Advancing Mental Health Supports for Youth of Color Experiencing Homelessness and Other Youth Populations Critically in Need of Services and Supports

To:     Runaway and Homeless Youth Program Grantees, Adolescent Pregnancy Prevention Program Grantees

Re:     Advancing Mental Health Supports for Youth of Color Experiencing Homelessness and Other Youth Populations Critically in Need of Services and Supports

July is National Minority Mental Health Awareness Month, which is a good time to highlight the importance of mental health and how essential it is to overall well-being. As part of our efforts to raise awareness, the U.S. Department of Health and Human Services’ (HHS), Administration for Children and Families (ACF), Administration for Children, Youth and Families, Family and Youth Services Bureau (FYSB); the Office of Minority Health (OMH); and the Substance Abuse and Mental Health Services Administration (SAMHSA) are pleased to release this joint letter, which shares our commitment to highlighting critical resources to support the mental health of youth of color experiencing homelessness and other youth populations critically in need of services and supports.  

We know from the National Institute of Mental Health (NIMH) that in the United States, there can be notable differences in the experience of mental illness, access to quality health care, and health outcomes based on gender and gender identity, sexual orientation, age, race, ethnicity, and geography. In addition, recent data and information provide evidence that many of our nation’s youth, including those from underserved and marginalized communities, are experiencing significant mental health challenges. 

Other reports have shared additional concerning data. For example, the:

• White House Fact Sheet released on May 23, 2023, Actions to Protect Youth Mental Health, Safety & Privacy Online , noted that the United States is experiencing an unprecedented youth mental health crisis. The document shared that “the number of children and adolescents with anxiety and depression has risen  nearly 30% in recent years; between 2011 and 2021, the number of teens and young adults with depression more than doubled; and nearly 1 in 3 high school girls reported having seriously considered suicide.”

• Centers for Disease Control and Prevention, Youth Risk Behavior Survey Data Summary & Trends Report (2011-2021),  (PDF) which provides 2021 surveillance data and 2011-2021 trend data on health behaviors and experiences among high school students in the United States, noted that the percentage of Black students who were injured in a suicide attempt increased from 2011 to 2021.

• Surgeon General's Advisory on Protecting Youth Mental Health reported in 2021 that the COVID-19 pandemic most heavily affected those who were already vulnerable, including youth with disabilities; racial and ethnic minority youth; youth who identify as lesbian, gay, bisexual, transgender, queer, or questioning (LGBTQ+); and other marginalized communities.

• NIMH Director’s Message conveyed that as of 2018, suicide became the second leading cause of death in Black children aged 10-14, and the third leading cause of death in Black adolescents aged 15-19. The address also reflected that “one factor that may be contributing to increases in the risk of suicide in Black youth may be disparities in access to mental health services.” Similarly, it conveyed that “Black youth continue to be less likely to receive mental health treatment for depression when needed, compared to White youth .” 

Moreover, youth of color face unique challenges due to compounding issues deeply rooted in systemic and historical inequities and marginalization. Through data, research, and important conversations with youth with lived experiences, including pregnant and parenting youth and those that identify as LGBTQI+, we recognize that these youth are particularly at risk for experiencing homelessness, and have a significant need for high-quality, compassionate responses and culturally and linguistically appropriate solutions.

Given the tremendous need to prevent and support youth experiencing mental health challenges, we are writing to underscore the importance of several critical resources, including hotlines, we believe should be at the forefront of your program’s strategies when developing and expanding mental health supports for youth of color experiencing homelessness and other youth populations critically in need of services and supports. 

As a leader in your community, we ask that you use and disseminate the resources we are sharing and take steps to collaborate with your state, territory, tribal, faith-based, and community organizations as well as local businesses and other youth-serving and health care entities (e.g., primary care providers, schools) related to this issue. Creating a community response plan, or strengthening existing community response plans, establishes a coordinated strategy for communities to ensure youth experiencing mental health challenges have access to the vital supports needed. As these plans are developed, and as existing plans are strengthened, they can support meaningful engagement with culturally and linguistically relevant community-based organizations to address the systematic barriers to health care access and other critical supports.

When developing collaborations and strategies, we invite you to use tools  (PDF) such as the Behavioral Health Implementation Guide for the National Standards for Culturally and Linguistically Appropriate Services (CLAS) in Health and Health Care  (PDF) and research that promotes the use of an equity lens .

It is our desire to help Runaway and Homeless Youth (RHY) and Adolescent Pregnancy Prevention (APP) programs and other partners across the human services spectrum increase access to mental health services for youth. This is one of many actions we are taking to underscore how having mental health resources can be the key to achieving long-term success for youth of color experiencing homelessness and other youth populations critically in need of services and supports. We are pleased to join many organizations and communities nationwide in acting from every angle to offer help.

We thank you for the work you are doing and your willingness to share tools, including hotlines that are free, confidential, and available to all in multiple languages 24/7, 365 days a year. We look forward to communicating again in the future as we expand ways to help youth experiencing homelessness and mental health challenges, find the care they need.

Should you have questions or would be willing to share how your program has implemented actions to advance mental health supports for youth of color experiencing homelessness and other youth populations critically in need of services and supports in your programs, please contact: Linda Reese-Smith at linda.reesesmith@acf.hhs.gov and Curtis Porter at curtis.porter@acf.hhs.gov.

Sincerely,

FREE AND CONFIDENTIAL CRITICAL MENTAL HEALTH HOTLINES AND ADDITIONAL RESOURCES

• The Substance Abuse and Mental Health Services Administration’s (SAMHSA) FindSupport.gov offers support for issues with mental health, drugs, or alcohol.

• The SAMHSA National Helpline , 1-800-662-HELP (4357) (also known as the Treatment Referral Routing Service) or TTY: 1-800-487-4889, is a confidential, free, 24-hour-a-day, 365-day-a-year information service, in English and Spanish, for individuals and family members facing mental and/or substance use disorders. This service provides referrals to local treatment facilities, support groups, and community-based organizations. Also visit the online treatment locator , or send your zip code via text message to: 435748 (HELP4U) to find help near you. Read more about the HELP4U text messaging service .

• The 988 Suicide & Crisis Lifeline  (formerly known as the National Suicide Prevention Lifeline) offers 24/7 call, text and chat access to trained crisis counselors who can help people experiencing a suicidal, substance use, and/or mental health crisis, or any other kind of emotional distress. People can also dial 988 if they are worried about a loved one who may need crisis support. 988 serves as a universal entry point so that no matter where you live in the United States, you can reach a trained crisis counselor who can help. If you or someone you know is struggling or in crisis, help is available. Call or text 988  or chat 988lifeline.org . Visitors can press “2” for Spanish or “3” to receive specialized LGBTQI+ youth counseling. To access more information, please visit: behavioral health and homelessness resources .

• The National Runaway Safeline (NRS) crisis hotline offers online services 24 hours a day, 365 days a year to youth at risk of running away, those who have run away or are homeless, and their families. NRS helps in the following ways:
  • Crisis Intervention: Front line staff and volunteers are trained to use a solution-based crisis intervention model.
  • Information and Referrals: NRS locates local resources and makes appropriate referrals to meet each caller’s needs.
  • Three-Way Conference Calls: NRS initiates calls between youth and their parents or guardians, staying on the line to mediate the discussion. NRS also initiates calls between youth and social service protection agencies, and between adults and organizations that can help resolve their problems.
  • Message Relay: When youth and their parents or guardians are not yet ready for one-on-one interactions, they may take the first step toward reconnecting with each other by leaving messages with NRS.
  • Free Trip Home: NRS has a partnership with Greyhound Bus Lines to offer runaway and homeless youth a free bus ticket home.
  • Advocacy: The NRS front line team advocates for youth and ensures they get support and guidance from authorities, school administrators, social service agencies, and medical and legal professionals.
    • CALL: 1-800-RUNAWAY
    • CLICK: 1800RUNAWAY.org
    • TEXT: 66008
       
• The Health Resources and Services Administration (HRSA) has a maternal mental health hotline that pregnant and parenting youth can use. To reach the National Maternal Mental Health Hotline , call or text 1-833-943-5746 (1-833-9-HELP4MOMS). TTY users can use a preferred relay service or dial 711 and then 1-833-943-5746. This hotline service is offered 24/7 and provides free, confidential support before, during, and after pregnancy. Parents and their loved ones who contact the Hotline will speak to professional counselors who speak English and Spanish. Interpreter services are also available in 60 languages. Counselors will immediately provide real-time support, information, and resources. Counselors will also provide referrals to local or telehealth providers if you need longer-term care and support. Counselors are licensed or certified and have training in how to provide culturally appropriate and trauma-informed support.
• The National Human Trafficking Hotline provides assistance to individuals in crisis through safety planning, emotional support, and/or immediate connections to emergency services through our network of trained service provider and law enforcement partners.

MENTAL HEALTH RESOURCES:

• Issue Brief: Runaway and Homeless Youth, Mental Health, and Trauma-Informed Care
• Issue Brief: Understanding and Addressing Mental Health Issues of African American Youth Experiencing Homelessness
• Issue Brief: Trauma-Informed Care for the Full Range of RHY Services
• Youth.gov—RHY and Behavioral Health Resources
• Administration for Children and Families, Behavioral Health webpage includes a range of federal resources, including resources specifically for teens and young adults, parents and caregivers, tribes, and providers.
• NIMH Get Involved webpage includes resources on Child and Adolescent Mental Health for raising awareness on several mental health topics such as anxiety, teen depression, signs of bipolar disorder in teens and young adults.
• Indian Health Service Mental Health—Behavioral Health Resources
• HHS Center for Faith-based and Neighborhood Partnerships Mental Health: Youth Mental Health and Well-being in Faith and Community Settings: Practicing Connectedness  (PDF)

RESOURCES FOR PROVIDERS:

• National Clearinghouse on Homeless Youth and Families, Runaway and Homeless Youth Screening and Assessment Toolkit Resource Page
• SAMHSA’s Mental Health and Substance Use in Young Adults Resource
• SAMHSA’s Parent and Caregiver Resources
• SAMHSA’s National Child Traumatic Stress Network
• National Clearinghouse on Homeless Youth and Families (NCHYF) Mental Health Partners Resource
• Office of Minority Health — Improving Cultural Competency for Behavioral Health Professionals E-Learning Program
• Office of Minority Health/SAMHSA — Behavioral Health Implementation Guide for the National Standards for Culturally and Linguistically Appropriate Services in Health and Health Care  (PDF)
• Expanding Access to and Use of Behavioral Health Services for People At Risk for or Experiencing Homelessness

ADOLESCENT PREGNANCY PREVENTION MENTAL HEALTH RESOURCES:

• Family and Youth Services Bureau, Adolescent Pregnancy Prevention, Youth Mental Health Resources
• Family and Youth Services Bureau, Dealing with Grief  (PDF) Resources
• Family and Youth Services Bureau, We Think Twice Resources: We Think Twice is a movement designed with teens, for teens, with tools and resources to help you make healthy decisions, set goals, manage money, improve leadership skills, look out for your mental health, and resist peer pressure.

RELATED SPECIAL REPORTS:

• Protecting Youth Mental Health: The U.S. Surgeon General’s Advisory  (PDF)
• Ring the Alarm: The Crisis of Black Youth Suicide in America.  (PDF) A Report to Congress from the Congressional Black Caucus Emergency Taskforce on Black Youth Suicide and Mental Health.

RELATED RESOURCES:

• After an Attempt: A Guide for Taking Care of Your Family Member After Treatment in the Emergency Department
  Aids family members in coping with the aftermath of a relative's suicide attempt. Describes the emergency department treatment process, lists questions to ask about follow-up treatment, and describes how to reduce risk and ensure safety at home.
• Family Therapy Can Help: For People in Recovery from Mental Illness or Addiction
  Explores the role of family therapy in recovery from mental illness or substance abuse. Explains how family therapy sessions are run and who conducts them, describes a typical session, and provides information on its effectiveness in recovery.

RELEVANT FACT SHEETS, ROADMAPS, AND INFORMATION MEMORANDUM:

• Fact Sheet: President Biden to Announce Strategy to Address Our National Mental Health Crisis, As Part of Unity Agenda in his First State of the Union
• The HHS Roadmap for Behavioral Health Integration  (PDF)
• The White House Executive Order on Further Advancing Racial Equity and Support for Underserved Communities Through the Federal Government
• SAMHSA and Administration for Children and Families (ACF) issued a joint Information Memorandum (IM) in 2019 calling for increased collaboration between domestic violence, mental health, and substance use disorder treatment service providers and systems. Working at the intersections of domestic violence, substance use, and mental health, this IM highlights the prevalence of domestic violence among individuals receiving services in mental health and substance use disorder treatment settings and offers information about training, resources, and strategies for improved collaboration between systems to effectively respond to survivors, youth and children experiencing the traumatic effects of domestic violence.