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Nurturing children's mental health
As more young kids struggle with mental health issues, our Child and Adolescent Psychiatry team is actively responding with an expanded array of services.
In 2023, then U.S. Surgeon General Vivek Murthy, MD, described youth mental health needs as “the defining public health crisis of our time.”
In spite of perceptions, it’s not just teenagers. Over the last five years, “we’re seeing everything shift younger,” notes Elizabeth Booma, MD, the Michael S. Jellinek Chief of Child and Adolescent Psychiatry. “We were already seeing that trend in the years leading up to the pandemic,” she adds.
As the only community hospital in our region with a dedicated child and adolescent psychiatry team providing services in the emergency department, outpatient setting, and community, Newton-Wellesley is rising to the challenge.
Over the past decade, consult and clinic visits have nearly tripled. Today, our multidisciplinary team serves 6,000 patients a year, and annually both the number and acuity of cases keep rising. Community- and school-based services reach thousands more.
Aided by philanthropy, NWH has expanded its array of programs to address the unique needs of younger children and their families, including its support of local schools. As one small example of their efforts, Dr. Booma shares that she’s getting ready to speak on the subject to parents and teachers of preschoolers in Natick. Whenever she presents, she drives home a key message: psychiatric illness is common and treatable. Never worry alone. We’re here to help.
Intervening early
Jennifer DelRey, PhD, echoes Dr. Booma’s point. From her experiences on the frontlines of care in both the clinic and community, “we’re definitely seeing families of younger children seeking mental health services and supports more so now than we had in the past,” she observes.
As the director and associate director of The Resilience Project, Dr. Booma and Dr. DelRey work hand in hand.
An innovative school and community-based initiative of NWH’s Division of Child and Adolescent Psychiatry, the project promotes the emotional health and wellbeing of children, teens, and those who support them.
Importantly, “we know that intervening early with kids can be so helpful,” Dr. DelRey adds. Moreover, education and prevention at an early age can be vital—and may keep children from needing treatment.
“How can we reach families at younger and younger ages to give them support, guidance, and education?” Given the evolving needs, that’s become a more pressing question for the team, she adds.
Providing the right help and support to a family and young child can have an impact throughout the entire course of a child’s development. “When we support the adults in kids’ lives, we know it also helps kids,” Dr. DelRey notes.
Raising Resilient Kids
Beyond the benefits of reaching kids at younger ages, “reaching the parents of younger children is incredibly important, too,” says Susan Maxwell, LICSW, the team’s lead social worker and director of therapy. “Giving them skills of how to approach things like anxiety in children can be incredibly helpful.”
For many years, NWH has offered a “Raising Resilient Teens” workshop, open to parents across the community. Now in its third year, a parallel workshop on “Raising Resilient Kids” offers invaluable support for parents of children ages 5-12.
Susan co-leads the seven-week workshop with Dr. Booma, offered twice a year in fall and spring. Topics include child development, emotional regulation, challenging behaviors, and positive connections.
Parent surveys describe in participants’ own words how much the workshop has meant to them: “This was incredible and touched on so many issues that we experience daily,” says one. “Really wonderful to have a space where we can learn how to better do this parenting job that no one preps/trains you for.” “Rich content, very relatable, and delivered by incredibly supportive and knowledgeable providers.”
Along with parenting skills, Susan hopes they take away an understanding of how treatable most mental health issues are, especially with kids. It’s a message that she’s passionate about spreading.
Especially as children approach adolescence, parents may begin to feel that friends have a greater influence. “One lesson for parents is how incredibly important and influential they are,” Susan reflects. “And they can learn ways of responding to kids that can be more helpful. Perhaps more helpful than the automatic responses that parents may have from their own upbringing.”
In the end, “it’s giving people hope,” she concludes. Working together with Dr. Booma, she strives to instill hope that difficult things can be talked about and worked on.
Expanded parent guidance
In the outpatient clinic as well, “our parent guidance program is growing so much,” explains Dr. Booma.
This year the team introduced a new approach, deciding to make parent guidance universal. Now, every new
family who comes into the clinic sees someone from the team. In doing so, “we underscore right from the start that we’re there to support both parents and kids,” she says.
Tai Katzenstein, PhD, directs the program. She joined the team in 2017 with the goal of helping to build out parent programming.
For her, the Surgeon General’s description of a “crisis” in youth mental health is spot on. Since the pandemic, she feels the needs have only intensified, including among younger children. “When a child has a challenge, the whole family is going through it,” she reflects.
At Newton-Wellesley, “we have a family focus,” she adds. “Being able to support parents is incredibly important. It’s an essential piece of successful treatment, which doesn’t always happen in other settings.”
Dr. Katzenstein brings to her work a profound respect for parents. “I think they are amazing,” she says. Raising a child “is beautiful and at the same time grueling and harrowing.” Parenting is hard enough as it is; layer on top of that psychological challenges, and it can be even more difficult.
Whatever families face, she encourages them that things can get better—for them and their child.
Providing them with the right help and support improves children’s outcomes. At the same time, “parents feel their own sense of efficacy,” she reflects. “They’re also frankly able to feel less alone in their struggles,” she adds.
Supporting schools and pediatricians
As the needs of the community continue to evolve, the Resilience Project brings to life a vision of building relationships and connections beyond the walls of the hospital. Partnerships with local public schools have been a cornerstone of those efforts.
In reflecting on the rise in mental health concerns among younger kids, Dr. Booma and Dr. DelRey point to this year’s expansion of school services into elementary and preschools as an important new resource.
What initially began with a focus on high schools expanded to middle schools, thanks to philanthropic support of the Manton Foundation. A successful pilot in elementary schools last year set the stage for the new initiative.
“The way we’ve been able to connect with people and to really listen to what the community needs and be able to respond to that has been such a gift,” Dr. DelRey notes.
When it comes to supporting younger patients, the team also works with pediatricians across the community. “That’s always an ongoing collaboration,” Dr. Booma notes. “With any kind of question that comes up, we try to help them in any way we can.”
A better future for kids
Across the team, engaging every day with children and families energizes them.
“We really care about the community,” Susan Maxwell reflects. “We really care about connecting to families and children. We’re constantly learning from them about what they need, and we’re always trying to do more.”
What makes the NWH team so special? “I could go on and on,” says Dr. Katzenstein. Families go on and on in their praise: “extremely empathetic and caring,” “very respectful, responsive, and understanding,” “experienced and professional,” and “the most knowledgeable, compassionate, thoughtful, kind, intelligent therapists.”
“And we all believe in the work that we’re doing,” adds Dr. DelRey. “I’m often in a position where families are allowing me to walk with them during what is probably one of the most difficult or challenging times of their life, and I’m always so inspired by them.”
Together with her colleagues, she shares a hope that the team’s efforts lead to a future for kids where we can focus not only on the treatment of illness but also on the promotion of well-being.
When Dr. Booma thinks about what it means to kids, she gets emotional. “It gives me a lot of hope when I see families who are really struggling, and we’re able to work with them and then see a child who’s really thriving,” she says.
Especially for young children, she knows, early care can mean a brighter future.
Expanding support to local elementary and preschools
Throughout the 2024–25 academic year, a significant new expansion of The Resilience Project’s school-based programs has paralleled the growing focus on the needs of younger children by NWH’s Child and Adolescent Psychiatry team.
After a yearlong pilot for earlier grades, “this year we started our full expansion of our services into public elementary schools and preschools,” explains Jennifer DelRey, PhD.
The effort builds on an NWH initiative that began with public high schools and grew to embrace local middle schools. Thanks to the generosity of the Manton Foundation, it offers free professional development and clinical consultation from NWH’s world-class, multidisciplinary team.
School-based support focuses on the six towns in our hospital’s primary catchment area: Natick, Needham, Newton, Waltham, Wellesley, and Weston. With the most recent expansion, 64 public schools across those communities can now access these free services.
What is typical child development?
For both educators and parents, sometimes it can be difficult to know what is typical and a natural part of children’s growth and development.
Along with addressing typical child development, the team touches on how schools can identify children at earlier ages who may need some mental health support.
As part of professional development for staff, they also discuss proactive ways of helping kids learn how to manage their emotions and communicate with others.
The team offers presentations for the parent community in the school as well. “So often that can really help families during a time when there’s so much developmental change happening and kids are growing so fast,” Dr. DelRey notes.
Annual Educational Summit
As yet another facet of The Resilience Project, its Educational Summit has provided hundreds of school personnel and community partners with an annual opportunity for professional development. Attendees learn from leading experts in the field and collaborate with colleagues about specific school innovations, best practices, and future directions.
This spring marked its ninth year and featured a keynote on “Addressing Loneliness and Strengthening School Connections” by Jerome Adams, MD, MPH, FASA, former U.S. Surgeon General and now executive director of the Center for Community Health Enhancement and Learning at Purdue University.
Welcomed into school communities
The ongoing focus of serving schools grows out of an understanding that they play a leading role in every child’s emotional, social, behavioral, and cognitive development.
“Our schools and our families have really welcomed us into their community, and we are so grateful for that,” Dr. DelRey reflects. “And the relationships that we’ve gotten to build with people over time have been the foundation of our success.”
