Youth Villages offers in-home counseling to children and families with mental health issues

Nine-year-old Vega was nearing the end of her counseling sessions with Youth Villages, a non-profit organization helping families with troubled children. 

Vega and her younger sister had always had difficulty making friends and tended to stick with one another. 

When the pandemic began and schools shut down, families were forced behind closed doors. Daily patterns of lives were interrupted as parents contended with staying financially afloat and finding stability for their children. 

 Vega’s mother soon noticed behavioral issues in her daughter, whose last name is being omitted to protect her identity. 

Being stuck inside all the time led to increasing fights and tantrums between the siblings.  Their problems migrated outside as well. Neighbors complained the girls had kicked and pushed the other kids in the neighborhood. 

 Vega and her sister eventually returned to school, but the problems didn’t end there. Vega’s mother began to increasingly receive complaints about her daughter’s behavior. Despite her small frame, Vega was hard to calm down when she was upset. 

 Things escalated one night after Vega and her sister fought, but this time Vega grabbed a knife. 

 “It got to the point where I was just crying myself trying to find someplace to go for her to get that help,” said Vega’s mother. 

Mental illness and the demand for psychological services have surged, especially among children. Families were affected by isolation, increased anxiety due to the virus, trauma from domestic abuse and/or the loss of a family member due to the pandemic. Incidentally, record levels of domestic abuse occurred following lockdowns to control the spread of the virus, according to UN Women, an entity of the United Nations dedicated to gender equality and the empowerment of women.

In 2021, Tennessee parents listed child mental health and suicide among their top concerns  for kids, according to a poll by The Center for Child Health Policy at Vanderbilt University Medical Center. 

In rural Tennessee, demand for mental health services are complicated by scarcity.

Apart from having to drive 45 minutes for her own counseling sessions, Vega’s mother had even less success finding a therapist for her teenage daughter, who was struggling with mental health issues. There was only one therapist available in town who worked with children, and appointments were booked out for months. 

“I would love to see another office or two open up for children,” she said.

Only after connecting with the Tennessee Department of Children’s Services did Vega’s mother learn about Youth Villages, which could not only provide her daughter the care she needed, but therapists would come to them.

“They can do that?” she asked. “Yes, that would be fantastic!” she told them.

Since June, Youth Villages counselor Jacie Boyd traveled three times each week to DeKalb County to help Vega learn coping mechanisms. And since the sessions take place at home, Vega’s sister and mother were able to participate. 

After the first few sessions, Vega would wait eagerly in the parking lot  of her apartment complex for Boyd to arrive. 

 And while Vega was doing much better than she had when she first started counseling sessions last June, Vega’s mother worried about what would happen after Vega’s counseling sessions ended.

 It takes a village to raise a child

 In 1986, Youth Villages was founded in Memphis by Pat Lawler, who noticed that troubled children taken from their parents and then returned were unlikely to improve. Youth Villages would instead focus on avoiding that scenario at all costs and bringing mental healthcare treatment to families instead. 

 While their operations center is still located in Memphis today, Youth Villages expanded to 15 states. Apart from Memphis, Youth Villages has several locations throughout East, West and Middle Tennessee, allowing counselors to provide services in the more rural parts of the state. 

Youth Villages programs are covered by a combination of federal funding, state funding and donations. In Tennessee, state and federal funding comes through partnerships with the Department of Children’s Services, the Department of Mental Health and Substance Abuse Services and TennCare.

And since Youth Villages services come to them, families are no longer prevented from seeking mental health care due to transportation and distance. 

“Which is a great advantage for families and for treatment, because you’re different at home than you are at an office,” said Connie Mills, Youth Villages spokesperson. 

But mental health resources are limited. There is currently a nationwide shortage of psychiatrists, especially pediatric psychiatrists, said Mills.

“They’re kind of like unicorns if you spot one,” she said. 

Apart from high demand for mental health workers, some therapists don’t accept insurance, which prevents the insured or TennCare recipients from seeking care. And while telehealth increased access to mental health services, rural areas often struggle to have broadband or internet.

Youth Villages can also meet families at the hospital to conduct evaluations.

“It’s a testament really to Tennessee, because a lot of things we proposed in Tennessee, started in Tennessee, we’ve taken to other states,” said Mills. 

Otherwise, sessions with Youth Villages usually start with a referral. 

“I didn’t understand what was wrong”

 In 2021, Charla Davis watched her then 9-year-old son spiral into severe anxiety as he was cut off from a variety of activities due to the pandemic. He began to have increasing outbursts, temper tantrums and difficulty managing his anger.

“Being cooped in the house 24/7 where you’re looking at the same people everyday. Tempers rise, attitudes just fly,” said Davis, explaining that working from home meant she and her two boys were always together.

“He had nothing but us and his Legos, and there’s only so much you can do with Legos,” she added.

The situation didn’t improve with school, which switched to virtual classrooms as COVID-19 cases surged across the country. 

By the end of the school year and right before his 10th birthday, Davis was forced to hospitalize her son.

“Nobody expects their nine-year-old to be hospitalized for mental health issues,” said Davis.

Davis and her child were then assigned a case manager, who referred them to Youth Villages for care. More than a year later, the now 11-year-old has made significant improvement. Most recently, his mother watched as a little girl approached and asked to play. While his anxiety normally caused him to react badly to social interactions, Davis watched her son take a deep breath and use the coping skills he had learned. 

“He just told her, he said ‘I don’t want to play right now, I’m going to walk away.’ That was tremendous for him,” said Davis. 

Davis also noted that talking about her son’s mental health issues brought up uncomfortable conversations. When her son was initially hospitalized, family members advised her not to tell anyone about what happened.

Brittney Williams, a Youth Villages counselor working with the Davis family, noted that acknowledging mental health issues still remains a taboo in Black communities. 

“You don’t talk about it. It’s not seen, nor heard. Nobody goes to get help or anything like that,” said Williams.

“And I’m like, this is what’s wrong. How can we help somebody else who may be struggling with the same thing if we don’t let people know what’s going on?” asked Davis.

What defines a crisis?

“If a family says it’s a crisis, that defines enough of a crisis for their team,” said Raquel Shutze, Youth Villages director of specialized crisis services. 

Once a call is made, a mobile crisis team arrives on sight to assess the child and the family.  Every call comes with a safety plan. Families are told what to lock up, such as anything a child could hurt themselves with.

Some of Youth Villages’ patients may require to be hospitalized. While hospitalizations are rare, they’re often the result of suicide attempts or ideation, psychosis or other severe mental health issues.  And a counselor will only urge hospitalization if it’s not detrimental to the child.

“If we’re hospitalizing, that means that’s the safest option for that kid,” said Shutze. 

Because there are no state-operated mental institutions for children, only private hospitals can  approve or deny taking in troubled children.

But the delays can be lengthy. This summer, some children waited for a month before being admitted for care, said Shutze.

“Weighs on the nursing staff, it weighs on our staff, it weighs on the doctors. It’s a system challenge to have kids waiting on placement,” she added.

Children who are sent to detention centers after police intervention may remain there for long periods of time due to limited space at psychiatric hospitals. This makes it difficult for Youth Villages counselors to assess their condition and find them a place to stay to receive treatment

“We don’t often move them from a hospital if they are safe in their environment, because that can be traumatic too,” added Shutze. 

In the summer, when schools are closed, patient loads drop significantly. Schools are a major referral source for children in crisis. 

“The biggest trend we see every year in the summer is a rise in the acuity of the cases,” said Shutze.  “Intensity of the problems the kids are seeing in the summer just goes up. We see more (suicide) attempts in the summer, more intensity of suicide ideation and more frustration in the home, where they feel like they’re stuck.”

“The volume goes down, which is nice because these cases take a lot more to manage and last longer in the summertime because they are more intense and more acute,” she added. 

Since 2020, children served by Youth Villages’ specialized crisis services in Tennessee increased exponentially. In 2021, almost 15,000 children were served. By 2022, this number had increased to more than 16,000 children.

According to Shutze, 2022 had the highest volume of calls on record.

Counseling for the whole family

On average, a family will receive care with Youth Villages from 90 to 120 days, depending on their insurance and TennCare. 

At Vega’s home, her counselor comes prepared to each session with a large container filled with markers, books and other tools the children can interact with. As Vega plays with a coloring book in the living room, her sister and mother watch from the couch. Vega’s sister soon joins in the activities, as does her stuffed pug doll. 

These sessions often turn into counseling for the whole family. 

At the Davis family home, the family members learned that the success of the program depended on everyone working together to create a better environment. 

“It’s not just him in therapy, it’s all of us. The whole family has to learn the coping skills to make sure he does not feel he’s by himself in this, because he’s not,” said Davis. 

As Vega learned coping skills to cope with her environment, Vega’s mother found herself using the same skills to handle tense situations. 

When Boyd asked what she had learned from therapy, Vega emphasized the importance of being nice, since negative situations happened when she was mean. 

“If I’m mean this year and I go back to school next year, they’ll be mean to me,” she said, adding that she wanted to make more friends. 

The family insurance allowed an extension of Vega’s sessions beyond the normal Youth Villages coverage, but this would soon end. 

Boyd and Vega’s mother hoped to continue through Vega’s little sister. 

Repetitive work helps children retain the skills they learn to use later, said Boyd.