, as evidenced by workforce outcomes and reduced crime rates.

In addition to securing funding during budget season to create a mobile mental health unit to meet the needs of youth experiencing homelessness, we are asking the Committee on Health to ascertain the following information from DBH during the government witness performance oversight hearing: ‘

 

  • Based on data received from DBH’s fiscal year 2021 Mental Health and Substance Use Report on Expenditures and Services 
    • We would like to understand how experiences may differ for people in different groups. Specifically we are interested in DBH sharing results for minors (ages 17 and under) and youth (ages 18-24) by the type of services provided (e.g. therapy, prescriber visits, crisis/emergency services). We would like the data disaggregated by all youth, for children and youth experiencing homelessness, and for children youth who identify as LGBTQ+.
    • Of the youth who received therapy through DBH, is data available on how consistent the providers were. For example, if someone had 5 sessions, were they all with the same provider or with a different person each time? Can clients themselves initiate a change in therapist? Is there any data on the rates at which transition-aged youth in different groups (e.g. transgender vs. cisgender youth) did so this past fiscal year?
    • The report shows roughly 20,000 people being served with medication management versus fewer than 12,000 being served with therapy. Are those who are getting medication management but not coded as getting therapy through DBH getting therapy elsewhere through DBH (is that provided as part of the “Community Behavioral Intervention” or “Community Support” service groups)?

Receiving answers to these questions will paint a clearer picture of which subset of youth in the District are receiving mental health services through DBH and what these services actually are giving us the tools necessary to advocate for greater access to mental health supports.

 

Thank you for your time and consideration.  I would be happy  to answer any questions.

 

Rachel White, JD

Senior Youth Policy Analyst, DC Action

rwhite@dckids.org