The following is a conversation between John MacPhee, the Executive Director & CEO of the Jed Foundation, and Denver Frederick, the Host of The Business of Giving.
Denver: The Jed Foundation is a nonprofit that protects emotional health and prevents suicide for our nation’s teens and young adults. This is an issue that has become far more urgent during the current pandemic. What exactly has been the impact of this extended lockdown? And how has Jed responded to better serve young people? Here to discuss that, it’s a pleasure to have with us, John MacPhee, the executive director and CEO of The Jed Foundation.
Welcome to The Business of Giving, John!
John: Thank you! Thanks for having me on.
We help high schools, colleges, and universities look at, assess everything they do to promote mental health and reduce risk for substance use and suicide. And we help create plans and implement them to make it stronger
Denver: Share with us some of the history of The Jed Foundation and a little bit more about your mission.
John: Sure. So The Jed Foundation is a nonprofit, as you said, that focuses on protecting emotional health and preventing suicide for teens and young adults. And we were created 20 years ago by a family who lost their 20-year-old son to suicide. The parents, Donna and Phil Satow created the Jed Foundation to help schools create mental health safety nets to protect their students, and to be able to identify a student who might be struggling and get them to the mental health care they need. And so that’s how and why we started.
And if we go forward to today, this is really still the core of our work. We help high schools, colleges, and universities look at, assess everything they do to promote mental health and reduce risk for substance use and suicide. And we help create plans and implement them to make it stronger. And then we also do community education and campaigns to educate people about youth mental health and how to support teens and young adults.
Denver: So you really look for those key leverage points and try to impact them there, and hope it spreads down throughout the campus, whether it be a high school or college campus.
Well, JED, and I think it was Fluent Research you partnered with, recently did a study on children’s emotional and mental health challenges during the COVID-19 pandemic. What were some of those findings, John?
John: So, what we’ve learned from research is first, high school students, high school counselors, high school principals, parents, everybody believes that mental health issues such as anxiety and depression are incredibly important and are being under-addressed and underserved in the high school setting. That view is held by all of the stakeholders. And what we know and we’ve learned about the pandemic is that the pandemic has exaggerated and added new stressors in a whole multitude of ways.
Teenagers are meant to be social. They’re meant to be separating from their parents and finding themselves, and school is a really important place to develop those living skills and those social-emotional skills. And that development has been insulted and interrupted by the pandemic. But additionally, families are losing loved ones to COVID, so you have that grief and loss. You’ve got the grief and loss of the socialization… things like graduation — young people feel guilty for feeling bad about those things because they know other people have it worse.
And there are just terrible inequities because of COVID. Some students, their families are giving them tutors and augmenting their education. Others don’t even have internet access. Others are trying to go to work, to help their families because maybe their parents lost their jobs. So, it’s really been just a number of insults and stressors that are hard and worrisome.
If you think about the macro-environment that teenagers are in, they get more news and information pushed at them than any previous generation. We can’t even handle it as adults. They’re worried about climate change, school shootings, COVID. They’re spending so much time online and digitally that this generation spends less time outside, less time sort of playing with friends face-to-face, less time in family dinners, less time dating.
Denver: All of them spell anxiety, I guess. That must be really on the rise.
John: Anxiety is very much on the rise, and it was on the rise before the pandemic for a whole variety of reasons. If you think about the macro-environment that teenagers are in, they get more news and information pushed at them than any previous generation. We can’t even handle it as adults. They’re worried about climate change, school shootings, COVID. They’re spending so much time online and digitally that this generation spends less time outside, less time sort of playing with friends face-to-face, less time in family dinners, less time dating. There’s all this social comparison stuff.
I really believe that today’s youth have a more challenging environment to grow up in than the previous generations. It’s different, but I also think it’s more challenging.
Denver: I would agree with that wholeheartedly, and I also don’t think the news media helps at all. And this is a little bit off the track, but I kind of look at it, and all the news that I ever get on social media– and I stay as far away from it as I possibly can– it’s only bad news. You’re not getting any puppy dog stories; you’re just getting “if you think things are bad now, they’re only going to get worse.” And to have a steady stream of that, it’s got to take a toll.
John: I agree. I think it takes a toll on all of us and, unfortunately, what the media has decided attracts eyeballs or advertisements or sells leans negative. And so, it’s really important that we moderate our news intake and we’re balanced, and that young people are doing that as well.
Denver: So, John, when the scope and the dimensions and the depth of this pandemic really hit you at first, and you realized the impact it was going to have on young people, what was the first thing you did?
John: From a work point of view, we came together as a JED team to talk about what we would have to change or adapt in order to best serve the schools and the constituents we work with, and also to look after each other. We had to shut down our office and go virtual. We used to visit schools, and we will again in the future in person to do this work. We had to make all of that virtual.
And our work traditionally is a little bit more around long-term planning for schools — how can they create a plan and priorities around mental health and make it sustainable? And we had to pivot to help them acutely plan around COVID. So how are they going to provide mental health care through telehealth since they can’t do it in person? How are they going to train teachers?
Now, teachers… And I feel very badly for teachers. They have so much on their plate, but they are the front line. Like you know it takes a village to support a student. In a school, you have the village. You have coaches and staff and all these people that can say “We’re worried about this particular student.” Now, the teacher is almost by themselves as that front line. And so, we’ve helped schools think through that through new trainings for teachers around what to do with students who are absent…. or they’re turning off the camera, how to notice if you’re concerned about them, and what to do about it.
And what we’ve also done is we started to just create forums for schools to come together, confidentially with JED. So schools can talk to each other about what they’re doing, what their challenges are, what’s working, and that’s been very successful.
Denver: So as you have re-imagined the service delivery model, what parts of it do you think are going to stick post-pandemic as you do get back to visiting some of those schools in person?
John: I think we will go back and visit in person, but we will also do virtual visits. I think now it will be a mix. It’s less costly to do virtual visits, so I think some schools that are challenged with resources and budget pressures, it will be easier and more efficient to do it virtually. So, I think that that’s here to stay in a mixed model. I also hope that telemental health is here to stay in a mixed model. That’s actually been a success because of the pandemic, and I think can be one of the silver linings because access to care and access to mental health care is so hard.
And if you’re a youth, first of all, can you even get care? And then can you get care with a counselor with whom you feel comfortable with, who is going to understand what your challenges are, for example? Are you a first-gen student? Are you an international student, a BIPOC student? Are you struggling to tell your family that you’re gay because you’re worried that you won’t experience family acceptance? These are the kinds of things. And for a young person, having a counselor with whom they’re comfortable is very important, and having a broader set of choices because of telemental health, I think is a positive.
Denver: I read recently, I think it was the Cincinnati Children’s Hospital, and in 2019, they did 2,000 telehealth visits, and they were thinking that to get where they wanted to go, it was going to take years and years. It turned out in 2020, they ended up doing 5,000 a week, and it’s just growing from there. So, to your point, I think there are some silver linings. It’s almost like we’ve awakened in the year 2030 because things that would have taken us a long, long time have really been compressed in such a short period of time.
Let me ask you about scale versus vulnerability. Because again, I’m trying to sit in your shoes for a minute, and I’m thinking about what happens, and I’m saying, “Hey, do we go big? Do we try to help as many kids as we need to help as quickly as we can? Or do we go deep and look at those marginalized communities and look at those with the greatest needs?” How did you kind of grapple with that?
John: It’s such an important question. We still grapple with it to this day when there are 3,200, maybe 3,300 not-for-profit colleges in the country and 40,000 high schools. And so, we have this question about breadth versus depth all the time. We work with a college for four years. We work with a high school for two years. So, these are deep engagements. If we shortened that, we could work with more schools. So, what’s the lowest dose effective technical assistance? And we’re trying to figure that out.
What we know from our work with colleges is that the work we’re doing now for the four years is highly effective. We’re showing big increases in the number of students that are getting help at the counseling center, at the health center; big increases in terms of stronger attitudes and behaviors. But are we doing more than we need to do? And could we help more schools? We’re trying to figure it out. Test, evaluate, collect data, learn, adjust.
And you also talked about specific-need populations — Are they marginalized? Or who is potentially marginalized or at higher risk or different risk? And this is very, very important. So, when we work with a school, we are going to that level of depth. Who are your students? What does the data tell us? It tells us that LGBTQ students are at higher risk for suicide. It tells us that Black youth, while not at higher risk today, the increases in the suicide rate are at a trajectory that is extremely worrisome. We know that Black and BIPOC students may be less likely to seek help at the school.
So, these are the kinds of things that if you’re going to have a comprehensive mental health plan as a school, it really needs to be tailored to your student population, and have tailored and culturally competent approaches for your students.
We do believe that it is in the best mental health interests of youth to be at school as soon as they can and as much as they can, given the recommendations around physical health from the CDC.
Denver: Key is to customize, no doubt. Sticking with schools, does The Jed Foundation have a position as it relates to the reopening of schools during the pandemic?
John: We do, and it’s on our website. And the takeaway is, of course, there’s a lot that has to be balanced here, and the physical health recommendations from the CDC need to be followed and honored. But we do believe that it is in the best mental health interests of youth to be at school as soon as they can and as much as they can, given the recommendations around physical health from the CDC.
Denver: I think sometimes there’s this tendency to look at these things as a zero-sum game, and there are going to be some COVID cases going back to school. But that also has to be weighed against, as you say, what’s happening with these kids in social isolation. And it’s a balancing act, very much along the lines you were talking about, in terms of going big or going deep.
John: That’s exactly right. And our orientation at JED is to look at the emotional health and mental health impacts of this. But there are also, of course, big impacts related to just the disruption in education and the inequity in terms of how that disruption is having its impact. So, we’d like to see as many students back safely as possible as soon as possible,
Denver: Also, on your website, there’s an announcement that you had just launched a new resource outlining a comprehensive approach to mental health promotion and suicide prevention in high schools. Tell us about it. What does it entail, and what are your plans for implementation?
John: Yes. So the idea is this: Every school should have a written plan for how they’re supporting student mental health and reducing risks for suicide. That sounds obvious, right? And the plan should be updated every year, and it should have a budget, and everyone should know what it is. But in fact, that’s not the case. Overwhelmingly, that is not the case. And so, what The Jed Foundation produced, The Comprehensive Approach for Mental Health Promotion and Suicide Prevention in High Schools, is a description of what high school should do to implement a comprehensive plan. And it includes multiple domains.
The first is: Have a strategic plan, and then you need to develop life skills, independent living skills, and social-emotional skills for students. That’s one. And then, make sure that a sense of connectedness and belonging is being created in a positive school, a positive school climate. Then, let students know it’s OK not to be OK, and how to seek help, and how to give help, and where to get that help. Then, intervening in ways… or setting up ways to make sure that if a student is struggling, the school notices — that might be a change in grades; that might be a change in absenteeism — training everyone to know if you have a gut feeling or what to watch out for. And then making sure that mental health care is available in the community, et cetera. So, it’s quite a comprehensive description of what schools can do to support their students.
And in terms of implementation, we partner with schools, and we help look at what they’re doing today. We compare it to all of the best practice recommendations, and then we help them create and implement a plan to strengthen what they’re doing.
Denver: That’s good advice. Also, just keeping it top of mind, not to trivialize it, but I know if I buy a red car, I leave the lot and I see nothing but red cars. And there is something about getting in people’s minds to look for these things. And once they’re geared to look for it, they’ll see things that they otherwise never would have seen, and that can make all the difference in the world.
John: It really can. And I would add: See things; also, just trust your gut. If you have a feeling something’s wrong with someone else, you’re probably right, and you’ll do no harm by saying, “Hey Denver. How are you doing? Are you OK? I noticed that you’re quieter than usual, or you seem to be withdrawing. Can we talk?” And just open the conversation that way… and just feeling comfortable doing that, knowing you’re only going to make things better.
Denver: I don’t think anybody ever questions themselves about speaking up too soon, but they will question themselves if they speak up not at all or too late. So, it’s a way to air it if you’re going to air it at all. It’s a very safe one.
And along with those schools, you have a couple of existing programs. One would be The JED Campus Program. And I know everything you’re talking about now is kind of building upon that, but tell us about that, and how many campuses are you on across this country?
John: JED Campus has about 350-, maybe 360 colleges and universities that have participated or are participating in that program. It’s 4.5 million students at those schools, so it’s something like 22% of those students in the country.
Mental health fundraising is far below what it could be or it should be, given the impact of depression and anxiety and other mental illnesses and sources of stress. It’s far lower than it could be or should be.
Denver: If I can sort of elevate this for a moment to a macro level and just wanted to get your take, John, on the level of funding for mental health in this country, both from public and private sources, and additionally, how maybe your fundraising has been impacted by this pandemic?
John: So, I would say that mental health fundraising is far below what it could be or it should be, given the impact of depression and anxiety and other mental illnesses and sources of stress. It’s far lower than it could be or should be.
At JED, we are approximately a $9 million or a $10 million organization in terms of the amount of money that we spend per year to do the work we do. Our capacity is full. Every year, it’s full. And so with more resources, we could help more schools. There’s a clear sort of demonstration in history of that. And we have a lot of supporters, but we could use more philanthropic support, and I think that’s true of multiple nonprofits in this space.
As it relates to the pandemic and COVID, we performed fine from a fundraising point of view, but in 2020, we were below our fundraising in 2019. We held our own, but the pandemic did result in a decrease in our fundraising.
Denver: Where are we again on a national level about getting mental health screening for the entire population? Maybe age 10, 11, 12. Are there any efforts afoot? Is there any progress being made? Because it does seem to be something that is pretty close to being indispensable.
John: Yes. Progress is being made. It’s being made more slowly than it could or it should. Patrick Kennedy likes to say that when you go for a physical, you should get a checkup from the neck up. And I think he’s exactly right. So this I think is really about the integration of mental health into primary care. So that when students are at the pediatrician or young people are at the pediatrician, or we’re at the doctor, that we get screened for depression and anxiety, and that the doctor’s asking, “Hey. How is your emotional health?” And it just becomes part of that. And then depending on how those questions are answered, there may be a more formal screening that’s used.
This happens actually, and a lot of college campuses are doing this work, but it needs to take hold just absolutely everywhere throughout healthcare, all the way, Denver, to the point that if you go to the doctor and the doctor doesn’t ask you, you know that they didn’t do what they were supposed to do.
Denver: That is exactly right. And the smart thing about that is: don’t get me to do something else. I’m busy as is. But if you can plug me into an established line of communication, well, I’m there already. You have taken all the friction out of doing that and removed it entirely.
John: Yes. And Denver, let’s bring it into friendships and family. It may sound silly, but I ask my daughters who are 26 and 24 regularly — How’s your emotional health? And they chuckle and they laugh, and they answer honestly. And I have a sort of permission to do that because obviously I’m with The Jed Foundation, but I really advocate for this idea that with your friends and everything, just ask, “Hey. How’s your emotional health?” COVID gives us permission. We’re all having difficulties. So, let’s make that another silver lining where this just becomes part of what it means to be a friend or family member.
Denver: And if I can just add to that. In my little spare time here, I’m an executive coach. And somebody asked me the other day, “What was the best question I ever had?” And I said, “The best question is ‘what else?'” Because when you ask somebody about their emotional health, they’re going to give you a very glib, off-the-top-of-the-head answer. But if you ask two or three times, “What else?” or “Is there anything else?” They’ll eventually say, “Well, there is something, Dad.” You know what I mean?
John: Yes. I like that. I’m going to add that. Yes.
Denver: Tell us about Each and Every Day. It’s a documentary. I know it’s MTV. Tell us a little bit about that, and maybe a story from it to really bring this home.
John: It’s a documentary that was produced by MTV and Sheila Nevins. And we partnered with Sheila, and Sheila is an extraordinary–
Denver: HBO. She’s great.
John: Just great. And she moved from HBO to MTV actually a couple of years ago. I think she’s won more Emmys or Daytime Emmys than anyone in history.
Denver: More than the two of us.
John: For sure. And so, we partnered with her and with MTV on this film, this documentary film Each and Every Day. And it’s really a number of young people who have lived experience, including with suicidal ideation and behaviors, telling their stories. It’s a beautiful, beautiful film that I really recommend everybody watch.
I don’t know that I want to tell the story so much as just to say: These are stories of people that have struggled and found their way to help and have helped. Not that it’s been… every step is not easy. And they’re doing well and giving back by sharing their experiences in such an authentic way. It’s a really great film.
Denver: And that’s what really struck me, was the real and authentic nature of those stories. Completely unguarded and completely from the heart. And there was a tremendous emotional connection.
What have you learned about leadership in a crisis? Are you finding, John, you’re making decisions any differently? And maybe are there ways that you’re leading The Jed Foundation now that, again, will inform your leadership going forward?
John: It’s been difficult to lead during all of this. I would say that, first of all, I’m leading along with other colleagues, and what we have tried to do is be very flexible around people’s needs, understanding that different people have different needs and situations; so we’ve tried to give a lot of room for that.
So, if you need to take a day off, take the day off. Can we take multiple days off? Take all the time you need. And those who are not in need at that moment will pitch in and cover for you. We’ve also created a lot of space for conversations, and just sharing and talking about what we’re experiencing.
I feel like we’ve done really a pretty good job by just being very, very caring and attentive, but it has been hard. There’s just no way around that. And the work we do at JED is hard. So the folks that are talking to people at schools, every day there’s a lot of stress from those schools. So, it’s a lot. And what we are doing… it probably sounds cliché, but we’re being very attentive in terms of checking in with each other and really just trying to let people know that it’s really OK if you have to step back. Plus we’re doing fun things. So we’re doing town halls; we’re playing games. We’re like trying to bring some joy into everything as well.
Denver: That’s so important.
Finally, John, let’s look ahead to the next decade — the decade of the 2020s. What would your number one priority be to assure the health of The Jed Foundation so you can deliver against mission?
John: Yes. I’ll answer first by just talking about the nation. I hope the pandemic has shown how broken the healthcare system and how broken access to care is. We already knew that, but if you didn’t know it, you know it now.
I really hope that we invest. The social determinants of health and social determinants of mental health are incredibly important. So, social safety programs, and addressing housing insecurity and food insecurity — these are mental health initiatives also. And so, I really hope that we start to do a better job around that. Also access to care… insurance. If, my gosh, the number of people who actually have the courage and find the courage to seek mental health care, and then they can’t find it or they can’t afford it! So, all of those things, we need to address.
For JED specifically, our goals are to work with literally thousands of high schools and colleges because we know the work we’re doing is helping them. And so, my goal is to find the resources philanthropically, or through earned income streams or other vehicles, so that we’re on really solid ground. I said we’re about a $9 million or a $10 million organization; We believe we should be about…. When I say we believe, I mean we have mapped this out in painstaking, careful detail. We need to be about a $16 million or $17 million organization per year to fill the demand and to help the number of high schools and colleges that want to do this work. And so that’s what we’re driving towards.
Denver: When do you hope to do that by?
John: Within five years. Hopefully, within three years. And it’s not growth for growth’s sake. It’s growth to meet the demand.
Denver: You said a moment ago, you were at an overcapacity, so you’re just not doing the things that you could be doing if you had the resources to do them, and that’s the situation.
Well, tell us about The Jed Foundation website, the kind of information visitors will find there, and maybe if anybody’s looking to help you get to that $16 million or $17 million, how they can make a contribution if they’re so inclined.
John: Yes. So, jedfoundation.org has a mental health resource center with a tremendous amount of information about how to support the teens and young adults in your life, and so I direct everyone there. The website also has all of the information about our programs and our resources for schools, for parents and families, for teens and young adults, including how to donate.
But I would also say that if you want to learn more about JED, and you want to donate, but you want to engage us and talk to us, my email is [email protected]. So write to me, and I’ll connect you to the team. There’s about 45 people on the team, and we’d love to talk to you.
We have other campaigns, Denver. We have something called Seize the Awkward, which you can find at seizetheawkward.com or seizetheawkward.org around how to talk to other people about mental health. And if you want to see the colleges that work with us, go to jedcampus.org and you can see the list of the hundreds of schools that are doing this work with us.
Denver: Fantastic. Well, thanks, John, for being here today. It was a real delight to have you on the show.
John: Thank you so much.
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