Think Out Loud

How youth are coping with anxiety and stress

By Allison Frost (OPB)
Nov. 24, 2021 12:32 a.m. Updated: Dec. 8, 2021 10:33 p.m.

Broadcast: Thursday, March 3

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Courtesy MissMayoi

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The COVID-19 pandemic is having dramatic impacts on the well-being of youth in many ways. School districts are struggling to maintain safe learning environments for their students, staff and teachers. For many young people, the most significant impacts are on their mental health. And even if we’ve turned some corners in the pandemic, the emotional effects linger.

We held a live Zoom conversation recently, where we heard directly from students, from mental health professionals and from participants in a youth support circle. The event was a co-production between OPB and “Call to Mind,” American Public Media’s initiative to foster new conversations about mental health. We talked about how young people are coping with mental health struggles and how the individuals and the institutions in their lives could best support their resilience. Our guests were Alyssia Menezes, a junior at Portland’s Lincoln High School, and Jospin Mugisha, a sophomore at Portland State University.

We also wanted to get another view of students and stress, and the adults who are helping them. So we turned to Katherine Iliyn, a counselor at Cascade High School in Turner, and Craigan Usher a professor of psychiatry at Oregon Health & Science University with a special focus on child and adolescent psychiatry. We also got a closer look at one specific response to help young people cope from Shalene Joseph. She co-facilitates a youth support circle for the Native Wellness Center. And we met Andy Miller, a high school freshman who is part of that circle.

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Note: The following transcript was computer generated and edited by a volunteer.

Dave Miller: This is Think Out Loud on OPB. I’m Dave Miller. The COVID-19 pandemic is having dramatic impacts on the well being of our youth in many ways. School Districts are struggling to maintain safe learning environments for their students, staff and teachers. For many young people, the most significant impacts are on their mental health because even if we’ve turned some corners in the pandemic, the emotional effects linger. We held a live Zoom conversation last week where we heard directly from students, from mental health professionals and from participants in a youth support circle. The event was a co-production between OPB and Call to Mind. That’s American Public Media’s initiative to foster new conversations about mental health. We talked about how young people are coping with mental health struggles and how the individuals and the institutions in their lives could best support their resilience. We started with Alyssia Menezes is a Junior at Portland’s Lincoln High School and Jospin Mugisha, a Sophomore at Portland State University. I asked Alyssia what she remembered most from the first days and weeks at the beginning of the pandemic, when everything changed almost overnight.

Alyssia Menezes: I think for me, my mental health journey over the pandemic didn’t just start on day one. I didn’t realize that we would be gone for school for not two weeks but almost a year. So it took a little while for it to settle in and just when the pandemic started, I was basically doing the same thing I was before the pandemic. If anything, I was happy to have the time off.

Miller: But my understanding is that at a certain point you ended up having panic attacks for the first time in your life. Did you know what was even happening to you?

Menezes: That’s true. So after I did start to experience life during the pandemic, I realized that we wouldn’t be returning to normal, I did start having increased stress and increased anxiety. So whereas when I was with peers, when I had a support network where I knew, relatively, what was going on, I was doing relatively fine. But when I was more isolated, when my time management... I didn’t have time to talk with friends or social time within my schedule. I think I got a little bit overwhelmed. I started getting panic attacks when the new school year started, when I was having harder classes when I was doing more extracurriculars and I just didn’t know how to handle it. I didn’t have like other students to talk to about what I was going through. I was just becoming really, really stressed. Somewhat, I didn’t know what I was going through. I had heard about what mental health was in the past. I never really thought that I had anxiety. I just assumed like, ‘Oh that’s something that other people have, I don’t have it.’ So then when I got so stressed that I struggled to write an email because my hands were shaking, I just had no idea what I was going through, but I was like, I need to figure this out because I couldn’t write an email, that’s crazy.

Miller: At that point, did you feel like you had anyone you could talk to, anyone you could turn to?

Menezes: I think so, I think I had to make the decision that I was going to be open about what I was going through, and I think that was a somewhat tough decision to make, because for a lot of my life, some emotions I tell people about, and some emotions I don’t tell people about and that had been working out for me, but then when I realized that I wasn’t able to do this alone and I tried handling what I was going through alone and it wasn’t working, I had to make the conscious decision to reach out to people, which ended up being my immediate family,

Miller: How’d that go?

Menezes: I think it overall went well, I am very lucky to have a supportive family. I think towards the beginning, just like I didn’t know what I was going through, I don’t think my family knew what I was going through as well, so we were somewhat working through it together. Sometimes, there’s a little bit frustrating when I was saying one thing, but they weren’t quite understanding what I was going through, but I think just being really, really clear about what I was going through helped the most and obviously they can’t completely understand what I’m going through. I’m a different person, I have a different mind, different age, but just through really listening to what I was saying, I think that helped me the most.

Miller: Before you realized that you’re dealing with serious anxiety yourself, how did you think about mental illness?

Menezes: I definitely completely bought into the stigma around mental illness, which is really sad to me now.I had relatively learned off and on about mental health, probably starting in about Middle School, so, Sixth grade. I learned that some people have anxiety and depression, but I always thought that’s a weakness, that’s a choice, like it might impact other people, but I’m going to be stronger than that, that’s not going to happen to me. And I just had so many bad ideas with it, which, then when I started getting it firstly, it took me a really, really long time to realize I had anxiety. I remember the first panic attack I ever had, was in fifth grade, but I didn’t realize I had anxiety, let alone try to help my anxiety until just this year, which just blows my mind because I bought into that stigma and I didn’t think it was for me. And, because I bought into that stigma, I wasn’t really paying attention when people and resources in my life told me how to deal with mental health when they told me steps to take to help my mental health because I said, I would assume that I don’t have mental health they don’t need to worry about that. I’ll be stronger than that. Which is clearly untrue.

Miller: Jospin, I saw you nodding a little bit, as Alyssia was telling us the beginning of her story. So let’s hear some of your story, now. Correct me if I’m wrong here, but my understanding is that your family originally came from Burundi that you spent five years in a refugee camp in Tanzania before getting asylum and arriving in the US and that you started kindergarten here, outside of Portland not speaking any English and then zooming forward you graduated with a 4.1 gpa from Century High School in Hillsboro. I’ve encapsulated a lot of history in 45 seconds. But I’m imagining that you couldn’t have done what you did, succeeded the way you did, without some pressure to excel. Is it fair to say that?

Jospin Mugisha: Yeah for sure. Especially because where my family came from there was definitely some pressure to succeed from everybody. We all felt like, okay we came from a refugee camp. We’ve been at the bottom, so from everybody, like we’ve always had this mindset to just grind, grind, and work as hard as possible, especially because that’s what my parents did when we first got here. At one point they were both working two jobs; working 12 hours per day or more. So for me, I think part of the reason I struggled with anxiety and managing my stress is because, instead of actually getting the help that I needed, I believed that, oh I can just work it off, you know what I mean? I just need to keep working, working harder instead of actually addressing how I was feeling and like the emotions that I was going through.

Miller: Even if that work, that drive, was one of the reasons behind the anxiety. There was still some hope that just pushing even harder, and the anxiety will go away. So what happened when that drive ran smack into the pandemic?

Mugisha: The main reason I feel like I came to a breaking point, was because after high school, I played three years of varsity basketball, I was the team MVP two years in a row. I was first team, all league. My plan was to play basketball in college and due to the pandemic I didn’t have opportunities to do that. I had to transition from a life where my life was surrounded around basketball to a life without basketball, and luckily I did so well academically throughout high school that I was able to get into PSU with the full ride, academically with a few scholarships, so I didn’t have to stress on that side of school, but I didn’t really know what to do, and then having all that free time, I felt I was kind of confused almost to where, okay, what am I supposed to do now? And I had all this time and like I think she touched on something that I want to reiterate- when I was younger, I had the same symptoms that I do now, but I didn’t recognize them because I was always working. I always had a distraction. I always had something else that I could work at or do, whether that was school or basketball; it just was a distraction. I wasn’t able to process my emotions. But because of the pandemic, I didn’t have basketball, I didn’t have school. I didn’t have any friends or anybody else to distract me. I was alone with my emotions and just having that much time to really process everything, made everything just hit me all at once almost. Where once I went back into the normal life, is just like I had all these emotions that were like bottled up for so long that were ready to explode almost.

Miller: It almost sounds like for both of you, the pandemic exacerbated what had been going on, in painful ways and difficult ways, but one small benefit was it also forced you to realize what was happening and maybe what had been happening for a long time. So Jospin, were you then, able to get help when you talked about your breaking point, when you arrived there, what came next?

Mugisha: When I arrived there I actually had like a pretty decent support system. I had a girlfriend at the time and she encouraged me to go to therapy, and reach out to somebody and just figure out what I can do about how I’m feeling and just at least understand why it’s happening or why I’m feeling this way. Because I’ve never had a problem with talking about what I was going through in my emotions, but I still didn’t understand how to deal with them. And so I just wanted to talk to somebody and so I reached out to Kaiser which is my insurance provider and I tried to set up a meeting and I actually called them a month ago and I got my first like call back this morning at 8:35. So it took almost a month just to get a call. And even then just today they just gave me a referral to make an appointment with a different organization that’s affiliated with Kaiser. And so I still have not reached somebody that can I actually talk to and it’s been a month of talk to multiple people and it was just really difficult and then on top of that going there is no resource within the Kaiser website to actually- there’s no mental health dedicated section where you can just schedule an appointment. It’s weird, if you search ‘mental health’ within Kaiser it’ll just direct you to a phone number and then you call that phone number, that phone number will take you to the mental health department and then from there then you schedule an evaluation to see what type of mental health that you need. And so that’s what the appointment was for today but it was really difficult. I felt like I needed the help immediately, or to talk to somebody immediately and I just never was able to and within that time from when I made that first appointment to now my life is completely different. It got to the point where I did have that mental breakdown where I was on my way to school and I just ended up crying multiple days in a row, it was just overwhelming and I was just like, bro, I really desperately need to talk to somebody and I just feel like when I really needed that help, I didn’t really have anybody to go to, even though that resource was there and I knew what to do. I still felt like it was out of reach.

Miller: It’s the difference between having insurance and having theoretical access to care at some point and having care when you really want it. Alyssia, from what I understand, you’re developing a presentation about mental health for elementary school students right now. What made you want to do that?

Menezes: After I started realizing I had anxiety, I started addressing my own anxiety. I was reflecting on my life and what my fellow speaker had been going through. I realized that I had been experiencing symptoms of having anxiety even before the pandemic, I just didn’t realize that. And, partially the reason why, was because I totally bought into this stigma, which I must have learned early on in life. So then I kind of put two and two together and I realized that like within elementary school, maybe within fifth grade, and also middle school, even though I was hearing about, vaguely, what mental health was, it clearly wasn’t getting to me. Maybe it was because it was taught by teachers who never dealt with mental health in life. Maybe it was because I didn’t realize the stigma was a thing, because it was just taught, and not really talked about the stigma, or just I didn’t know how to handle my emotions. And I realized that I could change that. So I reached out to some local elementary schools, middle schools and I asked them if I would be able to teach their students about mental health, along with some of my friends who I got into it. And so far the counselors have been... I think it’s really interesting, but we’re still struggling with a lot of teachers who can’t make time in their schedules, are still trying to fit this into schedules, which is unfortunate because I do think that learning about mental health is just as important as learning about a day of algebra or reading, but I started this program because I think that if I can present to students, if I can tell them about my stories, they’ll realize that fellow students do deal with mental health. If I can talk openly about the stigma and then try to give advice for people who think they’re dealing with mental health problems or people who think their mental health is just fine about how do you have better mental health and how to live more happily? And I hope I can actually make a difference for the younger generations.

Miller: Jospin, what would you tell young students? I mean if you were going into an elementary school right now, what would you want to focus on?

Mugisha: I would honestly focus on getting them to understand that it’s okay to feel overwhelmed, it’s okay to feel burned out. It’s okay to feel upset, it’s okay to feel those emotions. I feel like a lot of times like there’s just a workaholic mindset within a lot of American society, we’re like, ‘oh if I get like I can just get through it, you know, by myself, I can just like dug through it’ or like, ‘oh if I’m sad or whatever, it makes me weak, if I’m overwhelmed, it makes me weak, if I’m struggling with this then I’m not strong enough’, and so just getting them to really understand that everybody in the whole world goes through what you’re going through. It might not be for the same reasons, but a lot of people struggle and even the people that you admire may also be going through the same things and so just truly, really getting them to understand that even the most successful people out there have struggled with mental health- anxiety, stress, depression, whatever that person might be going through. And so I think that’s the most important thing, just getting them to truly understand that it’s just as common as getting a cold or something like that; removing that stigma away from the negative connotation attached to mental health.

Miller: Jospin, what’s giving you joy right now? What’s giving you resilience?

Mugisha: Honestly, what’s given me joy is I started a clothing brand called Be Proud. It’s a little weird, but the whole idea behind the clothing brand was just being proud of yourself, being proud of the things that make you unique, that identify what you identify with. And so, that’s literally our whole mission and it’s been really cool to see the impact of it. A month ago we partnered with PSU and we had this in-person shop for two weeks and we did this wall where we had people just write. It was a glass wall, we had these markers, and there was a sentence structure where I said ‘I am proud to be…’. and then you just fill in the sentence and it was one of the most eye opening experiences because I was expecting people to put their race, their gender identity, their sexuality, all these different things. What really touched me was people were just proud to be here. They said they were proud to be loved, they were proud to be able to love, they were proud to be healthy, mentally. I wasn’t expecting those answers and I didn’t know that my brand could mean that to different people. They’re just proud to be themselves, proud to be liked. I didn’t realize it could actually apply to mental health and stress. Ever since then we’ve been more active and just more focused on advocating for mental health and that’s part of the reason why I’m here. Since I’m the co-founder, I wanted to show people that we’re behind mental health and stuff like that.

Miller: And Alyssia, what about you? What’s giving you joy these days or making you feel more resilient?

Menezes: For me. I’d say it’s a lot of things. One of them, so happy to be back in school. I don’t think I realized how much I missed just talking to people every day until I came back to it, and I was like ‘Wow, this is absolutely incredible.’ I get to go to school with all my friends every day, which of course in-person school has its benefits and drawbacks but it definitely does offer a support network. I made a lot of really strong friends and I fostered a lot of strong friendships that I had pre-pandemic and that I finally realized that I forgot about over the pandemic. I’d say other things that bring me joy is just focusing on me and prioritizing my mental health which I didn’t do pre-pandemic which has definitely given me a bigger outlook on life. So whether that means making time to go for runs and do exercise or if I’m feeling overwhelmed telling myself that I should prioritize myself and whether that means not finishing all my homework or not being able to make a club one day, just going into things with the mindset that focusing on me is the best thing I can do, has just brought me a lot of joy as it’s been a bit freeing.

Miller: Alyssia and Jospin thanks so much for joining us today. I appreciate it.

Menezes: Thank you so much for having us.

Mugisha: Thank you, thank you for the opportunity

Miller:That was Alyssia Menezes, a junior at Portland’s Lincoln High School, and Jospin Mugisha, a sophomore at Portland State University.

Coming up after a break, we’ll get a wider picture of the experiences of young people right now from a school counselor and a Psychiatrist.

Dave Miller: From the Gert Boyle Studio, this is Think Out Loud. I’m Dave Miller, we’re focusing this hour on how young people are coping with stress and anxiety as the COVID-19 pandemic continues. Before the break, we heard from two young people about the stress and anxiety they’re facing and how they’re dealing with it. We wanted to get another view of students and stress and the adults who are helping them. Katherine Iliyn is one of two Counselors at Cascade High School in Turner, Oregon, near Salem. She tries to provide a safe space for students and has just wrapped up a program to help kids deal specifically with social anxiety. Craigan Usher is a Professor of Psychiatry at OHSU with a special focus on child and adolescent psychiatry.

I asked Katherine Iliyn what she took from the stories she had just heard.

Katherine Iliyn: What they’re doing to fill their cup. Jospin’s ‘I’m proud to be here.’ That was really deep, to hear that ‘proud to be here, proud to be alive,’ rather than a race or spirituality or ethnicity; people are just proud to be here, and I thought that was really powerful during this time.

Miller: Craigan, Stacy in Zoom wrote, ' My daughter goes from ‘okay’ to ‘overwhelmed’ instantly. She can’t even talk about it but has to leave the room when she is stressed. I’m curious how all this tracks with what you’ve been seeing in your patients or appearing from your colleagues?

Craigan Usher: That’s really consistent. I think over the pandemic one of the things that I learned from Jospin and Alyssia is that youth who are struggling right now, with going from 0 to 60 in terms of feeling calm to anxious and overwhelmed, unable to speak about their problems. Anyone who is dealing with that is very much not alone during this pandemic. Rates of anxiety and depression for youth in a study that came out in August in JAMA Pediatrics [Journal of the American Medical Association Pediatrics] showed that those rates have doubled and that was with over 80,000 youth polled in 29 different studies. So if this young person is suffering, she’s very much not alone.

Miller: It’s such a striking place to start, it reminded me of one of the other comments that we saw on Zoom: Christine wrote this. Well, she wrote that, what would help her now is to know that the experience she’s having with her children is normal. I think she too is talking about not feeling alone. That feeling like hers is not the only family going through something. But it also makes me wonder what any of us mean, now, when we talk about being normal -- I mean what does it mean to be normal?

Iliyn: I don’t know.

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Usher: That’s funny. That’s something that comes up in sessions a lot. Like, well let’s define what is a ‘disorder’ versus what is ‘normal.’ How would we even define that, given that this is sort of a variation on a way of being? This is a variation on a way of living. I think that’s what made going back to what Alyssia was saying was if only she had known perhaps if she had had someone who came from Lincoln High School and came to her elementary school and said, this is actually a thing that can happen to you, and it’s normal. It doesn’t feel good, but you can live through the experience. And these are the, these are the symptoms. I was just thinking about how powerful that intervention would be, but I think we’re all right to wonder about that dividing line.

Miller: Katherine, let’s get to some specifics. Amanda from Portland says on Zoom, ‘As a principle we are seeing big behaviors at school.’ I’m curious and we can all imagine what the big behaviors are. We’ve seen reports of serious fights and really serious behavioral disturbances in classes or in bathrooms over the last half year or so. What are you seeing at your school?

Iliyn: Well, at Cascade we were one of the few schools to come back not hybrid. We did a hybrid model last year, but then toward the end of the year we did have all the students back for half, or shortened, days and for that month we were all prepared for a bunch of disciplinary things to happen,and now looking back on it, it was this magical golden month and a half, where we did all the sports, all the activities, all the things for seniors. We held graduation, we did three of those, and it was really awesome. And then press ‘play’ on this year, and we’re seeing a lot of disciplinary issues as well as that stress; and really, disciplinary issues are linked with stress, sometimes anxiety and depression is seen as anger, and is seen as defiance. And so I really think that it’s a huge possibility that they’re very connected.

Miller: What do you find that your students most want from you right now, or most need from you right now?

Iliyn: They need me to listen and I’m here.

Miller: But I mean, you always need to listen, right?

Iliyn: I know… [Voices Overlap]

Miller: Isn’t that a huge part of your job?

Iliyn: Yes. It is, but I have a lot of teens that need reassurance, that need a reminder of boundaries and self care. But I have a lot of kids that just come in and it feels like a whole two years worth of things that they need to tell me, and I really feel that. I’ve gone through so many tissue boxes. They want to help everyone, they forget to help themselves. I’m seeing a lot of emotions, which is really, really good. I missed it last year.

Miller: Do you find that they know how to ask you for what they need? I ask this because from what we heard earlier, I got the sense from Alyssia and from Jospin that it took them a little while to realize what they were going through because of the stigma they talked about, and because of their lack of awareness, the lack of societal awareness to a great extent about mental health issues. Do your students know even the questions to ask you to get the help that you know they need?

Iliyn: That is a wonderful question. I would say that there’s a good amount of kids that do know, but there’s also going to be another population that isn’t sure how. I often ask kids because as a school counselor here at this building, I also do schedule changes, which is different for different high schools. I do get a chance to see every kid on my caseload in one way or another and sometimes I tell them, do you know who I am? Do you know what I can do for you? I talk about everything that I can do and they’re like, ‘what, I had no idea.’ So I am aware that not all of them are aware of those things. So last year, not being in school, kids being in school, I worked with one of our interns from Willamette University to try and continue to reach out to everyone through social media, making really quirky little videos and just trying to get the word out to kids that your school counselor is here. You need to email me or call me, but I’m here and waiting for you. They’re still gonna be kids out there that aren’t sure of how to ask for help. But the counseling office is a buzzing place of kids coming in. I’m really grateful that they know that they can come in and the teachers have that relationship with our office that if a kid says that they need to go to the counseling office that they’re coming here.

Miller: I want to hear more about the teacher’s role in this. And we had some folks who have questions about that, but Craigan, to go back to you, you and I last talked on Think Out Loud in January of this year, which I was thinking back on. It is so long ago in terms of the emotional roller coaster of what’s happened. So that was before vaccines were widely available but also before the Delta variant and before the latest political divisions about vaccines. It was before the widespread return to in-person school, but also before the challenges of the return to school. And also in that time there were different waves of high case counts and then cases going down and just a true emotional roller coaster, just a lot of uncertainty. I’m curious what that uncertainty specifically does, how it affects young people in particular.

Usher: I think it’s led us all- and I want to include adults here because I think we are perhaps suffering in the same way and alongside youth, we don’t have all the answers, we’re living in a state of hypervigilance where danger seems to lurk just around the corner. Alyssia talked about this, it was two weeks to flatten the curve, and then it was, well the rest of the school year is out. So like you say, there’s the expectation relief has just been ‘right around the corner,’ and the expectation of danger is also alert and I’m seeing increasing youth online, thinking more and more, ‘What’s the next thing -- when is the other shoe going to drop?’ And it’s causing us all a lot of anxiety, but especially the young people that I’m working with.

Miller: It’s worth mentioning now, the next thing that we’re not just talking about the pandemic for young people or for anybody but to focus on young people. I mean obviously, they have school issues, family issues, racial justice protests and uprising and climate change and even huge, meaningful, scary questions about the resilience of our actual society and democracy. So it’s everything together.

Usher: Absolutely. Absolutely. And it’s so hard to know. We as adults don’t have a space for thinking about, ‘how would I promote resilience of these conditions?’ We’re asking ourselves these very questions, so we don’t have a lot of ready made answers. And I think when Katherine said, ‘well what do I do first, listen?’ We’re at that level right now, where we really need to listen for those signals and to hear someone’s anxiety out, before we answer. I think some of our pat answers, from pre-pandemic times.

Miller: Lynn, in Portland is on Zoom. So after the listening, if you both emphasize the listening, but her question is she’d like to know about language, or specific words that could help to get a young person to open up and to talk about their feelings, Katherine, could you take a stab at this first? I mean what have you learned about effective ways to get maybe a reticent or a shy or scared or an angry young person to open up.

Iliyn: One thing that I get a lot with kids that are new to my office is ‘I don’t know, I don’t know,’ and kind of that apathy piece. I’ve found the asking, and actually, we talked about it in my grad program. Okay, well, what if you did know? No pressure here to get it wrong. And actually, it’s surprising how often that works. Or just trying a bunch of icebreakers. I talked about my tapestry on the wall here, there’s all sorts of vessels of transportation, Led Zeppelin is on there and there’s dragons and there’s all these animals and sometimes they’ll say, okay, well, I see you looking at that map, if you could be on one of those ships going somewhere, which ship would it be and why? And it opens up a huge conversation because especially in high school and trying to find who we are and Erik Erikson’s stages of development, this stage of high school that I deal with is role identity versus role confusion. And I see that time and time again. And so I talk about the journey of high school and the journey of life and it all relates to this map here. And so that really does open up a lot of really good conversations with kids.

Miller: Craigan, what about younger kids, well before high school because they too are having serious issues right now. Kids, I don’t know, 5, 6, 10, 11, who may have less access to language skills and less access to emotional regulation or emotional intelligence.

Usher: I think one of my favorite techniques is to draw with kids; I draw a squiggle and, ‘You turn it into something...’ Often it becomes a creature or a vessel and I wonder ‘well what are the people on this boat thinking right now?’ And I draw a thought bubble. And I really introduced a lot of play because the language of childhood in terms of our emotional lives is expressed through play. It’s expressed through drawing, it’s expressed through singing. So I think again, what we wish to do is to sit alongside our kids, ask them a little bit about, ‘Well, how is it that you see the world,’ and if we can’t talk about it, could we draw this out? So I think, also I want to say for parents, one technique is to really sit on your hands and truly play, set a timer for 15 minutes without criticism, without a command. See if you can just play and immerse yourself in the world of a child for that much time,

Miller: What comes from that, what comes from truly playing and being with their kid in that way?

Usher: I think a lot of times it’s a lot of surprises, a lot of depth. Sometimes kids will play out themes, maybe of something that they’re stressed about occurring at school and so a parent can watch it unfold almost like a movie or a tv show, a theme will emerge, or a drawing will emerge, there will be a conflict. And one thing for all of Freud’s faults, he did teach us something about dream life and about artistic life that we are in our dream life, that in our characters that we draw, we are. There’s an element of us in everything that we put out on paper and there’s an element of us in everything that we play. And so I think if parents can read things in that way and play with kids, not over them, just immersing themselves in the world of a child, they’ll learn a lot of things that will give signals on how they might help them move forward.

Miller: Katherine, Michelle from Kaiser says on Zoom that she has seen anxiety about making new friends. That reminded me of the small group that you started for students to help with social anxiety. How did that group come about? And what did it entail?

Iliyn: I actually came up with a model for a gardening group linked with social anxiety in about 2018 in my grad program at George Fox University, wonderful program by the way. I kind of just had it because it was a project for school, but I was like, oh man, this would be so cool. And then, well then this crazy pandemic rolled around and we could really get kids in the building and then we could do it outside and there was funding for it. I linked it with dropout prevention and it just came about because there was... man, last year was so hard, it was so hard for everyone, but a bunch of teachers and counselors and therapists together, we’re like, wow, what do we do? And so we had this time to try and kind of recreate things and do things outside. We had several outdoor classes. This was one of those things that started and I partnered with the school... Trillium-based school counselor or therapist that we had here. And we did the group together and with the help of teachers sending in names of kids that they remember from the past year or even, you know, this kid isn’t really participating in Zoom or even from parent contribution. We even sent out a survey to all the students about anxiety or about just what’s going on with mental health -- if you didn’t agree, what would you like to do? And through months and months of data collection of feedback of reaching out to families, we were able to get it down to a small group and we built a garden on campus and we set those posts in concrete and it’s a permanent structure and it’s right next to our ag greenhouse. And we plan to do it every year.

Miller: Why a garden? Why connect gardening to a group focused on helping kids dealing with social anxiety?

Iliyn: Working with your hands, getting dirty, getting in that soil. There’s just endless lessons they get from the earth, and patience and failure and working with people, working alone, responsibilities, there’s just so many different lessons that you can learn in gardening. I enjoy gardening and I enjoy the outdoors. I’m also the Director of Outdoor School for our district. When I came up with this in grad school I was reading a couple of things on how, it’s really soothing, it’s calming and I’ve done it, but it’s really good for anxiety to be able to have that alone time, to have that time with others. And it turned into a social anxiety group because we didn’t have a lot of social things happening, and we were hoping for, you know, moving toward bringing everyone back the next year. And so we were working with that transition time and so we actually met once a week and harvested through the garden.

Miller: What was harvest like for the kids?

Iliyn: Oh gosh, it was so fun. I was talking with my counterpart from the garden group today about our garden and what was so fun about it. I think one of my favorite memories was the zucchini because we only met once a week, sometimes the zucchini were about three ft long, zucchini grows wild. But one of our students was so excited. They said that they had to put the zucchini in the passenger seat and put the seatbelt on it because it was so heavy that the car kept dinging. [Laughter] But really, hearing the following week from students of the looks on their parents or their family’s faces or their friends’ faces when they brought them sunflowers or when they brought him home a huge bag of tomatoes and just what joy they were bringing to people that they cared about. That was truly beautiful.

Miller: Craigan, Patricia from Portland asked questions on Zoom that I think either of you could answer, but I’d love to get your take on this. She wants to know how can we as members of the community support the great work that all of you are doing at this time? We got a similar question from Kelsey who wrote, ‘How can coalitions or community partners support schools?’ I wanted to ask you because I was curious about broadening this. What do you see, both of you are mental health professionals, this is your job, but these questions get to something more interesting, which is what is the community’s role now in helping young people?

Usher: That’s a great question. And I I think I have never had a better recreational soccer season; I volunteer recreational soccer coached for about six years, and I don’t think that the season has ever meant so much to me, nor to the boys that I work with. And I think relishing every opportunity you have to build that sense of community, to build that sense of trust, to build that sense of affiliation. I mean, these are research shows at the school level, these are anti-suicidal measures. These actually help prevent suicide, a sense of belonging and respect from adults. So, I would invite people in the community again, I hope there are policy changes. I hope that no one has to go through what Jospin has gone through, but I know thousands of youth and families are right now, which is dead end calls or endless bridges that seemingly go nowhere to mental health. So I’m certainly hoping that we can improve that at a policy level and hold our care organizations accountable and our insurers. But, at the community level, I also think looking for any opportunity you have to create space for youth to have that sense of affiliation is just so vital.

Miller: Craigan and Katherine, thanks so much.

Usher: Thanks so much. It’s an honor.

Iliyn: Thank you so much. This is so awesome.

Miller: That was Katherine Iliyn, one of two counselors at Cascade High School in Turner, Oregon. Craigan Usher is a Professor of Psychiatry at OHSU. We turn now to our last two guests, Shalene Joseph works for the Native Wellness Institute that’s a national nonprofit based in Portland. She runs the institute’s youth support circle on Zoom. It started shortly after the pandemic really hit in Oregon in March of 2020. Andy Miller is one of the young people who attended the support circle. He is a freshman at Adrian Nelson High School in Happy Valley. I asked Shalene how much the institute focuses on mental health as a part of overall wellness.

Shalene Joseph: It’s a big part of our work. So looking at ourselves holistically, spiritually, mentally, physically, emotionally. No matter the work we’re doing, that is at the basis, that is at the center. So, community is built of individuals, the mental health aspect is the most important piece.

Miller: How did the pandemic affect the work that you were able to do and the work you had to do?

Joseph: At first it was a bit of a panic right? We work in Tribal communities and so with our work we’ve been doing our training and facilitation all through Zoom, and really trying to be careful about when we’re going to go back into communities, right? Because Tribal communities were really hit hard. A lot of the panelists before were talking about access. So access to healthcare in some of these rural communities is very different than what we see here in Portland.

Miller: Can you describe what would happen in some average youth support circle meeting?

Joseph: Yeah. Andy knows this all too well. We check in at the very beginning, and we have our same staple question, so we make them say their names so that their name, even though we know them obviously meeting every week, they say their name to bring themselves into that space on a scale of 1 to 10, how are you? Really knowing and checking in with ourselves, how do we feel? What’s one positive thing about ourselves? So reminding ourselves we have good things and it’s okay to say, hey, I am optimistic or I am a hard worker and we just go right into games and we teach through games and my co-facilitator who is also one of my best friends, we don’t ask our youth to do anything we’re not willing to do.

Miller: Andy, if you don’t want to do this, no problem. But since Shalene would always start meetings on the 1 to 10 scale, how are you doing right now on that scale?

Andy Miller: On, I’m a little nervous.

D Miller: Well, I’m thrilled to have you on the show. I’m thrilled to meet you. Let’s go back a little bit because Shalene was talking about the beginning of the youth support circle. But I’m curious about what your social life was like before the pandemic hit?

A Miller: Well, like most kids I didn’t really have a direction in my life, kind of just going along the ride with everyone else. And then when the pandemic came along, I was looking at myself and became a little self conscious and so I started getting into science stuff and I never had been in my entire life. I was getting into Biology, specifically and over time I got these little goals and then of course the youth support circle came along and that was like just... I don’t know what the word would be, what really kept my life stable, I guess.

D Miller: That’s a big way to put it, adding stability to your life. Shalene, you’ve said in the past that you have an abundance-based approach to your programs. What does that mean?

Joseph: It’s just that. It’s focusing on the things that we do have. As Native people, we’re constantly told we’re ‘less than,’ or ‘we don’t exist,’ or all of these things and we tell our youth this as well, right? If we have our cup, and we’re constantly filling other peoples’ cups until we have nothing left, what does that do for us? We need to continue to fill our cups so that we can continue going. With our support circles, we let our youth pick what we want to do and we’ll really work. And our kids always wanted to cook, we were doing deliveries like madness, but we would give them enough food that they wouldn’t just cook for themselves. They’re cooking for their families. And so really coming from abundance, they are the provider.

D Miller: Andy, let’s close with the same question that I asked our first young people at the beginning. I’m curious what’s giving you joy these days? What’s filling your cup, or making you feel resilient?

A Miller: I think what’s really helping is finding a sense of meaning in life. And I know that’s sort of not really what kids should be thinking about. Maybe, like as a college students, but I still think it’s, it’s something to think about. And what happened during the pandemic is that’s all I had all that time. It was just me thinking about just sort of the meaning of life. I got kind of dark in some parts, but once I started finding, I don’t know what you call it, like gestures towards the world, it could be anything, it could be just going on a walk and seeing nature, those little tiny things, they’re like little steps. And another thing is, I just imagine if every kid who has lost or they need help or something, imagine what, how the world could be, imagine if our future had a vision and had a direction, maybe solving climate change, maybe finding a cure for cancer, I don’t know. And thinking outside the box, if all kids can do that and the kids are future, so can really, really go far.

D Miller: That was Andy Miller, he’s a freshman at Adrian Nelson High School in Happy Valley and he attended the Youth Support Circle created by the Native Wellness Institute. Shalene Joseph is one of the facilitators of the group. This show was a part of a national tour focused on youth, mental health with wellbeings and American Public Media as with all of our shows, you can get the podcast of this hour wherever you get your podcasts. There’s also our nightly rebroadcast that’s Monday through Friday at eight p.m. Thanks very much for tuning in to Think Out Loud on OPB and KLCC. I’m Dave Miller, we’ll be back tomorrow. Think Out Loud is supported by Steve and Jan Oliver, the Rose E. Tucker Charitable Trust and Ray and Marilyn Johnson.

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