Boston’s new mental health czar lays out his goals

Kevin Simon: I am originally from Brooklyn, NY My parents are Haitian. My father, Deacon Mauclair Simon, was the first black deacon in the Roman Catholic Archdiocese of New York.

Early on, I saw my father counseling people experiencing a wide range of challenges, whether immigration, spiritual or mental health in nature. And he has a certain disposition that is calm. In addition to being a deacon, he was a public school teacher for 25 years in New York, then became a social worker.

While in medical school, the rotations and courses that intrigued me the most, because they require you to think more holistically about people, were psychology and sociology. Then clinically it was psychiatry, because you can have a significant impact on individuals and a significant impact on families.

And so I learned that the vast majority of psychiatric illnesses—schizophrenia, depression, bipolar, substance use disorders—actually begin in early or mid-teens. If you want to be as preventive as possible, you need to start seeing children. And then when you see kids, you see that there’s a strong comorbidity of mental health, substance use, and juvenile justice involvement.

So I did a child psychiatry fellowship at Boston Children’s Hospital.

The work my father did to help people at their lowest, I find that’s what I do as a child psychiatrist and addiction specialist.

The most vulnerable people in society, that’s where I wanted to be.

Q: Why do kids have it so hard today?

To: There is evidence that increased anxiety, increased depression, increased emergency room visits, were increasing before 2020.

Now the pandemic has passed. There was a period of two years when the children were isolated, he told them not to come in person. If you increase isolation, that will increase anxiety, that will increase things like depression.

So if we think about a young person who had neurodevelopmental conditions, who at one point had maybe 10 hours of organized structured behavioral engagement, you took that away. And not just out for a day, but out for months at a time.

If we think about other subsets of young people (Latinos, blacks, minorities), who is being hit worse by COVID? In June 2021 nationally there were more than 140,000 young people who had lost a carer due to COVID. Now you combine that with: We don’t actually know when this is going to end.

All of this only exacerbated the pre-pandemic problems.

Q: What are the biggest problems you will try to solve?

To: One is access. Access to providers: therapists, counselors, psychiatrists, child psychiatrists.

I hear from the supplier side, “Hey, it’s hard to retain suppliers.” I hear from the parents and the patient, “I can’t take my child to a clinic.” “I can’t get help for my daughter – it’s a waiting list of over eight months.”

Access is a problem. At the same time, stigma is a problem. There are subsets of populations that will not engage with a mental health practitioner. I can speak from my ethnic culture of being a Haitian-American. There are questions about, “Who is a mental health provider? Why would I want to talk to one?”

So part of my role is also being a communicator about how therapy is healthy and normal. And to show that yes, someone who looks like you, thinks like you, has been doing this kind of work.

Also, workforce development. In essence, we have two systems: the pocket shadow system [providers who don’t accept insurance] and the MassHealth system, Medicaid. Unfortunately, there are a good number of behavioral health providers in the shadow system, because the remuneration for services is not there.

Q: How can the city help with access to mental health care?

A: There is already a model in which a physician or child psychiatrist serves as a consultant to primary care providers: the Massachusetts Child Psychiatry Access Program, or McPAP.

Potentially, the McPAP model could be tested within community health centers and schools. It’s a way to expand access.

The city can also advocate for different reimbursement rates and to simplify the billing process a bit so providers can see more patients.

Also, to try to address mental and behavioral health issues, Mayor and Dr. Ojikutu had thought of developing a behavioral health and wellness center, where we could have people under one roof trying to cope better the challenges we face. I will see.

There is an Office of Recovery Services that focuses on substance use. There are Homeless Services; a large subset of homeless people have mental illness. There is the Children and Family Office. How do you step back and say, “Oh wait a minute, there are actually connections here and we could work together”?

There is a subset of young people who have experienced an increase in homelessness during the pandemic period. These young people go to school, right? You begin to see that in reality we are all connected: housing, food insecurity, economic security, education, the living environment. We need to think holistically.

Q: What do you think will be different in Boston as a result of you being in this role?

To: I hope we can think about prevention, to create safe spaces for young people to come together, like East Boston’s Zumix, where 8-18 year olds learn how to host a podcast, play musical instruments, and feel comfortable making mistakes . It doesn’t identify itself as a place for therapy, but I would call it a very therapeutic place. There aren’t enough of these places around. We could promote this kind of environment.

The challenges related to mental and behavioral health are clearly more than one person, a mayor, a mayoral office, or the Boston Public Health Commission, can solve. It really is all covered.

We are all connected to someone who has a behavioral health problem. There is no way to say that it is not important to you.

Resources:

If you or a family member is experiencing a mental health or substance use disorder crisis, the Massachusetts Emergency Services Program/Mobile Crisis Intervention is available 24 hours a day, seven days a week week, 365 days a year. Call toll free at 1 (877) 382-1609.

Massachusetts also now has a three-digit hotline for National Suicide Prevention Lifeline callers. If you or a loved one is in emotional distress or having suicidal thoughts, flag 988 anytime from anywhere.

The Boston Public Health Commission provides a list of residential and outpatient services hereincluding services provided in multiple languages.

More resources are available at web site from the Massachusetts Department of Mental Health. https://www.mass.gov/guides/finding-mental-health-support-in-massachusetts


Felice J. Freyer can be reached at [email protected] Follow her on Twitter @felicejfreyer.

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